Assessing The Impact Of Illness On Cognition
Tests can be useful to assess if and how patients cognitive skills, such as concentration, memory, and organization, are or become impacted by illness. This additional testing can also be useful in identifying particular areas in which specific tools or strategies might help. Assessments and strategic interventions may be particularly helpful to children and adolescents with ME/CFS. Academic attendance and performance are important for these patients, and their specific educational needs should be addressed.
Disclaimer: The content of this ME/CFS website is for informational purposes only and does not represent a federal guideline or recommendation for the treatment of ME/CFS. The information provided on this website is not intended to be a substitute for the medical judgment of the healthcare provider and does not indicate an exclusive course of action or treatment.
Dr Cheney On Increasing Blood Volume
Dr. Cheney recommends
- Lying down -Lying down increases your cardiac a whopping 2 liters a minute. Some patients, he cautions, have more symptoms lying down.
- Increasing your fluid intake using Hydralyte or his HomeBrew particularly in the first six or seven hours of the day. (Some patients do not tolerate blood volume enhancement later in the day.
Measurements Of Plasma Brain Natriuretic Peptide Levels For Guidance Of Targeted Therapy Of Cfs
In a case-control study, Tomas and colleagues examined levels of the brain natriuretic peptide and their association with the cardiac abnormalities recently identified in CFS. Cardiac magnetic resonance examinations were performed using 3T Philips Intera Achieva scanner in CFS patients and sedentary controls matched for age and sex BNP was also measured by using an enzyme immunoassay in plasma from 42 patients with CFS and 10 controls. BNP levels were significantly higher in the CFS cohort compared with the matched controls . When these researchers compared cardiac volumes between those with high BNP levels and low BNP , there were significantly lower cardiac volumes in those with the higher BNP levels in both end-systolic and end-diastolic volumes . There were no relationships between fatigue severity, length of disease and BNP levels suggesting that these findings were unlikely to be related to deconditioning. The authors concluded that the findings of this study confirmed an association between reduced cardiac volumes and BNP in CFS lack of relationship between length of disease suggested that findings were not secondary to deconditioning. They stated that further studies are needed to examine the utility of blood BNP to act as a stratification paradigm in CFS that directs targeted treatments.
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Articles On Chronic Fatigue Syndrome
Thereâs no simple blood test or X-ray to diagnose chronic fatigue syndrome â also known as myalgic encephalomyelitis . And many of the symptoms of the illness — deep tiredness, unrelieved by rest or sleep, feeling worse after physical or mental exertion, trouble concentrating, feeling worse after standing and remaining on oneâs feet and other symptoms– are also seen in other conditions, too, making the diagnosis of ME/CFS more difficult.
Configuration And Microfabrication Of Assay
The nanoelectronic assay structure consists of two conductive layers with an insulating layer in between. There are two additional protective oxide layers above and underneath the sensors . The nanometer-sized sensing region of the sensor consists of a 30-nm-thin oxide layer sandwiched between two 100-nm-thin gold layers. The top protective oxide layer is intended to prevent the exposure of the top conductive electrodes to the solutions. There is a thermally grown oxide layer underneath the bottom electrodes to electrically insulate the sensors from the substrate. Each sensors width is 3 m to 5 m. A scanning electron microscopy image of a single sensor is shown in . The sensors are designed in 3D format to improve the molecules-to-sensors hit rate and to help diffusion occur in multiple directions. The sensors were fabricated on 4-in silicon wafers following several optical photolithography, deposition, and etching procedures.
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Enhancing Blood Volume In Chronic Fatigue Syndrome And Fibromyalgia
You guys are about a litre short in blood volume, ok? If Im sitting at five litres, youre sitting at four. So, youre really, really sensitive to blood volume changes. If youre a little dry, you crash. Dr. Nancy Klimas
Many people with chronic fatigue syndrome are about a liter short of blood
The low blood volume finding in chronic fatigue syndrome has been consistently replicated there is no doubt that low blood volume is common in this disorder. Low blood volume can cause, among other things, reduced blood flows to the brain , problems standing , increased heart rates and reduced heart functioning.
While not the entire answer to chronic fatigue syndrome, increasing blood volume can be quite helpful.
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
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Causes Signs Symptoms Treatments And Controversy
With James L. Wilson, PhD
Excess stress causes the adrenal glands to increase cortisol production.
If you’re feeling tired and fried, chances are you’ve probably heard of adrenal fatigue and wondered if it may be the source of your constant exhaustion. But what exactly is it, and how do you know if it’s what’s causing your lack of oomph? Let’s investigate.
Adrenal fatigue is an increasingly common yet sometimes controversial diagnosis used to indicate depletion of the adrenal glands. Cortisol is a hormone released by the adrenals for use in the regulation of blood pressure. In response to stress, the adrenals release greater amounts of cortisol. Adrenal fatigue is thought to occur when the adrenals have become overtaxed by excess cortisol release and can no longer produce levels of cortisol necessary for optimal body function.
