Chat w/Dr. Klimas - Part 3

Q: Which tests do you use to distinguish between CFS & depression?

Dr. Klimas: Depression can be a lifelong problem, or a consequence of a chronic painful and debilitating illness like ME/CFS. Half of ME/CFS patients will develop depression AND IT IS ABSOLUTELY TREATABLE. There are common instruments (Beck depression inventory, Hamilton-D) that screen for depression. I use them and then ask colleagues in psychology or psychiatry to help me sort it out and treat when appropriate. * * * * Q: Hi, I am a doctor. I was wondering what is the pathophysiology of Chronic Fatigue Syndrome. I am sorry if this question has been asked before. Is it mostly endocrine, or autonomic nervous system?

Dr. Klimas: It is a complex mix of immune, HPA axis, autonomic and sleep dysfunction. It is treatable, and patients really can get healthier with a careful stepwise approach. Go to http://www.iacfsme.org for more info. * * * *

Q: Dr. Klimas, I know one of your key goals as an educator is to disseminate the latest evidence on our illnesses to the provider community. The CFIDS Association has announced that it will not be applying for a renewal of its contract with the CDC for services to educate healthcare professionals on ME/CFS diagnosis and management. ""Based on concerns about the direction of the program."" Can you comment on this?

Dr. Klimas: Well I can’’t. But I can tell you that the IACFS/ME is extremely keen to develop very detailed guidelines to help primary care providers work through the many complex problems that face CFS/ME patients. [See Dr. Klimas’’s letter to the IACFS/ME on "The Need for Treatment Guidelines".] I think the national awareness campaign was a great first step, and hope that the IACFS/ME can work with the CFIDS Association and other advocacy groups to reach more and more providers.

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Q: For someone wanting to provide info to their MD that the doctor would respect concerning the organic abnormalities in CFS –– what source do you recommend? The CDC info is in lay terms.

Dr. Klimas: I just published a nice review in Current Rheumatology Reports - out in December, on important research findings in the past year: ""Chronic Fatigue Syndrome: Inflammation, Immune Function, and Neuroendocrine Interactions.""

And the IACFS/ME webpage/ links professionals to a number of very helpful reports and articles. Web committee chair Lee Meisel, MD, and the staff of the IACFS/ME have worked long and hard to keep this up to date and useful. Also, as I mentioned, the Toolkit on the CFIDS Association webpage is very helpful. http://www.cfids.org/sparkcfs/health-professionals.asp

By the way, the IACFS/ME needs patient members to support our professional organization and keep us alive and kicking. As the President, I ask you to please join, and keep up with research and clinical advances through our newsletter, conferences, etc. A membership application form for both professionals and ""associate"" students, patients, and other interested individuals or groups is available at the IACFS/ME website

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Closing Remarks

Our live chat is now drawing to a close. We thank Dr. Klimas for her remarkable generosity in being here today. And we thank all of you for contributing to this very interesting exchange.

Doctor, you mentioned getting hugs from patients in public places. I will send big hugs and thankfulness from all of us who do not get well on our own. Your research and what you do is much appreciated!

Dr. Klimas: Thank you! Thank you, everyone, for such a lively discussion! I wish you all a happy and healthier 2008! And thanks to ProHealth for keeping this going!

______ To read a hope-inspiring personal profile of Dr. Klimas, her current studies, and her thinking, click here. And for links to information about her projects and publications, click here.

You can read a German translation of this Q&A, by Regina Clos, editor of CFS/ME-Actuell, at http://www.cfs-aktuell.de/februar08_1.htm

Note: This information has not been evaluated by the FDA. It is generic and is not intended to prevent, diagnose, mitigate, treat, or cure any illness, condition, or disease. It is very important that you make no change in your healthcare plan or health support regimen without researching and discussing it in collaboration with your professional healthcare team.