“We just needed to put to rest, once and for all, the idea that this is just psychosomatic or that people were making this up, or that they were just lazy,” said Ellen Wright Clayton, professor of pediatrics and law at Vanderbilt University. Clayton was the chair of the committee of the Institute of Medicine, health arm of the National Academy of Sciences.
Chronic fatigue syndrome may affect as many as 2.5 million Americans, yet the cause is still unknown, and more research is needed to narrow down options for sufferers. According to the panel, there are three critical symptoms for chronic fatigue syndrome, also called myalgic encephalomyelitis. They symptoms include:
- Sharp reduction in the ability to engage in pre-illness activity levels that lasts for more than six months accompanied by a chronic sense of fatigue that has only recently developed.
- Worsening symptoms after any type of exertion, whether physical, cognitive, or caused by emotional stress
- Fatigue that is not refreshed by sleep in the sufferer.
Causes of Chronic Fatigue Syndrome
Although much is left to be learned about CFS, doctors have studied a number of factors that may contribute to the onset of the disease. Among them:
- Viral Infections: Some patients develop CFS after having a viral infection. Some researchers believe that the disease is triggered by certain viruses, including Epstein-Barr, human herpes virus 6 and mouse leukemia viruses. To date, no definitive link has been found.
- Immune System Problems: The immune systems in CFS patients appear to be at least slightly compromised. Unfortunately, it has been difficult to determine whether the immune impairment is a cause of the disease or a result of it. It remains unclear if this impairment is significant in most sufferers to actually contribute to its onset.
- Hormonal Imbalances: Patients with CFS sometimes experience abnormal blood levels of hormones produced by the hypothalamus, pituitary glands or adrenal glands.
Chronic Fatigue Syndrome: The Symptoms
Because of a lack of objective findings in patients and a continually evolving understanding of the disease, diagnostic criteria may not be consistent. Typically, CFS is diagnosed when a patient exhibits:
● Clinically evaluated, unexplained, persistent or relapsing fatigue that is of new or definite onset, is not the result of ongoing exertion, is not alleviated by rest, and results in a significant reduction in previous levels of occupational, educational, social or personal activities
● Four or more of the following symptoms that persist or recur during six or more consecutive months, and which did not predate the onset of fatigue:
◦ Self-reported impairment in short-term memory or concentration
◦ Sore throat
◦ Tender cervical or axillary nodes
◦ Muscle pain
◦ Multi-joint pain without redness or swelling
◦ Headaches of a new pattern or severity
◦ Unrefreshing sleep
◦ Post-exertional malaise lasting over 24 hours
CFS is a very individual disease, with a varied set of symptoms and individual response to different therapy options. There are no diagnostic lab tests that can diagnose CFS, and it typically remains a diagnosis based on exclusion - ruling out all other options based on the pattern of symptoms and signs.
Because of this, how you describe your symptoms will often drive your treatment plan, and addressing symptoms accurately and specifically is essential in aiding your healthcare provider with understanding your symptoms. For example, when discussing your fatigue, be sure to specify when you’re having fatigue. A doctor may ask about your sleep and whether you have sleep interruptions, when you could be speaking about general daytime energy. Treatments for those two symptoms are very different.
Treating Chronic Fatigue Syndrome
Because there is still much to be learned about the cause and effects of CFS, most treatments deal with the symptoms of the disease. Among them:
● Antidepressants and benzodiazepines: Although not everyone with CFS is depressed, some antidepressants can help ease some of the debilitating symptoms of the disease, including fatigue, pain, and disrupted sleep.
● Anticonvulsants: For reasons that are yet to be understood, medications typically used in the prevention of seizures can sometimes help ease symptoms in patients suffering from CFS.
● Thyroid Medications: Thyroid medications can be added to other treatments in patients who are not responding to other medications alone.
● Stimulants: While some doctors go as far as prescribing amphetamines to aid in the fatigue suffered by CFS patients, many doctors don’t recommend this as a long-term solution. Other stimulants can be prescribed to boost daytime alertness and increase energy.
● Pain Medications: Because many CFS sufferers also experience severe headaches, joint pain, and other forms of body pain, pain medications are sometimes prescribed to help patients cope with those symptoms.
Living With Chronic Fatigue Syndrome
Reporting your symptoms to your doctor is imperative in getting a proper diagnosis and establishing a treatment plan. There are steps you can take at home to minimize the impact CFS has on your life. Among them:
Stress Management and Reduction: Develop a plan to reduce your stress levels and limit overexertion. Build time into your daily schedule to relax and rest.
Improve Sleep Habits: Get yourself into a strong sleep routine - including going to bed and waking up at the same time each day. Limit daytime naps and reduce or eliminate your caffeine, alcohol and nicotine intake, as these can disrupt your sleep patterns.
Pace Yourself: Plan your daily activities on an even level. If you’re having a good day, don’t try to overcompensate and overexert yourself, as it can trigger several bad days to follow.