James L. Wilson, PhD, who coined the term adrenal fatigue in his book Adrenal Fatigue: The 21st Century Syndrome, describes the adrenals as two little glands that sit over your kidneys and are about the size of two large grapes and weigh about five-to-eight grams.
According to Wilson, The adrenals put out over fifty hormones. We often only hear about DHA and cortisol, but forty percent of womens estrogen or progesterone are made in the adrenal glands and about forty percent of testosterone in males is made in the adrenal glands.
When Should I Call The Doctor About Chronic Fatigue Syndrome
People seek medical care when the fatigue and cognitive difficulties of chronic fatigue syndrome affect their quality of life. People who have questions about a particular treatment should contact a qualified health-care provider, local medical society, or university medical school for additional information.
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What Is The Concluding Mental Health Assessment And/or Diagnosis
Number three rule taught in medical school is to find a unifying diagnosis for all the symptoms. So, if you have 5 symptoms, you should not be given 5 diagnoses. If your unifying diagnosis is decided to be Major Depressive Disorder , make sure it can explain all your symptoms! Once a medical condition has been ruled out or treated, then the psychiatrist can provide a diagnosis from the Diagnostic and Statistical Manual of Mental Disorders . Specific criteria must be met. You can see the criteria for GAD on Wikipediahere, and here for MDD
What Is The Treatment For Chronic Fatigue Syndrome
There are many described therapies for chronic fatigue syndrome. Because the cause of chronic fatigue syndrome is unknown, treatment programs are directed at relief of symptoms rather than cure. The goal is to regain some level of preexisting function and well-being. With this in mind, many people with CFS do not quickly return to a satisfactory level of function. People who expect a prompt recovery and do not experience it may have worsening CFS symptoms because they work too hard, become frustrated, and become less responsive to rehabilitation programs.
Always talk to your doctor about any treatment decisions for CFS. You and your doctor together will develop a treatment program individually tailored to your needs. The treatment program should be based on your overall medical condition and current symptoms and should be modified over time as your symptoms change. This requires regular follow-up visits to your doctor to monitor changes in your condition. Currently, most doctors use a combination of the therapies discussed below.
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Intravenous Magnesium For The Treatment Of Chronic Fatigue Syndrome
Furthermore, an UpToDate review on Treatment of myalgic encephalomyelitis/chronic fatigue syndrome states that Other modalities that have been tried but have not been successful include amantadine, cimetidine, interferon, magnesium, ranitidine, vitamin B12, bovine or porcine liver extract, dialyzable leukocyte extract, essential fatty acids, evening primrose oil, Biobran MGN-3 , exclusion diets, and removal of dental fillings.
Guidelines For Diagnosing Me/cfs
Guidelines from the National Institute for Health and Care Excellence say doctors should consider diagnosing ME/CFS if a patient has extreme tiredness that cannot be explained by other causes and the tiredness:
- started recently, has lasted a long time, or keeps coming back
- means you cannot do the things you used to do
- gets worse after activity or gentle exercise, such as a short walk
You must also have some of these symptoms:
- problems sleeping, such as insomnia
- muscle or joint pain
- fast or irregular heartbeats
- doing exercise or concentrating makes your symptoms worse
The GP should consult a specialist if they’re unsure about the diagnosis or if you have severe symptoms.
If a child or young person under 18 has symptoms of possible ME/CFS, they may be referred to a paediatrician.
As the symptoms of ME/CFS are similar to those of many common illnesses that usually get better on their own, a diagnosis of ME/CFS may be considered if you do not get better as quickly as expected.
The diagnosis should be confirmed by a doctor after other conditions have been ruled out, and if your symptoms have lasted at least 3 months.
Page last reviewed: 29 October 2021 Next review due: 29 October 2024
What Is Myalgic Encephalomyelitis/chronic Fatigue Syndrome
Myalgic encephalomyelitis , commonly referred to as chronic fatigue syndrome , is a complex disorder characterized by unexplained and persistent fatigue. Generally, it is not the result of ongoing exertion and rest does not improve symptoms. The condition usually results in a substantial reduction of previous levels of occupational, educational, social or personal activities.
Chronic Fatigue Syndrome: Evaluation And Treatment
TIMOTHY CRAIG, D.O., and SUJANI KAKUMANU
Pennsylvania State University College of Medicine, Hershey, Pennsylvania
Am Fam Physician. 2002 Mar 15 65:1083-1091.
Severe fatigue is a common complaint among patients. Often, the fatigue is transient or can be attributed to a definable organic illness. Some patients present with persistent and disabling fatigue, but show no abnormalities on physical examination or screening laboratory tests. In these cases, the diagnosis of chronic fatigue syndrome should be considered. CFS is characterized by debilitating fatigue with associated myalgias, tender lymph nodes, arthralgias, chills, feverish feelings, and postex-ertional malaise. Diagnosis of CFS is primarily by exclusion with no definitive laboratory test or physical findings. Medical research continues to examine the many possible etiologic agents for CFS , but the answer remains elusive. It is known that CFS is a heterogeneous disorder possibly involving an interaction of biologic systems. Similarities with fibromyalgia exist and concomitant illnesses include irritable bowel syndrome, depression, and headaches. Therefore, treatment of CFS may be variable and should be tailored to each patient. Therapy should include exercise, diet, good sleep hygiene, antidepressants, and other medications, depending on the patient’s presentation.
