The Link Between Histamine And Chronic Fatigue Syndrome
Cytokines are not the only chemicals released during an immune response. Histamine is also released as part of the inflammatory process in response to pathogens, allergens, or wounds. When released as part of the immune response, histamines role is to increase capillary permeability so white blood cells can enter capillaries and target pathogens and irritants.
Histamine also plays an important role in maintaining numerous bodily functions, including:
- Sexual function
- Smooth muscle contraction
Our bodies are designed to handle small amounts of histamine to function properly with occasional spikes when responding to foreign invaders. But when your body is in a constant state of inflammation, you end up with an overload of histamine, meaning your body has more histamine floating around than it can break down.
This overabundance of histamine in the body can contribute to many of the symptoms associated with chronic fatigue syndrome. To learn more about how histamine overload can cause fatigue, head over to my post about what to do when histamine goes haywire.
How To Diagnose Chronic Sinusitis
Many patients we see with chronic sinusitis have been to multiple physicians prior without a diagnosis. An exam will usually include a nasal endoscopy, where a very small scope is used to look at the inside of the nose. This process is usually suggestive of the diagnosis, but a low dose CT scan a 3-minute test that can be performed in the office is needed to confirm the diagnosis of chronic sinusitis.
Pediatric Patients With Me/cfs Anticipating Surgery: Special Considerations*
Myalgic encephalomyelitis/chronic fatigue syndrome is a complex, debilitating disease characterized by severe overwhelming fatigue with a substantial loss of physical and mental functional capacity. The cardinal feature is malaise and worsening of symptoms following minimal physical or mental exertion which can persist for hours, days, or weeks and is not relieved by rest or sleep. Other symptoms include cognitive impairment, non-restorative sleep, generalized, or localized pain, and immune, neurological and/or autonomic symptoms. Remissions and relapses are common.
Most young people with ME/CFS demonstrate vasovagal syncope, postural tachycardia syndrome , neurally mediated hypotension and increased venous pooling on tilt table testing. Syncope can be precipitated by catecholamines , sympathomimetics , and vasodilators . Care should be taken to hydrate patients prior to surgery and avoid drugs that stimulate neurogenic syncope or lower BP. Many patients benefit from extra IV fluids in the perioperative period.
Propofol, midazolam, and fentanyl are generally well-tolerated. However, studies in adults have shown that some patients with ME/CFS can be sensitive to histamine-releasing anesthetic agents and muscle relaxants . If possible, they are best avoided. Young patients can also be extremely sensitive to sedative medicationsincluding benzodiazepines and antihistamines.
Garlic, gingko, and ginsengcan increase bleeding by inhibiting platelet aggregation.
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Alternative And Complementary Medicine
Many alternative and complementary therapies have been promoted for ME/CFS. It is difficult to determine whether these therapies actually work, because the symptoms of ME/CFS vary so much from day-to-day. Anecdotal evidence suggests that acupuncture, massage, pilates, and yoga can help pain in some adults, but no published studies have assessed their benefit in young people.
The clinician should identify the use of herbal/natural remedies or supplements. The contents of complementary medicines are not regulated for dose or composition. Caution must be exercised regarding side effects because if used with prescribed medications, there can be interactions.
Unfortunately, in the hope of a cure, parents of young patients with ME/CFS often ask the young patient to try costly, non-established and speculative treatments but find little or no clinical improvement. Feedback from young people with ME/CFS indicated that 80% had tried up to 30 different alternative therapies. Only massage for pain relief and good dietary advice achieved some benefit in up to 30% of patients. A common comment from the patients was that they were glad when their parents stopped shopping around for a cure. . A review of alternative medicine studies in adults with ME/CFS revealed generally poor methodologies and limited evidence of any benefit .
Fukuda Research Case Definition For Chronic Fatigue Syndrome
Patients can be classified as having CFS if they meet the following criteria:
1. The individual has had severe, clinically evaluated, persisting or relapsing fatigue for six or more consecutive months. The fatigue is not due to ongoing exertion or other medical conditions associated with fatigue. The fatigue significantly interferes with daily activities and work.
