CHRONIC FATIGUE SYNDROME

INTRODUCTION

Chronic fatigue syndrome, also referred to as CFS, is recently coming to light as one of the main causes of excessive fatigue in otherwise healthy individuals, which can not be explained by an underlying medical condition. If the source of the fatigue can be identified or explained, the patient most likely does not suffer from chronic fatigue syndrome. A hallmark of CFS is that it does not improve with rest, although it can worsen with stress and physical exertion. It is also called systemic exertion intolerance disease.

Patients with CFS may be depressed because of their inability to perform normal duties at home and at work, but they are not depressive individuals per se.

CAUSES:

Scientists don’t know exactly what causes chronic fatigue syndrome. It may be a combination of factors that affect people who were born with a predisposition for the disorder.

Some of the factors that have been studied include:

Viral infections. Because some people develop chronic fatigue syndrome after having a viral infection, researchers question whether some viruses might trigger the disorder.

Suspicious viruses include Epstein-Barr virus, human herpes virus 6 and mouse leukemia viruses. No conclusive link has yet been found.

Immune system problems. The immune systems of people who have chronic fatigue syndrome appear to be impaired slightly, but it’s unclear if this impairment is enough to actually cause the disorder.

Hormonal imbalances. People who have chronic fatigue syndrome also sometimes experience abnormal blood levels of hormones produced in the hypothalamus, pituitary glands or adrenal glands. But the significance of these abnormalities is still unknown.

SIGNS AND SYMPTOMS

Chronic fatigue syndrome has eight official signs and symptoms, plus the added symptom of fatigue. These include:

Fatigue

loss of concentration and/or memory

enlarged lymph nodes in the neck or armpits

sore thoat

unexplained muscle pain

headache of a new type or severity

migratory pain (pain travelling from one joint to another). Usually there is no swelling or redness in the joint

exhausting sleep (unrefreshing sleep)

extreme exhaustion lasting more than 24 hours after physical or mental exercise

Patients with CFS typically report problems with short-term memory but not with long-term memory. They may also report verbal dyslexia that is manifested as the inability to find or say a particular word during normal speech. This typically disturbs patients with CFS and may interfere with their occupation.

MANAGEMENT

Although CFS is a diagnosis of exclusion (diagnosed when other possible causes of fatigue and other presenting signs and symptoms are ruled out), laboratory tests should be performed. They have two functions in chronic fatigue syndrome (CFS). First, they may be used to assess the possibility that another condition is causing the fatigue; second, they may be used to help diagnose CFS. CFS laboratory abnormalities are not specific, but, taken together, they can make up a pattern consistent with CFS in patients who have a cognitive dysfunction in whom other diseases have been excluded as a cause for their fatigue.

The basic battery of test that might be performed by your doctor will include:

  • Complete blood count (CBC)
  • Liver function tests
  • Thyroid function tests
  • Erythrocyte sedimentation rate (ESR)
  • Serum electrolyte level measurement

In terms of treatment, there is no known cure for CFS. However, in the long run, multi-pronged approach towards the issues will help the patient cope with it in a better way. These include graded exercise (gradually increasing levels of physical activity), pacing ones self, antidepressants and psychological evaluation and therapy to help understand and deal with limitations on a physical level. Decreased stress and improved quality of sleep have shown to result in significant improvement in the energy levels of patients suffering from CFS.

 

Dr. Annie

Physician, mom and wife

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