What Doctor To See For Extreme Fatigue

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.

Why Doctors Have A Hard Time Diagnosing And Treating Cfs

Unlike diseases like cancer where there is a clear cut diagnosis because it is something doctors can see on x-rays and clear indication of treatment as friends and relatives can see the effects of chemotherapy treatment like loss of hair or weight, chronic fatigue syndrome has this invisible presentation where the patient looks normal but yet is so ill they have no energy to function in a normal capacity. In fact, many doctors, friends, and family tell individuals who suffer from CFS that its all in their head. CFS is difficult to diagnosis which is why it is important to seek out a physician who is an expert in diagnosing and treating chronic fatigue.

Problems With Current Research

Research into this important illness is hampered by small sample sizes, different definitions, and the lack of a coordinated approach. CFS is probably not one illness, and it is likely that the different phenotypes are due to different underlying biological pathways requiring different treatment approaches. This may explain the relatively low response rate to current treatments. To develop better treatments, we need larger trials with carefully characterized participants to understand more about treatment response. We need to develop treatments in the areas identified previously where there is no evidence for effective treatment. This includes the treatment of CFS and comorbid mood disorders, CFS in primary school children, those who are severely affected, and those with refractory fatigue. We also need to start to develop an understanding of the biology of CFS/ME and whether different biological pathways are associated with different disease phenotypes. Some early studies with small sample studies suggest that an omic approach to dissecting out the different subtypes may help to clarify different biological pathways. This approach will require a large bioresource of well-characterized patients.

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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.

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.

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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.

Pots: A Little Known Cause Of Extreme Fatigue

Everyone knows what being tired feels like at the end of a long day. But some people experience fatigue so severe and so seemingly random that its hard to describe. If that sounds familiar, there could be more going on than daily stress.

While there are many causes of fatigue, one of them is frequently missed and misdiagnosed: postural orthostatic tachycardia syndrome . Physical medicine and neuromuscular specialist Tae Chung, M.D., answers questions about POTS and extreme fatigue as one of its symptoms.

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When To See A Doctor

Fatigue can be a symptom of many illnesses, such as infections or psychological disorders. In general, see your doctor if you have persistent or excessive fatigue.

We have a Chronic Fatigue Specialist available to help you with your condition. Please set an appointment to see one of our professionals.

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

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Severe Or Very Severe Cfs/me

If you have severe or very severe CFS/ME, you will need more frequent reviews and increased support and care. You should also be referred:

• To a physiotherapist or occupational therapist working in an CFS specialist team for support on developing energy management plans.
• To a dietician with a special interest in CFS.

The process and pace of any CBT should be adjusted to meet your needs. This might include shorter, less frequent sessions and longer-term goals.

Continued Research Should Lead To Better Understanding And Treatments

A great deal more is known about ME/CFS today than 35 years ago. With continued and expanded support from the NIH, CDC, and private foundations dedicated to ME/CFS, I expect a lot of progress in the coming decade. Instead of doctors saying, The tests came back normal, there is nothing wrong, they will say, Tests showed us what was wrong, and we have treatments to fix it.

And doctors will recognize the wisdom of the wise advice we all learned in medical school: Listen to your patient. The patient is telling you the diagnosis.

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How Do I Know If I’m At Risk

While there is no explanation as to why a particular person may experience chronic fatigue syndrome, there are several factors that play an important role in influencing someones likelihood of being diagnosed with CFS. These risk factors include:

• Age: Most individuals with CFS will receive an official diagnosis when they are between 40 and 50 years old.
• Gender: Women are diagnosed with chronic fatigue syndrome two to four times more often than men.
• Genetics: It is commonly accepted that certain individuals are born with a predisposition to CFS.
• Stress levels: Inability to effectively manage stress can contribute to the development of CFS.
• Prior health concerns: While there is no clear link, evidence suggests that individuals who suffer from a compromised immune system, abnormal hormone levels, human herpes virus 6, Epstein-Barr virus, or mouse leukemia viruses may be more likely to become affected by CFS.

What Is Fatigue

Fatigue is a lingering tiredness that is constant and limiting. With fatigue, you have unexplained, persistent, and relapsing exhaustion. It’s similar to how you feel when you have the flu or have missed a lot of sleep. If you have chronic fatigue, or systemic exertion intolerance disease , you may wake in the morning feeling as though you’ve not slept. Or you may be unable to function at work or be productive at home. You may be too exhausted even to manage your daily affairs.

In most cases, there’s a reason for the fatigue. It might be allergic rhinitis, anemia, depression, fibromyalgia, chronic kidney disease, liver disease, lung disease , a bacterial or viral infection, or some other health condition. If that’s the case, then the long-term outlook is good. Here are some common causes of fatigue and how they are resolved.

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What You Can Do

Before your appointment, you may want to write a list that includes:

• Your signs and symptoms. Be thorough. While fatigue may be affecting you most, other symptoms â such as memory problems or headaches â also are important to share with your doctor.
• Key personal information. Recent changes or major stressors in your life can play a very real role in your physical well-being.
• Health information. List any other conditions for which you’re being treated and the names of any medications, vitamins or supplements that you take regularly.
• Questions to ask your doctor. Creating your list of questions in advance can help you make the most of your time with your doctor.

For chronic fatigue syndrome, some basic questions to ask your doctor include:

• What are the possible causes of my symptoms or condition?
• What tests do you recommend?
• If these tests don’t pinpoint the cause of my symptoms, what additional tests might I need?
• On what basis would you make a diagnosis of chronic fatigue syndrome?
• Are there any treatments or lifestyle changes that could help my symptoms now?
• Do you have any printed materials I can take with me? What websites do you recommend?
• What activity level should I aim for while we’re seeking a diagnosis?
• Do you recommend that I also see a mental health provider?

