Living With Chronic Fatigue Syndrome
Although experts have not yet found a cure for CFS/ME, many people who have the illness are able to make lifestyle changes and find treatments that allow them to reduce or manage their symptoms. Improvement is possible by living within your limits and working with a doctor to find treatments that help you. There are also many CFS/ME support groups both online and in-person. Meeting with such a group might prove to be helpful.
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Long Covid/ Long Haulers
Following the outbreak of COVID-19 in late 2019 in Wuhan Province, China, and its rapid spread into other parts of the world, researchers, scientists, and patients familiar with post-viral syndromes began to become concerned not only about the acute danger of this particular virus but the potential long-term sequelae. Following SARS-1, West Nile Virus, H1N1 influenza virus, and other reports claim, that up to 11% of patients who had severe infections from Epstein-Barr virus , Q fever , or Ross River virus , and others, develop ME/CFS. Other studies following SARS and MERS suggest an even higher proportion develop ME/CFS or Fibromyalgia.”
Given that some estimates suggest as much as 75% of all ME/CFS patients developed their illness following a post-viral or post-bacterial illness, there has been considerable frustration in the ME/CFS community-researchers and patients alike-that had ME/CFS patients been taken more seriously all along, then research into what causes this debilitating outcome in some patients and not in others would have been identified and potentially remedied by now.
Additionally, there is great frustration in the ME/CFS community as they watch these new cases as they are now being officially diagnosed as they pass the six-month mark required for official ME/CFS diagnosis.
Chronic Fatigue Cause No : Anemia
“If you are in your reproductive years, and particularly if you experience heavy menstrual cycles, have fibroid tumors or uterine polyps, or if you’ve recently given birth, the blood loss may have caused you to develop anemia — a leading cause of fatigue in women,” says Rebecca Amaru, MD, clinical instructor of obstetrics and gynecology at the Mount Sinai Medical Center in New York City.
Problems occur, she says, when the bleeding leads to a deficiency of hemoglobin, the iron-rich protein in red blood cells that carries oxygen from the lungs to other parts of your body. When your tissues and organs don’t get enough oxygen, she says, the result is fatigue.
Other causes of anemia include internal bleeding and a deficiency of iron, folic acid, or vitamin B-12. Anemia may also be caused by chronic diseases like kidney disease. Symptoms can include dizziness, feeling cold, and irritability.
To confirm a diagnosis of anemia, your doctor will give you a blood test. Treatment, she says, usually consists of iron supplements if iron deficiency is the cause, and adding iron-rich foods — such as spinach, broccoli, and red meat — to your diet.
The good news: With effective treatment for anemia, your fatigue should begin to lift in 30 days or less.
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How Is Chronic Fatigue Syndrome Treated
Treatment is determined by your healthcare provider and based on:
- Your overall health and medical history
- Extent of the condition
- Your tolerance for specific medicines, procedures, or therapies
- Expectations for the course of the condition
- Your opinion or preference
- Medicine, including corticosteroids, antidepressants, and others
- Light-intensity aerobic exercise
- Dietary supplements and herbal preparations
- Psychotherapy and supportive counseling
What Causes Chronic Fatigue Syndrome
The cause of CFS is not yet fully understood, but it is likely that several factors contribute to its development. There are changes in the immune system and body chemistry.
CFS is usually triggered by a viral infection, such as glandular fever or influenza, but any infection may be the trigger. It is likely that the potential for getting CFS is genetic and runs in families. Some people experience ongoing effects of COVID-19 infection, known as long COVID, which are very similar to the symptoms of chronic fatigue syndrome.
Other factors that may contribute include:
- emotional or physical distress
- multiple joint pain without joint swelling or redness
- headaches of a new type, pattern or severity
- unrefreshing sleep
- tiredness that can last for more than 24 hours after physical or mental effort.
Some people also report a range of other symptoms such as nausea, loss of appetite, irritable bowel syndrome , bloating, diarrhoea, irregular heartbeat, chest pain, jaw pain, night sweats, increased sensitivity to alcohol or medication, chronic cough, dizzy spells or dry eyes.
The severity of symptoms can vary from day to day, or even within a day.
