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Chronic Fatigue Syndrome Stress Management

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You Dont Have An Appetite

What Is Chronic Fatigue Syndrome?

In more severe cases of COVID-19, Khabbaza says patients often have more serious delirium that accompanies their fatigue. This, he says, may be a result of a lack of appetiteanother symptom that can help you distinguish if your fatigue is being caused by COVID. People may also have lower appetites so their nutritional status might not be great, they might be sleeping too little or too much, which can affect how your mind is wired, Khabbaza says. And for more helpful information delivered to your inbox, .

What Is The Latest Research On Me/cfs

Today, we have a better understanding of ME/CFS, but researchers are still searching for the cause. ME/CFS is sometimes seen in members of the same family, perhaps because of a genetic link. Researchers are also testing a variety of treatments for ME/CFS, including anti-viral medications and medications that affect the immune system.

Researchers also are looking at ways to help health care providers identify and diagnose ME/CFS more quickly. HHS currently supports a study led by the Institute of Medicine to recommend improved and updated criteria to help physicians make a diagnosis of ME/CFS. The IOMs recommendations may also guide future research.

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.

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Nutrition And Supplemental Therapy

As with hormones, Dr. Borenstein will perform a series of tests to determine your vitamin and nutrient levels. Then hell prescribe a supplement plan/diet to address your deficiencies and their related symptoms which present differently in, and are delivered differently to every patient.

To maintain your normal health and optimal energy levels, he may also prescribe a diet that will flush out your specific irritants. If your tests show you have candida, for example, he will determine the strongest candida killer for your age and body type. If it turns out youre deficient in magnesium, acetyl L-carnitine, glutathione, vitamins B-12, A, B, C or D he will prescribe the optimal supplementation in the most efficient form.

As research shows that only about 30% of oral vitamins are absorbed and available to the body, Dr. Borenstein prefers to use IV infusion to deliver these treatments:

Myers Cocktail

This powerful treatment combines vitamin C, several B vitamins, and magnesium to provide a patients metabolism with optimal cellular and immune function.

The cocktail is usually given 1-2 times per week, and beneficial effects are usually felt by the fourth visit. Many patients with chronic conditions choose to continue the infusions every 1-4 weeks or when they feel their energy slipping.

What To Expect At Your Provider’s Office

DIY Chronic Fatigue Syndrome Treatments

There is no laboratory test for chronic fatigue syndrome. But your health care provider may use tests to rule out other illnesses. Your provider will go over your symptoms, check your medical history, and do a physical examination.

If you have CFS, your provider may prescribe drugs to treat your symptoms, or suggest herbs, vitamins, or dietary changes to help you. Get plenty of rest, exercise regularly, and learn to pace yourself. Often this combination of treatments will help you get better.

If the usual treatments do not work, your provider may check for other conditions that can cause symptoms similar to those of CFS.

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Treating Cfs By Strengthening The Immune System

Image: Lingzhi mushroom on Wikipedia

Among Chronic Fatigue Syndrome patients certain parts of the immune system tend to be weak. Strengthening these weak parts might be of benefit. An important test for immune system weakness is called Natural Killer Cell Function. NK Cell functional testing is a difficult test to do. For selected patients we send out this test. However, whether or not NK cell functional activity is low, strengthening the CFS immune system could likely be useful. One powerful immune stimulant, AHCC, a form of Shitake mushroom, has been shown to suppress HHV-6 virus levels in cancer patients undergoing chemotherapy. Reishi mushroom might have similar good effects. Thus AHCC and Reishi mushroom might be considered as natural additional treatments for Epstein Barr or HHV-6 viruses.

How Is It Diagnosed

To be diagnosed with ME/CFS, you must have all of these symptoms:footnote 1

  • Major decrease in your ability to do the things you did before you got sickincluding work, school, social, or personal activitiesthat has continued for more than 6 months.
  • Worsening of symptoms after being mentally or physically active .
  • Sleep problems, including not feeling rested after sleeping .
  • Extreme fatigue that is:
  • New or has not been a life-long problem.
  • Not caused by being active for a long period of time.
  • Not much better after resting.

You must also have one or more of these symptoms:

  • Problems with concentration, short-term memory, or using the correct word .
  • Feeling dizzy or faint while standing or sitting upright that gets better when you lie down .

Doctors may also use a variety of tests to confirm a diagnosis or to rule out other conditions.

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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.

How Will Me/cfs Affect My Quality Of Life

Diagnosis and Management of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome

Not everyone will experience the same symptoms so itâs important not to compare people with ME/CFS. People with ME/CFS can have very different experiences of the condition and how long their symptoms last.

The impact of symptoms can be:

As symptoms change over time so does the impact they have on peopleâs lives.

