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Posted to Co-Cure Fri, 14 Jan 2000 11:36:21 -0500

Hair calcium and magnesium levels in patients with fibromyalgia

Hair calcium and magnesium levels in patients with fibromyalgia: a case center study.
Author: Ng SY
Journal of Manipulative and Physiological Therapeutics 1999 Nov-Dec;22(9):586-93
NLM citations: PMID: 10626702, UI: 20090128

The authors found that Wilcoxon rank sum tests showed that tested fibromyalgia patients had significantly higher calcium and magnesium levels than control subjects. They concluded that when this is the case, calcium and magnesium supplements may be indicated as an adjunctive treatment of fibromyalgia.

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Posted to Co-Cure Thu, 13 Jan 2000 20:27:07 -0500 by Gail Kansky

Childhood polio infection may cause CFS in baby-boomers

Englewood Hospital and Medical Center
350 Engle Street
Englewood, NJ 07631

For Immediate Release
Contact: Claudie Benjamin
(201) 894-3486


Englewood, NJ, January 11, 2000-- A childhood poliovirus infection may cause chronic fatigue in baby-boomers concludes a paper published in the January, 11, 2000, issue of the American Journal of Physical Medicine and Rehabilitation "Paralytic Versus 'Non-Paralytic' Polio: A Distinction without a Difference," by Dr. Richard L. Bruno, director of The Post-Polio Institute at New Jersey's Englewood Hospital and Medical Center and chairperson of the International Post-Polio Task Force.

Bruno reviewed the personal laboratory notebooks, publications and private correspondence of Dr. Albert Sabin, developer of the oral polio vaccine, regarding a 1947, Cincinnati, Ohio outbreak of the "Summer Grippe," a flu-like disease that affected more than 10,000 children. Because Summer Grippe was associated with a stiff neck-- a hallmark symptom of polio--Sabin hospitalized and studied a dozen children. "Sabin concluded that Summer Grippe was caused by a mild form of the Type 2 poliovirus which caused a flu-like illness even though it did not cause paralysis," said Bruno. However, when Sabin infected monkeys with poliovirus from the Summer Grippe children, spinal cord and brain stem neurons were killed just as they would have been by a paralytic poliovirus. "Both the Summer Grippe and paralytic polioviruses damage the brain stem," Bruno continued. "Sabin showed us that even a 'mild' poliovirus infection could cause neuron damage that, although not apparent in terms of causing polio-like symptoms, was very real."

However, Bruno reports that another "mild" poliovirus outbreak did cause symptoms. In the very next year, 1948, over 1,000 Icelanders became ill with a flu-like illness causing stiff neck, some muscle weakness, and fatigue. While many of those with "Iceland Disease" recovered, some who became ill in 1948 still have fatigue today. "Iceland Disease was also apparently caused by a relatively mild Type 2 poliovirus," said Bruno, "but one that did more severe and therefore more apparent damage to the brain stem -- damage that caused chronic fatigue."

Fifteen years of research at The Post-Polio Institute has found evidence of brain stem damage in polio survivors who have fatigue associated with Post-Polio Syndrome, including lesions on MRI of the brain, attention deficits on neuropsychologic testing, reduced levels of brain activating hormones, and brain wave slowing. "These abnormalities are evidence of damage to the brain stem neurons that activate the brain - the brain activating system that keeps the brain awake and focuses attention - and they are identical to abnormalities seen in patients with Chronic Fatigue Syndrome (CFS)," said Bruno. "We believe that brain activating system damage causes fatigue in both polio survivors and those with CFS."

Between 1934 and 1954, the year the polio vaccine was developed, nine outbreaks of CFS occurred either at the same time as polio epidemics or affected the staff at polio hospitals. "In fact, the first CFS outbreak was in 1934, sickening the staff at the Los Angeles County polio hospital," said Bruno. And, just as in Iceland, some who were became fatigued in L.A. in 1934 remained fatigued for decades. "The symptoms of polio and CFS were so similar," said Bruno, "that 48% of the patients in the CFS outbreaks between 1934 and 1954 were thought initially to have had non-paralytic polio."

