Gulf Way Syndrome in fibromyalgia and chronic fatigue syndrome

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What is gulf war syndrome??
Gulf War Syndrome is a debilitating, multi-system illness that, according to researchers was caused by exposure to toxic chemicals. Many of those chemicals were intended to protect military personnel, such as pesticides against sand flies and other pests and a drug to protect them against nerve gas. Very few of those who developed gulf war syndrome have gotten better.

The Persian Gulf War began in 1991, but more than 170,000 veterans still are battling Gulf War Syndrome. For 17 years they battled stigma and disbelief, but finally in late 2008 a congressionally mandated panel concluded that Gulf War Syndrome is in fact, “real” and is not a psychological condition.

Veterans with Gulf War Syndrome prone to fibromyalgia and CFS, as well as to a few other conditions

Symptoms of Gulf War Syndrome

Symptoms of Gulf War Syndrome include:




>>Joint and muscle pain

>>Chronic fatigue

>>Cognitive dysfunction


>>Pain or discomfort related to sexual intercourse

Of those symptoms, bronchitis, asthma and pain related to intercourse are the only ones shared by FMS and ME/CFS

GWS also is associated with post-traumatic stress disorder and alcohol abuse.

Gulf war syndrome in fibromyalgia and ME/CFS

The jury is still out on why GWS apparently predisposes people to FMS and ME/CFS. The conditions all have similar symptoms and include neurological involvement.

All three conditions are linked to migraine (as an overlapping condition) FMS, ME/CFS, and migraine are all considered to be central sensitivity syndromes, meaning that they involve hyper-sensitivity of the central nervous system.

A 2012 study revealed abnormal pain processing in many cases of GWS, especially when it came to exposure to heat. FMS is known to involve a similar reaction to temperature. This could mean the conditions have a common underlying mechanism.

So is GWS a central sensitivity condition? We can’t answer that question yet but evidence suggests that it could be, or that it’s somehow related to that class of illnesses.

Although we now know an important cause of GWS, the underlying processes involved are still not clear. It’s likely that we’ll have to learn more about all these conditions before we truly understand their relationship to each other.

Diagnosing GWS is similar to diagnosing FMS and ME/CFS. Self-reported symptoms and tests to exclude other possible causes of those symptoms

Living with GWS

Veterans with GWS are eligible for benefits from the veterans Administration, which can help provide asses to proper health care and cover the cost.

The fact that GWS is now officially recognized as a physiological illness should help remove the social stigma and end disbelief in the medical community, which can be physiologically damaging.

The congressional panel on GWS recommended 60-million dollars in annual funding for GWS research. If research is funding at that level, it could provide better treatments in the future. Finally, the outlook for veterans with GWS appears to be improving.

Treating Gulf War Syndrome

So far, there are no specific treatment regimens for GWS.

Currents treatments focus on symptom relief, i.e. drugs for depression and pain, as well as psychological counseling for problems such as depression, anxiety, post-traumatic stress disorder and alcoholism.

Some veterans report finding relief from complementary/alternative therapies, including acupuncture, nutrition, supplements, and hypnotherapy.

Gulf War Syndrome treatment VS FMS and CE/CFS Treatment

Because treatment for all three of these conditions focuses on symptom relief and the symptoms are all so similar, it’s unlikely that treatment for GWS would conflict or interfere with treatment for FMS or ME/CFS.

Any time you’re being treated for more than one condition, however, it’s important to talk to your doctor and pharmacist about possible drug interactions, and to make sure all of sure health-care providers are informed about your treatment and management regimen.

How similar are GWS and Fibromyalgia?

Fibromyalgia is characterized by chronic widespread pain and tenderness, problems sleeping, fatigue, and problems with concentration and memory. It is diagnosed using two scales, the widespread pain index (WPI) and the symptom severity (SS) scale.

The WPI assess pain experienced when touching 19 different areas on the body. The SS scale has two parts. Part one measures the severity of fatigue, waking unrefreshed and problems with thinking and remembering. Part two tallies the number of other symptoms experienced into a few, moderate and many.

These other symptoms may include fibromyalgia and skin rashes, muscle weakness, diarrhea and constipation, vomiting, loss appetite, headache, dizziness, insomnia, numbness in legs, depression, nervousness, abdominal pain, chest pain, blurred vision, fever etc

Fibromyalgia is diagnosed when a person receives a WPI of seven or higher and a SS score of 5 or more or a WPI of 3 to 6 and a SS score of 0 or more. The symptoms must be present at a similar level for more than 3 months and there must be no other illness that would explain the symptoms.

People with GWS do not have to experience muscle or joint pain. Where fatigue or sleeping difficulties are more common, they might fit the criteria for chronic fatigue syndrome more closely. It seems that there may be some common link between these syndromes and science is just beginning to look into what that might be.


Committee on gulf War and Health: Treatment for Chronic Multisymptom Illness; Board on the Health of Select Populations; Institute of Medicine. Gulf War and Health: Treatment for Chronic Multisymptom Illness. Washington (DC): National Academies Press (US); 2013 Apr.

Gopinath K, Gandhi P, Goyal A, et al. FMRI reveals abnormal central processing of sensory and pain stimuli in ill Gulf War veterans. Neurotoxicology.2012 Jun;33(3):261-71.

Institute of Medicine of the National Academies. “Gulf War and Health, Volume 4”

Ismail K, Kent K, Sherwood, et al. Chronic fatigue syndrome and related disorders in UK veterans of the Gulf War 1990-1991: results from a two-phase cohort study. Psychological medicine. 2008 Jul;38(7):953-61.

Rayhan RU, Ravindran MK, Baraniuk JN. Migraine in gulf war illness and chronic fatigue syndrome: prevalence, potential mechanisms, and evaluation. Frontiers in physiology.2013 Jul 24;4:181

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