Chronic Fatigue Syndrome

Chronic fatigue syndrome is a complex disorder characterized by extreme fatigue of unknown origin that worsens with physical or mental activity, but doesn't improve with rest.

It’s not clear what causes chronic fatigue syndrome. It is believed that no single factor, rather a combination of different factors is responsible for chronic fatigue syndrome.

Like its cause, the method of diagnosis is also unknown.

Since the symptoms of chronic fatigue syndrome are not specific, extensive tests are needed to exclude other conditions that cause similar set of symptoms.

The treatment is primarily aimed at managing the symptoms.

Apart from the central symptom, fatigue, on which name of the condition is based, there are eight other official signs and symptoms of chronic fatigue syndrome:

• Loss of memory or concentration
• Sore throat
• Enlarged lymph nodes in your neck or armpits
• Unexplained muscle pain
• Pain that moves from one joint to another without swelling or redness
• Headache of a new type, pattern or severity
• Unrefreshing sleep
• Extreme exhaustion lasting more than 24 hours after physical or mental exercise

When to see a doctor

The symptoms can be non-specific and various other conditions can cause fatigue. But if you feel unreasonably exhausted, visit your doctor.

No cause of Chronic fatigue syndrome has been identified yet. Possibly, some genetic factors combined with external triggering factors could be the culprit.

Some of the possible causes include:

• Viral infections: Some viruses, especially Epstein-Barr virus, human herpes virus 6 and mouse leukemia viruses are thought to cause the symptoms of chronic fatigue syndrome.
• Immune system problems: Immune impairment and chronic fatigue syndrome could have some links as people with chronic fatigue syndrome are found to have some degree of immune impairment.
• Hormonal imbalances: Abnormal hormonal levels and chronic fatigue syndrome could be possibly associated. But no definite link has been established between these two.

There's no exact diagnostic test for chronic fatigue syndrome. Your doctor needs a bit more time to confirm the diagnosis because the symptoms are not specific.

Visit your doctor if you have persistent exhaustion that does not seem to have any known cause.

How to prepare yourself for the visit

Getting prepared for the visit can optimize the therapy and help make the visit more fruitful.

• List out all the symptoms.
• Write down your key medical information.
• Write down the names of all your medications, vitamins or supplements.

Make a list of the questions to ask your doctor. Some typical question can be:

• What could be possible causes of my symptoms?
• What tests do I need?
• What are the treatment options?
• Can any lifestyle changes help my symptoms now?
• Do I need to see a mental health provider?

What your doctor wants to know

A clear talk with your doctor can optimize the therapy and improve the outcomes. Prepare yourself to answer some essential questions from your doctor.

Your doctor might ask you typical questions like:

• When did the symptoms start appearing?
• Does anything improve or worsen your symptoms?
• Have you noticed any problems with memory or concentration?
• Do you have sleep problems?
• How often do you feel depressed or anxious?
• Does the condition restrict your daily life?

The approach of diagnosis is excluding the conditions that produce same set of symptoms.

You may have to check for:

• Sleep disorders: Sleep disorders like insomnia, sleep apnea or restless leg syndrome could disturb normal sleep and lead to chronic fatigue. A sleep study can be used.
• Medical problems: Fatigue is commonly associated with several medical conditions, such as anemia, diabetes and underactive thyroid (hypothyroidism). Blood tests can reveal these conditions.
• Mental health issues: Common mental health problems such as depression, anxiety, bipolar disorder can also make you feel tired. Talk to your counselor if you have such conditions.

Diagnostic criteria

To facilitate the diagnosis and rule out other causes of chronic fatigue, a diagnostic criteria has been established for chronic fatigue syndrome, according to which:

“To have chronic fatigue syndrome, you must have unexplained, persistent fatigue for six months or more, along with at least four of the following signs and symptoms:

• Memory problems or problems with concentration
• Sore throat
• Enlarged lymph nodes in your neck or armpits
• Unexplained muscle pain
• Pain that moves from one joint to another without swelling or redness
• Headache of a new type, pattern or severity
• Unrefreshing sleep
• Extreme exhaustion lasting more than 24 hours after physical or mental exercise

The treatment for chronic fatigue syndrome is symptomatic as the exact cause is not identified.

The treatments may include:

• Medications: Medications can be prescribed to address symptoms that might be specific to a patient. Some medications to ease symptoms are:

1. Antidepressants: Depression could be an underlying cause of the symptoms of chronic fatigue syndrome. Treating depression can lift your mood and help you better cope with the debilitating symptoms. Also, these depression treating drugs may improve sleep and alleviate pain.
2. Sleeping pills: A poor sleep can worsen symptoms of chronic fatigue. You may talk to your doctor if sleeping aids are beneficial.

• Therapy: For most of the patients, a combination of psychological counseling with exercise program is effective to cope with the symptoms of chronic fatigue syndrome.
• Graded exercise: A physical therapist can design an exercise regimen that is best suited to your condition. Simple stretching exercises can help improve your strength and endurance.
• Psychological counseling: Having a positive outlook on your condition and accepting the reality could make you stronger and ready to cope with the symptoms. Talk to your counselor to help you find out how things can work for you.

It is difficult to determine if any alternative remedy for Chronic fatigue syndrome can work for you.

However, you may try acupuncture, massage, yoga or tai chi for pain relief.

There are different ways to adapt your lifestyle in coping with chronic fatigue syndrome.

Some self-care measures that may help you are:

• Reduce stress: Try managing your stress and learn some relaxation techniques that can help you sleep better.
• Improve sleep habits: Follow a sleep routine and limit on caffeine, nicotine.
• Emotional support and counseling: The symptoms can be distressing first but as the time passes by, they become more acceptable. Emotional support and counseling can work wonders to people who are slowly adapting to a new change in life and learning to live with chronic fatigue syndrome.
• Join a support group: Join a support group if you feel happy meeting people like you. Being with people suffering the same condition may make you more empathetic and acceptable.

There are several risks and complications associated with chronic fatigue syndrome.

Risks

1. There are several risks and complications associated with DISEASE

• Age: People in their 40s and 50s are more likely to suffer chronic fatigue syndrome.
• Sex: More women have been diagnosed with chronic fatigue syndrome as compared to men.
• Stress: Your chances of having chronic fatigue syndrome are higher if you are not able to handle the stress of your life.

Complications

• Depression
• Social isolation
• Limitation on daily activities