The Role Of Doshas In Cfs
When these doshas are out of balance they affect the Dhatus . Agni with help of Apana & Prana composes all Dhatus. When any of the three doshas disturbs.
It affects all components of the body. This creates further weakness for the tissues resulting in loss of immunity. During this time opportunistic agents or parasites get a chance to affect the body further.
When these three doshas are not in balance. It results in loss of appetite, poor digestion, fatigue, anxiety, etc., which are the major symptoms of Chronic Fatigue Syndrome.
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.
The Possible Impact Of Me/cfs On The Family
A child or adolescent affected with ME/CFS presents challenges for the entire family. The challenges are similar to those faced by families of children with other chronic illnesses such as leukemia or juvenile rheumatoid arthritis, but with the additional challenges of widespread disbelief in the authenticity of the illness, the pervasive social stigma associated with a diagnosis of ME/CFS and a paucity of medical professionals who are knowledgeable about the illness.
In our experience, the majority of families draw on their strengths. The parents are usually able provide the necessary care, and siblings learn to cope with diminished parental attention. When families cope well with their childs illness, the risk of emotional damage to siblings is minimized.
Research has shown that siblings of young patients with ME/CFS are more anxious than normal adolescents. Siblings identified factors having a negative impact on their lives, as lack of knowledge about the illness, change in their role in the family, lack of communication within the family, new restrictions placed on family life, change of parental focus, emotional reaction to having a sick sibling, and the social stigma of being the sibling of a young person with ME/CFS. Communication within the family, social support and extra activities were found to have a positive impact .
Helpful strategies to support the family can include:
Participation of both parents in the evaluation and management of the patient.
Also Check: Is Fatigue A Sign Of High Blood Pressure
Fukuda Research Case Definition For Chronic Fatigue Syndrome
Patients can be classified as having CFS if they meet the following criteria:
1. The individual has had severe, clinically evaluated, persisting or relapsing fatigue for six or more consecutive months. The fatigue is not due to ongoing exertion or other medical conditions associated with fatigue. The fatigue significantly interferes with daily activities and work.
2. The individual has four or more of the following symptoms, persisting, or relapsing and concurrent with the fatigue:
Post-exertional malaise lasting more than 24 h
Unrefreshing sleep
Significant impairment of short-term memory or concentration
Muscle pain
Pain in the joints without swelling or redness
Headaches of a new type, pattern, or severity
Tender lymph nodes in the neck or armpit
A sore throat that is frequent or recurring
3. A thorough medical history, physical examination, mental status examination, and laboratory tests are necessary to identify other conditions with similar symptoms that require treatment. The diagnosis of chronic fatigue syndrome cannot be made without such an evaluation.
Does Coffee Cause Brain Fog
Coffee is one of the main substances that can disrupt your sleep cycle. Only 400 mg of caffeine can have a direct influence on your central nervous system even six hours upon consumption.In this way, coffee can severely affect you and cause brain fog that you may not easily anticipate. Gradually removing coffee from your life could help you find mental and physical health when you suffer from brain fog syndrome.
Read Also: Is Chronic Fatigue Syndrome A Disability
Fresh Evidence Points To A Cause And Possible Treatments For Chronic Fatigue Syndrome
Chronic fatigue syndrome, or myalgic encephalomyelitis, has been largely dismissed as psychological. But recent trials of antiviral and immunosuppressant drugs have yielded encouraging results, suggesting a complex disease mechanism at play that researchers are hopeful they might be able to treat.
Drug research
Shutterstock.com
Anna suffered severe symptoms of chronic fatigue syndrome , a mysterious disease also known as myalgic encephalomyelitis , from the age of 21 years. The disease forced her to abandon her masters degree and leave her job as a teacher. She became increasingly confined to her apartment, removed from the life she once knew. Any time I tried to do something that I didnt have the energy for, I felt nauseous and dizzy, with fever and pains in my joints and muscles, she says.
After a couple of years she sought help from a physiotherapist for her wasting muscles. mentioned this study and asked if she could give my name to the researchers, she says. So in 2008, Anna was enrolled in a phase II double-blind placebo-controlled trial testing a radical new treatment for CFS/ME. The research group, from Norways Helse Bergen University, administered intravenous drips to Anna but she showed no improvement and, after 12 months, discovered she was in the placebo arm of the trial. She was then eligible to receive the real medicine.
For the first time in my life I felt restless because I wanted to do things
Identify Treatments Youve Tried
In addition to tracking the symptoms you have experienced, keep a list of treatments you have tried. The Centers for Disease Control and Prevention provides a medications and supplements list you can use to track your medications, their dosage, how well they help, and if you experienced side effects. Write a separate list of other treatments you have tried beyond medications and supplements, such as cognitive behavioral therapy, exercise, acupuncture, or meditation.