Sabin's Summer Grippe, Iceland Disease and the long association between polio and CFS have important implications for those diagnosed with Post-Polio Syndrome and CFS today," according to Bruno. Englewood Hospital and Medical Center's The Post-Polio Institute treats many middle-aged adults with fatigue who had non-paralytic polio as children. "Albert Sabin showed us that even a mild poliovirus infection can damage the brain activating system setting the stage for fatigue to develop later in life," said Bruno.

The Post-Polio Institute's experience is supported by the 1987 U.S. National Health Interview Survey which found that 21% of those who had had non-paralytic polio report fatigue in mid-life. "The one million North Americans who had non-paralytic polio must be assertive," said Bruno, "telling their doctors that both paralytic and non-paralytic polio survivors develop late-onset fatigue."

An epidemiological study by Dr. Leonard Jason, published in the October 11, 1999, issue of the Archives of Internal Medicine, found that half of the estimated 836,000 Americans with CFS are at least 40 years old. Jason concluded that baby-boomers may be at greater risk for CFS.

"Potentially half of those diagnosed today with CFS may in fact have had Summer Grippe or undiagnosed non-paralytic polio as children in the years before the polio vaccine became available," said Bruno. "They may also have brain activating system damage that causes chronic fatigue."

"There is no question that neither the naturally-occurring poliovirus nor the Sabin oral polio vaccine causes CFS today," said Bruno. "But the possibility of a non-paralytic poliovirus infection in childhood causing chronic fatigue in middle-aged baby-boomers is a reason for hope." The Post-Polio Institute's research has found that conserving energy, daytime rest breaks, stopping activities before fatigue starts, and a higher-protein diet significantly reduce symptoms of fatigue."

See also:
Website of the Lincolnshire Post-Polio Network in eastern England

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Posted to Co-Cure Sat, 8 Jan 2000 08:20:53 -0500

Fibromyalgia: a risk factor for osteoporosis

Fibromyalgia: a risk factor for osteoporosis.
Authors: Swezey RL, Adams J
Osteoporosis Prevention and Treatment Center, Santa Monica, California 90404, USA.
Journal of Rheumatology 1999 Dec;26(12):2642-4
NLM citations: PMID: 10606376, UI: 20072392

The authors studied bone mineral density (BMD) and osteoporosis in 24 patients with fibromyalgia and twice as many matched healthy controls. Simple T tests were used to compare hip and lumbar spine BMD of FM cases to controls. The results showed a significantly lower mean BMD of the spine in all age groups of patients, and a significantly lower BMD of the femoral neck in patients in the 51-60 age group, suggesting a frequent association of FMS to osteoporosis.

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Posted to Co-Cure Sat, 8 Jan 2000 00:42:39 -0800 by Melissa O'Toole

The development of the CFS Attitudes Test

The development of the Chronic Fatigue Syndrome Attitudes Test. A psychometric analysis.
Eval Health Prof 1999, Dec;22(4):442-65.
Shlaes JL, Jason LA, Ferrari JR.
DePaul University, Department of Psychology, Chicago, IL 60614, USA.
PMID: 10623400, UI: 20051951

Chronic Fatigue Syndrome (CFS) is characterized by debilitating symptoms including persistent or relapsing fatigue.

As a result of CFS, some individuals experience significant stigma that is attached to this illness. Many medical professionals are skeptical of the validity of the illness, and employers often fail to appreciate the seriousness of the symptoms.

Although negative attitudes greatly affect the lives of individuals with CFS, there is presently no measurement of attitudes toward this illness and people who have CFS.

The purpose of the present studies was to create a scale that measures attitudes toward individuals with CFS--the Chronic Fatigue Attitudes Test (CAT)--and to assess the scale's reliability and validity. The 13-item scale was created using several constructs outlined in the literature regarding negative attitudes toward people with CFS, disabilities, and AIDS. Theoretical implications of the findings and the utility of the CAT are discussed.

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Posted to Co-Cure Sun, 2 Jan 2000 21:15:25 -0500

Competition for glutathione precursors between the immune system and the skeletal muscle: pathogenesis of CFS

Competition for glutathione precursors between the immune system and the skeletal muscle: pathogenesis of chronic fatigue syndrome.
Authors: Bounous G, Molson J
Department of Surgery, McGill University, and Medical Research Council of Canada.
Journal: Medical Hypotheses 1999 Oct;53(4):347-9
NLM citations: PMID: 10608272, UI: 20073951

The authors discuss abnormalities in the immune systems of people with CFS, proposing that these result in overdepletion of glutathione precursors, which are essential to the immune response. Such depletion would reduce the level of glutathione available for normal aerobic metabolism, resulting in fatigue and eventually pain.

