Myalgic Encephalomyelitis / Chronic Fatigue Syndrome

Is ME/CFS Real - Or Is It Really All In The Mind?

One of the most common questions about this illness is whether Myalgic Encephalomyelitis / Chronic Fatigue Syndrome and Post Viral Fatigue Syndrome is actually real....

... or is it all in the mind?

There are so many opinions out there that's it's difficult to figure out just what's going on. Is what you're suffering from all in your mind? Or is it a physical illness?

Does evidence exist that proves that ME/ CFS is real?

Find out below...


OK, let's get one thing straight:

ME/CFS /PVFS is NOT all in your mind.

It is a real condition.

It is a serious condition.

And it is a physical one.


Here are a few quotes from some experts in the field:

"In my experience, (it) is one of the most disabling diseases that I care for, far exceeding HIV disease except for the terminal stages"

-- Daniel Peterson, International Expert [ref 9]--

"Australian researchers found that patients with this disorder had more dysfunction than those with multiple sclerosis, and that in ME / ICD-CFS the degree of impairment is more extreme than in end-stage renal disease and heart disease, and that only in terminally ill cancer and stroke patients was the sickness impact profie (SIP) greater than in ME / ICD-CFS."

-- E.P. Marshall, M. Williams, M. Hooper
'What Is ME? What Is CFS?'
[ref 11]

'Studies by the CDC show that people with CFS can be as impaired as someone with heart disease, cancer or multiple sclerosis,'

-- Dorothy Wall, ' From Skepticism to Science' --

There is considerable evidence from different investigators, using different technologies and studying different groups of patients, of a state of chronic immune activation.

In summary, there is now considerable evidence of an underlying biological process in most (CFS) patients (which) is inconsistent with the hypothesis that (the syndrome) involves symptoms that are only imagined or amplified because of underlying psyciatric distress. It is time to put that hypothethis to rest."

-- Anthony L Komaroff,
Assistant Professor of Medicine at Havard
and world expert on ME/CFS
The Biology of the Chronic Fatigue Syndrome [ref 12]--


Unfortunately, there are many people out there who still don't think that Post Viral Fatigue Syndrome / Myalgic Encephalomyelitis / Chronic Fatigue Syndrome really exists. And an alarming number of (misinformed) doctors still mistakenly believe that PVFS / ME/CFS is purely 'all in the mind' - that PVFS / ME/CFS is purely psychological - a figment of the patients' imagination! CFS real, real, CFS, all in the mind, all in mind

As with any chronic illness, there is the psychological aspect of having to adjust to living with ME/CFS /PVFS. But that is true for any chronic illness.

Nevertheless, the evidence that is now emerging suggests that PVFS / ME/CFS is indeed a real neurological, physical condition, and that the basis of PVFS / ME/CFS itself, is NOT psychological.

Click here to find out why PVFS / ME/CFS is DIFFERENT to depression...


In fact, the World Health Organisation classifies both Myalgic Encephalomyelitis (ME) and Post Viral Fatigue Syndrome (PVFS) as 'diseases of the nervous system' (ICD-10, Section G93.3).

What's more, Myalgic Encephalomyelitis /Chronic Fatigue Syndrome is now recognized as a very real and serious, physical, biochemical condition by the United Kingdom's government.

"CFS/ME should be classed alongside other diseases such as multiple sclerosis and motor neurone disease"

-- Professor Sir Liam Donaldson,
the chief medical officer for England and Wales, 2002 --


Click here to learn more about UK government's recognition of CFS...

So Where's The Hard Evidence ?

PVFS / ME/CFS sufferers show abnormalities in the immune, neurological, endocrine, and other systems.

In 2005, a study by a group of British scientists led by Dr Jonathan Kerr of Imperial College London, confirmed that Chronic Fatigue Syndrome sufferers do indeed have biological abnormalities. It was found that the cells in CFS sufferers behave differently from those of non-sufferers. [ref 4]

The study discovered that CFS sufferers have a group of genes which are 4 times more active than those in healthy people, and one gene which is less active. What's also interesting is that this occurred while the CFS patients were at rest.

So what does that mean?

Well apparently it has to do with something called gene expression, which refers to the pattern in which genes are switched on and off. And gene expression has a major effect on your body's biological processes.

Each cell in your body contains a 'power-factory' that produces energy, called the mitochondria. And Dr Kerr's study revealed that many of the cell genes that were identified as 'behaving abnormally' in CFS sufferers, are cell genes that actually affect how the 'mitochondria' works!

