Chronic fatigue syndrome (CFS) is overwhelming fatigue that is not explained by a known medical condition.
CFS gets worse with too much activity and is not relieved by rest. The cause of CFS in unknown, however there are many theories. In some cases it may be caused by viral illnesses including Epstein Barr, HHV-6, and parvo.
There is also evidence to suggest it can develop after a bacterial infection like Lyme or prolonged respiratory infections.. There may be impairment of the immune system or hormonal imbalances of the hypothalamus, pituitary gland, or adrenal glands. Other theories include excessive stress, from any source including, physical, emotional, chronic diseases, or infections. Most likely it is a combination of genetic and environmental factors, and that multiple triggers alone or in a combination can cause the onset of chronic fatigue.
How is Chronic Fatigued Syndrome Diagnosed?
There is no single test to confirm CFS. To make the diagnosis of CFS underlying medical conditions need to be ruled out. A comprehensive work up should be done and include a comprehensive history, physical and appropriate laboratory tests. Some of the more common causes of fatigue including anemia, diabetes or an underactive thyroid can be easily ruled out with simple blood tests. Additional diagnostic tests should be done based on an individuals symptoms and physical findings.
The diagnosis of CFS is based on the following criteria. Severe persistent or relapsing fatigue lasting six months or more, in which the fatigue is not caused by a known disease, and is not relieved by rest. The fatigue also causes a significant (50%) reduction in a person’s activity level. In addition, to diagnose CFS four out of the following eight symptoms needs to be present.
- Not feeling refreshed after sleep
- Impaired memory/concentration
- Muscle pain
- Joint pain, involves one joint to another without swelling or redness
- Sore throat
- Tender cervical/ axillary lymph nodes
- Extreme exhaustion lasting more than 24 hours after physical exercise
What are the risk factors for developing CFS?
Risk factors for developing CFS include age, female gender, genetics, high stress occupations and or lifestyle.
CFS occurs more commonly in people in there 40s and 50s. Anyone can develop CFS, but it is more common in women, this may be that women are more likely to seek treatment for fatigue. There appears to be a genetic link as well. People with a first degree relative with CFS have an increased risk of developing CFS. Those with high stress lifestyles are also more susceptible to developing CFS.
Some people with CFS also fit the criteria for FMS (a chronic pain syndrome). People with CFS who do not get help are at risk of developing anxiety, depression, social isolation, lifestyle changes (reduce activity level), and increased work absences.
Treatment for Chronic Fatigue
The treatment for Chronic Fatigue Syndrome must be individualized; a comprehensive holistic approach can help the body return to a healthy state. There is no magic pill that will make your symptoms disappear. It will take time for your body to recover. It is best to find a Practioner who has experience in treating CFS. The first step your doctor should do is to confirm the diagnosis, making sure there is not another cause for your fatigue. After your diagnosis is confirmed they need to help you develop an individualized treatment and wellness plan. Your wellness plan is not limited to but should include the following:
- Stress management plan- tools and ways to reduce and manage stress. Excessive production of stress hormones can cause fatigue and make it difficult to recover.
- Nutritional plan- you are what you eat you need to follow a whole food diet, avoid processed foods and artificial sweeteners, and chemical additives. It is best to work with a practitioner who can help you develop a healthy eating plan. A diet rich in nutrients can help heal your body.
- Vitamins/ Supplements- Appropriate vitamins and supplements if indicated.
- Medications- Appropriate medications when indicated.
- Sleep Hygiene Program- a program to help you get enough restorative sleep, so your body can heal.
- Exercise program- individual exercise program tailored to your energy level.
- Psychological support: Appropriate support in dealing with emotional issues, making sure to address automatic negative thoughts. Negative thinking can further fatigue your body. A referral to a good mental health professionals can help you when indicated.
- Additional Treatments: Additional treatments to consider in your wellness plan include, Cognitive Behavioral Therapy, Acupuncture, Massage, Physical therapy, and Chiropractic therapy.
- Support: on going support, working with a doctor who is there to support your recovery. It will take time to recover but with the right treatment and wellness plan you will get better.