What Can I Do To Cope With Me/cfs
Talking about your feelings with a friend or family member can help. Sometimes it also helps to talk with people who are going through the same thing. Consider joining an ME/CFS support group. See the “ME/CFS Organizations” section at the end of this fact sheet for a list of organizations that offer additional information on ME/CFS and can help you find ME/CFS support groups.
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 .
Will I Still Be Able To Work With Me/cfs
Research shows that about half of people with ME/CFS work part-time or full-time jobs. For some people with ME/CFS, the ability to work is possible thanks to a supportive employer and certain workplace accommodations, including a flexible schedule, a quiet comfortable place to rest, and memory aids.
But, if you can’t work because of ME/CFS, you may be eligible for Social Security benefits. Learn more about applying for disability through the Social Security Administration.
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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
Chronic Fatigue Syndrome Symptoms
Chronic fatigue syndrome is diagnosed on the basis of extreme fatigue lasting at least 6 months, with no indications of underlying causes or explanations. This fatigue often worsens with physical activity, yet no amount of sleep can leave a person feeling well-rested.
- Difficulty with memory and inability to concentrate
- Dizziness that worsens with physical activity
- Sore throats
- Unexplained muscle or joint pain
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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
- Muscle aches
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.
Additional Naturopathic Work Up For Chronic Fatigue Syndrome And Fibromyalgia
Naturopathic medicine views a patient from a holistic perspective. It is not simply about using natural substitutes for drug products or surgery. A clear diagnosis such as that which comes from fitting the above criteria is important, and it is just as important to evaluate other factors which may contribute to the symptoms and intensity of CFS / fibromyalgia.
As an example, a naturopathic approach in depression might involve, depending on the detailed history, looking at subtle thyroid or adrenal hormone imbalances, toxicities that affect neurological function and communication, deficiencies or dependencies on nutrients that affect mood, or sometimes even infection or inflammatory disorders. It would not simply involve giving a natural substitute for the serotonin reuptake inhibitor drugs, although that could be a part of the whole plan.
In trying to investigate suitable naturopathic treatments for chronic fatigue syndrome, we might look at things such as hormone balance, tests for micronutrient deficiencies, toxins that may impair energy production within the cell, whether or not a specific chronic fatigue syndrome diet may be suitable for one persons individual case, as examples.
Our work up for chronic fatigue syndrome and fibromyalgia for example may include the following tests depending on the case:
hsCRP to assess for inflammation
ESR to assess for inflammation
blood chemistry panel
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Talk To Your Doctor About Chronic Fatigue Syndrome
If you suspect you may have ME/CFS, consult your doctor. You might keep an activity log or health journal to note changes in your wellbeing and help your physician understand your situation. With the aid of your physician, you can eliminate other possible causes of your fatigue. Then, together you can develop a plan for treatment and relief of symptoms.
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Management Of Chronic Fatigue Syndrome Symptoms
Rest and sleep in CFSRest periods in the daily routine are part of management strategies for all people with chronic fatigue syndrome. Relaxation techniques at the beginning of each rest period can be helpful. Try to balance the need for rest during the day against how you are sleeping at night. Introduce changes to your sleep pattern gradually.
Physical functioning and mobility problems in CFSStrategies to help maintain and prevent deterioration of your physical function and mobility need to be carried out in small amounts and spread out throughout the day. Strategies should include joint mobility, muscle flexibility, balance, postural and positional support, muscle function, bone health and cardiovascular health.
Care and support plans in relation to physical functioning and mobility may include bed mobility, moving from lying to sitting to standing, transferring from bed to chair, using mobility aids, walking, joint mobility, muscle stretching, muscle strength, balance, and going up and down stairs.
People with CFS may experience intolerance of changing position, such as when first standing up. This may include postural orthostatic tachycardia syndrome . You may need to be refered to a specialist if your symptoms are severe or worsening, or there are concerns that another condition may be the cause.