Don’t hesitate to ask other questions during your appointment as they occur to you.

How Would You Describe Fatigue Associated With Pots

People with POTS experience fatigue differently. Many describe it as feeling beyond exhausted. Its as if your energy is completely depleted. The fatigue is probably hundreds of times worse than your worst flu. People with POTS may also have trouble concentrating and thinking straight. Doing simple tasks may feel like youve just run a marathon.

This fatigue might come and go, hitting you without warning daily, weekly or less frequently. For some people, extreme fatigue lasts for days. Others may experience periodic attacks. It can come on at any moment even if you just woke up. And there is no amount of sleep or coffee that can make it go away.

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What Is Chronic Fatigue Syndrome

Chronic fatigue syndrome is a complex illness marked by extreme or debilitating fatigue that is not improved by rest. This condition includes other symptoms that may come and go. Chronic fatigue syndrome can affect your ability to think clearly, sleep or perform ordinary activities without exhaustion.

The cause of chronic fatigue syndrome is unknown. Some experts think two or more contributing risk factors might work together to cause it. This illness is most common in white women between 40 and 60 years old. However, it may be underdiagnosed in other groups of people.

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What Are The Symptoms Of Myalgic Encephalomyelitis/chronic Fatigue Syndrome

For many people, the symptoms of ME/CFS resemble other diseases, like influenza. Symptoms may come and go over time and may increase or decrease in severity. ME/CFS symptoms vary widely from person to person.

Many of the symptoms of ME/CFS make daily life difficult. These symptoms include:

• Severe fatigue lasting at least 6 months that does not improve with rest or sleep
• Difficulty sleeping
• Flu-like symptoms, including swollen lymph nodes , headaches, and joint pain
• Cognitive difficulties, including attention and memory problems

Less common symptoms of ME/CFS include:

• Problems with vision
• Irritable bowel, an intestinal condition causing painful bloating, gas, constipation and diarrhea
• Psychological issues, including mood swings, irritability and anxiety
• Tingling or numbness in the feet, hands or face

For many people, ME/CFS symptoms get worse following physical exercise or strenuous mental exertion. In some cases, orthostatic intolerance causes dizziness, weakness, and fainting.

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What Is The Treatment For Chronic Fatigue Syndrome

A treatment plan for CFS aims to relieve your symptoms to improve your quality of life. The plan should include:

• a plan for how to manage stress
• a very gentle exercise plan
• a nutritious diet, with regular meals/snacks to keep up your energy
• supplements if your diet lacks a good balance or if your blood tests indicate deficiencies
• a sleep management plan, which may include medication
• physiotherapy to help with pain and good breathing techniques
• medication for pain
• psychological input if you are particularly stressed or depressed.

Psychological Causes Of Tiredness

Psychological tiredness is much more common than tiredness caused by a physical problem. Both anxiety and depression can make you feel very tired. Eating disorders can make you feel tired, particularly if you are underweight or overweight. Any cause of a sleep problem will also cause tiredness during the day.

Stress is a common cause of tiredness, either because it interferes with sleep, or because of the effect of having a worry on your mind all the time.

Other possible causes include:

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Rheumatoid Arthritis And Fatigue

Symptoms: Fatigue, morning stiffness, joint pain, inflamed joints

Rheumatoid arthritis , a type of inflammatory arthritis, is another cause of excessive fatigue. Because joint damage can result in disability, early and aggressive treatment is the best approach for rheumatoid arthritis.

Medications that may be used early in mild RA include:

• Nonsteroidal anti-inflammatory drugs
• Disease-modifying antirheumatic drugs

Other drugs used in more serious forms of RA include the anti-cytokine therapies , as well as shots and other forms of treatment.

Other autoimmune disorders, such as lupus and Sjogren’s disease, may also cause fatigue.

What Else Should I Know

• Strong emotions can be a part of the illness, so its important to recognize and express your feelings. Feelings like sadness, anger, and frustration are completely normal and its important to acknowledge how you feel and recognize that its not your fault. Recognizing emotions can help you figure out whats behind your feelings and help you manage problems.
• It can help to keep a daily diary of feelings and energy highs and lows. This also can let you share information that might help your doctor. You can also track trends for example, if your energy is high at one time of day and low at another that will help you figure out when to exercise or do other activities.
• Give yourself more time to do things, especially activities that take concentration or physical exertion.
• Get support from family, teachers, and friends.
• Get information about CFS from reliable sources. Theres a lot of misinformation and confusion about this disease. So its important to know and trust your sources.

Most important, dont give up. Having chronic fatigue syndrome can be hard. But for most people, the symptoms are most severe in the beginning. Later, they may come and go. Teens with CFS generally get better faster and recover more completely than adults do. Most teens get partial or full recovery within 5 years after symptoms began.

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Is It Ever Normal To Feel Fatigued Every Day

While its perfectly normal to long for your bed at the end of a hectic workday, all of the experts SELF spoke to agree that constant fatiguemeaning you feel significantly tired daily and it starts to disrupt your day-to-day lifeis not something you should have to put up with. Daily fatigue, even in our pandemic-disrupted, high-stress lives now, is just not normal, Dr. Tallia says.

You should absolutely not feel significantly fatigued every day, Dr. Kane agrees. That needs an explanation.

What Is The Outlook For Someone With Chronic Fatigue Syndrome

The long-term outlook varies quite a bit. There may be times when your symptoms are not too bad and other times when they flare up and become worse. However, many people improve over time and some recover well. Children and younger people have a better rate of full recovery. Early diagnosis and treatment may lessen the impact of the illness. The important thing to remember is that this is not a progressive or life-threatening disease and that for many people full recovery is possible.

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