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Chronic Fatigue Cause No : Undiagnosed Urinary Tract Infection

Although most women associate a urinary tract infection with symptoms such as burning or urgency, sometimes fatigue is the only clue.

In most instances, a UTI is caused by bacteria in the urinary tract, often the result of improper bathroom hygiene . Sexual intercourse can increase the risk because it can push bacteria from the into the urethra.

If your doctor suspects that you have a UTI, your urine will be tested. Treatment is quick and easy, and usually involves an oral antibiotic medication. You can expect the fatigue to lift within a week or less if the antibiotic works effectively.

If your symptoms return, get tested again. Some women have chronic UTIs, which are very difficult to resolve. If this is your case, ask your doctor about preventive care, which may include low dose antibiotics.

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Your Brain Feels Sluggish

Some people with chronic fatigue experience some cognitive impairment, according to the IOM panel. Mostly what happens is they have a delay in their ability to process information, said Keller. They can still process information, but they cant do it quickly. They may also have blips in their short-term memory, she added.

These problems with mental processeswhich may also include difficulty paying attention, problem solving, and planningcan make it difficult to hold down a job, or interact in social situations. And the issues get worse when youre stressed, or youve over-exerted yourself. Unsurprisingly, they can lead to feelings of isolation and hopelessness.

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Treatment Plans For Me/cfs

There’s no single way of managing ME/CFS that works for everyone, but there are a number of treatment options.

The National Institute for Health and Care Excellence says you should be offered a treatment plan tailored to your symptoms.

Your doctor should discuss all of the options with you, and explain the benefits and risks of any treatment.

They should work with you to develop a treatment plan that suits you and takes into account your circumstances and preferences.

You may need advice about making lifestyle changes, specialist treatments, or a combination of both.

If your symptoms are severe, your doctor should ask a specialist for advice.

Your treatment plan should be reviewed regularly.

Diagnostic Criteria For Me/cfs Using The National Academy Of Medicine Clinical Criteria

Chronic Fatigue Syndrome Treatments

For a diagnosis of ME/CFS, the person must have the following three symptoms:

  • Substantial reduction in functioning and persistent and profound fatigue for at least 6 months. The person is unable to undertake the same level of activity before they became ill. Their fatigue is not the result of significant exertion and is not substantially alleviated by rest.
  • Post-exertional malaise.
  • Diagnosis also requires at least one of the following two symptoms:

  • Cognitive impairment .
  • Orthostatic intolerance .
  • It is important to note that these are not the only symptoms of ME/CFS, just the minimum needed to meet the diagnostic criteria.

    While diagnosis requires that a person has had symptoms continually for six months, early intervention with pacing and rest can help reduce symptoms, improve quality of life and reduce the risk of exacerbating the disease. Research suggests that patients who are able to pace their activity and not push themselves tend to do better in the long term. Pacing and rest can start even prior to an official diagnosis.

    While there is currently no cure and no evidence-based treatments, it is important to find a doctor who is not only sympathetic to ME/CFS, but can work with you to help manage your symptoms.

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    Many Patients With Psoriatic Arthritis Consider Fatigue To Be One Of The Most Problematic Symptoms After Joint Pain Being Able To Identify And Describe What Fatigue Feels Like May Help Both Loved Ones And Health Care Providers Better Understand Your Experience

    Check out Fight Back Against Fatigue: A Psoriatic Arthritis Patients Guidefor more information on this topic.

    Wiped out. Utterly exhausted. Like youre coming down with the flu. Unable to get your head above water. Pumping gas, but the gas tank is empty.

    The fatigue that people with psoriatic arthritis have is real and it interferes tremendously with daily life.

    In fact, nearly 50 percent of patients with psoriatic arthritis report high levels of fatigue and consider fatigue a high-ranking problem, after joint pain and before skin issues, according to a 2016 study published in the journal Joint Bone Spine.

    If you live with fatigue from psoriatic arthritis, we dont have to tell you what it feels like. However, hearing from other people with PsA who are also wrestling with this nagging, persistent feeling of exhaustion can help you feel less alone.

    Talking about what fatigue feels like can also help you explain to loved ones why you arent able to do certain activities or why you turn down invitations or leave things early. Perhaps, most importantly, it can help you figure out if you need to talk to your health care provider to get better control of your fatigue.

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    Tests To Confirm A Diagnosis Of Me/cfs

    Other conditions can cause symptoms similar to ME/CFS, so your doctor may do more tests to confirm the diagnosis. These may include:

    Orthostatic testing.
    Tests may be done to see if you have symptoms after being upright for long periods of time.
    Neuropsychological testing.
    This may be done to see if you are having problems with your ability to think, concentrate, or remember.
    Cardiopulmonary exercise test .
    This may be done to see if you recover after physical activity. Often the test is done and repeated about 24 hours later.