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Blood Test Might Diagnose Chronic Fatigue Syndrome
TUESDAY, April 30, 2019 — Chronic fatigue syndrome is such a mysterious illness that it took years to be recognized as a legitimate ailment, and doctors still struggle to accurately diagnose it.
Now, an experimental blood test has successfully spotted the syndrome, also known as CFS, in a finding that hopefully provides new insights into the inscrutable illness.
The test tracks changes in the electrical pattern of a person’s cells, and it accurately flagged all CFS patients in a small group of 40 people, researchers report.
“When we stress the cells, we can easily differentiate them based on the signal they are showing,” said lead author Rahim Esfandyarpour. “It’s a huge difference.”
Esfandyarpour worked on the test with a team while at Stanford University in California. He’s now an assistant professor of electrical engineering and computer science at the University of California, Irvine.
Currently, doctors must diagnose CFS based on the symptoms a patient has developed. There’s no lab test that can provide a definitive diagnosis.
“There is no biomarker or diagnostic tool,” Esfandyarpour said. “It’s all based on the symptoms.”
Sometimes people are even told it’s all in their imagination. As many as 2.5 million Americans suffer from CFS, and 9 of 10 have not been diagnosed, according to estimates from the U.S. Centers for Disease Control and Prevention.
So they created a way to track the metabolism of cells by observing their electrical activity.
Viral And Other Infections
The term post-viral fatigue syndrome is used to describe CFS-like symptoms that occur after a viral infection. A recent review found Epstein-Barr virus antibody activity to be higher in patients with CFS, and that a subset of patients with CFS were likely to have increased EBV activity compared to controls. Viral infection is a significant risk factor for CFS, with one study finding 22% of people with EBV experience fatigue six months later, and 9% having strictly defined CFS. A systematic review found that fatigue severity was the main predictor of prognosis in CFS, and did not identify psychological factors linked to prognosis. One review found risk factors for developing CFS after mononucleosis, dengue fever or the bacterial infection Q-fever include longer bed-rest during the illness, poorer pre-illness physical fitness, attributing symptoms to physical illness, belief that a long recovery time is needed, as well as pre-infection distress and fatigue. The same review found biological factors such as CD4 and CD8 activation and liver inflammation are predictors of sub-acute fatigue, but not CFS, however these findings are not generally accepted due to the use of the Oxford criteria in selecting patients. The CDC does not recognize attribution of symptoms as a risk factor.
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Chronic Fatigue Syndrome Vs Other Causes Of Fatigue
The tricky thing about fatigue is that its a common symptom of countless different health problems, including CFS. Some of the more obvious culprits include sleep disorders, malnutrition, and anemia, while the less obvious include depression, thyroid problems, and diabetes, according to the NIH.
But the fatigue that comes with CFS is distinct in several ways. Typically, CFS isnt diagnosed until youve been struggling with it for at least six months and find that rest doesnt improve your symptoms. Additionally, CFS-related fatigue may get worse with physical activitywhereas exercise typically increases energy levels in people dealing with depression and stress.
When your tiredness doesnt go away with better sleep , good nutrition, and a low-stress environment, the next step is to see your doctor for a check-up. They can help you rule out more serious underlying issues and help determine whether you have CFS.
Inflammatory Proteins As Biomarkers For Chronic Fatigue Syndrome
Strawbridge and colleagues stated that immune dysfunction has been posited as a key element in the etiology of CFS since the illness was first conceived. However, systematic reviews have yet to quantitatively synthesize inflammatory biomarkers across the literature. These researchers carried out a systematic review and meta-analysis to quantify available data on circulating inflammatory proteins, examining studies recruiting patients with a CFS diagnosis and a non-affected control group. Results were meta-analyzed from 42 studies. Patients with CFS had significantly elevated TNF , interleukin-2 , IL-4 , TGF- and c-reactive protein and 12 proteins did not differ between groups. These data provided some support for an inflammatory component in CFS, although inconsistency of results indicated that inflammation is unlikely to be a primary feature in all those suffering from this disorder. The authors hoped that further work will examine if there are subgroups of patients with clinically-relevant inflammatory dysfunction, and whether inflammatory cytokines may provide a prognostic biomarker or moderate treatment effects.
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Testing For Chronic Fatigue
It is important to test for nutrient deficiencies and possible underlying causes of your chronic fatigue. The Comprehensive Blood Analysis and Organic Acids Test can reveal insight into the numerous physiological and metabolic processes of your body.
With this valuable information, your functional medicine provider can develop a protocol to help improve your energy levels and reduce your chronic fatigue.