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Symptoms Of Chronic Fatigue Syndrome
Most people who have chronic fatigue syndrome are successful and function at a high level until the disorder begins, usually abruptly, often following a stressful event. The main symptom is fatigue that usually lasts at least 6 months and is severe enough to interfere with daily activities. Severe fatigue is present even on awakening and persists throughout the day. The fatigue often worsens with physical exertion or during periods of psychologic stress. However, physical evidence of muscle weakness or of joint or nerve abnormalities is absent. Extreme fatigue may begin during or after recovery from an illness that resembles a viral infection, with a fever, runny nose, and tender or painful lymph nodes. However, in many people, fatigue begins without any such preceding illness.
Other symptoms that may occur are difficulty concentrating and sleeping, sore throat, headache, joint pains, muscle pains, and abdominal pain. Depression is common, particularly when symptoms are severe or worsening. Symptoms often overlap with those of fibromyalgia Fibromyalgia Fibromyalgia is characterized by poor sleep, fatigue, mental cloudiness, and widespread aching and stiffness in soft tissues, including muscles, tendons, and ligaments. Poor sleep, stress, strains… read more , a possibly related disorder.
Chronic Fatigue Cause No : Depression
Sometimes depression is at the root of fatigue. Depression affects twice as many women as men and often runs in families, starting between the ages of 15 and 30. Women can also get postpartum depression after the birth of a baby. Some people get seasonal affective disorder in the winter with feelings of fatigue and sadness. Depression is also one part of bipolar disorder.
According to Ronald Fieve, MD, psychopharmacologist and professor of clinical psychiatry at Columbia Presbyterian Medical Center in New York, mood is a dominant aspect of life. In his book, Bipolar II, Fieve explains that mood disorders are a large group of psychiatric conditions. Abnormal moods and physical disturbances — like changes in eating habits, sleep patterns and body motion, either speeded up or slowed down — dominate the picture.
While feeling low from time to time is normal,major depression needs medical treatment it is a risk factor for suicide. This medical problem is usually recurrent, with repeated depressive episodes. With major depression, you might be in a depressed mood most of the day with little interest in normal activities, Fieve says. “Along with feelings of fatigue, you may eat too much or too little, over- or under-sleep, feel hopeless and worthless, and have other serious symptoms.”
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Get Specialist Care When You Need It
Visit your doctor every few months to help track your symptoms and check for any need to change your treatment.
Get specialized care if you need it. For example:
- A rehabilitation specialist can help you treat pain and improve your ability to do your daily tasks.
- A pain management specialist can offer a number of pain treatments.
- There are some specialists who work with experimental treatments such as antiviral medicines.
Keep Track Of Your Symptoms And Their Onset
Tracking the frequency, timing, and severity of your symptoms might help your doctor better understand what youre experiencing. Tracking your activity level and symptoms can also help you draw connections and learn your limits so that you can reduce flare-ups.
When tracking your symptoms, remember to write down everything ailing you, not just fatigue. People with CFS/ME often also have issues with pain, cognition, such as memory and concentration, and sleep. You might also consider keeping a sleep diary, so your doctor can see how well youre sleeping and determine if sleep might play a role in your symptoms.
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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.
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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How Is Fatigue Related To Multiple Sclerosis
Fatigue is the most common symptom of multiple sclerosis . It occurs in 75 percent to 95 percent of patients with MS. Fatigue can occur at all stages of the disease. The symptom is not related to the severity or to the duration of MS. At times, fatigue interferes with function and is an important symptom to manage. There are a variety of ways to combat fatigue in MS.
What Are The Symptoms Of Chronic Fatigue Syndrome
Symptoms of CFS often mimic the flu. The following are the most common symptoms of CFS. However, each person may experience symptoms differently. Symptoms may include:
- Sensitivity to light
- Low-grade fever
The symptoms of CFS may look like other medical conditions. Always talk with your healthcare provider for a diagnosis.
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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.
Graded Exercise Therapy Controversy
The PACE TRIAL
In 2005, patient recruitment began for the PACE Trial – Pacing, Graded Activity, Cognitive Behavioral Therapy, and randomized Evaluation, which was conducted in the UK under the auspices of the UK Medical Research Council, Depart of Health and Social Care for England, Scottish Chief Scientist Office, and Department for Work and Pensions. The investigators were Peter White, a psychiatrist, Trudie Chalder, a professor of cognitive behavioral therapy, and Michael Sharpe, a professor of psychological medicine.
