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Effective Treatment of Chronic Fatigue Syndrome

Jacob Teitelbaum, MD

Abstract
Chronic fatigue syndrome (CFS) and its often simultaneously present cousin, fibromyalgia syndrome (FMS), are common names for an overlapping spectrum of disabling syndromes. It is estimated that FMS alone affects three to six million Americans, causing more disability than rheumatoid arthritis, and later research suggests a prevalence of CFS/FMS and/or disabling fatigue ranging from 7.3% to 12.9% across different countries.1,2 The majority of patients I see in clinical practice who have FMS also have CFS.3 Myofascial pain syndrome (MPS), pain caused by a localized area of muscle shortening, often shares many of the same underlying metabolic processes as FMS4 and affects many millions more.5 Structural abnormalities are more of a concern in MPS; however, because this article discusses the metabolic problems often seen in all three processes, I will often refer to the three (CFS/FMS/MPS) together.

Fortunately, two studies (including a recent randomized, controlled trial) done in our research center showed an average 90% improvement rate when using the SHIN. protocol.3,6 SHIN stands for Sleep, Hormonal support, Infections/Immune dysfunction, and Nutritional support. When a patient has fatigue and insomnia coupled with widespread pain, he or she is seen as having a body-wide energy crisis. Treatment with the SHIN approach will help them. A recent editorial in the Journal of the American Academy of Pain Management noted that our studies, as well as years of clinical success, have confirmed that subclinical abnormalities are important, and that our comprehensive and aggressive metabolic approach to treatment is a powerfully effective part of the standard of practice for treatment of FMS and MPS patients.7 Fortunately, although we still have much to learn, effective treatment is now available for the large majority of patients with these syndromes.3,6

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