Buchwald, D, Garrity, D · Archives of internal medicine · 1994
This study compared 90 patients with three conditions that cause fatigue and other symptoms: ME/CFS, fibromyalgia, and multiple chemical sensitivities. The researchers found that these three conditions are very similar in many ways—patients often report overlapping symptoms, and many people meet the criteria for more than one condition. All three groups used a lot of healthcare services, visiting doctors about 22-40 times per year on average.
This study provides important evidence that ME/CFS, fibromyalgia, and multiple chemical sensitivities may share common underlying biological or pathophysiological mechanisms rather than being completely distinct diseases. Understanding these overlaps helps patients and clinicians recognize that having multiple diagnoses is common and may inform future research into whether these conditions share a common cause.
This cross-sectional design cannot establish causation or determine whether symptom overlap reflects shared etiology or simply represents different manifestations of a single process. The study does not prove that these conditions are the same disease or explain why some patients meet criteria for multiple conditions while others do not. Small sample sizes and recruitment from specialty clinics may limit generalizability to broader patient populations.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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