Chronic fatigue syndrome, sometimes called myalgic encephalomyelitis, is a complicated disorder characterized by debilitating fatigue that does not improve with bed rest and may worsen with physical or mental activity. Often there are additional nonspecific symptoms such as; a sore throat, headache, tender muscles, joint pain, difficulty thinking and loss of short-term memory.
Chronic fatigue syndrome is hard to diagnose because a single diagnostic test does not exist and there is no identifiable cause of the illness. The syndrome is therefore undiagnosed in an estimated 80 percent of people living with the illness. Chronic fatigue syndrome is more common in females than males and affects all racial and ethnic groups, particularly those in the 30 to 45 age group.
Because the medical profession, let alone the general public does not understand the disease or often does not even believe it exists, many patients report that a chronic fatigue syndrome diagnosis carries a considerable social stigma, and has frequently been viewed as malingering, hypochondriasis, phobia, wanting attention, or yuppie flu.
Causes and Incidence
The cause of Chronic Fatigue Syndrome is unknown but there are many postulations that it may occur after viral infections, bronchitis, mononucleosis, hepatitis, glandular fever or intestinal illness. Recent studies have shown that inflammation of nervous system pathways, acting as an immune response, may play a role as well.
One trial suggested that exposure to childhood trauma was associated with a six fold increase in the risk of having chronic fatigue syndrome. Sexual abuse, emotional abuse and emotional neglect have also been associated with chronic fatigue syndrome.
A number of conditions overlap or coexist with chronic fatigue syndrome and have similar symptoms. In fact, many experts believe fibromyalgia is simply another variant of chronic fatigue syndrome or different manifestations of the same disease.
Signs and Symptoms
The characteristic symptom is prolonged, often overwhelming fatigue which is commonly associated with a varying complex of other symptoms that are similar to those of many infections. Chronic Fatigue Syndrome can last for many years.
The following description of the plight of one woman in her own words is typical:
Coming back from a tiring and long overseas business trip with what I thought was a bad cold, I began to feel very tired, had headaches, muscle pains and joint pains. Initially I just thought I had picked up a bad case of flu, but over time the tiredness got worse. I visited my doctor and there started a procession of diagnoses which included; thyroid problems, depression, pre menopause. None of the treatments and drugs prescribed helped, instead things got considerably worse.
I was trying to hold down a responsible position as national sales manager for a major pharmaceutical company and having to come home twice a day to get a half hours sleep, then eventually getting home so tired I found myself climbing up the stairs on my hands and knees. Finally when I had to get a chair to sit on while showering I called my company and resigned. The human resources manager suggested that instead I take medical leave and referred me to a specialist. This time the diagnosis was sleep apnea. In I went for tests at a sleep clinic and again wrong diagnosis.
By this time despairing as otherwise healthy 48 year old would be, at last I came across a doctor who said she had suffered from the same symptoms and it had turned out to be Chronic Fatigue Syndrome. With her support, sleeping as much as 16 hours a day and 2 years off work I recovered to the point where I could take on part time work again and eventually full time work in a less stressful position.
Even now some 7 years later I still need to sleep as much as 12 hours a day. Over the years I have met many others who suffered from CFS, including one young and very fit professional athlete. This is a serious condition which is far more common than anyone realizes.
Because the cause and nature of Chronic fatigue syndrome are still unknown, no single test unequivocally confirms its presence. Therefore diagnosis is based on patient history and should include, severe chronic fatigue of six months or longer duration with other known medical conditions excluded by clinical diagnosis. Concurrently a patient must have four or more of the following symptoms: substantial impairment in short term memory or concentration, a sore throat, tender lymph nodes, muscle pain, multiple joint pain without swelling or redness, headaches of a new type, pattern or severity, unrefreshing sleep, and post exertional malaise lasting more than 24 hours.
No treatment is known to instantly cure CFS. Symptomatic treatment may include a combination of several modalities. Medication to treat depression, anxiety, pain, discomfort and fever are commonly used. Hidden yeast infections may be present and need to treated. Anti viral drugs can be tried. Cognitive behavioral therapy for chronic fatigue syndrome can be useful in helping patients to live with their condition.
Many patients prefer the natural approach to the treatment of chronic fatigue syndrome, this involves a long and gentle process to help rebuild the immune system and help the body to detoxify itself and is likely to involve; complementary or alternative treatments, such as massage, acupuncture, chiropractic care, yoga, stretching, or self hypnosis. Some research has found that natural D ribose supplements may significantly improve the symptoms of chronic fatigue syndrome, with particular benefit in study participants energy level and overall wellbeing.
Several studies in China have indicated acupuncture may help treat chronic fatigue syndrome. A development from this is the recent advent of acupressure patches which are reported to have been used with considerable success in reducing symptoms substantially.