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Posted to Co-Cure Sun, 2 Jan 2000 21:25:44 -0500

Fibromyalgia in the irritable bowel syndrome: prevalence and clinical implications

Fibromyalgia in the irritable bowel syndrome: studies of prevalence and clinical implications.
Authors: Sperber AD, Atzmon Y, Neumann L, Weisberg I, Shalit Y, Abu-Shakrah M, Fich A, Buskila D
Department of Gastroenterology, Soroka Medical Center and Faculty of the Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
American Journal of Gastroenterology 1999 Dec;94(12):3541-6
NLM citations: PMID: 10606316, UI: 20072332

The authors studied the coexistence of irritable bowel syndrome (IBS) and fibromyalgia syndrome (FMS) in IBS patients vs. a group of healthy controls and in FMS patients. 31.6% of the IBS patients and 4.2% of healthy controls had FMS. 32% of the FMS patients and had IBS. Significant differences between the various groups are discussed, and the authors recommend that physicians be aware of the overlap of the two diseases.

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Posted to Co-Cure Wed, 22 Dec 1999 15:33:14 -0800 by Melissa O'Toole

CFS Patients Who Are More Likely to Recover

Researchers Pinpoint Chronic Fatigue Sufferers Who Are More Likely to Recover

Those With More Symptoms, Less Clear Thinking Are Less Likely to Get Better

By Liz Meszaros
WebMD Medical News

Dec. 14, 1999 (Cleveland) -- Chronic fatigue syndrome (CFS) is more likely to improve in patients who have less unclear thinking and fewer symptoms that seem to be unrelated to CFS. Those who improved were also more likely to have infrequent awakening, to sleep fewer hours, and to be married. That's according to a prospective study that appears in the November/December issue of the journal Archives of Family Medicine. Individuals who had more than two symptoms not usually used to define CFS and who never thought clearly were the least likely to experience improvement in their fatigue.

Lead author Arthur J. Hartz, MD, PhD, and colleagues analyzed questionnaires completed by 199 subjects aged 18 years or older who had unexplained, or idiopathic, fatigue for at least 6 months. Most patients were women, were aged 30-55, and were college graduates. At one time, more than 90% of these subjects had received some treatment by a physician for their fatigue, but at the time of follow-up, only 52% were still receiving treatment.

The full article can be read at

[Note: It is unclear whether all the individuals in this study met the CDC definition for CFS. The article only indicates that the study participants had "unexplained, or idiopathic, fatigue for at least 6 months."]

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Posted to Co-Cure Thu, 23 Dec 1999 14:37:57 -0500

Melatonin levels in women with fibromyalgia and CFS

Melatonin levels in women with fibromyalgia and chronic fatigue syndrome.
Authors: Korszun A, Sackett-Lundeen L, Papadopoulos E, Brucksch C, Masterson L, Engelberg NC, Haus E, Demitrack MA, Crofford L Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, USA.
Journal of Rheumatology 1999 Dec;26(12):2675-80
NLM citations: PMID: 10606381, UI: 20072397

Melatonin is involved in synchronizing circadian systems, and melatonin replacement has become widespread as one treatment for patients with CFS and FM. The authors measured and compared blood levels of melatonin and cortisol in premenopausal women with CFS and FM over a 24-hour period and concluded that the data indicate that there is no rationale for melatonin replacement therapy in these patients.

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Posted to Co-Cure Fri, 17 Dec 1999 20:40:02 -0500 by David Axford

Personality and social attitudes in CFS

Personality and social attitudes in chronic fatigue syndrome.
J Psychosom Res 1999 Oct;47(4):385-97 Related Articles, Books
Wood B, Wessely S
Maudsley Hospital and the Institute of Psychiatry, London, UK.

