How To Treat Chronic Fatigue Syndrome
This article was co-authored by Chris M. Matsko, MD. Dr. Chris M. Matsko is a retired physician based in Pittsburgh, Pennsylvania. With over 25 years of medical research experience, Dr. Matsko was awarded the Pittsburgh Cornell University Leadership Award for Excellence. He holds a BS in Nutritional Science from Cornell University and an MD from the Temple University School of Medicine in 2007. Dr. Matsko earned a Research Writing Certification from the American Medical Writers Association in 2016 and a Medical Writing & Editing Certification from the University of Chicago in 2017. This article has been viewed 60,219 times.
Chronic Fatigue Syndrome, or CFS, is a debilitating condition which leaves the afflicted individual with an ongoing feeling of exhaustion. Persons with CFS may be unable to perform even mundane activities which under normal circumstances present no problem. There is no cure for CFS, and there are no medications developed specifically for the condition. Fortunately, there are a number of treatment options available which can alleviate the symptoms associated with CFS.
What Complications Are Associated With Myalgic Encephalomyelitis/chronic Fatigue Syndrome
For some people, the fatigue associated with ME/CFS makes activities of daily living very difficult or even impossible. Research shows that only half of all people diagnosed with ME/CFS work full-time or part-time jobs.
ME/CFS causes significant depression in many people living with the condition. If you experience depression, talk with your doctor â effective treatments are available.
Where Can I Get Support
Even in its mildest form, chronic fatigue can have a significant emotional and financial impact on your life. A lack of understanding and awareness about CFS/ME means patients can experience disbelief, and even discrimination, from friends, family, health and social care professionals and employers.
People need wider support in order to continue to manage aspects of their life. Information on entitlements to welfare benefits, accessing health and social care and others sources of support for patients and carers are available from Action for M.E.
Action for M.E. has a number of booklets that may be useful for people living with CFS/ME, their families and their health professionals. They also offer resources and services for children and young people affected by chronic fatigue and their families.
What Is Myalgic Encephalomyelitis/chronic Fatigue Syndrome
Myalgic encephalomyelitis/chronic fatigue syndrome is persistent and crippling fatigue lasting 6 months or longer. People living with ME/CFS often experience other symptoms, like unrefreshing sleep and muscle aches. The condition is also sometimes called chronic fatigue syndrome.
Doctors do not know what causes ME/CFS, and there is no cure. You may be able to manage symptoms with cognitive-behavioral therapy, exercise, and medications, like antidepressants and sleep aids. The goal of treatment is to make symptoms as manageable as possible to increase your quality of life.
What Helps My Fatigue
Even though nothing can completely alleviate my fatigue, there are some things that make it more manageable. If I dont treat it, it gets worse. To combat fatigue, my go-to habits include:
- Getting regular exercise and movement
- Eating healthy and stay hydrated
- Keeping a sleep routine
- Minimizing stress and keeping things simple
- Tracking my health and keeping a symptom journal
- Writing down things that are important
- Reminding others to remind me about things that are important
- Reading things three times over to understand or save for later
- Being kind to myself: I am fighting to climb an invisible mountain
- Taking certain vitamins and supplements like B complex, vitamin D, iron, and green tea
Dr. Barlett emphasized to me the importance of maintaining a sleep schedule. Ive spoken with many people who have experienced more fatigue during the pandemic, in part because they have felt more stressed, but also because their sleep schedules have become more erratic, she says. One of the best things we can do to ensure we stick to a regular sleep schedule by going to bed at the same time each night and get enough sleep. Too much screen time in the evening, heavy meals eaten late at night, and even strenuous exercise shortly before bed can also make it more difficult to fall asleep.
You can get creative with chores, she says. Dont pile all the laundry into one overflowing basket. Use it as an opportunity to make two trips and get a few more steps.
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Diagnosis Of Chronic Fatigue Syndrome
Laboratory tests to exclude other causes of symptoms
At least one of the following manifestations is also required:
Feeling of light-headedness or dizziness when standing up that is relieved by lying down
The frequency and severity of the symptoms should be assessed by a doctor. If people do not have these symptoms at least half of the time with moderate, substantial, or severe intensity, doctors reconsider the diagnosis of chronic fatigue syndrome .
Criteria for diagnosis are important mainly because they help doctors communicate clearly with each other when they study a problem. However, when treating a specific individual, doctors focus more on that person’s symptoms rather than the criteria.
How Is Myalgic Encephalomyelitis/chronic Fatigue Syndrome Diagnosed
Your doctor diagnoses ME/CFS by performing a mental and physical examination. Doctors will ask about your medical history and order blood and urine tests to check for infection. In many cases, doctors refer people with suspected ME/CFS to other specialists to rule out other illnesses that could be causing symptoms.
