Diagnostic Criteria For Me/cfs Using The National Academy Of Medicine Clinical Criteria
For a diagnosis of ME/CFS, the person must have the following three symptoms:
Diagnosis also requires at least one of the following two symptoms:
It is important to note that these are not the only symptoms of ME/CFS, just the minimum needed to meet the diagnostic criteria.
While diagnosis requires that a person has had symptoms continually for six months, early intervention with pacing and rest can help reduce symptoms, improve quality of life and reduce the risk of exacerbating the disease. Research suggests that patients who are able to pace their activity and not push themselves tend to do better in the long term. Pacing and rest can start even prior to an official diagnosis.
While there is currently no cure and no evidence-based treatments, it is important to find a doctor who is not only sympathetic to ME/CFS, but can work with you to help manage your symptoms.
Try Heating And Cooling To See What Helps
Temperature sensitivity is another common symptom of ME/CFS. Its sometimes easy to overheat and difficult to cool back down. You can mitigate this symptom by using heating or cooling products. Try taking a warm or cool bath with Epsom salts before bed to optimize your temperature.
If your muscles are uncomfortably tight, you can use heat to soothe them. You can try using a heating pad, hot water bottle, or heated slippers. This will warm you up and relax your muscles at the same time.
Dealing with chronic fatigue syndrome can be frustrating, but there are many approaches you can take. Using supplements for CFS is another approach that has been shown to potentially improve your quality of life.
In addition to medication, you can also mitigate your symptoms by making healthy lifestyle changes.
Finding the right balance to ensure that your symptoms are under control is tricky. But its also essential to living a fulfilling life! You can do this.
Complementary And Alternative Therapy
There is no good evidence that diets, supplements, homeopathy, and phototherapy are effective in treating CFS. Despite their lack of proven benefit, complementary and alternative treatments are used by the majority of CFS patients. In a large RCT of paced exercise in patients with CFS, 70% of subjects were using some form of CAM, 31% were seeing a CAM practitioner, and 64% were taking a CAM medication. CAM use did not correlate with any clinically important trial outcomes.
A systematic review of 26 RCTS involving 3,273 CFS subjects included trials of mind-body medicine, massage, tui na and tai chi, homeopathy, and dietary supplements, including ginseng and nicotinamide adenine dinucleotide . Studies of qigong with meditation, massage, and tui na and tai chi showed these therapies had modest positive effects on CFS symptoms such as fatigue. There was no evidence for benefit from homeopathy. There was no efficacy of dietary approaches, including a low-sugar and low-yeast diet, pollen extract, or supplements, with the possible exception of NADH and magnesium.
A large, controlled report found some benefit from acupuncture in CFS. Patients who benefited from acupuncture were treated for 4 weeks and were able to continue their usual care.
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Causes Of Extreme Fatigue
Many people struggle with fatigue, which has many causes some obvious, others not so much. Causes of chronic fatigue include poor quality or not enough sleep, a bad diet, not exercising, and metabolic and hormonal imbalances. It becomes a vicious cycle when fatigue sets in and worsens your fatigue.
But you can manage your fatigue when you first figure out the root causeor causes of feeling tired all the time. Some reasons why you might feel extreme fatigue include:
- Adrenal burnout
- Other hormonal imbalances like testosterone, estrogen, and cortisol
- Being a perfectionist
- Being around overly critical or negative people
- Not having a positive mindset
- Food sensitivities
- Mitochondrial dysfunctions mitochondria are those little power plants in your cells. Malfunctioning mitochondria can create massive energy crashes.
- Overexercise a good workout should leave you feeling energetic and strong. Overexercising or overtraining can have the opposite effect, creating chronic fatigue that zaps your energy and mood.
- Toxicity including things like environmental pollutants, but also less-obvious toxins, including mold, mercury from amalgams, and electromagnetic fields from electronics.
This list goes on, and oftentimes multiple factors create or worsen fatigue. On the other hand, chronic fatigue might result from one primary reason, like poor sleep, stress, a bad diet, or not getting the right nutrients. These five strategies may help you boost your energy.
How Should I Take Armodafinil
Follow all directions on your prescription label. Do not take armodafinil in larger or smaller amounts or for longer than recommended.
Armodafinil may be habit-forming. Never share armodafinil with another person, especially someone with a history of drug abuse or addiction. Selling or giving away armodafinil is against the law.
Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.
Armodafinil is usually taken each morning to prevent daytime sleepiness, or 1 hour before the start of a work shift to treat work-time sleep disorders.
You may take armodafinil with or without food.
Armodafinil is usually given for up to 12 weeks. Follow your doctor’s instructions.
If you are taking armodafinil to treat sleepiness caused by obstructive sleep apnea, you may also be treated with a continuous positive airway pressure machine. This machine is an air pump connected to mask that gently blows pressurized air into your nose while you sleep. The pump does not breathe for you, but the gentle force of air helps keep your airway open to prevent obstruction.
Do not stop using your CPAP machine during sleep unless your doctor tells you to. The combination of treatment with CPAP and armodafinil may be necessary to best treat your condition.
