So how can so many causes result in an illness that has so many symptoms? Stresses, car accidents, surgeries etc. happen to everybody. Why do only some people come down with FM/CFS? The answer is that we all have a unique biochemical individuality and susceptibility to disease with unique weaknesses. In FM/CFS patients I have seen a degree of sensitivity that puts them at risk of developing the condition given the ups and downs of life circumstances. This sensitivity is in the neurological system, which is the master control of all body functions.

I believe that FM/CFS is a neuroendocrine dysfunction that happens to people with sensitive nervous systems. The disorder happens right at the cellular and metabolic level causing widespread symptoms in many of the body's systems that is at an invisible level such that most of you do not appear to be ill at all to an outside observer and standard medical tests are negative.

The main location of the dysfunction is the mid-brain which is our emotional, instinctive or animal brain as opposed to the higher brain which controls our thinking and intellectual functioning. Pain signals from the body coming up the spinal cord pass through the mid-brain before reaching the higher brain or cortex and we become aware of the location and severity of the pain. A dysfunction in the mid-brain may result in pain signals becoming magnified from anywhere in the body. The pain can come and go from various muscles. The fact that there are days in which a muscle has no pain suggests that there is not really anything wrong with the muscle but rather there is a variation in the function of the nerves relaying signals to the higher brain with the midbrain being a key relay station that can allow intensification of the signals. The endorphin theory explains how this mechanism works. Chapter 5 discusses the brain and nervous system and will give you more details of the endorphin theory. The midbrain also affects our autonomic nervous system, the nerves that serve as the automatic pilot of our internal organs, our blood pressure, heart rate, etc. These nerves go to our lungs, heart, bowels, bladder, uterus and all the blood vessels of our circulatory system. Dysfunction of the midbrain can effect this system resulting in a domino effect on the workings of any or all of our internal organs; low blood pressure may cause dizziness, the heart may have palpitations, the airways may constrict, the bowels may be irritable, the uterus may cramp up, the bladder may be weak and the blood vessels in the extremities may constrict causing cold hands/feet and paresthesias (similar to our legs "falling asleep" when we sit cross-legged compressing the blood vessels and nerves).

The mid-brain is also the emotional center of the brain and of course any dysfunction would result in emotional difficulties of anxiety, depression and poor stress tolerance. The tiredness of the brain which many of you recognize as "brain fog" spreads from the emotional areas to the cognitve areas. Our intellectual capacities may be affected. PET scans of the brain of CFS patients have been taken for research purposes. The scans show active parts of the brain as bright lights of various colours. CFS patients showed reduced brain activity. Measures of cognitive function also show a reduction of IQ.