2. The individual has four or more of the following symptoms, persisting, or relapsing and concurrent with the fatigue:
Post-exertional malaise lasting more than 24 h
Unrefreshing sleep
Significant impairment of short-term memory or concentration
Muscle pain
Pain in the joints without swelling or redness
Headaches of a new type, pattern, or severity
Tender lymph nodes in the neck or armpit
A sore throat that is frequent or recurring
3. A thorough medical history, physical examination, mental status examination, and laboratory tests are necessary to identify other conditions with similar symptoms that require treatment. The diagnosis of chronic fatigue syndrome cannot be made without such an evaluation.
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Fatigue Depression And Chronic Sinusitis
Many individuals with sinusitis will stress to you chronic sinusitis is no minor thing at all. It’s long-term symptoms can lead to fatigue with possible depression or can worsen depression in a few ways:
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As weeks of symptoms continue to drag on, the discomfort can really take a toll. If you already struggle with depression, the added stress the symptoms bring on can make it worse.
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Sleep issues are common in individuals with chronic sinusitis and not obtaining quality sleep could hurt your mood even more.
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Many individuals with this condition have allergies and studies show a possible link between allergies and depression, probably due to the inflammation-promoting immune substances an allergy attack releases.
Once you feel depressed, you may find life to be bleeker and more difficult to manage, including your sinus symptoms. Research has shown depression can enhance sinus-related issues in various ways:
When you’re experiencing both full-blown depression and chronic sinusitis, they can fuel one another and make your symptoms worse. Therefore, treating just one of these conditions might not provide you with total relief. You might have to obtain a professional diagnosis and receive treatment for both of these conditions to feel your best.
How Can I Tell If I Have A Sinus Infection Cold Or Nasal Allergy
It can be difficult to tell the difference between a cold, allergies, and a sinus infection. The common cold typically builds, peaks, and slowly disappears. It lasts a few days to a week. A cold can transform into a sinus infection. Nasal allergy is inflammation of the nose due to irritating particles . Symptoms of a nasal allergy can include sneezing, itchy nose and eyes, congestion, runny nose, and post nasal drip . Sinusitis and allergy symptoms can happen at the same time as a common cold.
If you are fighting off a cold and develop symptoms of a sinus infection or nasal allergy, see your healthcare provider. You will be asked to describe your symptoms and medical history.
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How To Treat A Sinus Infection At Home
You can effectively treat sinus infections at home with over-the-counter medicines or one or more home remedies.
Dethlefs recommends, Drink plenty of water, use Vicks vapor rub on chest and bottoms of feet, rest and sleep and humidifier. One thing I like to do when my family is sick is boil water on the stove and melt Vicks vapor rub in it. Then pour solution in ice cube trays and freeze. Add 1-2 ice cubs to bottom of shower.
OTC medicines that may improve symptoms of a sinus infection include:
- Nasal decongestant sprays help reduce swelling in the nasal passages to promote drainage flow from the sinuses. This sinus infection treatment should only be used for three to four days to reduce the risk of rebound congestion.
- Nasal corticosteroid sprays help reduce swelling and inflammation in the nasal passages without causing rebound congestion.
- Antihistamines remain particularly helpful for those whose nasal passages become inflamed and swollen due to seasonal allergies.
- Nasal saline washes and rinses help clear mucus from the nasal passages to promote easier breathing.
Your doctor may also prescribe antibiotics if OTC medicines fail to relieve your symptoms within seven to 10 days. Antibiotics are usually only prescribed as a last-resort treatment for sinus infections due to the risk of overuse, which may lead to other difficult-to-treat infections.
Home remedies for sinus infection include:
Discharge From The Nose Or In The Throat
The most noticeable symptom of a sinus infection is the presence of discharge from the nose. This sign is similar to what you would experience with a regular cold or seasonal flu. The mucus from your sinuses may also drip down the back of your throat .
The color of the discharge may help you identify whether youre experiencing a common cold or a sinus infection. The former will often cause nasal mucus that is watery and clear or cloudy. The latter often comes with mucus that has a green or yellow tint. The discoloration is not a product of the bacteria itself. Instead, it is a result of your immune system fighting the infection by increasing white blood cells.