As Dr Kerr said:

'The involvement of such genes does seem to fit with the fact that these patients lack energy and suffer from fatigue,'

-- Dr Jonathan Kerr --

And that's not all...

The study revealed abnormalities in other types of cell genes too. Some of the cell genes that were identified as 'behaving abnormally' are involved in controlling the activity of the immune system, and others play important roles in nerve cells.

"This exciting new work shows that some aspects of this complex illness may be understandable in molecular terms, and that CFS is not a 'made up' illness."

-- Russell Lane, Neurologist,
Charing Cross Hospital in London --


Although more research needs to be done, the results of the study (and so far, of a larger study) also suggest that a continuing viral infection is one of the most likely causes of Chronic Fatigue Syndrome . And it offers the strongest indication yet that at least one of the possible triggers of CFS is indeed physical.

These findings support the common belief that CFS can sometimes be triggered by viruses such as Epstein-Barr (or Mononucleosis), enteroviruses and so forth.

Click here to find out more about causes of Chronic Fatigue Syndrome ...

More Hard Evidence ... An Unusual Gene Signature ?

The findings by Dr Kerr and his team are also supported by similar work by Dr John Gow and his team, at the University of Glasgow Scotland. When talking about his findings that CFS sufferers have a particular kind of "unusual gene expression" he said:

"This means the genes are switched on or off at an inappropriate time. We have identified a number of genes that are wrongly switched on (') It looks like the immune system is working overtime when it shouldn't be, making the patient tired."


-- Dr John Gow, [ref 5]


Dr Gow and his team have also generated what they believe to be a "gene signature" of patients with Chronic Fatigue Syndrome [ref 6]. In fact, the novel work on CFS by Dr Gow and his team is so ground-breaking that the University of Glasgow actually patented it in February 2005! [ref 7]

"Professor Kenny De Meirleir, who incidentally helped to frame the Canadian definition, gave a wonderful exposition summarizing the research enshrined in over 5000 scientific papers.

(...) Briefly, he and others have elucidated a whole battery of biochemical tests that reflect the great complexity of CFS. Settling for the moment on a panel of five or six basic tests, (...) he is able to separate ME/CFS patients into three separate groups, each with different causes, therapies and (sometimes) outcomes.

His clinic in Brussels sees 800 CFS patients every three months. Interestingly, given the biochemical results of these tests, without seeing the patient he is now able to predict into which group the patient falls, correctly in 95% of cases. This would be impossible if ME/CFS is a psychiatric illness. It is also highly significant that these tests can discriminate between ME/CFS and normal or non-CFS patients."

-- Michael Barratt MBBS FRCPA, Medical Adviser,
Alison Hunter Memorial Foundation, 'Where to now?' --

“ME/CFS Sufferers Generate Too Many Free Radicals”

Want some more evidence ?

You may have heard of ‘free radicals’ - they are the molecules in your body that can cause damage to the cells in your body.

If you were healthy, your body would neutralise these free radicals with 'antioxidants'. But if you have ME/CFS , recent research by Dr Vance Spence et al [ref 15] has shown that your body is actually producing too many free radicals for it to handle. CFS : real or all in the mind?

"Circulating in the bloodstream are highly reactive molecules, known as free radicals, which can cause damage to the cells of the body, a process called oxidative stress.

In healthy people, increases in free radicals are neutralised by antioxidant defences, and it is only when these defences are overwhelmed that cell injury results.

The source of excessive free radical generation in ME/CFS patients may be associated with a variety of altered biological processes."

-- Dr Neil Abbot, MERGE [ref 16] --


If you have ME/CFS, you’ll probably have wondered why you cannot tolerate any exercise. Why do your symptoms often get worse after you’ve exerted yourself physically? Well it could all be linked to this oxidative stress

"(…) recent research has demonstrated that incremental exercise challenge induces a prolonged and accentuated oxidative stress that might well account for post-exercise symptoms in ME/CFS patients."

-- Dr Neil Abbot, MERGE [ref 16] --


Bottom line?

Myalgic Encephalomyelitis / Chronic Fatigue Syndrome sufferers show abnormalities in the immune, neurological, endocrine, and other systems. This page has referred to just a handful of the studies which provide compelling evidence that ME/CFS is a very real and serious, neurological condition.

ME/CFS is not all in the mind. Sufferers are not 'making it up because they are lazy', or because they are 'looking for attention' or 'feeling sorry for themselves'.

It's very serious. It's very physical. And it's very real.


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