Elsevier

Medical Hypotheses

Volume 81, Issue 3, September 2013, Pages 506-508
Medical Hypotheses

Allostatic overload in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)

https://doi.org/10.1016/j.mehy.2013.06.023Get rights and content

Abstract

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating condition characterised by diverse symptoms such as fatigue, pain, sleep disturbance and autonomic dysfunction. There remains to be a singular biomarker identified for this illness, hence numerous theories about its development and perpetuation have been posited in the literature. This brief report presents the model of ‘allostasis’ as a framework for understanding ME/CFS, specifically the notion that the physiological mechanisms employed in the body to deal with stress termed here as ‘allostatic states’ (e.g. elevation of inflammatory cytokines), may in and of themselves contribute to the perpetuation of the disorder. This theoretical assertion has important consequences for the understanding of ME/CFS and treatment; rather than searching for a singular pathogen responsible for this condition, ME/CFS can be conceptualised as a maladaptive stress disorder and interventions aimed at addressing the allostatic states may be incorporated into current symptom management programmes.

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Funding statement

No external funding was awarded for this work.

Conflict of interest

None.

Acknowledgements

I am grateful to colleagues at the Optimum Health Clinic for discussions around this topic and feedback on drafts; namely Alex Howard, Anna Duschinsky and Thora Blondal.

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