This study on 102 patients with CFS (Oxford and CDC criteria ‘94) and 45 people with rheumatoid arthritis (RA) found no difference on measures such as perfectionism, attitudes to mental illness, ‘harm avoidance’ and depression (even when fatigue-related items were removed).. The RA group had higher alexithymia scores (reflecting difficulties identifying and distinguishing between feelings and bodily sensations).

The researchers conclude that the findings fail to support “media and self-help stereotypes” of the “high-achieving, over-dedicated sufferer with high personal standards” and a hostility towards all things psychiatric. They also note that depressive disorders in their CFS clinic “have been decreasing over time” which they attribute to better recognition and treatment by GPs (rather than improved diagnosis of CFS by researchers.)

[Ed. note: the archive indicates that the origin of the perfectionist stereotype was not the media, nor the self-help literature but the opinions of a small group of sceptical researchers and clinicians, one article by a social anthropologist and a few anecdotal, and often ambiguous, reports. The sceptical medical professionals were responsible for insinuations about these patients sharing a particularly hostile attitude towards psychiatry.]

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Posted to Co-Cure Fri, 17 Dec 1999 21:17:44 EST by Suellen Tritt

Stress-Induced Immunomodulation Implications for Infectious Diseases?

Stress-Induced Immunomodulation Implications for Infectious Diseases?
Ronald Glaser, PhD; Bruce Rabin, MD, PhD; Margaret Chesney, PhD; Sheldon Cohen, PhD; Benjamin Natelson, MD

There is now significant literature showing that psychological stress can down-regulate various aspects of the cellular immune response. It is also established that communication between the central nervous system and the immune system occurs through bidirectional signals linking the nervous, endocrine, and immune systems. Psychological stressors affect the immune system by disrupting these networks. In this overview, we discuss the implications of psychological stress-associated immune modulation and risk for infectious disease.

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Posted to Co-Cure Fri, 10 Dec 1999 20:17:22 -0500

Can we predict recovery in chronic fatigue syndrome?

Can we predict recovery in chronic fatigue syndrome?
Authors: Pheley AM, Melby D, Schenck C, Mandel J, Peterson PK
Ohio University College of Osteopathic Medicine, Athens, USA.
Journal: Minnesota Medicine 1999 Nov;82(11):52-6
NLM citations: PMID: 10589213, UI: 20056591

The authors studied 117 CFS patients who had been ill for an average of nine years. Their results support previous research that complete recovery from CFS is rare, but they feel accurate prediction of recovery in individual CFS patients is not currently feasible.

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Posted to Co-Cure Tue, 14 Dec 1999 21:58:06 -0500

Instantaneous orthostatic hypotension in children and adolescents

Instantaneous orthostatic hypotension in children and adolescents: a new entity of orthostatic intolerance.
Authors: Tanaka H, Yamaguchi H, Matushima R, Tamai H
Department of Pediatrics, Osaka Medical College, Takatsuki-shi, Japan.
Journal: Pediatric Research 1999 Dec;46(6):691-6
NLM citations: PMID: 10590025, UI: 20055970

The authors state they are the first to report clinical characteristics and circulatory and catecholamine responses to postural change in 44 children with instantaneous orthostatic hypotension (INOH). The symptoms include chronic fatigue, orthostatic dizziness, weakness, sleep disturbance, syncope or near syncope, headache, and loss of appetite. Results suggest that mechanisms responsible for INOH may depend on insufficient sympathetic activation during standing, possibly due to centrally mediated sympathetic inhibition.

[Note: Examples of catecholamines include adrenaline, noradrenaline and dopamine.]

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Posted to Co-Cure Thu, 9 Dec 1999 18:30:31 -0500

Monitoring and assessing symptoms of CFS: use of time series regression

Monitoring and assessing symptoms of chronic fatigue syndrome: use of time series regression.
Authors: Jason LA, Tryon WW, Taylor RR, King C, Frankenberry EL, Jordan KM
Department of Psychology, DePaul University, Chicago, IL 60614, USA.
Journal: Psychological Reports 1999 Aug;85(1):121-30
NLM citations: PMID: 10575979, UI: 20043233

The authors recommend monitoring of CFS symptoms hourly and daily to help resolve theoretical and methodological problems in CFS research. They found there are significant correlations between fatigue and patient reports of perceived energy, physical exertion, and mental exertion.

