from
Dr. Richard Horowitz
Dr. Richard Horowitz
Patients diagnosed with Chronic Fatigue Syndrome (CFS/M.E.) comprise up to 2.5 million Americans. How does a health care provider make the diagnosis?
"The Diagnosis requires three core symptoms: Fatigue and reduction in pre-illness levels of activity that last for more than six months, the post-exertion worsening, and sleep that is unrefreshing despite exhaustion. Also, patients must have at least one other symptom: Cognitive impairment, sometimes described as "brain fog," or what's called orthostatic intolerance — meaning symptoms improve when lying down and patients find it hard to stay upright for long." Lyme disease patients often complain of exactly the same symptoms of fatigue, unrefreshed sleep and cognitive impairment, with many having low blood pressure and autonomic dysfunction (see chapters 2, 12, 13, and 14 in "Why Can't I Get Better?, on the Horowitz 16 point differential diagnostic map, Lyme and the Brain, Lyme and Sleep Disorders, and Lyme and Autonomic Nervous System Dysfunction/POTS) The Institute of Medicine (IOM) is now going to call this syndrome a new name: Systemic Exertion Intolerance Disease, or SEID. This name is meant to validate the severity of the disease, which is an excellent first step, but unfortunately, it does not help patients to get to the source of why they are ill, as there is no blood test for SEID. Dr. Ellen Wright Clayton who chaired the IOM panel stated that the reason for the change of name is that "These patients have real symptoms. They deserve real care." I agree with her, but many patients who have come to me after suffering for years with a prior diagnosis of CFS or "SEID," usually have suffered with Lyme-MSIDS. They have up to 16 overlapping factors keeping them ill and the majority get better with my treatment. Lets shift the paradigm for chronic disease diagnosis and treatment for the millions who suffer with "SEID," and stop ignoring tick-borne disorders with MSIDS as factors contributing to their underlying disease process.
