New Study Shows Biological Differences In People With Chronic Fatigue Syndrome
The findings could also help with earlier diagnosis of the condition. (Photo: Getty Images)
For people who suffer from chronic fatigue syndrome, tiredness isn’t just an annoying feeling you can’t shake — it’s a symptom of a much larger disease. In fact, millions of people could suffer from myalgic encephalomyelitis (ME/CFS), as it’s medically known. But while studies have hinted at biological differences in people with the condition, it’s also been brushed off as a psychological disorder — or even something that’s “not real.”
But now, new research out of Columbia University’s Mailman School of Public Health provides further evidence of specific biological differences in people with chronic fatigue syndrome.
“It’s really exciting — we were able to detect evidence that there are immune markers that are disturbed early after the onset of illness,” says Mady Hornig, MD, lead author of the study. “Many people who were inclined to think of this as a psychological illness thought of these changes as secondary, but there are actually distinct phases of immune dysfunction that change over time — and there could be a way to use these markers to get people to an earlier diagnosis,” she says.
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For the study, researchers looked at levels of different immune biomarkers in the blood of people with and without chronic fatigue syndrome. They discovered strange patterns of cytokines, which are immune molecules involved in cell signaling, in people with the disease that were not present in healthy people. People who had it for three or fewer years had increased amounts of cytokines. (This mimics a car stuck in high gear.) But after three years with the disease, their amount of cytokines was unusually low.
Here’s why that matters: Being able to have biological markers to go off of could help a doctor diagnose the condition in the future. That’s especially important with chronic fatigue syndrome, as 70 percent of people with it have delayed diagnosis of at least a year, and many more can be diagnosed as late as 10 years after onset, she says. And diagnosis, as it stands now, is difficult. A doctor will look at physical features, medical history, and current symptoms — which can be difficult as many diseases sprout similar symptoms. For instance, fatigue and pain can be a sign of everything from a cold to cancer.
“In the future, we envision these biomarkers as helping us travel in the direction of getting to a place where we can help clinicians with diagnosis,” Hornig says. And some day, there could be a biological test for the disease.
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As of now, researchers aren’t quite sure who could be more susceptible to chronic fatigue syndrome, but Hornig says that’s exactly what they’re trying to figure out. Some research suggests that a subset of folks who have suffered from mononucleosis — caused by the Epstein-Barr virus — or the West Nile virusnever fully recover could be at risk. “There are specific similar cytokine signatures that have been seen in these populations,” she says.
So what could treatment look like? Could you really pop a pill for energy in a futuristic world? Possibly. “Because we see different immune signatures in early and later stages of the disease, we believe there may be different treatments by different stages,” says Hornig. For example, in the early stages of the syndrome, the activation of many cytokines increased. “Perhaps those people would benefit from something that suppressed the increase.” In the later phases, since cytokine activity decreased, patients may need a boost in activity.
And while the research is still murky, there are countless intriguing interactions between your immune system, cell signaling, and biological markers, says Hornig. And future treatments could include better incorporating a healthy lifestyle. “Every time you have a thought, you have a biochemical reaction — and those biochemical reactions also interact with your immune system,” she says. There are studies, too, that show immune system changes with exercise, meditation, sleep, and even with the microbiome: “Understanding these interactions is a fascinating and important area of research.”
