What Are The Symptoms Of Chronic Fatigue Syndrome
The onset of chronic fatigue syndrome symptoms can be fairly sudden , or more gradual. CFS should be suspected if the following symptoms are not explained by any other condition, and persist for a minimum of six weeks in adults, or four weeks in children and young people:
- Extreme tiredness that is worsened by activity, but is not caused by excessive exertion, and is not significantly relieved by rest.
- Post-exertional malaise : feeling unwell with no energy after activities, with a worsening of symptoms that:
- Often doesn’t start until hours or days after the activity.
- Is much greater that you would expect for that particular activity.
- Has a prolonged recovery time that may last hours, days, weeks or longer.
- Difficulty concentrating or multitasking.
- Inability to engage fully in work, educational, social or personal activities.
The diagnosis can only be confirmed after three months of persistent symptoms, but only if the symptoms cannot be explained by any other condition.
How Is Cfs Treated
Theres currently no specific cure for CFS.
Each person has different symptoms and therefore may require different types of treatment to manage the disorder and relieve their symptoms.
Work with your team of healthcare providers to create the best treatment plan for you. They can go over the possible benefits and side effects of the therapies with you.
Misdiagnosis Of Me Common
Less than one percent of people in Australia suffer from it – thats up to 240,000.
But because theres no test to diagnose it, sufferers often say their symptoms are dismissed or misdiagnosed.
Research done by ME advocates say doctors miss the symptoms of the disease four out of five times.
President of the Royal Australian College of GPs, Dr Bastian Seidel, said doctors need to listen to their patients to make sure their health needs are being met.
Dismissing symptoms is inappropriate. We need to take those symptoms seriously.
Medical advice to engage in exercise or undertake cognitive behavioural therapy – the therapy that counsellors often use when you see them for mental health concerns – have been discredited in the treatment of ME.
Even after his diagnosis, doctors kept giving Andrew the wrong advice.
She said oh its terrible you have chronic fatigue syndrome, just try to exercise and stress less, he said.
Mental illness often accompanies ME as a secondary symptom, Bastian said.
Of course those patients are going to have severe mental side effects, and thats why more and more patients who really have Chronic Fatigue Syndrome are increasingly isolated. They dont leave the house, they dont talk to people, he said.
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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
Etiology Of Chronic Fatigue Syndrome
Etiology of CFS is unknown. No infectious, hormonal, immunologic, or psychiatric cause has been established. Among the many proposed infectious causes, Epstein-Barr virus, Lyme disease, candidiasis, and cytomegalovirus have been proven not to cause CFS. Similarly, there are no allergic markers and no immunosuppression.
Some people who have recovered from COVID-19 infection COVID-19 COVID-19 is an acute, sometimes severe, respiratory illness caused by a novel coronavirus SARS-CoV-2. COVID-19 was first reported in late 2019 in Wuhan, China and has since spread extensively… read more have become “long-haulers” with persistent symptoms. Some of these symptoms result from organ damage from the infection and/or treatment, and others may be from posttraumatic stress disorder Posttraumatic Stress Disorder Posttraumatic stress disorder is recurring, intrusive recollections of an overwhelming traumatic event recollections last > 1 month and begin within 6 months of the event. The pathophysiology… read more . In addition, in some patients COVID-19 seems to trigger typical CFS, but further study is needed to confirm this association and determine causality.
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Pathophysiological And Cellular Abnormalities Following Host Exposure To Insults Or Stressors
Prior to exploring the course of ME/CFS, we propose to revisit some concepts related to mechanisms of disease that have been used in the context of life-threatening emergencies and to potential return to homeostasis, such as those occurring in sepsis or poly-trauma. Although very different to ME/CFS, these acute injuries have been extensively studied, and the high intensity and speed of events result in changes that are easily identified and well-described, from potential homeostatic failure to recovery. We present the following models as a paradigm for the understanding of disease mechanisms, based on well-studied examples. They merely serve as a reference for mechanisms that the host may partially engage with in the presence of insults of different severities. Hence, in the following paragraphs, we explore the pathophysiological mechanisms that may be taking place in ME/CFS, which have been related to abnormal homeostasis guided by these established disease descriptions.
Symptoms And Signs Of Chronic Fatigue Syndrome
Before onset of CFS, most patients are highly functioning and successful.
Onset is usually abrupt, often following a psychologically or medically stressful event. Many patients report an initial viral-like illness with swollen lymph nodes, extreme fatigue, fever, and upper respiratory symptoms. The initial syndrome resolves but seems to trigger protracted severe fatigue, which interferes with daily activities and typically worsens with exertion but is alleviated poorly or not at all by rest. Patients often also have disturbances of sleep and cognition, such as memory problems, “foggy thinking,” hypersomnolence, and a feeling of having had unrefreshing sleep. Important general characteristics are diffuse pains and sleep problems.
