Ep 206 The Science behind Chronic Fatigue Syndrome with Dr Nath Part 1

Jun 11, 2025

Dr. Avindra Nath, a renowned neurologist and clinical director at the NIH, joins to discuss chronic fatigue syndrome (ME/CFS) and its relationships with fibromyalgia. He shares insights from his extensive research, including the challenges of accurate diagnosis and the criteria for distinguishing both conditions. The conversation addresses common misconceptions and emphasizes the importance of rigorous patient selection in studies. Dr. Nath also touches on personal experiences and the emotional toll of living with these invisible illnesses, shedding light on their complexities.

Ask episode

AI Snips

Chapters

Books

Transcript

Episode notes

ANECDOTE

Dr. Nath's Career Path

Dr. Avindra Nath's early neurology work with AIDS patients led him to study persistent post-viral neurological symptoms.
This experience directed him toward chronic fatigue syndrome research at NIH following patient and Congressional pressure.

INSIGHT

NIH's Unique Research Advantage

NIH's intramural program allows in-depth, cost-efficient testing beyond typical clinical limits.
This uniqueness enabled comprehensive metabolic, neurological, and cognitive evaluations impossible elsewhere.

INSIGHT

Rigorous Patient Selection

They rigorously selected ME/CFS patients meeting all diagnostic criteria with unanimous expert agreement.
Strict inclusion ensured a pure sample, eliminating diagnostic doubts for reliable study results.

Get the Snipd Podcast app to discover more snips from this episode

Get the app

Text Dr. Lenz any feedback or questions

In this episode, we kick off a series on chronic fatigue syndrome (ME/CFS), often overlapping with fibromyalgia. The discussion features Dr. Avindrah Nath, a leading expert on neurologic infections and intramural clinical director at the NIH. Dr. Nath provides insights from his extensive research on ME/CFS, which includes a comprehensive study involving metabolic, neurologic, and cognitive tests. Delving into the relationships between post-viral syndromes, chronic fatigue, and fibromyalgia, Dr. Nath explains the intensive process of selecting pure patient samples for accurate study results and debunks common misconceptions. The episode also covers the criteria for diagnosing ME/CFS and fibromyalgia, highlighted by personal accounts from those living with these conditions, and explores the controversial topic of whether they represent the same or different illnesses.

00:00 Introduction to Chronic Fatigue Syndrome and Fibromyalgia
02:18 Meet Dr. Avira Nath: Journey into Chronic Fatigue Syndrome
04:38 The NIH Study: Unveiling Chronic Fatigue Syndrome
07:14 In-Depth Testing and Patient Selection
09:44 Diagnostic Criteria: Chronic Fatigue Syndrome vs. Fibromyalgia
13:24 Symptom Comparison and Overlaps
25:34 Patient Experiences and Definitions of Fatigue
29:00 Conclusion and Next Steps

International Conference on ADHD in November 2025 where Dr. Lenz will be one of the speakers.

Support the show

When I started this podcast—and the book that came before it—I had my patients in mind. Office visits are short, but understanding complex, often misunderstood conditions like fibromyalgia takes time. That’s why I created this space: to offer education, validation, and hope. If you’ve been told fibromyalgia “isn’t real” or that it’s “all in your head,” know this—I see you. I believe you. You’re not alone. This podcast aims to affirm your experience and explain the science behind it. Whether you live with fibromyalgia, care for someone who does, or are a healthcare professional looking to better support patients, you’ll find trusted, evidence-based insights here, drawn from my 28+ years as an MD.

Please remember to talk with your doctor about your symptoms and care. This content doesn’t replace personal medical advice.*

...