Pain in CFSChronic pain is commonly associated with CFS. You may need referral to specialist pain services if appropriate.
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How Is Me/cfs Diagnosed
Because many symptoms of ME/CFS are also symptoms of other illnesses or side effects of medicine, your doctor will need to do physical exams and tests to help determine if you have ME/CFS. There are no standard lab tests to diagnose ME/CFS.
If you think you may have ME/CFS, see your doctor. Your doctor may:
- Ask you about your physical and mental health.
- Do a physical exam.
- Order lab tests based on your symptoms, such as urine and blood tests, which will tell your doctor if something other than ME/CFS might be causing your symptoms.
- Order tests that check for problems found in people with ME/CFS.
- Classify you as having ME/CFS if:
- You have the main symptoms of ME/CFS, including extreme fatigue or exhaustion that does not go away and that prevents you from doing the things you want and need to do for you and your family exhaustion that comes after mental or physical exercise sleep problems and pain AND
- You have had the extreme fatigue and other symptoms for 6 months or longer AND
- You and your doctor cannot find another explanation for your symptoms.
The process to make a final diagnosis of ME/CFS can take a long time, so try to be patient. It is usually best to develop a relationship and follow up often with one doctor so that he or she can get to know you and see how you respond to treatment over time.
Other Lifestyle Changes To Manage Me/cfs
Other ways to manage ME/CFS include:
- equipment â some people may need a blue badge for parking, a wheelchair, a stairlift, or other adaptations for their home
- changes in your place of work or study â when you’re ready and well enough to return to work or studies, your doctor should be able to advise you on changes that could ease your return
There’s limited or no evidence to recommend:
- resting completely â there’s no evidence this helps
- complementary medicine â there is not enough evidence that it’s helpful for ME/CFS
You should not take up vigorous unsupervised exercise such as going to the gym or for a run as this may make your symptoms worse.
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Impact And Prognosis Of Me/cfs
- Nacul L.
- Lacerda E.M.
- Campion P.
- et al.
BMC Public Health.J Chronic Fatigue Syndr.
- Cox D.L.
- Findley L.J.
Br J Occup Ther.
- Mild: mobile and self-caring may continue working but will have reduced other activities
- Moderate: reduced mobility, restricted in instrumental activities of daily living, needs frequent periods of rest usually not working
- Severe: mostly housebound limited to minimal activities of daily living severe cognitive difficulties may be wheelchair dependent
- Very severe: mostly bedridden unable to independently carry out most activities of daily living often experience extreme sensitivity to light, sound, and other sensory input
- Tian H.
- et al.
Am J Epidemiol.Chronic Illn.
Qual Life Res.Disabil Rehabil.Occup Med .
Rehabil Psychol.Front Pediatr.Fatigue.
Chronic Fatigue Syndrome Diet
While there is no one specific diet for chronic fatigue syndrome, optimizing the diet is a very important part of the supportive treatment. This typically involves ensuring that optimal nutritional needs are met from both a calorie as well as vitamin and mineral perspective is met. Very few people eat enough fruit and vegetables, and get enough fiber. This becomes even more important to make sure the body has the basic building blocks to produce energy.
In some patients, identification and removal of foods that may be contributing to fatigue is important. There are multiple mechanisms possible. Food sensitivities could be contributing immune activation and serving as a drain on energy. One study found marked improvement in a group of fibromyalgia patients when gluten sensitivities were addressed – they did not have celiac disease.
In other cases, treating the gut in general and ensuring that the diet is anti-inflammatory for gut health is the chronic fatigue syndrome diet. There is emerging evidence that the gut bacteria can have compounds that translocate across the gut bacteria, contributing to certain CFS pictures. Some of our patients have a clear gastrointestinal comorbidity and symptom complex in addition to their chronic fatigue, and in such cases we might use the anti-inflammatory diet and nutrients below as well as evaluate gut ecology.
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Drug And Alternative Therapies
Specific chronic fatigue syndrome symptoms such as pain, depression, and poor sleep are treated.
