The Case For Autoimmunity
Some researchers have found evidence suggesting ME/CFS is, at least in part, an autoimmune disease. A few different targets of a misfiring immune system have been suggested.
In a 2013 study in Molecular Neurobiology examining the possible relationship of O& NS and autoimmunity, researchers said that the presence of pro-inflammatory cytokines and several other known dysfunctions associated with ME/CFS may predispose to autoimmunity. That means autoimmune activity may be a consequence of the condition rather than a cause of it. These researchers suspect that constant viral infections may lead to processes that could induce autoimmunity: bystander activation and molecular mimicry.
In molecular mimicry, the immune system fights an infectious agent and then begins to confuse it with a similar cell in the body and begins attacking it. Essentially, because both cells look similar, the immune system labels them as identical, when in fact one type actually belongs in your body.
In bystander activation:
- The body is attacked by a virus
- The immune system responds by activating specialized cells
- That activation mistakenly begins attacking the body’s tissues
In the same study, researchers also list several other methods by which ME/CFS may trigger autoimmunity, including dysfunction of mitochondria, which provide energy to your cells, and cellular damage caused by O& NS that cause your immune system to misidentify them.
How Is Ra Treated
RA can be effectively treated and managed with medication and self-management strategies. Treatment for RA usually includes the use of medications that slow disease and prevent joint deformity, called disease-modifying antirheumatic drugs biological response modifiers are medications that are an effective second-line treatment. In addition to medications, people can manage their RA with self-management strategies proven to reduce pain and disability, allowing them to pursue the activities important to them. People with RA can relieve pain and improve joint function by learning to use five simple and effective arthritis management strategies.
Recommended Reading: Stanford Chronic Fatigue Clinic Phone Number
What Is The Prognosis For These Diseases
In most cases, the symptoms of dermatomyositis resolve with therapy. The disease is usually more severe and resistant to therapy in individuals with heart problems. Approximately one-third of individuals with juvenile-onset dermatomyositis recover from their illness, one-third have a relapsing-remitting course of disease, and the other third have a more chronic course of illness.
The prognosis for polymyositis varies. Most individuals respond fairly well to therapy, but some people have a more severe disease that does not. These individuals may have significant disability. Since polymyositis can cause difficulty swallowing, people can become malnourished. They are also at increased risk for falling, which can lead to hip and other bone fractures, disability, or death. In rare cases people with severe and progressive muscle weakness can develop respiratory failure or pneumonia.
Although necrotizing autoimmune myopathy is more difficult to treat than polymyositis and dermatomyositis, it generally responds well to long-term combination immunosuppressive therapies.
IBM is generally resistant to all therapies and currently available treatments do little to slow its progression.
Also Check: What Is Chronic Fatigue Syndrome Called Now
Is There A General Defect In Tolerance Development In Me/cfs
Tolerance induction is a major property of the gut mucosal immune system . A special kind of T helper cells, Treg, mediate mucosal tolerance, and anergy of tolerized B cell clones, via IL10 and TGF. It may be more than a coincidence that a change in TGF levels in serum was the most consistent cytokine change in ME/CFS versus controls .
A defective tolerance development could in principle be detectable as a tendency to develop autoimmune disease in ME/CFS. The comorbidity between ME/CFS and better studied autoimmune disorders such as SS , SLE, and multiple sclerosis is an indication of this. Fatigability, which may or may not be related to the PEM of ME/CFS , occurs as a major symptom in some autoimmune , mitochondrial and infectious diseases. Immunostimulation, e.g., with Staphylococcal vaccine, theoretically could induce tolerance to autoepitopes involved in ME/CFS pathogenesis . It was reported to be effective in ME/CFS in a double-blind study . Symptom relief paralleled anti-staphylococcal antibody presence , arguing for impaired development of tolerance to autoepitopes of microbial origin in ME/CFS. Further studies are needed.
In autoimmunity dependent on autoantibodies, the erroneously activated B cells are the root of the evil.
