To begin with, as a former chronic fatigue syndrome (CFS) sufferer and with 20+ years as a ceaseless and somewhat more objective researcher, I am in the unique position to shed much needed light on the extraordinarily related syndromes/disorders in this article. For decades researchers all over the world have been spending an enormous amount of time and labor searching for logical causes of chronic fatigue syndrome, autism, Asperger's, and fibromyalgia, and only catching many solitary glimpses of what's going on in those affected by them by exploring, understanding, and explaining in research studies the separate disorders such as immune, cognitive and digestive dysfunction; this approach reminds me of the story of the blind men who start walking around an elephant touching its tusk, its tail, its ears, its sides, its rear, and each blind man taking with him an extremely limited idea what the animal is really like. The current method the medical/scientific world is using to investigate what's wrong in CFS, autistic, Asperger's, and FM sufferers is like the blind men's approach. Hundreds of millions of dollars can be invested in research for the next 50 years and little progress will come from it. The whole approach is wrong; researchers are analyzing individual disorders and completely missing and overlooking the "big picture."
By now, enough research has been already done in order to draw some hard conclusions; it's simply a matter of putting together the "puzzle pieces" in the "right logical order" and making sense of the many relevant research studies. I propose a different approach: let's look at two "different" and equally challenging "diseases" and compare them; let's compare chronic fatigue syndrome to autism; both have been time and again referred to as mysterious illnesses, and implied to be impossible to overcome by established medical authorities and associations.
I will mainly address CFS and autism and compare them throughout this article. If you have either Asperger's or fibromyalgia, hold on and keep reading until you progress towards the end where I will shine light on both and tell you about their root cause; you cannot properly, or effectively, cure any illness or disease without knowing its root cause. I will tie the four diseases together by showing how they are all interconnected.
In reality, both CFS and autism are basically, by the most part, the same collection of disorders that are manifesting differently in different people with their specific set of symptoms, which interestingly explains why they overlap so often. For a long time, countless people affected by CFS, FM, or asperger's, have been already suspecting the existence of a very strong connection among these disorders/diseases.
These Overlapping Symptoms Are Not Coincidences
I will not only review and substantiate the lingering suspicions that most, if not all, symptoms, disorders, alternative treatments, diet, tendencies, and preferences are strikingly and unyieldingly common among those with CFS and ASD, but also prove ultimately that both diseases share the same root cause, supported by hard facts and solid, verifiable scientific research; I have provided footnotes of all research studies cited in the end of this article. (Please feel free to check them for inaccuracies.)
As I mentioned, there are clinically an overlap of many symptoms of CFS and autism (ASD), which include fatigue; brain fog; cognitive impairment; increased sensitivity to light, sound, and odor; increased tenderness and pain; and impaired emotional contact1 that Dr. Michael Goldberg writes: "In both chronic fatigue syndrome and autism the multifocal areas described--strikingly in the occipital lobes and always more extensively in temporal lobes--suggest strongly the inflammatory nature of both disorders, at vascular or cellular level (vasculatis versus cellular damage), thus opening expectations for early diagnosis and hopefully for treatment for these and other potentially related crippling diseases."2
Where's the Proof?
I will provide monumentally convincing proof that will prove that there exists a powerful connection between CFS and autism. Anything less, will fail miserably. Here we go.
In two studies, researchers found abnormalities in the gut microbiome of both CFS and ASD groups. The lead author of another study, Ruth Ann Lana says: "We saw the biggest differences in the autism group who had gastrointestinal symptoms."3 In a study, Dr. Maureen Hanson says: "Our work demonstrates that the gut bacteria microbiome in chronic fatigue syndrome patients isn't normal, perhaps leading to gastrointestinal and inflammatory symptoms in victims of the disease."4 Both CFS and autistic patients showed abnormalities in their gut microbiome.
A study showed neuroinflammation in the brain of CFS patients. A Japanese researcher explains: "Neuroinflammation is present in widespread brain areas in CFS/ME patients and was associated with the severity of neuropsychological symptoms."5 I emphasize, this neuroinflammation was linked with the severity of neuropsychological symptoms. In another study, researchers observed: "ASD does not have a distinct pathogenesis or effective treatment. Increasing evidence supports the presence of immune dysfunction and inflammation in the brains of children with ASD."6 Both CFS and autistic patients have inflammation in their brains.