Many different drugs and alternative therapies have been tried to relieve the chronic fatigue itself. Although many treatments, such as antidepressants and corticosteroids, seem to make a few people feel better, none are clearly effective for all. It can be hard for people and doctors to tell which treatments work because symptoms are different in different people and because symptoms may come and go on their own.
Controlled clinical trials The Science of Medicine Doctors have been treating people for many thousands of years. The earliest written description of medical treatment is from ancient Egypt and is over 3,500 years old. Even before that, healers… read more , which compare the benefits of a drug to those of a placebo , are the best way to test therapies, and no drug therapy has been shown to be effective for the treatment of chronic fatigue syndrome in controlled trials. A number of treatments directed at possible causes, including use of interferons, intravenous injections of immune globulin, and antiviral drugs, have been mostly disappointing and potentially dangerous. Dietary supplements, such as evening primrose oil, fish oil supplements, and high-dose vitamins, are commonly used, but their benefits remain unproved. Other alternative treatments have also been ineffective. Treatments that have no proven benefits are best avoided because they can have side effects.
Questions To Ask Your Doctor
- Im always tired. Is there something wrong with me?
- Do I need any tests to help determine why Im so tired all the time?
- What is the likely cause of my fatigue?
- Will alternative therapies such as yoga or acupuncture help?
- Do I need to make any diet or lifestyle changes?
- Is it safe for me to exercise? What kind of exercise should I do?
- How do I convince people that my fatigue is real?
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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 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.
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Myalgic Encephalomyelitis Chronic Fatigue Syndrome
Myalgic Encephalomyelitis Chronic Fatigue Syndrome or a more severe type of Chronic Fatigue Syndrome. It can leave your body in a state of Chronic Inflammation that can lead to other serious conditions like heart disease, Depression, Hormone Imbalance, Rheumatoid Arthritis to name a few. Stopping the cause of your chronic inflammation can save you from the excess wear and tear on your body and joints.
You need to alkalize your body to help it get rid of the excess acidity that is a boon for viruses, cancers and disease to flourish in your body. Begin by drinking plenty of fresh purified water, particularly alkaline water, which is in itself an antioxidant. It is part of this natural treatment for chronic fatigue syndrome because of the higher electrical potential that alkaline and structured water gives to your body. Energy is life.
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.
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Causes Of Chronic Fatigue Syndrome
Despite considerable research, the cause of chronic fatigue syndrome remains unknown. Controversy exists as to whether there is a single cause or many causes and whether the cause is physical or mental, but either way the symptoms are very real to the person.
Some researchers believe the syndrome ultimately will prove to have several causes, including genetic predisposition and exposure to microbes, toxins, and other physical and emotional factors.
Vitamin B12 And Folic Acid
Researchers have been exploring whether vitamin B12 injection or other means of supplementation, along with folic acid, can relieve CFS symptoms.
There is a biochemical theory as to how this may be of benefit: People with CFS show reduced methylation which plays a role in gene expression as well as regulation of many of the body’s systems, including detoxification, cardiovascular and the neurologic system. Vitamin B12 and folic acid both promote healthy methylation pathways.
A study of B12 injections in addition to oral folic acid supplementation found that some subjects with CFS responded well, while others had only a mild response. A better response was associated with more frequent injections, lack of use of opioids, and a certain genetic phenotype.
Another study looked at using B12 nasal drops as an alternative to injections in subjects with CFS. This study also found good response in two-thirds of the participants. The researchers demonstrated that those who had a better response had a higher blood level of B12 and were more physically active .
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Panex Ginseng And Echinacea
Both of these herbs have been known to increase endurance and immunity. Researchers from the University of California Irvine Medical Center tested both Panex ginseng and Echinacea herbs on blood from a group of people who had either Chronic fatigue syndrome or AIDS.
The researchers found that both herbs significantly boosted immune factors in the patients blood cells.