Store at room temperature away from moisture and heat.
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Central Nervous System Stimulants May Be Helpful
in Chronic Fatigue Syndrome and fibromyalgia because they increase alertness, concentration, motivation and energy and can assist with circulatory problems. One study suggests they may be able to help with fatigue and pain as well.
Plus, the disorder stimulants are most commonly used in attention hyperactivity deficit disorder appears to be common in fibromyalgia and probably ME/CFS. One study which employed an ADHD self-test found that almost 50% of FM patients tested positive for ADHD.
Increase Your Vitamin B Intake
According to a study published in the Journal of Royal Society of Medicine, researchers found a direct link between reduced vitamin B levels and chronic fatigue syndrome.
The study focused on B-6, riboflavin and thiamine, and researchers believe that B6 is particularly important. Vitamin B6 rich foods include wild tuna and salmon, bananas, grass-fed beef, sweet potatoes, turkey, hazelnuts, garlic and cooked spinach.
Vitamin B6 helps to prevent and relieve fatigue, and it supports a healthy immune system. As stated above, some researchers believe that certain viruses play a role in CFS, therefore increasing B6 levels can be a helpful treatment. B6 helps supports T-cell functioning, allowing them to more adeptly fight infections.
Importance of Methylation
Methylation is the term given to the process in the body where methyl compounds are used in the critical functions of the body immune function, energy production, mood, inflammation, nerve function, detoxification, and even DNA all of which are challenges in chronic fatigue syndrome patients.
Methylation helps you process toxins, make hormones, and even helps in the production of neurotransmitters such as melatonin. How well your body can methylate effects all of these important areas. Poor methylation can lead to a variety of chronic conditions including certain types of cancer, cardiovascular disease, diabetes, allergies, digestive upset, mood and psychiatric disorders, and chronic fatigue.
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Treatments For Chronic Fatigue Syndrome
Since researchers do not yet fully understand the cause of chronic fatigue syndrome/myalgic encephalomyelitis and people with the illness can experience a wide variety of symptoms, multiple treatments exist. Treatments are aimed at managing and reducing the severity of CFS/ME symptoms, rather than at curing the illness.
The Importance Of Education
The physician might need to take an active role in supporting young people with ME/CFS and ensure that they receive an education that is appropriate for their physical condition. Long-term follow-up of young people with ME/CFS shows that engagement in education is a key issue that improves their ability to function regardless of whether or not they recover . Students can become demoralized if they are asked to withdraw from school. Education helps students to fulfill their aspirations and allows important aspects of their lives such as socializing with their peer group, to develop . It widens the range of possible occupations in later life. Work that is low skilled is usually more physically demanding. Although students with ME/CFS have cognitive dysfunction and reduced energy reserves, intellectual reasoning is frequently retained and most students with ME/CFS are capable of keeping up with their peers in some academic classes provided that the number of their classes is strictly limited .
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Bonine Or Dramamine For Dizziness
Dizziness is another common symptom of FMS and ME/CFS. It can be really debilitating.
Motion sickness drugs can help control dizzy spells. They include:
These drugs also are antihistamines , however, they are not as effective for allergy symptoms as diphenhydramine for hives or as effective for allergic rhinitis as the 24 hour antihistamines like cetirizine Check with your healthcare provider or pharmacist before combining them with other allergy drugs.
Vertigo is the feeling that the world is spinning around you. Its different from lightheadedness.
Get 7 9 Hours Of Sleep Nightly
The National Sleep Foundation recommends adults get seven to nine hours of sleep per night. Some questions you can ask yourself to see if you are not sleeping enough include: Does it take me a long time to fall asleep? Do I wake up often or am I restless? Do I feel sleepy when driving? Do I need caffeine to get through the day? Answer, yes, to any of these indicates you may not be getting enough quality sleep.
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Myalgic Encephalomyelitis/chronic Fatigue Syndrome: Essentials Of Diagnosis And Management
- Alison C. BestedAffiliations
- Lily ChuCorrespondenceCorrespondence: Address to Lily Chu, MD, MSHS, Independent Consultant, 16 Lorton Ave, Unit 4, Burlingame, CA 94010.
- Nancy G. KlimasAffiliationsInstitute for Neuro Immune Medicine, Dr Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL
- Jose G. MontoyaAffiliationsDr Jack S. Remington Laboratory for Specialty Diagnostics, Palo Alto Medical Foundation Research Institute, Palo Alto, CA
- Irma R. ReyAffiliationsInstitute for Neuro Immune Medicine, Dr Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL
Who Is At Risk For Chronic Fatigue Syndrome
Because the cause of CFS is not known, its hard to know what might put someone at risk for getting the condition. However, certain factors are seen more often in people with CFS. These factors include:
- Gender. CFS happens up to 4 times more often in women than in men.
- Age. CFS commonly affects middle-aged people, but people of any age can get it.
