Charles Lapp, M.D., on the Effective Treatment of Chronic Fatigue Syndrome and Fibromyalgia

From: ImmuneSupport.com

Charles Lapp, M.D., is nationally recognized and sought after as a medical consultant regarding CFS and FM. He is Co-Chairman of the Clinical Affairs Committee for the American Association for CFS, medical advisor to the CFIDS Association of America, and a board member of the American FM Syndrome Association. Dr. Lapp is currently Director of the Hunter-Hopkins Center, P.A., Medical Consultations, in Charlotte, North Carolina, where he is a practicing physician, and is also Assistant Consulting Professor at Duke University Medical Center in Durham, North Carolina.

ImmuneSupport.com: When did you first become aware of Chronic Fatigue Syndrome (CFS) and fibromyalgia (FM) as valid illnesses with real symptoms (what were the circumstances)?

Dr. Lapp: I had never heard of CFS or FM until 1984, when the VP of a Fortune 500 company came to me and described a debilitating illness that was triggered by the flu, and prevented him for working more than 1-2 days per week. Soon after I began researching his case, a similar case presented to my office, then another, and another. Before long it became clear that many of these cases were related, so I called the CDC to report a possible epidemic. The CDC put me in touch with two other groups (Dan Peterson and Paul Cheney in Lake Tahoe, and David Bell in Lyndonville, NY) who were experiencing similar epidemics in their towns, and thus began my new career and ambition! As you probably know, Paul, David and I collaborated together in Charlotte, North Carolina, for several years, during which time we pretty much set the foundation of our clinical knowledge today.

Most doctors who study both CFS and FM find the two disorders so similar that we consider them “identical” for all intents and purposes. There are some subtle differences, however. CFS is most likely triggered by an infectious or flu-like illness, whereas a number of FM cases are triggered by minor injury or trauma. CFS is characterized biochemically by elevated levels of RNaseL (an anti-viral enzyme), whereas FM is unique in having excess Substance P (which triggers pain in nerves) in the bodily fluids. Profound exertional fatigue, post-exertional malaise, deep myalgias, sleep disruption, cognitive dysfunction, and autonomic abnormalities are common to both. FM tends to be a more persistent ailment, whereas studies have shown more spontaneous improvement in PWCs (Persons with CFS). Persons with “pure FM” (that is, minimal cognitive dysfunction) tend to improve with low level, slowly progressive exercise, whereas persons with CFS are more likely to flare or relapse with even minimal activity.

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Charles Lapp, M.D., on the Effective Treatment of Chronic Fatigue Syndrome and Fibromyalgia