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    What Is Chronic Fatigue Syndrome

    Chronic fatigue syndrome is a complicated disease for doctors to diagnose and even fully understand.

    CFS is a chronic condition that makes people feel very tired and weak. They can also have headaches, dizziness, or other physical symptoms. Sometimes they have emotional symptoms too, like anger or sadness.

    Different people with CFS can have different symptoms. Many CFS symptoms are similar to those of other health conditions, like mono, Lyme disease, or depression. And the symptoms can vary over time, even in the same person.

    This makes treating the illness complicated. No single medicine or treatment can address all the possible symptoms.

    CFS is sometimes called myalgic encephalomyelitis . Myalgic means muscle aches. Encephalomyelitis means that there may be inflammation in the brain or spinal cord.

    You Feel Even Worse When You Push Your Limits

    Stress, Fatigue, and Chronic Pain

    The technical term is post-exertional malaise. It means that when you put more stress on your body than it can handle, your symptoms flare. lymph nodes might swell up, said Keller, or they might have joint pain, or pain in other areas.

    The authors of the IOM report quote one patient who described it like this: When I do any activity that goes beyond what I can doI literally collapsemy body is in major pain. It hurts to lay in bed, it hurts to think, I cant hardly talkI cant find the words. I feel my insides are at war.

    It may take a full day to recover, or longer.

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    Viral And Other Infections

    Post-viral fatigue syndrome or post-viral syndrome describes a type of chronic fatigue syndrome that occurs following 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 including 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.

    Similar risk factors have also been found following the bacterial infection Q-fever. 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.

    Children Young People And Me/cfs

    ME/CFS can affect people of all ages, including the very young. Young people with ME/CFS, especially children under the age of ten, might have trouble knowing or articulating that something is wrong. They may not realise that their loss of stamina, or other symptoms they are experiencing, are not normal. Alternatively, they may not have the words to describe what they are feeling.

    For both younger children and teenagers, schooling can be affected but ME/CFS is not school refusal. While school refusal can often be accompanied by physical complaints , and these complaints may tend to disappear when the young person stays home, the pattern is different with ME/CFS. In a young person with ME/CFS, some symptoms never ease and symptom exacerbation is triggered by activity. In ME/CFS, symptoms are likely to be worse after school attendance, and can reduce with pacing and rest, which includes time away from school or during holidays.

    Some young people with ME/CFS can continue to attend school, and others may be too unwell for regular classroom attendance. Parents, healthcare providers, schools and the child or teenager need to work together to come up with a plan for the young persons continued education. This plan needs to take into account the energy limits of ME/CFS. Being creative and flexible is key and might include things like fewer subjects or school from home.

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    The Double Challenge Of Stress In Me/cfs And Fibromyalgia

    By Bruce Campbell

    Stress can be a challenge for anyone, but it can be doubly difficult for people who have ME/CFS or fibromyalgia.

    In addition to whatever stresses you had before becoming ill, sickness adds new ones, including the discomfort of symptoms, isolation, financial pressure, loss of identity and meaning, strained relationships and uncertainty about the future.

    Second, there is something special about ME/CFS and FM that makes people with them more sensitive to stress than before. It is as if ME/CFS and fibromyalgia reset your “stress thermostat,” so that the effects of a given level of stress are greater than they would be for a healthy person.

    I remember how any kind of conflict set off my symptoms and often things as simple as making decisions like what toothpaste to buy felt overwhelming. Even modest amounts of stress greatly intensified my symptoms, creating a feedback loop in which my symptoms and my response to them intensified one another.

    Once I realized how vulnerable to stress I had become, I decided that dealing with stress sensitivity had to be a big part of my effort to manage CFS, I would say that controlling stress was one of the two most important things I did to cope with CFS, the other being pacing.

    Stress leads to bodily changes. Any of the following can indicate that we are under stress:

    • Muscle tension
    • Feeling anxious or nervous
    • Nervous movement
    • Irritability
    • Sleep problems
    • Grinding teeth or clenching jaw
    • Increase in ME/CFS or FM symptoms

    How We Do It

    Chronic Fatigue Syndrome

    The CPFRC provides educational opportunities for patients and health care providers through this Website, participation in research studies, presentations at scientific and patient conferences, studies and articles published in peer-reviewed scientific and patient-advocacy journals.

    Internally, we continue to educate ourselves by attending lectures given by faculty and researchers from our team, other U-M divisions and invited external speakers. In addition, we encourage junior faculty from U-M and elsewhere to become involved in this field.

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