Don’t Miss: Headache And Fatigue After Eating
Physiologic Responses To Upright Posture
In response to standing, approximately 500750 mL of an adults blood volume is redistributed to vessels below the level of the heart. A similar circulatory change is thought to occur in adolescents. At all ages, the response to the gravitational pooling of blood is a reduction in blood return to the heart, in turn leading to a drop in cardiac output, less stretch of baroreceptors, and ultimately less blood flow to the brain. The nervous system response involves an increase in sympathetic neural outflow, improved vasoconstriction, up to a 40 bpm increase in HR, and the return of enough venous blood to maintain BP and cerebral perfusion . Symptoms of OI can appear when these adjustments do not occur in an efficient manner.
Figure A1. The three main pathophysiologic influences on orthostatic intolerance are shown in this Figure. Increased pooling of blood, or defective vasoconstriction in the lower half of the body, along with lower intravascular volume are each important, and can be present in the same individual. Upon assumption of an upright posture, exaggerated sympathetic nervous system and adrenal hormone responses lead to increased release of epinephrine and norepinephrine . It is postulated that the relative balance of NE to Epi is one factor in determining whether the phenotype of OI is POTS or neurally mediated hypotension . Some patients with POTS in the early phase of orthostatic testing go on to develop a classic NMH pattern later in the test.
Home Remedies And Lifestyle
Making lifestyle changes may greatly impact how you feel, and the specific changes you need can depend on the severity of your illness and whether certain activities exacerbate your symptoms. While some people may see the tremendous benefit just from making changes to the way they eat, for example, others may find that more sweeping changessuch as a job changemay be necessary.
Read Also: Stage 4 Lung Cancer Extreme Fatigue
The Aetiology And The Pathogenic Mechanisms Of Cfs
As the criteria for CFS diagnosis are not based on the understanding of aetiopathogenic mechanisms, some patients present similar clinical manifestations but are diagnosed with other conditions because fatigue is not the primary symptom. Some of those conditions are fibromyalgia, irritable bowel syndrome, and temporomandibular joint syndrome. Furthermore, in addition to sharing several symptoms with CFS, currently available evidence suggests that those diseases also share similar pathophysiologic mechanisms .
Although the aetiology and the pathogenic mechanisms of CFS are not fully understood, several hypotheses have been postulated and described below, being the disorders of the central nervous system neuromodulator the one supported by more evidence to explain the possible pathogenic mechanisms involved in CFS .
Infectious theory
Epstein Barr virus, Candida albicans, Borrelia burgdorferi, Enterovirus, Citomegalovirus, Human Herpesvirus, Espumavirus, Retrovirus, Borna virus, Coxsackie B virus, and hepatitis C virus have been associated to CFS, but their pathogenic relationship with the syndrome has not been demonstrated .
Immunological theory
Neuroendocrinological theory
In patients with fibromyalgia, the research on neurotransmitter disorders has started to yield positive findings, and it is known that different clinical manifestations will appear according the type and the site of action of affected neurotransmitters .
Pathophysiological Basis For Symptoms
Despite the wide variability in precipitating factors and in pathophysiological findings, there appear to be some common underlying mechanisms behind the most prevalent symptoms.
Infection
Although sporadic cases are more common, ME/CFS can also occur in cluster outbreaks, suggesting an important etiologic role for microbial pathogens. This assumption is supported by the common pattern of an abrupt onset in association with flu-like symptoms in many sporadic cases. In the absence of evidence of persistent replication of an infectious agent, the main scientific debate currently centers around whether there is an occult active persistent infection or whether infectious agents have been cleared, but have triggered chronic symptoms due to a maladaptive host immunologic response.
Some studies in adult patients with ME/CFS report benefit from anti-viral treatment, suggestive of a viral pathophysiology, but other studies have not confirmed the efficacy of anti-viral treatment . We are not aware of studies of anti-viral agents in young patients.
Immune Dysfunction
A small randomized trial in adults demonstrated improvement in ME/CFS symptoms after rituximab-mediated B-cell depletion , but there have been no pediatric studies.
Circulatory Abnormalities
Low blood volume has also been found in some adult patients with ME/CFS . The initiation of treatments directed at OI can sometimes relieve ME/CFS symptoms in pediatric as well as adult patients .
Neuroendocrine Abnormalities
Recommended Reading: Dizzy Shortness Of Breath Fatigue
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.
Mild Pain Relievers And Nsaids
CFS/ME patients may benefit from NSAIDs, which are commonly used to relieve pain and reduce inflammation. In this context, the NSAIDs include ibuprofen and naproxen. They sometimes relieve frequent or severe joint and muscle pain, headaches, and fevers .
