How Is Chronic Fatigue Syndrome Diagnosed

What Causes Myalgic Encephalomyelitis

The underlying cause of ME/CFS is still not well understood. Prior to a ME/CFS diagnosis, patients are mostly healthy, fully functional and have a good quality of life.

• Approximately 50-80% of people with ME/CFS start suddenly with a flu-like illness.
• ME/CFS is often found after infection by a virus, bacterium, or parasite, suggesting an immunological dysfunction, accompanied by a strong genetic predisposition, as shown in twin analysis.
• Viral involvement is a well-supported theory due to the high index of an infectious onset in at least half of the patients.
• Life stressors can cause a negative impact on the neuroendocrine circuits of stress, leading to other complications besides immunological impairment.
• In addition to immune and viral aetiology, the attenuation of the hypothalamus-pituitary-adrenal axis is documented in adult and adolescent ME/CFS patients, with marked evidence of systemic hypocortisolism, which can influence immunological and neuronal homeostasis.
• Studies have reported enhanced sympathetic nervous activity, as well as increased levels of catecholamines in ME/CFS, providing some evidence for a neuroactive pattern in the pathophysiology of ME/CFS.

Find A Chronic Fatigue Syndrome Healthcare Provider

The more you know about chronic fatigue syndrome , the better prepared youll be when trying to find a healthcare provider. Its a difficult process, and you may need to educate a few health-care professionals along the way. Be sure you know the list of symptoms and become familiar with the various ways ME/CFS is treated.

The crux of the problem is that no medical specialty has claimed ME/CFS, so finding a knowledgeable healthcare provider isnt as easy as with most illnesses. Even fibromyalgia, which is considered closely related to CFS, falls under the auspices of rheumatology. Chronic fatigue syndrome is not well understood, and many health-care providers have a hard time recognizing it. Some dont even believe it is an actual condition.

All this means that the burden of finding someone qualified to treat you falls squarely on your shoulders. However, you have a number of resources to use in your search.

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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Role Of The Health Practitioner In Diagnosis And Management

Young people who appear to have ME/CFS should be evaluated by a physician. A comprehensive history, a thorough physical examination, and appropriate laboratory testing are necessary to make the diagnosis and to exclude other fatiguing illnesses. Co-morbid illnesses are common and require appropriate treatment . Some patients with an initial diagnosis of ME/CFS are later found to have a different treatable illness.

Establishing a diagnosis frequently provides the patient and parents much relief. Early diagnosis of ME/CFS can lessen the impact of the illness through timely support and intervention. The unequivocal advice for careful avoidance of overexertion can help to both avoid deterioration and facilitate improvement.

Since there is no medication or intervention which will cure ME/CFS, clinical care focuses on managing symptoms and improving function. A management plan might include:

Educating the patient, the parents, the family, and the school about the illness .

Guidance on determining the optimum balance of rest and activity to help prevent post-exertional symptom worsening.

Advice on diet, social interactions, and education.

The treatment of symptoms with non-pharmacological interventions and/or medications.

Regular assessment of progress and watchfulness for the emergence of other illnesses.

Literature Review And Findings

In response to the proposals, WHO conducted an extensive literature review of research relating to chronic fatigue. The review found that there remains insufficient evidence to classify chronic fatigue as an infectious disease, at this time. The review also confirmed the lack of consensus on a reliable diagnostic pattern of symptoms, the continued debate about etiology and the absence of any uniform or reliable treatment. The only constant in the studies reviewed was the lead symptom of fatigue, persistent over time.

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Oral And Dental Issues

Dental and orofacial problems are found in many young people with ME/CFS, but are often neglected because the young patient is too ill to make dental office visits. Correction of dental problems can improve overall health. Commonly reported problems are xerostomia , dental caries, periodontal disease, bruxism, temporomandibular joint disorder and impacted third molar teeth.

Dental visits can be stressful, result in lingering discomfort and debilitating fatigue and recovery can be prolonged. Young patients with ME/CFS and orthostatic problems might not tolerate prolonged sitting in the dental chair and some young patients have difficulty in maintaining an open mouth for the duration of dental treatment.

During dental procedures, discomfort can be minimized by the use of a mouth prop to maintain an open posture of the mouth. The smallest size mouth prop that is effective should be used. Dentists also need to be familiar with the clinical features of OI and be prepared to treat patients at risk of developing syncope. Treatment planning of elective dentistry in more extensive cases should allow time between appointments to recover from fatigue.