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Fresh Evidence Points To A Cause And Possible Treatments For Chronic Fatigue Syndrome
Chronic fatigue syndrome, or myalgic encephalomyelitis, has been largely dismissed as psychological. But recent trials of antiviral and immunosuppressant drugs have yielded encouraging results, suggesting a complex disease mechanism at play that researchers are hopeful they might be able to treat.
Anna suffered severe symptoms of chronic fatigue syndrome , a mysterious disease also known as myalgic encephalomyelitis , from the age of 21 years. The disease forced her to abandon her masters degree and leave her job as a teacher. She became increasingly confined to her apartment, removed from the life she once knew. Any time I tried to do something that I didnt have the energy for, I felt nauseous and dizzy, with fever and pains in my joints and muscles, she says.
After a couple of years she sought help from a physiotherapist for her wasting muscles. mentioned this study and asked if she could give my name to the researchers, she says. So in 2008, Anna was enrolled in a phase II double-blind placebo-controlled trial testing a radical new treatment for CFS/ME. The research group, from Norways Helse Bergen University, administered intravenous drips to Anna but she showed no improvement and, after 12 months, discovered she was in the placebo arm of the trial. She was then eligible to receive the real medicine.
For the first time in my life I felt restless because I wanted to do things
Joint Hypermobility Connective Tissue Laxity Ehlers
Some 60% of young patients who meet the criteria for ME/CFS also have joint hypermobility, compared with about 20% of healthy adolescents . Although joint hypermobility is a physical trait that can confer advantages in athletics and dance, some patients with joint hypermobility also have constitutional symptoms including tiredness, difficulty sleeping, gastrointestinal symptoms, arthralgias, myalgias, lightheadedness, and OI suggestive of undiagnosed co-morbid ME/CFS.
Joint hypermobility is one of the clinical features of Ehlers-Danlos syndrome . Other features of this heritable connective tissue disorder can include: stretchy or fragile skin, delayed wound healing, easy bruising, unusually wide or thin scars, striae in the absence of marked weight changes, blue sclerae, easy eversion of the upper eyelids, and a positive Gorlins sign . Some with EDS develop early onset of varicose veins. In the classical form of EDS there can be hemosiderin deposition around the knees and shins. Those with the hypermobile form of EDS are more likely than those with other forms of EDS to have OI . Constitutional symptoms that overlap with symptoms of ME/CFS are common in EDS. Fatigue and pain are substantial contributors to impaired quality of life in EDS . The mechanism for the overlap of ME/CFS and joint hypermobility or EDS has not been explained.
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How Is Cfs Diagnosed
CFS is a very challenging condition to diagnose.
According to the Institute of Medicine, as of 2015, CFS occurs in about 836,000 to 2.5 million Americans. Its estimated, however, that 84 to 91 percent have yet to receive a diagnosis.
There are no medical tests to screen for CFS. Its symptoms are similar to many other conditions. Many people with CFS dont look sick, so doctors may not recognize that they indeed have a health condition.
In order to receive a CFS diagnosis, your doctor will rule out other potential causes and review your medical history with you.
Theyll confirm that you at least have the core symptoms previously mentioned. Theyll also ask about the duration and severity of your unexplained fatigue.
Ruling out other potential causes of your fatigue is a key part of the diagnosis process. Some conditions with symptoms that resemble those of CFS include:
- severe obesity
- sleep disorders
The side effects of certain drugs, such as antihistamines and alcohol, can mimic symptoms of CFS as well.
Because of the similarities between symptoms of CFS and many other conditions, its important to not self-diagnose. Talk to your doctor about your symptoms. They can work with you to get relief.
Before Taking This Medicine
You should not use amantadine if you are allergic to it, or if:
you have severe kidney disease or
you received a live nasal flu vaccine within the past 14 days.
To make sure amantadine is safe for you, tell your doctor if you have ever had:
alcoholism or drug addiction or
mental illness, psychosis, or suicidal thoughts or actions.
People with Parkinsons disease may have a higher risk of skin cancer . Talk to your doctor about this risk and what skin symptoms to watch for.
It is not known whether amantadine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
You should not breast-feed while using this medicine.
Amantadine is not approved for influenza in a child younger than 1 year old. Gocovri is not approved for use by anyone younger than 18 years old.
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What Are The Treatments For Chronic Fatigue Syndrome
There is no cure or approved treatment for CFS, but you may be able to treat or manage some of your symptoms. You, your family, and your health care provider should work together to decide on a plan. You should figure out which symptom causes the most problems and try to treat that first. For example, if sleep problems affect you the most, you might first try using good sleep habits. If those do not help, you may need to take medicines or see a sleep specialist.
Strategies such as learning new ways to manage activity can also be helpful. You need to make sure that you do not “push and crash.” This can happen when you feel better, do too much, and then get worse again.
Since the process of developing a treatment plan and attending to self-care can be hard if you have CFS, it is important to have support from family members and friends.
Don’t try any new treatments without talking to your health care provider. Some treatments that are promoted as cures for CFS are unproven, often costly, and could be dangerous.
Centers for Disease Control and Prevention