Chronic Fatigue Controversy

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Chronic Fatigue Controversy

Are exercise and behavioral therapy the answer? Maybe not

By Working Nurse
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For years, clinicians and even the CDC have recommended that patients with chronic fatigue syndrome (CFS) try exercise and cognitive behavioral therapy (CBT). Now, critics contend that these often-repeated recommendations may be based on faulty research.

Research Under Fire 

Among the biggest challenges facing the million or more, mostly female patients who suffer from CFS in the United States is that doctors often dismiss this debilitating condition as deconditioning or a psychological problem. Two highly influential British studies, based on the same five-year clinical trial, found that many patients improved or even recovered after a year of CBT or graded exercise therapy (GET).

 Those conclusions have come under fire from patients and critics like Rebecca Goldin, Ph.D., director of the nonprofit organization Sense About Science USA’s STATS project. Goldin charges that “the flaws in this [trial’s] design were enough to doom its results from the start.” The researchers who conducted that trial continue to defend their results and methodology. However, a new independent analysis, published in September on the virology blog of Columbia University microbiology professor Vincent Racaniello, Ph.D. (, claims that the trial data actually reveals little meaningful evidence of improvement or recovery with either GET or CBT. 

What Does This Mean for Patients? 

This controversy is another reminder that there’s still no real scientific consensus about what causes chronic fatigue syndrome or even how to properly diagnose it. Patients may take some comfort in knowing that two expert committees organized by the Institute of Medicine and National Institutes of Health have both agreed that CFS is real, it is serious and it isn’t just in patients’ heads.

 A Columbia University study, published in Science Advances in 2015, found evidence that CFS may actually be an unusual form of immune system exhaustion. If that’s true, it may lead to better diagnostic techniques and finally some better treatment for this poorly understood condition.   

Check Out These Online Resources:

The direct link to the reanalysis of the CFS data 

Rebecca Goldin's (absolutely withering) critique

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