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Chronic Fatigue Syndrome: Symptoms and Treatments

In our hectic lives, there is little room for extreme exhaustion; however, for people diagnosed with chronic fatigue syndrome, it is their daily reality.

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Chronic fatigue syndrome, also called myalgic encephalomyelitis, is a poorly understood and complicated condition. Its characteristic symptom is extreme and persistent exhaustion. The severity of symptoms can vary from day to day, completely disrupting a person’s personal and professional life and straining their relationships and ability to make or stick to plans.

“By definition, symptoms of chronic fatigue syndrome should last at least six months,” says Dr. Srivani Sridhar, a family physician at UW Health Northern in Rockford, Illinois. “It can last several years or a lifetime without treatment. Symptoms may also wax and wane over months and years.

Symptoms of Chronic Fatigue Syndrome

The most common symptoms of chronic fatigue syndrome include:

  • Challenges with memory, focus and concentration.
  • Dizziness created by the movement of lying down, sitting or standing, which improves when the person lies down.
  • Enlarged and possibly tender lymph nodes in the neck or armpits.
  • Joint pain without swelling or redness.
  • Persistent or extreme fatigue that is not helped by rest or sleep and affects a person’s ability to carry out daily activities.
  • Post-exercise malaise which is the aggravation of symptoms following physical or mental exertion.
  • Unexplained muscle weakness.

According to a report According to the National Academy of Medicine, formerly known as the Institute of Medicine, an estimated 836,000 to 2.5 million Americans suffer from chronic fatigue syndrome, and at least a quarter of patients are bedridden or housebound at some point in time. their illness.

“Chronic fatigue syndrome strikes people of all ages, including children, from all racial, ethnic and socioeconomic groups. It is diagnosed two to four times more often in women,” says Dr. Avi Nath, clinical director at the National Institute of Neurological Disorders and Stroke at the National Institutes of Health in Bethesda, Maryland.

Where does chronic fatigue syndrome come from?

Researchers have yet to definitively determine what causes chronic fatigue syndrome, but potential culprits may include:

  • infections. Some people develop chronic fatigue syndrome after an illness. One in 10 people who have contracted Epstein-Barr virus, Ross River virus or Coxiella burnetii will develop symptoms that meet criteria for chronic fatigue syndrome, according to the Centers for Disaster Control and Prevention.
  • Genetic. Researchers have found that in some cases, a person is more likely to get chronic fatigue syndrome if other family members have had it. However, no gene has yet been definitively proven to play a role.
  • Hormones. The hypothalamus is a center in the brain that produces hormones that maintain the body’s internal balance, called homeostasis. Hormonal fluctuations can be caused by sleep disturbances, infections, toxins, physical or mental stress, poor diet, and autoimmune diseases. The body’s way of protecting itself is by decreasing the body’s energy demands, which leads to fatigue.
  • The immune system changes. The immune system of people with chronic fatigue syndrome appears to be mildly impaired, but whether this plays a role in contracting the disease has not been determined.
  • Mitochondria. Found in almost every cell in the body, mitochondria are the “powerhouses” of cells that generate energy. When they work inefficiently or are overused, it can lead to fatigue.
  • Physical or emotional stress. Some people report that shortly before their symptoms started, they experienced significant physical or emotional stress.

Diagnosing chronic fatigue syndrome

CDC research has shown that less than 20% of American patients with chronic fatigue syndrome have been diagnosed. Diagnosing chronic fatigue syndrome remains a challenge because the symptoms overlap with many other illnesses and because it’s a diagnosis that only comes after other illnesses are ruled out.

“Most often doctors try to rule out other underlying conditions such as diabetes, cancer, autoimmune diseases or other brain diseases. The tests are targeted at the symptoms they exhibit. There is no standard battery of tests”, explains Nath.

The CDC criteria for diagnosing chronic fatigue syndrome include severe fatigue that lasts longer than six months, along with four of the following symptoms:

  • Headaches with new patterns or severity.
  • Joint pain without swelling or redness.
  • Muscle pain.
  • Post-exercise malaise that lasts more than 24 hours.
  • Significant impairment of short-term memory or concentration.
  • Sore throat.
  • Tender lymph nodes.
  • Non-restorative sleep.

A diagnosis of chronic fatigue syndrome is a diagnosis of exclusion and therefore requires a thorough medical evaluation by your doctor. “Often people are referred to medical specialists to rule out other diseases,” says Dr. Houman Danesh, director of integrative pain management at the Icahn School of Medicine at Mount Sinai in New York.

According to Danesh, the most common conditions that chronic fatigue syndrome is mistaken for are:

Treatment of chronic fatigue syndrome

Currently, there is no cure for chronic fatigue syndrome. Current treatment focuses on relieving symptoms. “The most bothersome or disabling symptoms are usually treated first,” explains Nath.

Common ways to manage chronic fatigue syndrome is to plan activities that take into account energy levels that can help relieve the stress that the disease places on people.

According to the American Academy of Family Physicians, cognitive behavioral therapy and gradually increasing exercise over time have been shown to moderately improve fatigue levels, help patients with daily activities, and manage anxiety and mood. post-exercise malaise.

Depending on the person, chronic fatigue syndrome can last anywhere from six months to a few years, making it important to work with a healthcare team to find effective ways to find symptom relief and develop strategies that improve quality of life.

“Take charge of your health and be proactive about finding an integrative or functional medicine provider who can guide you through a multi-pronged approach to supporting your body as it recovers and heals, ultimately eliminating your symptoms,” says Sridhar.

Preparing for your visit to the doctor

Before seeing a doctor, prepare a brief history that summarizes your state of health. Try to include:

  • A list of your symptoms starting with those that affect you the most.
  • When your symptoms started and if they started soon after an illness or life-threatening event.
  • Which makes your symptoms worse.
  • How the symptoms affect your daily activities.
  • The frequency of symptoms.

“When helping your doctor make an accurate diagnosis, be sure to rule out POTS by taking your pulse and blood pressure while lying down, sitting, and standing. Wait two minutes after changing positions. Take these records to your doctor who can order you more tests,” says Danesh. Your doctor may also repeat the tests in the office.