The physical examination is normal, with no objective signs of muscle weakness, arthritis, neuropathy, or organomegaly. However, some patients have low-grade fever, nonexudative pharyngitis, and/or palpable or tender lymph nodes.
Because patients typically appear healthy, friends, family, and even health care practitioners sometimes express skepticism about their condition, which can worsen the frustration and/or depression patients often feel about their poorly understood disorder.
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What Are The 3 Foods That Cause Fatigue
Not eating enough, or eating foods that are not nutritious, can cause fatigue. If you eat foods that cause spikes in your blood sugar, as soon as those sugar levels drop, you feel fatigued. Eat a balanced diet, complete with fruits, vegetables, whole grains, and protein. Avoid or limit junk foods high in sugar and fat.
Disease Severity And Reversibility
It is unknown how the initial host response to a stressor or insult compares in individuals who do or do not develop typical symptoms of ME/CFS. However, the return to good health, which happens to most people following exposure to mild or moderate levels of insult, seems to be impeded in ME/CFS when symptoms persist for longer than 3â6 months the time interval that is featured in some of the currently used diagnostic criteria . This suggests that subsequent mechanisms involved in the host response will differ at some point in those who develop ME/CFS from those who regain full health. Therefore, a key question is what determines full recovery? Or alternatively, what determines the perpetuation and transformation of symptoms?
While the abnormalities observed in acute disease are general and mostly reversible once the challenge from the stressor ceases, some degree of dysfunction may persist for longer periods. The degree of reversibility of various physiological abnormalities is likely to decrease with time, and some permanent functional, and even structural, damage may occur consequently. This is likely caused by either the persistence or frequent reactivation of the initial stressor , an accumulation of insults, a continuing dysfunctional host-response, or the effects of the numerous psychosocial risk factors that influence disease development and progression , or a combination of all of these.
Figure 2. Hypothetical stages of disease in ME/CFS.
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Genetic Tests For Myalgic Encephalomyelitis Are They Available
While there is no exact test to detect the disorder, researchers have discovered a potential link between the methylfolate, or MTHFR, gene mutation and a persons risk for developing myalgic encephalomyelitis. The MTHFR gene is located on chromosome 1.
The MTHFR gene is responsible for metabolic regulation, brain function and DNA/RNA synthesis and repair. The Institute for Neuroimmune Medicine located at Nova Scotia University in Canada began a study in the summer of 2018 that is focusing on the MTHFR gene using data from 23andMe consumers who elected to participate.
The study, with only 450 participants to start, identified a defect in those who were diagnosed with ME/CFS.
The participants identified with the mutation will be prescribed a supplement for a period of 3 months and report on their symptoms over this time period. As the study progresses, more details will be released.
Myalgic Encephalomyelitis And Your Dna: Alternative Tests
Researchers have been busy carrying out studies to determine if there is a DNA connection that leads to the development or onset of myalgic encephalomyelitis. Recent findings have indicated that there may indeed be a correlation between a persons DNA and the disorder, so for some, it may be worth having your DNA tested, particularly if you have more than one family member that suffers from it.
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Treatment Of Chronic Fatigue Syndrome
Acknowledgment of patient’s symptoms
Sometimes graded exercise, limited to avoid a setback
Drugs for depression, sleep, or pain if indicated
To provide effective care to patients with CFS, physicians must acknowledge and accept the validity of patients’ symptoms. Whatever the underlying cause, these patients are not malingerers but are suffering and strongly desire a return to their previous state of health. For successful management patients need to accept and accommodate their disability, focusing on what they can still do instead of lamenting what they cannot do.
If these measures are ineffective, hypnotic drugs and/or referral to a sleep specialist may be necessary. Patients with pain widespread tenderness of muscles, areas around tendon insertions… read more ) can be treated using a number of drugs such as pregabalin, duloxetine, amitriptyline, or gabapentin. Physical therapy is also often helpful. Treatment for orthostatic hypotension Treatment Orthostatic hypotension is an excessive fall in blood pressure when an upright position is assumed. The consensus definition is a drop of > 20 mm Hg systolic, 10 mm Hg diastolic… read more may also be helpful.
Unproven or disproven treatments, such as antivirals, immunosuppressants, elimination diets, and amalgam extractions, should be avoided.
A Focus On The Brain And Spinal Cord
The history of documented brain abnormalities in ME/CFS, of course, goes way back at least three decades to the reports of white matter abnormalities scattered across the brain. Because the abnormalities were found in different places depending on the patient, and because theyre also sometimes found in healthy people, it wasnt clear what they meant. Such abnormalities were, however, more common in people with ME/CFS. Something was going on.
Brain studies since then suggest that quite a lot may be going on. The studies are generally small, and the findings have not always been validated, but the number of potential abnormalities is surprisingly large. From white/gray matter losses, to problems connecting one part of the brain to another, to alterations in the brains response to stressful exercise, to decreased basal ganglia activity the list goes on and on.