New research shows a connection between CFS symptoms and decreased thyroid hormone levels, indicating CFS could be explained by decreased thyroid hormones.7 A study from Stanford University Medical Center found a correlation between reduced levels of vasopressin, a hormone, and the autistic children's inability to understand the fact that their thoughts and motivations may differ from others.8 Thyroid dysfunction is often found in autistic children.9 Again, one sees a commonality in decreased hormone levels in CFS and autistic patients.
A study in Great Britain showed that 70% of ME/CFS patients have extreme structurally abnormal mitochondria. Because the mitochondria are working improperly, the body's cells and tissues are starved for energy, which in turn makes the body depend on anaerobic metabolism, which then results in poor concentration, muscle pain, fatigue, headaches, poor recovery from physical activities, and gastrointestinal dysfunction.10
In another study, the decreased nicotinamide adenine dinucleotide oxidase activity seen in lymphocytic mitochondrial from autistic children was markedly lower than compared with controls. Most autistic children had complex 1 activity that fell below control range values. At the results, researchers concluded: "Evidence of decreased activity of mitochondrial respiratory chain complexes, evidence of the presence of biomarkers of oxidative stress and mitochondrial dysfunction as well as indication of mtDNA mutations (deletions and replications)," as compared to normally developing children.11
In general, both CFS and autistic patients suffered from mitochondrial dysfunction.
CFS patients complain about abdominal pain which regularly plays a key role in the diagnosis of IBS or gastroparesis, which are quite common in CFS.12 About half of autistic children have abdominal symptoms that resemble IBS.13 Once more, one sees another common symptom.
A new study indicates that an immune response in the brain explain the inexplicable cognitive impairment that CFS sufferers call "brain fog."14 Autistic children also experience "brain fog."15 Theoharis C. Theoharides explains: "Brain fogis defined by reduced cognition, concentration, and short-term memory found in patients with autism spectrum disorders (ASDS), chronic fatigue syndrome, fibromyalgia, mastocytosis, and 'minimal cognitive impairment,' is an early presentation of Alzheimer's disease."16
Although a study found no major differences in sleep architecture between controls and CFS patients, researchers did find important changes in heart rate variability measures between CFS and control groups during sleep. In addition, they saw decreased sleep efficiency and decreased total sleep time in CFS patients.17
A new study showed that autistic children who sleep less had lower intelligence scores as well as more severe autistic symptoms, as compared to kids who slept more. This is vital information since insomnia affects up to 80% of autistic children, and they have problems either falling or staying asleep.18
Sensory Processing Disorder & Sensory Overload
Because hypersensitivity is thought to be a significant mechanism of CFS, CFS sufferers' bodies react strongly to all sorts of sensory input.19 Moreover, these patients experience a difficult time processing a ton of input, all at once, and often seek isolation by running away to a room to recover from sensory overload.
In another study, one researcher says: "Individuals with ASD have also been shown to have ubiquitous challenges in sensory processing with over 90% of children with autism reported to have atypical sensory related behaviors."20
First-hand accounts and scientific research tell us that autistics process sensory information differently. Autism is commonly associated with hypersensitivity to sensory input,21 which makes sensory overload much more possible like CFS sufferers.
As you see, both CFS and autistic sufferers experience sensory processing challenges and sensory overload quite frequently; a coincidence only?
There exists a powerful association between CFS with pain catastrophizing, which is defined as rumination, magnification, and feelings of hopelessness linked with either real or anticipated pain.22,23,24
A UT Dallas scientist led a study establishing a connection between autism and pain sensitivity. Dr. Xiaosi Gusaid found the following from the study:
- it verified that autistics are hypersensitive to pain
- it showed that when autistics anticipate painful stimulus, their brains create greater neural responses in the ACC
- the more brain activity autistics demonstrate during pain anticipation, they score less on empathy quotient questionnaire22
Another study confirmed that autistic individuals are not only hypersensitive to pain but again showed that when autistics anticipate painful stimulus, their brains often generate more neural responses in the ACC, as compared to non-autistic participants.25
Brain Imaging Abnormalities
With the use of many brain imaging methods, small studies have demonstrated a number of differences between CFS patients and controls which include reduction in cerebral blood flow, volume loss in gray and white matter, greater ventricular lactate, and increased activation of either astrocytes or microglia.26,27 It had been shown that by improving brain blood flow improves cognitive-related symptoms in patients with ME/CFS.28
Findings from a new study which was published in JAMA Psychiatry, showed structural abnormalities in the brain's white matter that matched up consistently with the severity of autistic symptoms. Researchers who analyzed digital images of 69 autistic brains, explain that the link between white matter structural patterns and symptom severity was most evident in the area of the brain called corpus callosum.29
Misdiagnosed as a Psychiatric Disorder
CFS has a long notorious history of being mistaken continuously for a mental disorder. In 2015, a researcher of National Academy of Medicine cautioned: "Many healthcare providers are skeptical about the seriousness of (CFS), mistake it for a mental health condition, or consider it a figment of the patient's imagination."30
Pauline Anderson remarked: "Investigators at the Institute for Clinical Evaluative Sciences (ICES) and York University in Toronto, Canada, found that 51% of young adults aged 18 to 24 years with ASD had received at least one psychiatric diagnosis."31
In a study where there was a total of 784 young people with a diagnosis of chronic fatigue syndrome, the patients also had irritable bowel, agoraphobia, eating disorder, etc.32
In another study, 172 children with ASD and their parents participated. According to the parent assessment for total anxiety and panic disorder/agoraphobia, more than 50% of the autistic children experienced some degree of subclinical anxiety symptoms.33
Routines and Habits
It's well known as a fact that CFS and autistic sufferers perform better when there are firmly established routines and habits. One CFS patient shares: "I decided that I could reduce the energy expended in pacing if I could automate my behavior. I found three ways to do that: rules, routines and reminders. All three were ways to help me to create new habits, so I automatically did the right thing.
