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Chronic Fatigue Is Killing Me

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Autoimmunity: The System Misfires

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

Autoimmunity is when the immune system mistakenly identifies a part of your body as a foreign invader, like a virus it needs to get rid of. Your own body triggers its inflammatory process and sends specialized cells to destroy the target and begin the healing process.

Only with autoimmunity, the healing process creates more of whatever body part your immune system doesn’t like, so it continues to attack. And heal. And attack. And the process continues indefinitely.

Autoimmunity is a specific type of immune-system dysfunction, but it’s important to note that not all immune-system dysfunction is autoimmunity.

The Difference Between Chronic Fatigue And Chronic Fatigue Syndrome

May 12th is International ME/CFS and FM Awareness Day, and throughout the month people are sharing posts which shed a bit more light on these misunderstood illnesses. For more, check out #May12BlogBomb, #MEAwarenessDay and #MillionsMissing on Twitter and Instagram.

One of the most common misconceptions about myalgic encephalomyelitis/chronic fatigue syndrome is the difference between the specific illness and other types of fatigue. This simple misunderstanding snowballs into real challenges for those with ME/CFS, who have to contend with peoples assumptions that they are not seriously unwell just tired.

The common name of the disease encourages these misconceptions. The conflation between different types of fatigue is just one of the many reasons why I believe chronic fatigue syndrome should be completely replaced with the term myalgic encephalomyelitis.

Above: The fact that images like this inevitably accompany articles about ME/CFS doesnt help.

Today I will compare different types of fatigue to make clear the difference between other types of tiredness and ME/CFS.


We all get tired. Even perfectly healthy individuals experience ordinary fatigue in the course of their day. Some examples of fatigue as a normal response to life circumstances include:

Above: While were talking about pictures that inadequately represent illnesses, whats worse: the ME/CFS tired lady, or this faux-Gumby picture I found under stock images of depression?


A Town For People With Chronic

In December of 2012, I came down with what at first looked like a bad case of mononucleosis. I felt tired and had a sore throat, a cough, and a slight fever. At the time, I was twenty-six and working as an adjunct English professor at a small college in Westchester, New York. It was Christmas break, so I thought that I would sleep it off and feel better by the New Year. But over the next few months my symptoms grew to include muscle pain, migraines, and occasional vertigo. The cough went away but the tiredness got worse, and by the summer I was spending half my time resting in bed. I was used to playing pickup basketball several times a week after work, but now a few pushups left me exhausted. I couldnt figure out what was happening. One afternoon, as an experiment, I went for a run near my apartment, in uptown Hoboken. I clipped my iPod Shuffle to my mesh shorts and jogged past Italian delis with dry-cured sausages in their windows and along a pier that hugged the Hudson. It felt amazing. But the next day, while grading papers with a few other teachers, suddenly, I became dizzy and weak. I left the office without explanation, and, for the next several days, I barely left my bedroom.

A previous version of this story incorrectly described cytokines and misstated the location of a clinic dispensing Ampligen.

Also Check: Is It Fatigue Or Depression

Can Antidepressants Cause Chronic Fatigue Syndrome

Most people are aware that antidepressants are often used to treat chronic fatigue syndrome, but what many dont know is that there are cases by which they actually can cause temporary cases of fatigue that could technically be diagnosed as chronic fatigue syndrome. The fatigue often sets in after a person has been medicated with an antidepressant or antipsychotic for an extended period of time, and may be thought of as a long-term effect of the treatment.

In other cases, people notice that when they pursue antidepressant withdrawal, one of the symptoms is fatigue. In many cases, the withdrawal is so prolonged, lasting for months , that people believe they have developed chronic fatigue syndrome. Based on the relatively vague diagnostic criteria for chronic fatigue syndrome, a doctor may end up throwing another medication onto your existing cocktail which may end up impeding the recovery of your natural, homeostatic energy levels over the long-term.

How I Decreased Fatigue And Restored My Energy Levels After Antidepressants

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At the time, I didnt have a specific plan of action in place to recover from the antidepressant-induced fatigue that I experienced. In fact, I didnt even fathom the possibility that I would ever overcome it I assumed that I was fated to become a lifelong sloth. My energy was so low that I was convinced I had a brain tumor an MRI eventually ruled this out. In hindsight, there are some specific things I couldve done that helped me overcome my fatigue.

