Q: What else can cause a sudden onset of CFS/FMS?

A: Other important triggers that can cause CFS/FMS to begin suddenly include:

1) Having just had a baby. This can occur for a number of reasons.

• After delivery, blood flow to the pituitary gland (the gland in the brain which, under the hypothalamus’ direction controls your hormone function) is dramatically decreased. In some cases, this is so severe that it can cause destruction of the pituitary (called Sheehan’s necrosis). Cases that are not severe enough to destroy the pituitary tend to be ignored medically. I suspect, however, that pituitary may be stunned long enough after pregnancy to trigger CFS/FMS.
• During pregnancy, levels of many hormones are elevated. These include estrogen, relaxin and CRH. Sudden drops in these hormones may trigger the syndrome.
• Sleep deprivation is common for 6 to 12 months after pregnancy and is probably a major contributing factor.
• Your blood volume drops markedly after pregnancy. During pregnancy it is often about 30 percent higher than normal.

2) Having an injury -- even an incredibly minor one that causes no damage to an automobile for example --, or having surgery where you were anesthetized with your head tilted backwards for an extended time can trigger Fibromyalgia. Two possible mechanisms for this include:

• Minor muscle strains that disrupt sleep. Anything that disrupts sleep can trigger CFS/FMS. Whiplash injuries to the neck are especially likely to cause these problems. This can occur because of strain on the spinal cord in the neck or the area where the brain leaves the skull and enters the neck. If the bony areas that the brain and spinal cord pass through are a bit smaller than normal, swelling in this area can trigger the process. Although surgery can sometimes relieve this, this is a rather drastic and expensive approach that cannot be reversed. In addition, there's only one surgeon in the country that I would trust to do it. Fortunately, medical therapy using our protocol almost always improves symptoms, making surgery unnecessary in the large majority of cases.
• Some people theorize that vaccines can trigger CFS/FMS in some patients. One way that this can occur is because of the preservative in multi-dose vials of the vaccine, which may contain mercury. I have heard that these mercury-containing preservatives are being eliminated from vaccines. This is why I ask this question (did you have a vaccination just before the onset of your CFS) of people doing my computerized web site program.
• Multiple toxic exposures can trigger CFS/FMS. This is why it's important to ask if someone moved into a new home just before the onset. If so, looking for molds behind the walls, carbon monoxide leaks, etc. can be important. Also, do your symptoms go away if you are away from home for a week (note -- it is important to test this when you are with and away from work and/or family as well!)? Do they get better when you're out-of-town? Did you have a pesticide or a (often work-related) chemical exposure? This is often especially common in agriculture workers.

These are just some of the more common causes of sudden onset of CFS/FMS

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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