"Routines meant having a regular schedule which enabled me to avoid a lot of decision making. Instead of having to ask whether something was or was not within my envelope, I tried to stick to a schedule I knew was safe."34
Dr. Gordon writes: "Routines can be a large part of a child's life when it comes to autism. Many individuals with autism like things to go a certain way. For example, eating at a certain time, going to bed in a certain position in a specific place, etc."35
Even routines are rather common among the CFS and autistic communities; is this merely a coincidence or a sure sign of an unwavering pattern between CFS and autism?
Obsessions and Repetitive Behavior
I remember that as a CFS sufferer, during the most challenging years of this horrible never-ceasing disease, I found myself obsessing with the same repetitive actions and thoughts; I was needlessly very obsessive without knowing exactly why. People who have autism are notoriously well-known for their repetitive behaviors such as spinning tops and repeating certain words and phrases over and over again. Dr. Boyd, a UNC researcher, theorizes that the autistic children's repetitive behaviors might differ widely, but share in common one thing; the doctor says: "What connects this broad category of behavior is inflexibility,"36 meaning, autistic people have a tendency to obsess with almost anything.
In a study, Dr. Michael Maes and his team of researchers, at the Maes clinics in Belgium, measured the amount of CoQ10 in plasma in 58 CFS patients and in 22 normal healthy controls. The researchers discovered that the plasma CoQ10 levels in the CFS participants were markedly lower than the healthy group's CoQ10 levels. Almost half of the CFS participants had plasma CoQ10 levels below the lowest plasma CoQ10 concentration in the healthy control group.Decreased CoQ10 levels were connected with higher levels of tiredness and automatic symptoms like anxiety, insomnia, IBS, etc.37
NADH levels were found to be lower in CFS patients as compared to healthy individuals. In addition, low NADH levels are associated with low CoQ10 levels in CFS.
Fact: Coenzyme Q10 takes part in cellular energy production.
In 2016, researchers in Spain treated CFS patients with a daily dose that combined 200 milligrams of CoQ10 and 20 milligrams of nicotinamide adenine. CFS patients undergoing the treatments of oral CoQ10 and NADH for 8 weeks saw a major improvement in fatigue levels. Moreover, the levels of ATP, citrate synthase, CoQ10, and NADH rose.
In another study, 60 children participated, divided into two groups, half having autism and the other half being healthy. The study's aim was to analyze the concentration level of CoQ10 in both groups. The concentration levels of CoQ10 in autistic children were significantly lower than the healthy group.38 In addition, findings from a study showed that autistic symptoms improved when taking 50mg of CoQ10 twice daily.39
In summary, not only did CFS and autistic patients have significantly lower levels of CoQ10 but their symptoms also improved when administered with a supplement of CoQ10 for a decent period of time.