Treatment for dental caries and periodontal disease follows standard dental practice. For those who might be concerned about whether mercury amalgam fillings should be avoided, all scientific and medical/dental organizations support the safety of amalgam.

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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Prescription Stimulants For Me/cfs

Some healthcare providers prescribe attention deficit disorder/attention deficit hyperactivity disorder drugs for their patients with ME/CFS and say theyve seen positive results. There is a growing body of evidence to back this up, although more research is needed.

These drugs are classified as neurostimulators, which means that they stimulate brain activity. Theyre used for ADD/ADHD because, paradoxically, they have a calming effect on ADD/ADHD brains. Given that, it makes more sense that theyd be helpful in a condition defined by fatigue.

The most popular stimulants prescribed for chronic fatigue syndrome include:

• Ritalin and Concerta, which contain methylphenidate
• Dexedrine, which contains dextroamphetamine
• Adderall, which contains amphetamine and dextroamphetamine
• Vyvanse, which contains lisdexamfetamine

Getting Older And Me/cfs

There is very little information on getting older and ME/CFS, however people can develop ME/CFS at any age. Additionally, all of the strategies such as pacing to reduce PEM and managing symptoms still apply. As people age, other problems with their health may also arise, so discussing any new symptoms with their doctor important.

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What I Want People To Understand About Eds And Cfs

I have never been able to answer the question “What is it like to be sick?” particularly well. How can I explain the hundred tiny adjustments I make every day? Or the challenge of chores and hobbies? Or the isolation of having to cancel plans yet again because of a flare-up? It can be challenging to convey other aspects of my life, too: Choosing my clothes to protect my joints from cold turning down foods I like because of nausea or having to go to bed at 9 p.m. because I need at least nine hours of sleep to function properly.

Through my Wilde Investigations book series, I have found the voice to explain my world to others. To some readers, my books offer a glimpse into a life they’re lucky enough to never have to experience firsthand. For others, it’s finally seeing themselves as the central character in a world filled with magic and wonder. The greatest compliment readers can pay me is telling me that my books made them feel seen.

The nature of illnesses such as EDS or CFS is that they are invisible. When I work my dog in the obedience ring or give a talk, it would be impossible to tell from looking at me that I have a chronic condition. As strange as it may seem, that is how I prefer it. On a good day, when I have no need for a cane or a sling, no one needs to know that I’m sick.

Who Diagnosis Chronic Fatigue Syndrome

Depleted uranium

Depleted uranium was widely used in tank kinetic energy penetrator and autocannonrounds for the first time ever during the Gulf War and has been suggested as a possible cause of Gulf War syndrome. A 2008 review by the U.S. Department of Veterans Affairs found no association between DU exposure and multisymptom illness, concluding that exposure to DU munitions is not likely a primary cause of Gulf War illness. However, there are suggestions that long-term exposure to high doses of DU may cause other health problems unrelated to GWI.

More recent medical literature reviews disagree, stating for example that, the number of Gulf War veterans who developed the Gulf War syndrome following exposure to high quantities of DU has risen to about one-third of the 800,000 U.S. forces deployed, with 25,000 of those having had a premature death. Since 2011, US combat veterans may claim disability compensation for health problems related to exposure to depleted uranium. The Veterans Administration decides these claims on a case-by-case basis.

A team at the University of Portsmouth led by Professor Randall Parrish tested urine samples of 154 US veterans in 2021, reporting that no soldiers with the syndrome were exposed to significant amounts of depleted uranium and that it is not and never was in the bodies of those who are ill at sufficient quantities to cause disease.

Pyridostigmine bromide nerve gas antidote

Organophosphates

Organophosphate pesticides

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Treatment Of Chronic Fatigue Syndrome

• Acknowledgment of patients 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 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.

Your Next Steps Towards A Proper Diagnosis

If your diagnosis came before 2015, I encourage you to book a follow-up appointment with your physician. Go through the new diagnostic procedures together. Make note of whether you still fit the diagnostic criteria.

If you no longer fit the diagnostic picture, be assertive. Ask your doctor to perform more testing that can help you identify the root cause of your fatigue. If your lab tests still come back within normal ranges, its time to find a knowledgeable functional medicine practitioner.

Now, I want to hear from you!

Did the change in diagnostic criteria affect your diagnosis?

Do you really have CFS?