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Symptoms Of Chronic Sinusitis
Nasal polyps: Abnormal, noncancerous tissue growths develop in the sinus and nasal cavities. Anyone can develop them. Many people with chronic sinusitis are not aware they have nasal polyps until they become large enough to interfere with their ability to breathe. They may also cause pain or bleed. It is not uncommon for chronic sinusitis sufferers to breathe through their mouths because their nasal passages are blocked or narrowed by multiple polyps. The presence of nasal polyps increases the risk of snoring, sleep apnea, asthma and other chronic sinusitis symptoms and medical concerns.
Chronic inflammation and swelling: Ongoing exposure to airborne irritants, allergens, environmental substances, and or inflammatory stimuli enables the infection to spread throughout the body, damaging other organ systems and cause other health concerns. Inflammation can cause your eyes to feel sore and puffy and congestion can make your nose feel stuffy. It can also cause additional infections and sinus headaches and pressure.
Sore throat and cough: The persistent mucus drainage into the back of the throat causes the area to become sore and irritated. The irritation usually triggers a cough, its a natural reaction that helps clear phlegm and mucus out of the throat. Persistent coughing taxes the muscles in the throat, causing additional soreness and in some cases voice hoarseness.
Diagnosis And Treatment For Me/cfs
Currently, there is no single test to diagnose ME/CFS. Doctors make a diagnosis by excluding all other illnesses that might be causing symptoms and following accepted diagnostic criteria. The persons results from routine medical tests will often be normal, but additional tests may show abnormalities.
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What Causes Chronic Fatigue Syndrome
The term chronic fatigue syndrome is not necessarily a diagnosis in itself. Rather, its a label to identify a group of symptoms caused by an unidentified underlying condition.
A diagnosis of chronic fatigue syndrome is often a diagnosis of exclusion. Meaning, doctors will first rule out other potential conditions that can cause fatigue, such as hypothyroidism, sleep deprivation, or adrenal burnout, before diagnosing chronic fatigue syndrome.
The cause of chronic fatigue syndrome is often multifactorial and different in each individual. Researchers have identified several underlying issues that can contribute to the root cause of chronic fatigue syndrome, including: 2,3,4
- Poor immune system response
- Oxidative stress
- Hormonal imbalances
Nearly all of the identified potential root causes have something in common. They all share a common pathway of dysfunctional immune activation and long-term inflammation.
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Sinus Problems Are Common In Those With Chronic Fatigue
A recent study revealed a connection between those suffering from chronic pain conditions, sinusitis, and problems such as chronic fatigue. The study was conducted at Georgetown University Medical Center and included 297 people that fell into the following categories:
- Those with fatigue made up 22%
- Those with chronic pain made up 11%
- Those with both came in at 9%
Interestingly, sinus problems were seen in the majority of these people, especially in those with unexplained fatigue. Why is this significant?
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What Are The Different Types Of Sinuses Near The Nose And Eyes
The paranasal sinuses are located in your head near your nose and eyes. They are named after the bones that provide their structure.
- The ethmoidal sinuses are located between your eyes.
- The maxillary sinuses are located below your eyes.
- The sphenoidal sinuses are located behind your eyes.
- The frontal sinuses are located above your eyes.
The biggest sinus cavity is the maxillary cavity, and it is one of the cavities that most often becomes infected.
There are different types of sinusitis:
- Acute bacterial sinusitis: This term refers to a sudden onset of cold symptoms such as runny nose, stuffy nose, and facial pain that does not go away after 10 days, or symptoms that seem to improve but then return and are worse than the initial symptoms . It responds well to antibiotics and decongestants.
- Chronic sinusitis: This term refers to a condition defined by nasal congestion, drainage, facial pain/pressure, and decreased sense of smell for at least 12 weeks.
- Subacute sinusitis: This term is used when the symptoms last four to twelve weeks.
- Recurrent acute sinusitis: This term is used when the symptoms come back four or more times in one year and last less than two weeks each time.