Autoimmune Disease Risk Factors
Researchers dont know what causes autoimmune disease, but several theories point to an overactive immune system attacking the body after an infection or injury. We do know that certain risk factors increase the chances of developing autoimmune disorders, including:
- Genetics: Certain disorders such as lupus and multiple sclerosis tend to run in families. Having a relative with autoimmune disease increases your risk, but it doesnt mean you will develop a disease for certain, says Orbai.
- Weight: Being overweight or obese raises your risk of developing rheumatoid arthritis or psoriatic arthritis. This could be because more weight puts greater stress on the joints or because fat tissue makes substances that encourage inflammation.
- Smoking: Research has linked smoking to a number of autoimmune diseases, including lupus, rheumatoid arthritis, hyperthyroidism and MS.
- Certain medications: Certain blood pressure medications or antibiotics can trigger drug-induced lupus, which is often a more benign form of lupus, Orbai says. Our myositis center also discovered that specific medications used to lower cholesterol, called statins, can trigger statin-induced myopathy. Myopathy is a rare autoimmune disease that causes muscle weakness. Before starting or stopping any medications, however, make sure to talk to your doctor.
Don’t Miss: Homeopathic Remedy For Chronic Fatigue
Cytokine Patterns In Blood And Csf In Me/cfs
The immune system is engaged in ME/CFS . Several studies have found changes in cytokine pattern in blood and CSF, and in expression of cytokine genes , especially after exercise , concomitant with an increase in reactive oxygen species levels and a decrease of HSP70 concentration , often in connection with a flare, an acute exacerbation of ME/CFS symptoms . A difficulty is that cytokine patterns are inherently variable. The cytokine profiles may be different in different stages of the disease .
Table 5. A selective list of cytokines whose concentrations were reported to change in ME/CFS.
A more permanent dysregulation of cytokines in plasma has also been reported , see Table 5. A correlation with disease duration was seen . A meta-analysis showed that an increased level of TGF in plasma in ME/CFS versus controls was the most consistent finding . Cytokines in CSF were also deranged in ME/CFS .
Table 5 is a compilation from recent publications on cytokine abnormalities in ME/CFS. A recent meta-analysis concluded that many of the reported findings are not reproducible . This could reflect different levels of physical activity, the volatile nature of cytokine levels and methodological problems, such as collection, handling, and preparation of samples. There could also be a heterogeneity within the ME/CFS group which blurs the patterns, see, e.g., Ref. .
Lupus Vs Rheumatoid Arthritis
A complex autoimmune disease, lupus can cause a wide range of symptoms that vary in severity, making it challenging to diagnose. Many people refer to lupus by its full medical name, systemic lupus erythematosus .
How is it similar to RA? One of the most common symptoms of lupus is pain and swelling in the hands, knees, and other joints. People often report fatigue, fever, and a general feeling of being unwell.
See Rheumatoid Arthritis Symptoms
How is it different? A person with lupus may find it painful to take a deep breath. He or she may have sensitivity to light, hair loss, mouth sores, and/or a skin rash, particularly over the face. Digestive difficulties and neurological problems, such as headaches and tingling, are also possible.
You May Like: Non Radiographic Axial Spondyloarthritis Fatigue
Viral Or Bacterial Infection And Fatigue
Symptoms: Fatigue, fever, head or body aches.
Fatigue can be a symptom of infections ranging from the flu to HIV. If you have an infection, youll probably have other symptoms like fever, head or body aches, shortness of breath, or appetite loss.
Infections that may cause fatigue include:
Treating the infection often relieves your fatigue. But some infections, including mononucleosis and COVID-19, can lead to long-lasting tiredness.
You May Like: How To Stop Adrenal Fatigue
What Does The Research Show
There havenât been many scientific studies on cupping.
One report, published in 2015 in the Journal of Traditional and Complementary Medicine, notes that it could help with acne, herpes zoster, and pain management.
Thatâs similar to the findings from a 2012 report, published in PLoS One. Australian and Chinese researchers reviewed 135 studies on cupping. They concluded that cupping therapy may be effective when people also get other treatments, like acupuncture or medications, for various diseases and conditions, such as:
There isnât research to back all of that up.