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What Procedures And Tests To Diagnose Chronic Fatigue Syndrome

There is no single test to diagnose chronic fatigue syndrome. The disease is a diagnosis of exclusion, which means that all other conditions and illnesses that cause the symptoms are ruled out. CFS may be diagnosed based on the following:

  • Certain signs and symptoms must be present.
  • Some nonspecific laboratory tests, such as blood tests and tests of the immune system, suggest the diagnosis.

Laboratory tests are used to rule out other fatigue-causing diseases. Also, some laboratory abnormalities are seen in CFS and support the diagnosis.

Your doctor may perform the following tests:

  • Tests to exclude other causes of fatigue: Thyroid, adrenal, and liver function tests are useful to rule out disorders that may cause fatigue. In people with CFS, the results of these tests should be normal.
  • Blood tests: The most consistent laboratory finding in people with chronic fatigue syndrome is an erythrocyte sedimentation rate at the very low end of normal, indicating an absence of inflammation. If the ESR is elevated or even in the high-normal range, another diagnosis is likely. If any other abnormalities are found on blood tests, your doctor may rule out CFS and begin testing for another condition.
  • Antibody tests: Your doctor may order antibody tests to determine whether you have had prior infection, such as Lyme disease, Chlamydia pneumoniae pneumonia, or Epstein-Barr virus.

Your doctor may perform the following imaging studies:

Other Chronic Fatigue Syndrome Symptoms

Other symptoms that may be associated with CFS/ME include:

  • Dizziness, palpitations, fainting, nausea on standing or sitting upright from a lying position.
  • Increased sensitivity to temperature, causing increased sweating, chills, hot flushes or feeling very cold.
  • Twitching and other abnormal uncontrolled body movements.
  • Flu-like symptoms, including sore throat, tender glands, nausea, chills or muscle aches.
  • Intolerance to alcohol, or to certain foods or chemicals.
  • Increased sensitivities, including to light, sound, touch, taste and smell.
  • Pain, including pain on touch, muscle pain, headaches, eye pain, tummy pain, or joint pain.

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What Are The Symptoms Of Chronic Fatigue Syndrome

Symptoms of CFS often mimic the flu. The following are the most common symptoms of CFS. However, each person may experience symptoms differently. Symptoms may include:

  • Sensitivity to light
  • Low-grade fever

The symptoms of CFS may look like other medical conditions. Always talk with your healthcare provider for a diagnosis.

What You Can Do To Improve Your Energy

Chronic Fatigue Syndrome IS LONG COVID? | Dr Sarah Myhill

Discovering your root cause of chronic fatigue is the first step in improving your energy. By uncovering any imbalance your body may be experiencing, we can develop a plan to get you on the track to full recovery. Through many different testing methods, we can tell exactly whats going on to cause chronic fatigue, and can tailor your individual healing plan.

Detoxing your body, killing parasites, adding vitamin and nutritional support and removing heavy metals are all modalities that can help increase your energy. For example, if testing reveals you are low in iron or certain B vitamins, supplementing with the correct form can be life changing.

Also Check: Chronic Leg Pain And Fatigue

Can Emotions Cause Fatigue

Are you fearful about the future? Do you worry about your health and who will take care of you? Are you afraid you are no longer needed? Emotional stresses like these can take a toll on your energy. Fatigue can be linked to many conditions, including:

  • Stress from financial or personal problems
  • Feeling that you no longer have control over your life

Not getting enough sleep can also contribute to fatigue. Regular physical activity can improve your sleep. It may also help reduce feelings of depression and stress while improving your mood and overall well-being. Yoga, meditation, or cognitive behavioral therapy could also help you get more rest. Talk with your doctor if your mental well-being is affecting your sleep or making you tired.