According to a study, CFS patients received a total of 15 treatment sessions of HBO2 therapy for three straight weeks, five days each week. Both Fatigue Quality of Life Score and Severity Scale were assessed prior to the treatment and after the end of the 15 sessions. After treatment, CFS patients' scores improved in respect to VAFS (visual analog fatigue scale) FSS, and FQLS. Researchers concluded that HBO2 therapy reduces the severity of symptoms and provides a boost in the life quality of CFS patients.40
In a study, Kinaci et al has reported on the favorable neurological effects of HBO2 at 1.5 atm/100% oxygen for 50 60-minute sessions daily in 108 autistic children. After the treatment, SPECT scans showed that 82.4% of autistic participants improved in temporal lobe perfusion, 85.3% improved in frontal lobe perfusion, and 75.8% improved in other brain areas. Researchers also observed behavioral improvements in these children.41
In conclusion, CFS and autistic participants experienced improvements in their symptoms during and after the oxygen therapy sessions; just a coincidence?
Dr. Sara Myhill writes: "What is interesting is how B12 is beneficial in so many patients with fatigue, including those suffering with CFS, and this suggests that there is a common mechanism of chronic fatigue which B12 is effective at alleviating, regardless of the cause of the fatigue."42
In a recent study, 51 patients with CFS received vitamin B12 nasal drops as an alternative to the vitamin B12 injections. 34 patients reported responding favorably to treatment. Two thirds of CFS patients saw improvement of CIS2 or fatigue scale, of the RAND-36 physical functioning scale, and an important increase in serum vitamin B12 levels.43
At the Defeat Autism Now! 2004 conference, Methyl-B12 was awarded "most recommended medical treatment" for autism spectrum disorders by the attending DAN! doctors. Moreover, Dr. James Neubrander writes: "In my practice, 94% of children (with autism) have been found to respond to Methyl-B12 therapy. Executive function is improved in 90% of children--things like awareness, cognition, appropriateness, eye contact when called, and 'just being more like a normal kid.' Speech and language is improved in 80% of children--all phases including spontaneous language, more complex sentences, increased vocabulary, etc. Socialization and emotion is improved in 70% of the children."44
Qigong or Qigong Sensory Training
In a study, 18 CFS patients were enrolled for weekly Qigong sessions; the whole treatment lasted for 6 months. Not only did researchers observe major improvement in sleep rate score but also saw improved mental health and physical functioning in CFS participants.45
In another study, in one session, 20 children age 4 to 7 with ASD saw pictures of emotional faces before and after receiving Qigong sensory training (QST). One researcher observes: "Heart rate variability was recorded throughout the visit, power in the high frequency band was calculated to estimate parasympathetic tone in 5-s nonoverlapping windows, and cerebral oximetry of prefrontal cortex was recorded during rest and during viewing emotional faces. The results: during the therapy parasympathetic tone grew more in autistic children. The prefrontal cortex response to emotional faces was more pronounced after therapy as compared to controls."46
In yet another study, 13 autistic children who received Qigong treatment for sensory impairment, were evaluated. They got daily therapy for 5 months. As compared with untreated children, the treated autistics improved significantly in their sensory impairment and showed greater social and basic living skills on standardized measures. Moreover, all the children with sleep and bowel problems demonstrated improvement after treatment.47
Because food sensitivity plays a potential role in immune, genitourinary, and gastrointestinal impairments, they are used for the diagnosis of ME/CFS. In a study, in which 55 young ME/CFS, milk-intolerant patients who participated in a milk-free diet, saw improvements in systemic and upper gastrointestinal symptoms, occurring within two weeks of beginning the new diet.48
In a study of 20 kids who switched to a milk-free diet, showed a major reduction in their autistic behavior.49 Another study demonstrated significant improvement in the autistic behavior of children going on a diary-free diet.50
Before I continue, I want to point out that the list of similarities of symptoms, treatments that work for CFS and autism, and the diets that helped both, can go on, adding exhaustively many more pages to this article. But not to bore and abuse the reader, I end the list here. For example, I could have compared the reduced glutathione levels, abnormality in metabolism, disturbances in phospholids, purines, spingolipids, ceramides, and sphingomyelins found in CFS and ASD,51 and seemingly never stop comparing several more amazingly similar "traits."
Fibromyalgia and Asperger's
I will now take a brief detour by addressing first fibromyalgia (FM), and then Asperger's. Many studies have found an important clinical overlap of CFS and FM symptoms, with most sufferers meeting criteria for both syndromes. In fact, some people who have CFS, also have FM, and vice versa. The only big difference between the two is that CFS patients experience greater tiredness, while FM patients experience significantly more pain than fatigue.
Moving on, what differentiates Asperger's syndrome from classic autism are its less severe symptoms, the lack of language delays, and the fact that people with Asperger's are not intellectually impaired.