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Alternative Or Complementary Medicine

Since there is no standard treatment for CFS/ME, people often consider alternatives to traditional medicine or use non-traditional treatments to complement their other medications. Commonly used alternative and complementary treatments include:

• Mind-body treatments, like qigong, tai chi, and meditation
• Trigger point therapy, called myofascial release
• Chiropractic treatments

Complementary therapies have received mixed results when scientifically studied. Before beginning an alternative or complementary treatment, talk with your doctor to ensure that you arent trying something potentially dangerous.

Articles On Chronic Fatigue Syndrome

• Tips for Living With CFS

Thereâs no simple blood test or X-ray to diagnose chronic fatigue syndrome â also known as myalgic encephalomyelitis . And many of the symptoms of the illness — deep tiredness, unrelieved by rest or sleep, feeling worse after physical or mental exertion, trouble concentrating, feeling worse after standing and remaining on oneâs feet and other symptoms– are also seen in other conditions, too, making the diagnosis of ME/CFS more difficult.

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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.

Can Complementary Or Alternative Medicine Help Manage The Symptoms Of Me/cfs

Some people say that complementary or alternative medicine has helped their ME/CFS symptoms. Keep in mind that many alternative treatments, dietary supplements, and herbal remedies claim to cure ME/CFS, but some might do more harm than good. Talk to your doctor before trying alternative therapies to be sure theyre safe.

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A Trial Of Solriamfetol In The Treatment Of Myalgic Encephalomyelitis/chronic Fatigue Syndrome

This will be an 8-week single center, randomized, double-blind, placebo-controlled, flexible titration trial evaluating the efficacy of solriamfetol in the treatment of fatigue symptoms in adult patients with a diagnosis of ME/CFS. Subjects will be randomized to a solriamfetol group or placebo group . The investigators will utilize an intent to treat model and impute data, if statistically feasible, from dropouts utilizing a MNAR approach.

The trial involves primary, secondary, exploratory and safety/tolerability objectives.

Primary objective: Evaluate IMP efficacy in treating ME/CFS fatigue symptoms

Primary endpoint: Difference in means at week 8 between treatment and control groups as measured by the Fatigue Symptom Inventory.

How To Boost Energy Faster

It is important to know that the human body is mostly made up of water. So if you can bump up your water intake and match it up with some easy-to-do home-based exercises, you can count on a positive change in a shorter time frame

Dehydration in your body can drop your blood sugar levels rather quickly, thus pushing the body to work harder into supplying oxygen and nutrients to all cells. This would court more expense of energy and would make you exhausted even faster.

Drinking enough water every day would also boost your metabolism rate with amazing results and help you feel more energetic at times. It may also help you get rid of health issues like mental fog, poor concentration, dizziness, and short-term memory.

Here are some of the best tricks you can try to boost your energy and vitality.

1. Aromatherapy

Grab some dried rosemary and crush it up in your hand. You can hold this under your nose, or boil it into a rosemary tea and let the steam from the tea rise gently over your face. The smell of this herb will help stimulate your mind and give you energy.

2. Cover Your Face with a Cold Washcloth

Soak a washcloth in icy water, wring it out, and then place the cold cloth over your face. The cool temperature will stimulate your facial muscles and your mind, giving you renewed energy. You may do this multiple times in a day to feel rejuvenated.

3. Get some sunlight

4. Go for a brisk walk

5. Drink green tea

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How Does Me/cfs Affect People

ME/CFS affects different people in different ways, some more severely than others. There are four levels of severity of ME/CFS, which give an indication of the level of disability ME/CFS can create:

• mild: 50% reduction in pre-illness activity
• moderate: mostly housebound
• severe: mostly bedridden
• very severe: totally bedridden and need help with basic activities including nutrition and hydration.

The severity of ME/CFS can vary over time. A person living with ME/CFS could be at one level of severity now, then their disease could either improve or deteriorate over time. For some patients, their disease can worsen significantly with no known cause. Other patients have a fluctuating illness where they have better and worse periods, which last for months or years. It is unclear why this happens.

For most people, ME/CFS is a lifelong disease. Full recovery is rare and estimated at less than 10%. For some people with ME/CFS, as time passes and their disease improves, they will find they can do more, but it is a slow and gradual process. However, this is not the case for everyone. Some people find their disease worsens over time, others may remain somewhat stable. With support and pacing, people can often improve their quality of life.