For your doctor to diagnose ME/CFS, you must have these 3 symptoms:
- Severe fatigue lasting at least 6 months that does not improve with rest or sleep
- Difficulty sleeping
- Fatigue that gets worse after mental or physical exercise
Additionally, you must have at least 1 of the following symptoms:
- Orthostatic intolerance
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Home Remedies And Lifestyle Changes
Making some lifestyle changes may help reduce your symptoms.
Limiting or eliminating your caffeine intake can help you sleep better and ease your insomnia. You should limit or avoid nicotine and alcohol too.
Try to avoid napping during the day if its hurting your ability to sleep at night.
Create a sleep routine. Go to bed at the same time every night and aim to wake up around the same time every day.
Increase Potassium And Magnesium Intake
Research shows that both potassium and magnesium can help improve the symptoms associated with chronic fatigue syndrome.
In a study published in the UK medical journal The Lancet, chronic fatigue syndrome patients were found to have low magnesium levels that accounted for a low red blood cell count.
In this study, patients that were treated with magnesium supplements self-reported improved energy levels, a more balanced emotional state and less pain. At the end of the six-week study, all patients that were given magnesium had their red cell magnesium levels return to normal.
If you have chronic fatigue syndrome, consider adding these magnesiumrich foods to add to your diet: spinach, chard, pumpkin seeds, yogurt and kefir, almonds, black beans, avocados, figs, dark chocolate and bananas.
These delicious foods can help you overcome chronic fatigue, one of the symptoms of a magnesium deficiency, and support healthy nerve function, healthy blood sugar levels, blood pressure regulation, and much more. Its estimated that nearly 80 percent of Americans are currently deficient in this essential mineral.
Potassium is responsible for proper electrolyte balance in the body. Potassium-rich foods include avocados, spinach, sweet potatoes, coconut water, kefir and yogurt, white beans, bananas, acorn squash, dried apricots and mushrooms.
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The Functional Medicine Approach To Chronic Fatigue Syndrome
Chronic fatigue syndrome, according to the CDC, affects between 836,000 and 2.5 million Americans and it can be a debilitating and life-changing condition.
Also known as myalgic encephalomyelitis , it is a complicated disorder that is often misdiagnosed by healthcare professionals.
Here we look at what chronic fatigue syndrome is, what causes it and how a functional medicine approach can provide an effective solution for those suffering from it.
Activate Your Lifestyle Again
The human body is designed to move, and if it sits too long, everything stagnates. Staying in motion increases blood flow, which washes out toxins, stimulates healing, and increases oxygen delivery to tissues. It also stimulates endorphins, the natural feel-good chemicals that reduce pain and stimulate immune functions, as well as stem cells, which are necessary to repair damaged tissues.
That said, experts warn that if you have chronic fatigue and overdo it, theres a risk of setback and post-exertional malaise , which is a worsening of symptoms such as fatigue, sleeplessness, cognitive issues, pain, dizziness, and more. So keep in mind that becoming active again must be a delicate balance between moving enough to gain benefit, but not so much that it aggravates inflamed tissues and causes further damage. Try these suggestions for starting slow and easy:
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Nourish Yourself With The Right Diet
Optimal nutrition is vital for overcoming any kind of chronic illness and related digestive issues. The right diet supplies the body with the proper balance of nutrients necessary for healing, acquired from foods that are naturally easy to digest, promote the growth of normal microbes in the gut, and support healthy metabolism.
To eat this way means leaving behind the processed food products that have come to dominate the modern food supply and are loaded with carbohydrates and toxic fat. These foods are mostly derived from processed forms of wheat, corn, soybeans, and sugar, all of which disrupt immune system function, communication, and all other systems in the body.
The best diet for overcoming chronic fatigue syndrome can be boiled down to six basic guidelines. Follow these, and youll quickly propel your recovery in a forward direction.
Memory And Concentration Problems
Memory aids, like organizers and calendars, can help with memory problems. For people with ME/CFS who have concentration problems, some doctors have prescribed stimulant medications, like those typically used to treat Attention-Deficit / Hyperactivity Disorder . While stimulants might help improve concentration for some patients with ME/CFS, they might lead to the push-and-crash cycle and worsen symptoms. Push-and-crash cycles are when someone with ME/CFS is having a good day and tries to push to do more than they would normally attempt .
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Signs You Have Chronic Fatigue
Chronic fatigue syndrome, also known as CSF, is a complex illness that affects approximately 17 to 24 million people each year. It can cause a wide array of symptoms, which can vary from person to person.
CFS is more than just being tired. It involves a feeling of ongoing fatigue, feeling unrefreshed even after sleeping and a variety of symptoms that worsen after physical activity. Myalgic encephalomyelitis, or CSF, cannot be diagnosed with a blood test. Diagnosis is made based on a persons symptoms, overall presentation and exclusion of other illnesses.
While some people who have CSF rely on medical modalities and treatment to alleviate their oftentimes painful symptoms, others may use a more holistic approach for symptom management.
