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Can I have both fibromyalgia and chronic fatigue syndrome?

William D. Knopf, MD
Cardiology (Cardiovascular Disease)
Chronic fatigue syndrome (CFS) and fibromyalgia (FM) are alike in many ways. In fact, it is not uncommon for a person to have both FM and CFS. Some experts believe that FM and CFS are in fact the same disorder, but expressed in slightly different ways. Both CFS and FM have pain and fatigue as symptoms.

The main symptom of CFS is extreme tiredness. CFS often begins after having flu-like symptoms. But people with CFS do not have the tender points that people with FM have. To be diagnosed with CFS, a person must have:
  • Extreme fatigue for at least 6 months that cannot be explained by medical tests
  • Forgetting things or having a hard time focusing 
  • Feeling tired even after sleeping 
  • Muscle pain or aches Pain or aches in joints without swelling or redness 
  • Feeling discomfort or "out-of- sorts" for more than 24 hours after being active 
  • Headaches of a new type, pattern, or strength 
  • Tender lymph nodes in the neck or under the arm 
  • Sore throat
This answer is based upon source information from the National Women's Health Information Center.
Chronic fatigue syndrome is sometimes hard to distinguish from fibromyalgia. With chronic fatigue syndrome, the fatigue lasts more than six months with no other medical problem to explain it.  And that interferes with daily activities at home and work. 

A study from the American College of Rheumatology suggests that fibromyalgia and chronic fatigue syndrome (CFS) may even overlap in the same person. With both conditions, the fatigue and other symptoms seem to increase after periods of high stress or physical exertion.

Other studies have indicated that many people who were initially diagnosed as having chronic fatigue syndrome probably have fibromyalgia. After some of these people started the specific treatment for fibromyalgia, their symptoms lessened dramatically and their energy levels increased. Some common symptoms of chronic fatigue syndrome include:  
  • relentless fatigue
  • memory and concentration problems
  • sore throat
  • swollen lymph nodes
  • muscle and joint pains
  • headaches
  • poor sleep that is not restful
  • exhaustion after exercise.
Jacob Teitelbaum
Integrative Medicine
In real life, most people who have fibromyalgia also have chronic fatigue syndrome (and vice versa). Unfortunately, the research and clinical definitions used for these conditions sometimes create more confusion than help. Basically, if you have persistent severe exhaustion that does not go way with vacation combined with severe insomnia and brain fog, you likely have chronic fatigue syndrome (or a related process) whether or not it fits the exact diagnostic criteria. If you also have widespread pain, you likely also have fibromyalgia.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.