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Health and Life Function Impairment in Patients with Chronic Fatigue Syndrome (CFS), Fibromyalgia (FM) and Multiple Chemical Sensitivity (MCS)

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Chronic fatigue syndrome (CFS), fibromyalgia (FM) and multiple chemical sensitivity (MCS) are common chronic health conditions which affect about 5% of Canadians older than age 12 years. Among women aged 45 to 64 years, the incidence is about 6.9%.  Chronic fatigue syndrome involves persistent unexplained fatigue, sleep dysfunction, mental depression, chronic pain in muscles and joints, headaches,

digestive problems and problems with memory, concentration and other mental functions.  Fibromyalgia involves problems similar to chronic fatigue and widespread problems with muscle and joint pain and weakness.  Multiple chemical sensitivity involves chronic fatigue, asthma, nasal problems, headaches, digestive and joint problems, muscle and joint weakness, mental depression and problems with memory, concentration and other mental functions.  MCS patients often experience much worsened symptoms when exposed to low levels of common chemicals such as second hand tobacco smoke, pesticides, perfumes/colognes, formaldehyde and molds.

Many patients with CFS, FM and MCS have difficulty in carrying out many life functions including working, driving, walking, exercising, driving, shopping and maintaining a home.  Patients with these conditions frequently have to quit work, but may have difficulty collecting disability payments.

Detailed studies were collected of 128 consecutive patients with at least one diagnosis of CFS, FM or MCS were seen in an environmental health clinic in Toronto, Ontario.  Average age was 46 years and 85% of the patients were women. Sixty-eight % of these patients had to quit work due to their illness.  Common additional health problems included depression in 34% of these patients, irritable bowel syndrome in 27%, food sensitivities in 27% and sleep disorders in 25%.  These 128 patients averaged 24.2 visits to physicians in the past year as compared to 3.7 annual physician visits for the average Canadian adult aged 30 to 60 years.

All 128 completed tests and questionnaires of physical and mental functioning.  Compared to the average population of Canadian adults, the patients with CFS, FM and MCS had significantly lower functioning in many areas such as physical function/limitation, emotional well-being and role function/limitation, energy levels and social functioning.  The average age of onset of symptoms was 36.9 years.  Patients who experienced health problems prior to age 36.9 had lower average functional levels than patients who had symptom onset later in life.

Much more research is needed to develop better ways of treating common conditions such as CFS, FM and MCS. More effort needs to be done to provide social, emotional and financial support to these chronically ill folks.

This research is published in the February 2010 Canadian Family Physician 2010;56:e57-e65.

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