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Posted to Co-Cure Sun, 5 Dec 1999 14:23:35 -0500 by Drew Martin

Chronic Chlamydia pneumoniae Infection: A Treatable Cause of CFS

Chronic Chlamydia pneumoniae Infection: A Treatable Cause of Chronic Fatigue Syndrome
Dr. John K. S. Chia, 3275 Skypark Drive, Torrance, California 90505
Clinical Infectious Diseases 1999;29:452 – 3

Chronic fatigue syndrome (CFS), an elusive and controversial illness, has been a difficult management problem for clinicians. A number of infectious agents have been implicated as the cause of CFS, although consistent and compelling evidence is still lacking [1]. Few well-documented infections could cause persistent inflammatory reaction leading to the symptomatology of CFS [2, 3]. Chlamydia pneumoniae is a common cause of respiratory infection and has been demonstrated within plaques of the coronary arteries years after initial infection [4]. Recently demonstrated replication of C. pneumoniae within human macrophages and endothelial cells [5] and a potent inducer of proinflammatory cytokines, such as TNF-a and IL-1 [6], raised the possibility of chronic infection that leads to persistent inflammatory response. A previous study failed to demonstrate elevated titers of antibody to C. pneumoniae in 50 patients with CFS [7], although fatigue is a common symptom reported by patients for whom sputum cultures are persistently positive for C. pneumoniae [8]. Over the past 3 years, we encountered 10 of 171 patients with symptoms of chronic fatigue who had elevated titers of antibody to C. pneumoniae long after initial respiratory infection. Most patients had favorable clinical and serological responses to a 1- to 2-months course of azithromycin therapy, although relapse was common.

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Posted to Co-Cure Fri, 3 Dec 1999 20:22:21 -0500

Impaired oxygen delivery or deconditioning?

In November, Co-Cure reported on research from KK McCully and BH Natelson entitled "Impaired oxygen delivery to muscle in chronic fatigue syndrome". The abstract is available at MedLine:

In the same issue, AJ Wagenmakers offers an alternative theory, revisiting the proposal that people with CFS (1994 CDC definition) are symptomatic because of deconditioning. These comments are available at the publisher's website:

The author's credentials include the phrase "ON BEHALF OF THE EDITORIAL BOARD".

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Posted to Co-Cure Fri, 3 Dec 1999 00:44:48 -0500

Premovement and Cognitive Brain Potentials in CFS

Premovement and Cognitive Brain Potentials in Chronic Fatigue Syndrome
Journal of Chronic Fatigue Syndrome (The Haworth Medical Press, an imprint of The Haworth Press, Inc.) Vol. 5, No. 3/4, 1999
Ronald Gordon
H. J. Michalewski
T. Nguyen
Arnold Starr

SUMMARY. Brain potentials from normals and patients with Chronic Fatigue Syndrome (CFS) were recorded in four different experimental tasks: (1) Auditory target detection, (2) Short-term memory scanning, (3) Fore-warned reaction time (contingent negative variation), and (4) Self-paced movement. In the auditory target detection task, a slow negative potential shift (maximum at Cz), appears prior to stimulus onset in normals, but is markedly reduced in amplitude in patients with CFS. However, all other sensory and cognitive brain potentials do not differ between normals and CFS. Reaction times are slower in CFS compared to normals. In the memory task, a slow negative shift associated with memory scanning is reduced in patients with CFS. For the fore-warned reaction time and self-paced movement tasks, no differences were found between the patients and normals. The finding of premovement related potential abnormalities in CFS supports the concept that central motor preparation and execution are impaired in CFS. In certain tasks, measures of neural processes related to sensory processing and attention arc normal for these patients. Results from the memory task suggest that neural processes related to short-term memory are also altered in CFS.

KEYWORDS. Memory, movement preparation, auditory target detection, event-related potentials, CFS

Ronald Gordon, H. J. Michalewski, T. Nguyen, and Arnold Starr are affiliated with the Department of Neurology, 154 Med Surge 1, University of California, Irvine, CA 92697-4290.

Supported by Grant #R01 AI-34250, National Institute of Allergy and Infectious Diseases.

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Contact Co-Cure support personnel through our on-line form or by sending an email message to

Note: All abstract summaries, unless otherwise noted, were prepared by Margaret Bailey.

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