Read Also: Fatigue And Joint Pain Symptoms
Autoimmune Disease And Adrenal Fatigue Syndrome
Millions of people are diagnosed with some form of autoimmune disease, and the number is rapidly growing. Prevalence of the disease is 75% more prevalent in women than men. Autoimmune disease occurs when the immune system thinks healthy tissues of your body are invading bacteria or viruses and begins to attack them. Women are thought to have a stronger, more reactive immune system than men, which is why they may be more susceptible to autoimmune conditions. Autoimmune diseases are classified by the main tissue the immune system attacks. While the conditions often cause systemic issues, there is usually one main organ system that the autoimmune system responds to.
There are many types of autoimmune diseases with differences in their development or progression, which results in widespread symptoms. Its important to note that an autoimmune disease diagnosis does not mean there is no hope. Autoimmune diseases vary from symptom to symptom and person to person, so depending on how you manage your diagnosis, you may have the opportunity to reclaim your health and your life. However, its important to understand that antibodies are usually always present and may flare up on occasion.
Read Also: How To Fight Period Fatigue
Which Facts Do Not Fit Into The Explanatory Model
Even if ME/CFS is of autoimmune origin, is it the metabolic block or the autoantibodies to hormone receptors which are most important for pathogenesis?
The mechanism behind the flare after exercise is obscure. Maybe a mitochondrial defect can lead to an increased activity in the innate immune network.
The disturbance in one-carbon metabolism may or may not be related to the disturbed transition between glycolysis and TCA cycle. It is indicative of a wider metabolic derangement than a block of PDH would be expected to lead to. There are several papers on hormones , including glucocorticoids and transient receptor potential channel hormones , and their receptors , in ME/CFS. It is conceivable that parts of the autonomic dysfunction can be explained in this way.
Read Also: How To Battle Extreme Fatigue
Weight Gain Fatigue And Autoimmune Disease
Failure to properly manage autoimmune diseases could lead to a nasty bout of weight gain and prolonged fatigue. Conditions like Type 1 diabetes, hypothyroidism and Celiac disease usually develop after long periods of neglecting symptoms of autoimmune diseases.
A compromised immune system could lead to a rapid accumulation of weight in previously-healthy individuals. Management of the conditions linked to autoimmune diseases is an effective way to solve related weight gain problems.
What Is Myalgic Encephalomyelitis/chronic Fatigue Syndrome
Myalgic encephalomyelitis/chronic fatigue syndrome is a complex and disabling disease. It has been classified as a neurological disorder by the World Health Organization, though it affects many parts of the body, including the brain and muscles, digestive, immune and cardiac systems.
The term myalgic encephalomyelitis means pain in the muscles, and inflammation in the brain and spinal cord. Scientists are starting to understand some of the biological changes in the bodies of people with ME/CFS, although they have not yet found how to prevent, or cure it.
Research has found that ME/CFS is associated with problems involving:
- The bodys ability to produce energy at a cellular level
- Immune, neurological and hormonal systems
- Blood pressure and heart rate regulation
- Cognition how quickly information is processed
ME/CFS affects men, women and children of all ages, ethnicities, and socioeconomic backgrounds. 75-80% of people with the disease are female. It is estimated that up to 600,000 Victorians may be living with ME/CFS, and as many as 90% are undiagnosed.
Recommended Reading: Chronic Fatigue Syndrome Symptoms And Treatment
How Would You Describe Fatigue Associated With Pots
People with POTS experience fatigue differently. Many describe it as feeling beyond exhausted. Its as if your energy is completely depleted. The fatigue is probably hundreds of times worse than your worst flu. People with POTS may also have trouble concentrating and thinking straight. Doing simple tasks may feel like youve just run a marathon.
This fatigue might come and go, hitting you without warning daily, weekly or less frequently. For some people, extreme fatigue lasts for days. Others may experience periodic attacks. It can come on at any moment even if you just woke up. And there is no amount of sleep or coffee that can make it go away.