Is A Hidden Infection Causing Your Chronic Fatigue
Does tired not even begin to explain how exhausted you feel every day?
Are you suffering from unrelenting fatigue that interferes with your ability to get through the day?
Can a tooth infection cause you to feel tired?
Perhaps youve even tried seeking help from your doctor and still arent getting any answers.
If this sounds like you, you are not alone. This is the reality for millions of people struggling with chronic fatigue syndrome.
While science still doesnt have all the answers when it comes to this disorder, research has found that chronic fatigue may, in fact, be a symptom of a more serious underlying issue. More and more research is finding that chronic fatigue syndrome may be the result of a hidden infection overworking your immune system and robbing you of your energy.
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Surgical Treatment For Chronic Sinusitis
Although medical therapy and lifestyle tweaks are the first-line treatment for chronic rhinosinusitis, some people may fail to respond to optimal therapy. In such cases, Ear, Nose Throat and Allergy Specialist performs a surgery to widen up the blocked sinuses and remove any trapped mucus or polyps.
Other situations in which surgery could be considered include:
- When chronic sinusitis symptoms do not respond to the medical treatments listed above, and CT scan of your sinuses reveals complete blockage of one or more sinuses.
- When nasal polyps fail to shrink enough with steroids.
- When a severe deviation of the septum completely blocks your nose or hinders sinus drainage.
- When theres a suspicion of allergic fungal sinusitis. The sinuses in allergic fungal sinusitis get clogged with thick, dense mucus that is hard to remove in any way other than surgery.
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What Is Chronic Fatigue Syndrome
Chronic fatigue syndrome, also known as myalgic encephalomyelitis, is a complicated illness characterized by at least six months of extreme fatigue that is not relieved by rest, and a group of additional symptoms that also are constant for at least six months. In many people with chronic fatigue syndrome, the disorder begins suddenly, often following a flulike infection or an episode of physical or psychological trauma, such as surgery, a traumatic accident or the death of a loved one. In other cases, chronic fatigue syndrome develops gradually. The illness lasts for many months or years, and only a small percentage of people recover full health.
Many people feel tired a lot of the time, and many seek help from their doctors. Most people who experience chronic fatigue are not suffering from chronic fatigue syndrome. Depression and overwork are much more common causes of chronic fatigue.
Several parts of the immune system remain activated for long periods in people with chronic fatigue syndrome. There is growing evidence that some patients with chronic fatigue syndrome have an autoimmune condition: their immune system is attacking particular tissues in the body.
Patients with chronic fatigue syndrome have defects in the ability of cells in their bodies to make energy. Some studies indicate that certain genes are built differently, and that the activity of genes in white blood cells is different, in patients with chronic fatigue syndrome.
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Sinus Infection Signs And Symptoms You Need To Know
Sinus infection symptoms overlap so much with allergy, cold, and flu symptoms that it can be hard to differentiate between them all. A runny and itchy nose, congestion, fatigue, difficulty sleeping, fever, and phlegm are pretty standard across the board. But there are some unique symptoms that can help you determine if youve got a sinus infectiona bacterial infection that usually needs to be treated with antibiotics.
A sinus infection usually starts as a virus, like the cold or flu. The virus then makes your mucous so thick that it doesnt cycle through your system like it normally would. Bacteria then overgrows in that mucous. Thats how a virus turns into a bacterial infection, Erich Voigt, M.D., director of the division of general otolaryngology at NYU Langone Medical Center, tells SELF.
Since the initial virus wont respond to antibiotics, doctors want to make sure youre actually experiencing a bacterial infection before they give you meds. Theyll usually want to confirm your symptoms have lasted long enough and may also take a culture of your sinus mucous to check for bacteria.
So how can you tell when youve got a sinus infection? Here are the sinus infection symptoms to look out for.
Your symptoms will also become more sinus-focused when a sinus infection develops. The congestion and stuffiness may get worse, and mucous coming out of the nose may be more productive and discolored, Voigt says.
Those symptoms include these, from the Mayo Clinic:
