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.
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.
Investigate Your Viral Levels
Before you think fatigue is all in your head, request a viral panel from your doctor to make sure your immune system isn’t bogged down by a virus. Everyone has viruses living inside their body, but it’s often hard to tell if they causing active problems or not.
Once you have a virus in your body, it never goes away. In healthy individuals the virus or viruses often stay dormant, but when health falls below par or you have prolonged stress, antibiotic overuse, vaccinations, toxic lifestyle, and/or surgeries, a virus can be reactivated. A classic example of this is when you or someone you know gets a cold sore when theyre under a lot of stress, as cold sores are caused by the herpes simplex virus. Another example of this is when someone who had the chickenpox in childhood gets shingles later in life, it’s just a reactivation of the chickenpox virus.
A virus works by invading healthy normal cells and take advantage of them, using them to multiply. By living inside your cells, they are protected from typical medicines that swim around in your bloodstream, making them hard to treat.
The most common viral signs are fatigue, night sweats, fever, and painful joints. If these symptoms are familiar, it’s time to consider checking in with a doctor or naturopath that can get you tested. Here are just a few things to consider testing for, although your doctor should know exactly what you need:
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To Diagnose Chronic Fatigue Syndrome
A few markers can indicate that somebody has chronic fatigue syndrome, and these can sometimes be discovered through laboratory tests. The most useful tests for diagnosing chronic fatigue are:
Complete blood count tests. This gives information about blood and everything in the blood, which may contain a few markers of chronic fatigue syndrome.
Erythrocyte sedimentation rate . This test determines if there is inflammation in the body that may indicate chronic fatigue or another condition.
Chemistry panel. A chemistry panel is another blood test that can provide an idea of your general state of health.
Recent Research Into Brain Inflammation Could Also Bring Hope For Me/cfs
Fortunately, recent research breakthroughs in brain inflammation offer promise in not only validating ME/CFS but also its treatment.
Brain inflammation is more common than previously realized and is increasingly linked to myriad conditions other than ME/CFS, including depression, anxiety, childhood brain development disorders, and Alzheimers and Parkinsons disease.
Immune cells in the brain outnumber neurons 10 to one and are vastly more important than previously realized. They are responsible for maintaining neuronal health and function and removing debris and plaque from the brain. However, when the brain is impacted by inflammation from dietary or lifestyle factors or a brain injury, the brains immune cells must abandon their jobs of supporting neuronal health and instead go into persistent warrior mode, damaging brain tissue in the process. Unlike the bodys immune system, the brains has no off switch.
There are no drugs to tame brain inflammation, however, it has been shown to respond to certain botanical compounds and functional medicine protocols that include dietary, lifestyle, and health interventions.
Ask my office for more advice on how we can help you with fatigue.
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Conditions That Exclude A Diagnosis Of Cfs
Alcohol or other substance abuse, occurring within 2 years of the onset of chronic fatigue and any time afterwards. Severe obesity as defined by a body mass index equal to or greater than 45. Note: BMI values vary considerably among different age groups and populations. No normal or average range of values can be suggested in a fashion that is meaningful. The range of 45 or greater was selected because it clearly falls within the range of severe obesity. Any active medical condition that may explain the presence of chronic fatigue, such as untreated hypothyroidism, sleep apnea and narcolepsy, and iatrogenic conditions such as side effects of medication.
Any active medical condition that may explain the presence of chronic fatigue, such as untreated hypothyroidism, sleep apnea and narcolepsy, and iatrogenic conditions such as side effects of medication.
Any past or current diagnosis of a major depressive disorder with psychotic or melancholic features bipolar affective disorders schizophrenia of any subtype delusional disorders of any subtype dementia of any subtype anorexia nervosa or bulimia nervosa.
Any unexplained abnormality detected on examination or other testing that strongly suggests an exclusionary condition must be resolved before attempting further classification.
Treat Your Chronic Fatigue Syndrome
Testing for chronic fatigue syndrome is definitely recommended and certainly helps to diagnose the condition. After testing is completed, a few different treatments can be used, including medication, getting plenty of rest, and natural remedies. To learn more about this condition and treatment options available for you, contact us at Medical Transformation Center in Louisville, KY today.
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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 a 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 a prior infection, such as Lyme disease, Chlamydia pneumoniae pneumonia, or Epstein-Barr virus.
Your doctor may perform the following imaging studies:
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
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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.
How Is Chronic Fatigue Syndrome Diagnosed
CFS can be difficult to diagnose. There is no specific test for CFS, and other illnesses can cause similar symptoms. Your health care provider has to rule out other diseases before making a diagnosis of CFS. He or she will do a thorough medical exam, including:
- Asking about your medical history and your family’s medical history
- Asking about your current illness, including your symptoms. Your doctor will want to know how often you have symptoms, how bad they are, how long they have lasted, and how they affect your life.
- A thorough physical and mental status exam
- Blood, urine, or other tests
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Symptoms include overwhelming fatigue, joint pain, headaches and sleep problems. No cause or diagnosis has yet been established and the condition can render patients bed- or house-bound for years.
The research, published in the journal Proceedings of the National Academy of Sciences on Monday, analyzed blood samples from trial volunteers using a nanoelectronic assay a test that measures changes in tiny amounts of energy as a proxy for the health of immune cells and blood plasma.
The scientists stressed the blood samples using salt, and then compared the responses. The results, they said, showed that all the CFS patients blood samples creating a clear spike, while those from healthy controls remained relatively stable.
We dont know exactly why the cells and plasma are acting this way, or even what theyre doing, said Ron Davis, a professor of biochemistry and of genetics who co-led the study.
we clearly see a difference in the way healthy and chronic fatigue syndrome immune cells process stress.
Other experts not directly involved in this work cautioned, however, that its findings showed there is still a long way to go before a biomarker is found that can establish CFS diagnosis and distinguish it from other conditions with similar symptoms.
Chronic Fatigue Syndrome Tests
While dealing with chronic fatigue syndrome is a difficult thing to do under any circumstances, it can be even more difficult before you have a diagnosis. Unfortunately, diagnosing chronic fatiguesyndrome is difficult on its own. There are no tests that can pinpoint a diagnosis of chronic fatigue syndrome rather, a combination of tests that rule out other conditions, tests that find possible markers of chronic fatigue, and an interview to learn about the symptoms you’ve been experiencing are used to make a diagnosis.
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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.
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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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
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.
What Home Remedies Treat Chronic Fatigue Syndrome
Physical activity performed at a comfortable pace is important for everyone to maintain good health, including people with chronic fatigue syndrome. People with CFS need to learn how much activity is helpful and when to stop, so they do not increase their level of fatigue.
In general, people with CFS should pace themselves carefully and avoid excessive physical or emotional stress. Remember, the goal is to avoid increasing fatigue or pain. Maintain a regular and manageable daily routine to avoid a relapse or increase of symptoms. Exercise should be supervised by a knowledgeable health-care provider or physical therapist.Total rest should also be avoided as it may make your fatigue worse. You should maintain physical activity at a comfortable pace. If you increase your level of physical activity, do so gradually.Decreased consumption of alcohol and caffeine at night may help you sleep.Try to minimize social isolation.
Always ask your doctor about any new treatment, including herbal supplements.
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Impact And Prognosis Of Me/cfs
- Nacul L.
- Lacerda E.M.
- Campion P.
- et al.
BMC Public Health.J Chronic Fatigue Syndr.
- Cox D.L.
- Findley L.J.
Br J Occup Ther.
- Mild: mobile and self-caring may continue working but will have reduced other activities
- Moderate: reduced mobility, restricted in instrumental activities of daily living, needs frequent periods of rest usually not working
- Severe: mostly housebound limited to minimal activities of daily living severe cognitive difficulties may be wheelchair dependent
- Very severe: mostly bedridden unable to independently carry out most activities of daily living often experience extreme sensitivity to light, sound, and other sensory input
- Tian H.
- et al.
Am J Epidemiol.Chronic Illn.
Qual Life Res.Disabil Rehabil.Occup Med .
Rehabil Psychol.Front Pediatr.Fatigue.
On Why She Believes Chronic Illness Is Representative Of This Time We’re Living In
One of the things I found in my reporting was that many people who lived with these illnesses, who lived with autoimmunity, thought that the problem was something in themselves … that they were living an inauthentic life. They hadn’t lived the life they should lead. And in this way, they took their illness and they turned it into a metaphor for personal inauthenticity that only they could overcome, which is a huge burden for an individual to live with. …
These diseases kind of allow both sick people and people who are healthy to see the problem as an individual problem, allows us to look away from the social factors that are contributing to the rise of these diseases. So everything from food deserts to lack of chemical regulation to probably our chronically fast-paced lifestyles and lack of social safety nets for new mothers and all sorts of things. I really just came to think that these diseases reveal something to us about our culture in a way that made them deeply representative of aspects of the time that we needed to look more deeply at.
Sam Briger and Joel Wolfram produced and edited this interview for broadcast. Bridget Bentz, Molly Seavy-Nesper and Carmel Wroth adapted it for the web.
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