Other prescription medicines include anticonvulsants, also called antiseizure medicines. These drugs are sometimes prescribed for pain and sleep problems. They seem to work best when used for nerve pain. Antidepressant medicine is also prescribed to ease depression and anxiety, to enhance the ability to concentrate and to improve sleep quality . For their part, narcotic medicines are sometimes prescribed for pain that is not relieved by overthecounter drugs. Narcotics are generally reserved for the most severe cases because of the risk of addiction, and are used only for a short time .
Also Check: What Does Rheumatoid Arthritis Fatigue Feel Like
Trending Clinical Topic: Chronic Fatigue Syndrome
Ryan Syrek
Each week, we identify one top search term, speculate about what caused its popularity, and provide an infographic on a related condition. If you have thoughts about what’s trending and why, share them with us on or . Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.
Recently published consensus recommendations on the diagnosis and management of myalgic encephalomyelitis/chronic fatigue syndrome , along with interest in its connections with long COVID, resulted in this week’s top trending clinical topic. A week after the National Institute for Health and Care Excellence delayed publication of updated guidance on ME/CFS, outraging a coalition of charities, the 23-member US ME/CFS Clinician Coalition . The document was published in Mayo Clinic Proceedingsand is the culmination of work that began with a summit held in March 2018. The target audience is both generalist and specialist healthcare providers.
From the eagerly anticipated release of consensus recommendations to ongoing interest in the similarities with post-acute COVID symptoms, interest in ME/CFS made it this week’s top trending clinical topic.
Read more clinical information about ME/CFS.
Any views expressed above are the author’s own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Ryan Syrek. Trending Clinical Topic: Chronic Fatigue Syndrome – Medscape – Sep 03, 2021.
Tables
Oi: Standing Test Protocol
The standing test begins with the subject lying supine with an automated BP cuff set to measure the baseline HR and BP. These are recorded each minute for 5 min. At the fifth minute, the patients current symptom intensity is rated on a scale of 010.
The patient is then instructed to stand, leaning back against a wall in a comfortable but motionless position. The patients feet should be 26 inches away from the wall. The HR and BP are recorded and any symptoms are noted each minute for a maximum of 10 min. At the conclusion of the standing period the patient is instructed to lie supine again, while the BP, HR, and symptom intensity are measured for a further 2 min.
Specific instructions for the patient are as follows:
Recommended Reading: Leg Cramps Dizziness Fatigue Nausea
Brain Research Sheds Light On How Fatigue Becomes Chronic
Posted June 3, 2016
Fatigue occurs for three reasons. In most instances, it is the normal reaction of the body to lack of sleep, overwork, acute illness and acute mental stress. It is a powerful physical reaction to events that sap our energy in a variety of ways. We only recover from these situations by rest and sleep. It may take one good nights sleep or several days of rest to recover from the flu, running a marathon, or working overtime to meet a deadline. But once we obtain that rest and restorative sleep, we recover. The feeling of fatigue goes away as we return to normal states of energy and physical and mental well being.
The second cause of fatigue is chronic illness. People with severe congestive heart disease, renal disease, anemia or chronic pulmonary diseases are often very easily tired. These disorders are often treatable, but when they are severe, the accompanying fatigue can be difficult to reverse. In addition, those with low thyroid, low testosterone, and other hormonal disorders often suffer from fatigue. Fortunately, these latter groups recover when given appropriate hormone replacements. Of course, depression and insomnia can also cause fatigue and effective treatment helps.
Here is a quote from Noakes book, The Lore of Running:
Since that time, I have had the opportunity to share my knowledge of mind-body syndromes with others and assist them as well in healing from the numerous and diverse illnesses, pain and fatigue that they have suffered from.
Impact Of Me/cfs Symptoms On Learning
Several prominent ME/CFS symptoms affect the students ability to learn. Cognitive problems are evident in most students even if they are less severely affected. Students experience mental confusion, forgetfulness, difficulty concentrating, a short attention span and a slowing of mental processing speed. Working memory can be significantly reduced and there is often increased distractibility, which can be exacerbated by noise in the classroom . IQ scores might be lower than the scores of healthy peers . Cognitive problems can sometimes mimic attention deficit disorder without hyperactivity. For those with more severe illness, cognitive problems are very limiting. Generally, if students are homebound, the most that they can manage are one or two essential or core subjects. Although not easy and requiring a real commitment, completing school work can give the student a real sense of achievement, which is important. The homebound student usually needs regular help from someone such as a Visiting/Homebound Teacher.
Students with ME/CFS are often unable to handle simple math calculations. They might be able to complete the steps to solve a complex problem correctly, but can make simple addition, subtraction, or multiplication mistakes. Teachers should be aware of this problem when grading tests .
Don’t Miss: How To Combat Menstrual Fatigue