Pragmatic Rehabilitation: The Fine Trial
Pragmatic rehabilitation is a programme involving gradually increasing activity designed collaboratively by the patient and the therapist. In response to an earlier successful trial, a larger trial was conducted. In this trial, patients fulfilling 1991 Oxford CFS criteria who were allocated to pragmatic rehabilitation reported a statistically significant though clinically modest improvement in fatigue compared with patients allocated to either supportive listening or treatment as usual, but after 12 months followup the differences were no longer statistically significant nor was there was any significant improvement in physical functioning at any time. About 10% of the trial participants were nonambulatory and about 30% met 1994 London criteria for ME, but separate results for these groups were not published . An accompanying editorial gave some possible reasons for the failure to replicate the earlier success in this trial, and called for further research. The patients in this trial had higher comorbidity and disability than patients in the earlier trial and in most other trials, and received fewer sessions than most successful trials of CBT and GET. The editorial also raised the question of whether generalists are as successful as specialists in offering behavioural interventions .
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Complexity Of Diagnosing Cfs
The complexity of this disorder is that it is unknown and vague. Many, including doctors, dont understand it or know what causes it. In the past, doctors told people suffering from CFS that they were hysterical or that their symptoms were physical manifestations of their psychological condition. A study conducted on CFS patients shows that 77% of the responders have had a negative experience with doctors.
However, some say its related to stress, illness, infection like a cold, or a virus like the Epstein-Barr virus the cause of mononucleosis. With so many variables, its no wonder why those suffering often feel confused by this ailment. If you feel you might have CFS, it is important to visit a doctor for an assessment.
How Chronic Fatigue Affects The Body
Unfortunately, this ailment is complex and no fun for those suffering. Below, youll find some ways how it impacts the body:
- Blurred vision or dizziness
- Flu-like symptoms, including headache or dizziness and sore throat
- Issues with remembering, thinking, and concentrating
- Fast, irregular heartbeats
- Mental health problems such as stress, depression, and anxiety
As you can see, the symptoms greatly range that can defer from person to person. From TCMs point of view, fatigue is harmful to your liver, kidney, and spleen. The liver itself circulates qi, or the energy responsible for the workings of the human body. Therefore, fatigue can affect the liver. This causes the flow of the qi to be disrupted as well, leading to illnesses.
TCM divides the illnesses into four categories: qi deficiency, yin deficiency, yang deficiency, and blood deficiency.
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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
Its Hiding In There Somewhere
Symptoms of CFS vary for each person and according to severity. If you suspect that you have CFS, understanding all the potential symptoms is the best approach. This way you can bring them to your doctors attention and get tests to rule out other conditions.
It may take time to get an official diagnosis, but you will be on the right path and can address each symptom as it occurs.
Fatigue is obviously the most common symptom, but it must have lasted for 6 months at least before it can be considered CFS. In addition to this continued fatigue, you must also have at least four other symptoms.
The possible symptoms include:
Rest does not alleviate the fatigue
Loss of memory or poor concentration
Unrefreshed feeling each time you wake up
Frequent sore throat
Swollen or tender lymph nodes
Extreme fatigue after physical and mental activities
CFS can also affect people in cycles, meaning some of the time they feel perfectly fine. There are periods of normality followed by periods of extreme fatigue, which can be confusing and makes diagnosis difficult.
Sometimes symptoms can disappear completely , but it is possible for them to come back.
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How Is Myalgic Encephalomyelitis/chronic Fatigue Syndrome Treated
There is no cure for ME/CFS. Treatment goals include managing symptoms and returning you to a higher quality of life. Some people arenât able to regain the level of health and function they had before their diagnosis.
First, your doctor works with you to determine which symptoms cause the most difficulty. Together, you will address those symptoms immediately.
Counseling is helpful for many people with ME/CFS. This type of treatment helps people better tolerate symptoms by changing thoughts and behaviors. Your doctor may prescribe medications, like antidepressants or sleep aids, if your symptoms are especially severe. These medications can relieve symptoms like unrestful sleep for some people living with ME/CFS.
Before prescribing sleep aids, however, your doctor may provide suggestions for improving sleep without drugs. For instance, he or she might suggest that you visit a sleep specialist. Other tips include:
- Develop a regular bedtime routineâgo to bed and wake up at the same time each day.
- Do not nap for more than 30 minutes total during the day.
- Use your bed and bedroom only for sleeping and sex. Take out all electronics.
- Avoid eating large meals before you go to bed also avoid alcohol and caffeine.
- Do your exercising at least 4 hours before you go to sleep.
Organize Your Medical Information
Having a handle on your medical information will make you a more powerful advocate for yourself.
I am a congenitally disorganized person. So, after years of papers flying all over the place, a friend helped me create a physical notebook, with tabs for Articles, Notes from Medical Appointments, Medical History, Current Medications, and Lab Results.
I had all of my lab results sent to me, and I alphabetized them with tabs, like Lupus, Lyme, Parvovirus, and Parasites. That made every appointment more productive for me and my providers.
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