Recommended Reading: How To Keep Anti Fatigue Mats From Sliding
When Explaining Fatigue To My Doctor What Details Are Most Important For A Diagnosis
All of the details listed are potentially important pieces of information to give your doctor, but timing, especially duration, is among the most crucial. How long has it been occurring, and has it been steady or intermittent? If the latter, how long does it last when present? Does it vary depending on the time of day? Did it start suddenly or gradually? Diagnosing the cause of fatigue can be tricky, and any assistance you can provide towards this effort will be greatly appreciated by your doctor.
As suggested in the question, another important aspect is the location of the fatigue, and whether it changes. Your doctor will also want to know if you experience more than one type of fatigue . In general, the more descriptive and inclusive you can be with your symptoms, the better chance there is of your physician being able to make a diagnosis. Still, it should be noted that a decent proportion of patients will not receive a definitive diagnosis, nor will the cause become apparent.
Finally, it is especially vital that you tell your doctor about any other symptoms or conditions, as well as any past medical history, even if you think they are entirely unrelated. In doing so, you should include any recent exposures to toxins, recent travel, medications currently taken, psychiatric issues, and complaints of snoring from others . What may appear unimportant or inconsequential to you could be an essential piece of information for your provider.
Recommended Reading: Information On Chronic Fatigue Syndrome
Modifying Behavioural Components To Fatigue
Significant central fatigue warrants lifestyle changes, which may include rest periods and reduced workloads . However, the maintenance of physical activity is of paramount importance. The natural inclination of patients with central fatigue is to decrease physical activity. However, decreased physical activity over time will lead to cardiovascular and muscular deconditioning, which then makes physical activity even more difficult . Therefore, all patients need to be counselled with regard to maintaining an appropriate level of activity. In addition, an increase in activity should be attempted through the institution of a graded exercise program .
Dont Miss: Upper Back Pain And Fatigue
When Should I Go To The Emergency Department
Go to the emergency department if any of the following autoimmune disease symptoms get severe:
- Trouble breathing/shortness of breath. Remember that some people with an autoimmune disease can experience this when theyre pregnant.
- Severe chest pain/pressure to your chest.
- A headache that starts suddenly and feels like the worst headache youve ever had.
- Sudden weakness, especially if you cant move.
- Dizziness that doesnt stop.
- Pain so severe that you cant stand it.
A note from Cleveland Clinic
Living with an autoimmune disease can be complicated. Diseases like lupus, rheumatoid arthritis and multiple sclerosis are complex and serious. Although there are no cures for these diseases, many of their symptoms can be treated, and sometimes they go into remission. Stay in touch with your healthcare provider about any advances in understanding and treating autoimmune diseases.
If you think you may have an autoimmune disease, see your healthcare provider as soon as possible for diagnosis and treatment. Your symptoms will be easier to control if the condition is treated promptly.
Last reviewed by a Cleveland Clinic medical professional on 07/21/2021.
References
Also Check: Can Blood Thinners Cause Fatigue
The Difference Between Rheumatoid Arthritis And Osteoarthritis
Like RA, people with osteoarthritis can experience painful and stiff joints that make moving around difficult.
People with OA may have joint swelling after extended activity, but OA doesnt cause significant enough inflammatory reaction to result in redness of the affected joints.
Unlike RA, OA isnt an autoimmune disease. Its related to the natural wear and tear of the joints as you age, or it can develop as a result of trauma.
OA is most often seen in older adults. However, it can sometimes be seen in younger adults who overuse a particular joint such as tennis players and other athletes or those whove experienced a severe injury.
RA is an autoimmune disease. The joint damage from RA isnt caused by normal wear and tear. Its caused by your body attacking itself.
You May Like: Is Fatigue A Symptom Of Uti
How Do Autoimmune Diseases Affect You If You’re Trying To Get Pregnant
Some autoimmune diseases can affect your ability to get pregnant and some have adverse effects on pregnancy. You may need fertility treatments to get pregnant. You might also want to wait until your disease is in the remission stage to try to conceive.
There is a higher risk for stillbirth or preterm birth if you have lupus. If you have myasthenia gravis, you may experience trouble breathing.
Also Check: Weight Loss And Fatigue Causes
