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This detailed podcast episode delves into the findings of a study on Chronic Fatigue Syndrome (CFS) using functional MRI and immune system analysis. The speaker explains the technology behind functional MRI and what it revealed about brain activity, specifically in the parietal temporal junction, which showed hypoactivity in CFS patients. The discussion extends to immune abnormalities, highlighting immune cell exhaustion, and hypothesizing links to persistent infections. The episode emphasizes the need for interdisciplinary, evidence-based approaches to treating these 'invisible' illnesses and calls for more integrated, patient-centric research. Other discussed topics include the limitations of current medical specialization and the need for generalist knowledge, the role of gut microbiome, and potential lessons from oncology on immune checkpoints.

00:00 Introduction to Functional MRI
01:48 Understanding Functional MRI Findings
04:08 Immune System Insights
04:54 Cancer Research and Immune Exhaustion
09:01 Genetic Susceptibility and Long COVID
10:33 Holistic Approach to Medicine
13:34 Challenges in Treating CFS and Fibromyalgia
15:38 Future Directions in Research
22:40 Gut Microbiome and Immune Response
25:41 Neurodivergence and Immune System
29:25 Conclusion and Final Thoughts

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

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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.*

Text Dr. Lenz any feedback or questions

In this episode, we delve into the ongoing research and new findings related to Chronic Fatigue Syndrome (CFS). The discussion covers the development of standardized diagnostic criteria known as the Hingston Criteria, as well as the discovery of biological abnormalities in CFS patients. Key areas of focus include the autonomic nervous system, heart rate variability, and muscle strength. The episode also touches on the concept of 'effort preference' and the complex interplay between sympathetic and parasympathetic nervous system activity in chronic conditions like CFS and fibromyalgia. Additionally, the episode previews upcoming discussions on findings from functional MRIs of the brain in CFS patients.

00:00 Introduction and Importance of Defining the Disease
00:15 The Hingston Criteria: A New Standard for Clinical Trials
00:59 Biological Evidence and Clinical Trials
02:13 Autonomic Dysfunction in Chronic Fatigue Syndrome
04:14 Sympathetic and Parasympathetic Systems Explained
08:24 Chronic Stress and Its Impact on Health
10:21 Comparing Functional Somatic Syndromes and Stress-Related Syndromes
20:59 Muscle Strength and Cognitive Effort in CFS
22:28 Understanding EMG and Its Diagnostic Value
26:57 Effort Preference and Its Clinical Implications
28:42 Conclusion and Next Week's Preview

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

Joy Lenz

Fibromyalgia 101. A list of fibromyalgia podcast episodes that are great if you are new and don't know where to start.

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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.*

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.*