One of the more striking and immediately understandable findings indicate that people with ME/CFS use more brain resources and expend more energy than healthy people when doing cognitive work. Another not so surprising finding at least to people with ME/CFS was that exercise took their cognitive faculties for a tumble and altered their brains functioning.
In short, theres reason to believe that a peek at ME/CFS patients brains after death might very well reveal something. Autopsies of ME/CFS patients brains have been rare, but last year an extensive one was done.
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Is Chronic Fatigue Syndrome Caused By A Virus
The cause of chronic fatigue syndrome is unknown, although there are many theories ranging from viral infections to psychological stress. Some experts believe chronic fatigue syndrome might be triggered by a combination of factors. Theres no single test to confirm a diagnosis of chronic fatigue syndrome.
A Sjogrens Syndrome Segue
Sjogrens Syndrome is of interest because of its growing association with POTS in particular. A Johns Hopkins 2014 case series used a high resolution magnetic resonance neurography to diagnose abnormal dorsal root ganglia in ten Sjogrens Syndrome patients.
The authors pointed out that the burning sensations found in SS often do not follow the typical stocking and glove pattern that occurs with most people who have small fiber neuropathy. They called small fiber neuropathy a surrogate marker of DRG neuronal loss but noted that the unusual distribution of SFN in SS can complicate getting an SFN diagnosis. Plus, some SS patients with burning or raking pain may have dorsal root ganglia problems without having small fiber neuropathy.
Five of the ten SS patients in the study had abnormal DRGs. The fact that none had evidence of small fiber neuropathy, and that two of the patients improved markedly on IVIG therapy, suggested that dorsal root ganglionitis by itself can cause these burning, painful sensations. It also suggested a new way to search for sensory ganglionitis.
In any case, the finding of sensory ganglionitis in Sjogrens Syndrome suggests that it may not be long given the proper studies before its also found in POTS, FM and ME/CFS.
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Living With Your Mother
The other day a friend asked me if I wanted to join her in canvassing the neighborhood selling chocolate almonds. The answer was an easy, No. Ill be entertaining my mother-in-law tonight. Living with this less-than-desirable house guest doesnt come with many up-sides, so I figure using it as a excuse now and then is fair.
post-exertional malaise . Simply put, this is the all-kinds-of-terrible you feel 24 to 48 hours after participating in rigorous physical activity. So while your mother-in-law may appear to be enjoying her time on the BMX track, make no mistake, she will make you pay later. There will be no telling what injuries she may acquire and how long you will have to hear about them.
Life Expectancy And Cfs/me
Mortality in a cohort of chronically fatigued patientsAbstractBackground.mortality among patients with chronic fatigue and chronic fatigue syndrome Method.Results.Causes of Death Among Patients With Chronic Fatigue SyndromeYear:AbstractChronic fatigue syndrome
Simply put, if we have a normal life span, the risk factors touted by the establishment are a myth.
Dean said: what about doctors who have been treating patients for over 20 years.A discussion on dying from cfs or cfs-related causes
Who did they study?The authors analyzed a memorial list tabulated by the National CFIDS Foundation of 166 deceased individuals who had had CFS….Was this study representative of patients with CFS?et al It also was unclear how representative the memorial list is and fromwhat population it draws its data. Clearly, it is not possible to generalize thedata from this memorial list to the overall population of patients with CFS.Longitudinal prospective studies with community-based samples are needed in order to better understand the unique health risks associated with having CFS.What were the findings of this retrospective study?Did everyone die at 55?
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What Is Chronic Fatigue Syndrome
Chronic fatigue syndrome , also referred to as myalgic encephalomyelitis , is a condition that causes marked long-term tiredness and other symptoms which are not caused by any other known medical condition.
- CFS stands for chronic fatigue syndrome. Chronic means persistent or long-term.
- MEstands formyalgic encephalomyelitis. Myalgic means muscle aches or pains. Encephalomyelitis means inflammation of the brain and spinal cord.
Chronic fatigue syndrome is a fluctuating condition in which your symptoms can change unpredictably in nature and severity over a day, week or longer. The impacts are variable in severity, but can involve flare-ups and relapses even if symptoms are well managed.
There is no test to diagnose the condition. The diagnosis is made in people who have a certain set of symptoms .
Diagnosis Of Chronic Fatigue Syndrome
Laboratory evaluation to exclude non-CFS disorders
The diagnosis of CFS is made by the characteristic history combined with a normal physical examination and normal laboratory test results. Any abnormal physical findings or laboratory tests must be evaluated and alternative diagnoses that cause those findings and/or the patient’s symptoms excluded before the diagnosis of CFS can be made. The case definition is often useful but should be considered an epidemiologic and research tool and in some circumstances should not be strictly applied to individual patients.
In February 2015, the Institute of Medicine published an extensive review of this disease called Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness. In this review, they proposed a new name, systemic exertion intolerance disease , and new diagnostic criteria that simplified the diagnosis and emphasized the most consistent features. In addition, the review clearly emphasized the validity of this debilitating disease.
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