Although Asperger's Disorder was listed in the Diagnostic and Statistical Manual of Mental Disorders in 1994 as a separate disorder from autism, many medical professionals still consider Asperger's Disorder as a less severe type of autism.52 Moreover, the two disorders are so similar, sharing many characteristics that Asperger's ceased to be recognized officially as a separate syndrome, when it disappeared from the Manual's fifth edition back in 2013; what occurred soon was that DSM-5 substituted Autistic Disorder, Asperger's Disorder, and other pervasive developmental disorders by putting them under the umbrella of autism spectrum disorder (ASD). Doctors have been instructed to diagnose Asperger's and autism as "autism spectrum disorders."53 So, in essence, high functioning autism is exactly Asperger's; there's no difference between these two. Thus, autism is Asperger's, but to a lesser degree in severity.
There are more than enough striking similarities such as cognition and sensory processing impairment problems with stimuli, marked social withdrawal, increased levels of oxidative stress, and a th2 immune response shift that Dr. Naviaux observes: "ASD and ME/CFS are on the same biological spectrum." He has personally encountered young patients with ASD in his clinic who go on interestingly to develop ME/CFS, and older patients with ME/CFS who develop autistic-like symptoms of social withdrawal, mutism, OCD-like symptoms, and sensory hypersensitivities;54 for certain, these fascinating occurrences are far from being mere coincidences.
Indeed, there are far too many similarities, far too many common symptoms, disorders, and even the very same treatments that relieve several similar symptoms, even showing the same tendency to have a routine-oriented preference and to be obsessive that all these amount to overwhelming evidence that the two principal diseases, CFS and autism (ASD), must without a doubt, share a common root cause, which is revealed when Tito Mendoza, the main character, discovers a two-step procedure, in King of the Bullies, that initiates his lengthy journey to a total recovery from chronic fatigue syndrome.
How They Are Connected: Solving the Enigma of CFS, Autism, Asperger's, and Fibromyalgia
I wish to make one point perfectly clear: the diagnosis itself of all four different syndromes/disorders is currently contributing largely to the general prevailing confusion and mystery surrounding them; the official name change, which I mentioned above, from Asperger's to ASD, is enough proof to show how superficial and counterproductive these labels can be; are we not splitting hairs with these different names? Don't let each syndrome's or disorder's name confound you. Think of the four syndromes/disorders like "bad guys" who cause a collection of many health problems that sometimes overlap; overlapping, for they all belong to the same band of "robbers," each playing a key and harmful role in robbing you out of your precious health.
I know the following statement will raise an outcry from some people with fibromyalgia and Asperger's: since both CFS and FM are so closely-related and autism and Asperger's are also, they are all essentially the same disease with the sole difference being that they differ from one another, from mildness to marked severity in certain symptoms. What is happening is that chronic fatigue syndrome, autism, Asperger's, and fibromyalgia are manifesting differently in different people because of the varying degrees of the root cause that is currently affecting them; the more of this root cause that they have--creating widespread havoc in their bodies--the more severe symptoms they will demonstrate, and accordingly, they will be labeled either CFS, FM, ASD, or Asperger's during the diagnosis. Inversely, the less of this root cause that they have, the less severe symptoms they will demonstrate; thus, some children may be diagnosed to have Asperger's instead of autism.
Let me explain the existing connection another way among the four syndromes/disorders: for example, if four people happened to inhale each a different amount of cadmium, that metal would spread itself randomly and enter various organs throughout their bodies; and since each person could potentially display a unique set of symptoms, depending which organs are affected more, they may each realistically receive a different diagnosis, from the same doctor, or doctors; that is what's happening with CFS, ASD, Asperger's, and fibromyalgia sufferers: everyone affected is showing overlapping and similar symptoms, because they all share the same root-cause.
Therefore, because the four syndromes are interconnected, what cures Tito Mendoza in King of the Bullies from CFS, will certainly also cure autism, Asperger's, and fibromyalgia with the same treatments that he uses.
Side note: The treatment which is recommended by a renowned doctor and unmistakably helps Tito recover from chronic fatigue syndrome, is mentioned in King of the Bullies. All the treatments that he experiments with extensively during the four-year experimental phase, are not only named but the amount taken, how often, how long, and whether or not he saw measurable improvements in his CFS symptoms. King of the Bullies is more than a story about a man being unjustly and secretly persecuted by the FBI; it's one man's true account of how he recovers agonizingly slowly from chronic fatigue syndrome, and also a "treatment guide" by which anyone with CFS, autism, Asperger's, and fibromyalgia can use to cure him/herself.
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