How Is Chronic Fatigue Syndrome Diagnosed

CFS diagnosis depends on two criteria:

  • Severity and duration. The severe and chronic tiredness lasts for more than 6 months and other medical conditions have been ruled out.
  • Number of symptoms. Four or more symptoms of CFS are present.
  • A specific treatment for CFS has yet to be proven effective. Vitamin supplements and medicines have some benefit. Many treatments just relieve the symptoms of CFS.

    Read Also: Extreme Fatigue And Leg Pain

    Severe And Very Severe Me

    Linda CrowhurstGreg CrowhurstWasteland

    Severe and very severe ME affects about 25% of people with myalgic encephalomyelitis , with patients being housebound or bedbound at some point in their illness, typically needing to use a wheelchair, unable to do any kind of work or study, and often unable to do basic self-care activities unaided. Some people have died of severe ME, including Emily Collingridge, Merryn Crofts, Sophia Mirza.

    Peripheral Blood Mononuclear Cell Isolation And Natural Killer Cell Isolation

    Pin on Chronic Fatigue

    A total of 85 ml of whole blood was collected in ethylendiaminetetraacetic acid tubes via venepuncture by a qualified phlebotomist from each participant between 8:30am and 10:30am at collection locations including Griffith University, Royal Brisbane and Womens Hospital, Robina Hospital, Sunshine Coast University Hospital, Calvary John James Hospital, Royal Melbourne Hospital, Australia. Routine full blood analysis was performed within four hours of collection for red blood cell count, white blood cell count and granulocyte cell count for each participant at Gold Cost University Hospital or Royal Melbourne Hospital, Australia.

    Samples were provided to the laboratory de-identified using a unique code by an independent blood collector. Peripheral blood mononuclear cells were isolated from 80 ml of whole blood by centrifugation over a density gradient medium as previously described . PBMCs were stained with trypan blue to determine cell count and cell viability. PBMCs were adjusted to a final concentration of 5×107 cells/ml for NK cell isolation.

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    I Was In A Wheelchair Before Finding Functional Medicine

    Rebecca Cotterall, 28, a nutritional therapist from Lancashire

    I was considered to be beyond help in my teens, during which I was wheelchair-bound after a ME/ CFS diagnosis at 13. After more comprehensive tests when I was 18 by a doctor who had an interest in nutrition and functional medicine, results came back with signs of an abnormality, including a positive test for Lyme disease. We also started looking at helping my poorly cellular, gut, adrenal and nervous systems to function properly. It took several years, but with stress management, supplements and subtle changes to my diet and sleep, the effects of ME/ CFS lessened. My experience inspired me to start training as a nutritional therapist in 2011, so that I can help people like me. Never did I think that at age 28 Id have a house with my husband and a baby boy.

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    Other Lifestyle Changes To Manage Me/cfs

    Other ways to manage ME/CFS include:

    • equipment â some people may need a blue badge for parking, a wheelchair, a stairlift, or other adaptations for their home
    • changes in your place of work or study â when youâre ready and well enough to return to work or studies, your doctor should be able to advise you on changes that could ease your return

    Thereâs limited or no evidence to recommend:

    • resting completely â thereâs no evidence this helps
    • complementary medicine â there is not enough evidence that itâs helpful for ME/CFS

    You should not take up vigorous unsupervised exercise such as going to the gym or for a run as this may make your symptoms worse.

    Read Also: How Do You Know You Have Adrenal Fatigue

    Inflammation: Helpful And Harmful

    Inflammation is involved in many illnesses and injuries, and most adults have used at least one anti-inflammatory drug in their lifetime. We routinely ice and elevate our injuries to keep them from getting too inflamed.

    We usually view inflammation as a problem–a symptom to be treated. However, inflammation is part of a healthy response to problems in the body. When your body detects a problemwhether it be invading viruses or bacteria, or tissues damaged from injurythe immune system triggers an inflammatory response.

    What happens during an inflammatory response is that blood vessels dilate to deliver more blood to the injured area, and immune proteins are released into that blood. White blood cells flow out of the blood vessels into the problem area to kill or clean up materials that shouldnt be there. Then the tissue can begin to heal.

    So when you bash your shin or twist an ankle, a little swelling is a good thing. It means the healing process is at work.

    On the other hand, when inflammation becomes chronic due to ongoing damage or a misfiring immune system, then you’ve got a problem.

