In the past, CFS and FM have been diagnosed on exclusion of similar appearing conditions. Due to the widespread symptoms experienced by a patient it is common to observe multiple dysfunctions within the same person contributing to their debilitated state.
Such common conditions to rule out include the following (Bested and Logan, 2008):
- Addison’s disease,
- Cushing’s syndrome,
- hypothyroidism/ hyperthyroidism,
- iron deficiency/ iron overload syndrome,
- anemia of various types,
- diabetes mellitus,
- treatable sleep disorders (ie. apnoea),
- neurological and auto-immune disorders (ie. multiple sclerosis, Parkinson’s disease, myasthenia gravis, B12 deficiency)
- infectious diseases (ie. AIDS, hepatitis, tuberculosis, Lyme disease),
- Celiac disease,
- primary psychiatric disorders and substance abuse
In order to rule out the above conditions, laboratory testing and imaging is necessary. Below is a thorough but not exclusive list of testing that is commonly performed with CFS and FM patients in order to rule out other pathophysiology or co-morbid conditions:
Etiology and Laboratory Testing of Chronic Fatigue Syndrome and Fibromyalgia
Blood tests: CBC, ESR, serum electrolytes, glucose, Calcium, RBC Mg, phosphorous, TSH, T3, protein electrophoresis screen, CRP, Ferritin, Creatinine, Rf, ANA, CPK, Liver function tests, Urinalysis.
Brain/ cervical imaging: SPECTS scan (blood flow, glucose uptake), MRI (white/ grey matter, Chiari Malformation, phospholipis, abnormal pain processing areas).
Neuroendocrine studies: HPA, CRH, ACTH, Cortisol 4 point salivary test.
Neuropsychological investigation and testing: cognition, brain fog, slowed processing speed, impaired working memory, inability to multitask, poor leaning of information, depression.
Other: Functional testing; food intolerances and allergies; oxidative stress; heavy metal toxicity, genetic testing, sleep studies.
Additional testing depending on personal and family history: STI, hepatitis B and C, tuberculosis, HIV, cancer.
Keep up-to-date on the latest research for Fibromyalgia and Chronic Fatigue Syndrome by read other related topics:
- Fatigue: What is FM and CFS?
- Etiology and Lab Testings for FM and CFS
- Fundamental Treatments for FM and CFS
- FM and Cognitive Behavioral Therapy
- How much sleep do I need?
- Fibromyalgia and CFS References
- Toronto Star FM Case Study: Sandy Bolyki
- Guaifenesin Protocol with Dr. St. Amand
Here are my FM/CFS book recommendations from fellow medical colleagues:
- Hope and Help for Chronic Fatigue Syndrome and Fibromyalgia, 2e – Dr. Alison Bested, MD and Dr. Alan Logan, ND
- The Complete Fibromyalgia Health, Diet Guide and Cookbook– Dr. Louise McCrindle, ND