A: The definition for fibromyalgia was developed by the American College of Rheumatology (ACR) and is much more straightforward. You have fibromyalgia if you have:

1) a history of widespread pain or achiness for at least three months that must have been present on both the right and left side of the body, both above and below the waist, and somewhere in the mid body (e.g. -- the neck, mid chest, or mid back). The pain can have been steady or intermittent.
2) pain on pressing on at least 11 of 18 spots on the body that are known as "tender points."

Having other illnesses does not exclude one from having fibromyalgia. In fact, is common to have other illnesses such as lupus or rheumatoid arthritis as a cause for fibromyalgia. It is important to be aware of this, as treating the associated fibromyalgia can dramatically improve these patients quality of life.

Q: How many people have CFS and fibromyalgia?

A: Current conservative estimates are that two percent of the population have fibromyalgia. I suspect that this is probably greater than four percent when one includes people with milder cases of the syndrome. This means that 6 to 12 million Americans suffer with this problem.

Interestingly, using strict CDC criteria (which is what the epidemiologists have to do) it is estimated that only about four to eight hundred thousand Americans have CFS. This is because of the exclusions that we discussed above. As most of the people in our studies (and many others) with fibromyalgia also have CFS, one would expect at least four million cases of CFS in the United States. Sadly, I suspect that this gross underestimate of the frequency of CFS has resulted in a major loss of research funding.

Q: How would you define these syndromes?

A: I think the above definitions without the exclusionary criteria are reasonable for now for research purposes. In day-to-day medical practice however, I propose the following definition. If you have fatigue that significantly interferes with your life that is not caused by overwork and does not go way with rest, poor sleep (despite making adequate time for sleep), and three or more of the following without a clear cause you have CFS and /or (if you have widespread pain as well) fibromyalgia unless proven otherwise!

1. diffuse widespread pain of unknown cause without joint swelling or redness,
2. brain fog
3. increased thirst
4. bowel dysfunction
5. decreased libido
6. recurrent infections and,
7. problematic medication, chemical, and /or food sensitivities.

Dr. Teitelbaum is a board certified internist and director of the Annapolis Research Center for Effective CFS/Fibromyalgia Therapies, where he sees CFS/Fibromyalgia/Chronic pain patients from all over the world (410-266-6958). Having suffered with and overcome these illnesses in 1975, he spent the next 28 years creating, researching, and teaching about effective therapies. He is the author of the best-selling From Fatigued to Fantastic!" and the newly released "Three Steps to Happiness! Healing through Joy". His web site can be found at: www.vitality101.com