    Ongoing damage can come from something like back pain from an injury that’s aggravated by poor posture, or repeated damage due to disease. When that damage is due to a misfiring immune system, it can mean autoimmunity.

    When Should I Call The Doctor About Chronic Fatigue Syndrome

    Number ONE Cause of Chronic Fatigue: 50 Years or Older

    People should 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 healthcare provider, local medical society, or university medical school for additional information.


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    Immunoinflammatory Pathways In Sickness Versus Me/cfs

    The central nervous system modulates the immune response via two pathways: the hypothalamic-pituitary-adrenal axis and the release of catecholamines and acetylcholine . Communication of proinflammatory cytokine signaling to the brain via the vagus provokes a rapid anti-inflammatory response through increased HPA axis and cholinergic nerve activity . This forms the basis of the CIRS response including the HPA axis, cholinergic and anti-inflammatory responses . This CIRS response in the CNS and autonomous nervous system generates its own characteristic symptom pattern and is thus part of the sickness response. The SNS modulates the immune response at systemic, local and regional levels . Catecholamines inhibit production of proinflammatory and T helper 1 cytokines, while enhancing the synthesis of Th2 cytokines together with IL-10 and transforming growth factor 1 . Acetylcholine release through activation of the parasympathetic nervous system attenuates the production of IL-1, TNF and IL-6 .

  • A plethora of other immune abnormalities have been detected in patients with ME/CFS, which when taken together demonstrate the existence of a dysregulated immune system. These findings include reduced natural killer cell function and T cell exhaustion . T cell exhaustion and the Th2 response may suggest that ME/CFS is accompanied by activation of the CIRS, as can be observed in many other inflammatory disorders .

  • Possible Causes Of Inflammation

    Much of the ME/CFS research community takes inflammation as a given. In the alternative name myalgic encephalitis , which has been adopted by some researchers, encephalitis means inflammation of the brain and spinal cord.

    Some researchers point to possible inflammatory triggers that don’t involve autoimmunity.

    A 2012 study published in Psychiatry Research attempted to separate chronic fatigue, chronic fatigue syndrome, and myalgic encephalitis into different categories. Researchers found that ME patients had higher levels of two specialized immune proteins called cytokines, which promote inflammation. They’re called interleukin-1 and tumor necrosis factor-alpha. They also found elevated levels of neopterin, which is an indicator of pro-inflammatory immune activity.

    More recently, studies have shown that inflammatory markers can accurately distinguish ME/CFS from depression or sickness behaviors.

    A study published in Metabolic Brain Disease is just one of a growing body considering oxidative and nitrosative stress coupled with low antioxidant levels as a possible mechanism of ME/CFS, suggesting that these factors could point to an immuno-inflammatory pathology.

    Other researchers have suggested that certain pathogens may, in predisposed people, trigger a chronic immune activation, which would create chronic inflammation and a cascade of problems. One of the main suspects in this scenario is the Epstein-Barr virus, which causes mononucleosis .

    Also Check: What To Do For Chronic Fatigue Syndrome

    Course: Sickness Behavior Versus Me/cfs

    Sickness behavior is conceptualized as a short-term response to acute infections or injuries. Sickness is an adaptive behavioral response that is appropriate to counteract acute bacterial or viral infections or inflammatory trauma and therefore plays a role in the resolution of inflammation and thus recovery. ME/CFS, on the contrary, is an enduring disorder with a relapsing-remitting or chronic course . Using international consensus criteria for ME/CFS, most studies report a waxing and waning or progressive pattern of this disease . In contrast to sickness behavior, which is a short-lasting, beneficial behavioral response, the recovery rate from ME/CFS is very low . For example, in studies using CDC criteria the recovery rate was only 4% . In another prospective study carried out over 12 months, none of the patients recovered, while 40% of the individuals with ME/CFS did not improve, 20% showed a progressive course, and 40% showed a relative improvement in their symptoms .

    In summary, while sickness behavior is a short-lasting, adaptive and acute inflammatory state, ME/CFS is a chronic disorder characterized by a waxing and waning or progressive pattern with an extremely low recovery rate .

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