This study, which is the most well-funded single piece of ME/CFS research ever conducted, was designed to compare three different approaches to treatment:
1) Specialist Medical Care , which included the use of medications for symptoms management and instruction in avoidance of extreme activity or inactivity to SMC plus Adaptive Pacing Therapy , which is activity engagement limited by symptoms of PEM on one extreme and complete inactivity on the other
2) Informing the group that they were not ill, but rather deconditioned and should gradually return to activities and that there was nothing preventing their recovery and
3) CBT and GET with the premise that deconditioning, dysfunctional cognition, and false ideas were the source of their symptoms and functional limitations. The GET was to be advanced in a structured manner with the ultimate goal of the patients participating in regular aerobic exercise.
The consequences of the PACE Trial were:
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What Medications Are Used To Treat Fatigue
There is no cure for chronic fatigue syndrome. However, many over-the-counter and prescription medications, as well as alternative therapies, can help to ease the symptoms of this disorder.
Every patient with chronic fatigue syndrome is different. The symptoms of CFS can vary significantly from person to person. A health care provider will usually tackle the worst symptoms first that are interfering with daily life. This could mean treatment of sleep disorders in one person, muscle aches in someone else, and memory problems in yet another person. Some of the medications used to treat chronic fatigue syndrome are described below.
British Columbia Specific Information
Many Canadians are affected by complex chronic diseases . CCDs are illnesses that last a long time, require treatment and management, and often do not get better on their own. Fibromyalgia , Myalgic Encephalomyelitis , which is also called Chronic Fatigue Syndrome , and Chronic Lyme Disease are examples of complex chronic diseases.
To learn more about fibromyalgia, myalgic encephalomyelitis or chronic Lyme-like disease, visit HealthLinkBCs Complex Chronic Diseases health feature.
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Chronic Fatigue: Tired Of Feeling Tired
Learn what may be causing your chronic fatigue … and 10 solutions.
Sure, we all know what it feels like to be tired. But chronic fatigue refers to a lingering tiredness that is constant and limiting.
According Harris H. McIlwain, MD, Tampa-based rheumatologist and author of The Fibromyalgia Handbook, patients who complain of fatigue feel tired even when they’ve had plenty of sleep and should feel rested.
While some patients admit to feeling sleepy, with fatigue there’s usually there’s a feeling of exhaustion without feeling drowsy says McIlwain, an adjunct professor at the University of South Florida. “Some patients with fatigue compare it to having the flu or to the feeling after working very long hours and missing a lot of sleep.”
These patients say they are fatigued on arising in the morning, fatigued after mild activity such as grocery shopping, too fatigued to function adequately at work or do household chores, and too fatigued to exercise or have sex, McIlwain says. “In most cases, there’s a reason for the fatigue, whether poor time management, too much caffeine, anemia, fibromyalgia, depression, or even undiagnosed heart disease.”
Before you blame your age or your “superwoman” lifestyle on your feelings of fatigue, learn what might be at the root of your unexplained tiredness and what some top experts recommend to resolve your chronic fatigue.
Treatments For Chronic Fatigue Syndrome
Since researchers do not yet fully understand the cause of chronic fatigue syndrome/myalgic encephalomyelitis and people with the illness can experience a wide variety of symptoms, multiple treatments exist. Treatments are aimed at managing and reducing the severity of CFS/ME symptoms, rather than at curing the illness.
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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 .
Housebound Or Bedbound With Me/cfs
About 25% of people with ME/CFS are housebound or bedbound. Those who are housebound may be able to undertake minimal daily tasks for themselves, such as brushing teeth, cooking or using a computer for short periods of time, but they have to pace their activity and often use aids to help them . They are unable to leave the house, often because this requires more energy than they have available. When they do leave the house, they often need mobility aids such as a wheelchair or mobility scooter, or other assistance . Recovery from a trip out of the house can take days, or longer.
Some people are so severely unwell that they are bedbound some or all of the time. The most severely unwell may be unable to undertake even simple tasks, like eating or going to the toilet by themselves. They may require additional medical devices, such as feeding tubes, to help them get enough nutrition and fluids, and can be totally dependent on carers.
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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 they’ve 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. They’re used for ADD/ADHD because, paradoxically, they have a calming effect on ADD/ADHD brains. Given that, it makes more sense that they’d 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
