Chronic Fatigue Syndrome

Introduction
Chronic fatigue syndrome is a chronic disorder, which is characterized by extreme and long-term fatigue. This persistent fatigue limits the ability of the individual to carry our daily activities efficiently. One of the most characteristic features of chronic fatigue syndrome is that the fatigue doesn’t occur due to exertion or depression, but is unexplained. Various biological and chemical means have been indicated in the etiology of the chronic fatigue syndrome.

Epidemiology
Various research groups have speculated that the prevalence is similar in different ethnicities; however, people in lower income communities are more prone to developing chronic fatigue syndrome. Moreover, Native and African Americans are more susceptible to the condition as compared to other races. Among adults, women are more predisposed to chronic fatigue syndrome than men and children.

Causes
The exact cause of the disease is still unknown; however, the commonly observed risk factors that are associated with the predisposition of chronic fatigue syndrome are:

1. Endocrine abnormality
Abnormal levels of various hormones produced by pituitary glands, hypothalamus, and adrenal glands are indicated in the development of chronic fatigue syndrome.

2. Infections
People having infections, particularly viral infections, are more susceptible to chronic fatigue syndrome as compared to the general population. Some of the commonly observed infections are herpes virus infection, Epstein-Barr virus infection, and leukemia. However, the exact cause of the association between viral infections and chronic fatigue syndrome remains unknown.

3. Immune defects
In patients with chronic fatigue syndrome, immune system is usually compromised.

Symptoms
Symptoms may be sudden or late onset, depending upon the immune system and other factors. Some of the common symptoms are:

  • Extreme and long-term physical fatigue, which is not relieved by rest, medication, or therapies
  • Difficulty in sleeping
  • Fluctuations in mood (mood swings)
  • Pain, can be localized or widespread, including joints, muscles, and head
  • Lack of focus and concentration
  • Increased sensitivity to light, noise, touch
  • Lack of neuromuscular coordination
  • Increased urination and thirst
  • Irritable bowel syndrome (rare)
  • Abnormal appetite and weight loss

Treatment Strategies
Use of medication and therapies are directed to alleviate the symptoms associated with chronic fatigue syndrome.

1. Drugs
Drugs, either alone or in combination, are administered to patients depending upon the severity of the disease and their tolerability profile. Some of the commonly used medications are:

  • Sleep-inducing drugs

To enhance sleep in patients, anticaffeine and antinicotine drugs are prescribed.

  • Antidepressants

These are used in patients to enhance mood, relieve pain, and increase sleep. These are effective in alleviating the physical symptoms in patients with chronic fatigue syndrome.

2. Therapies

Physical Exercise
It is recommended in patients to enhance neuromuscular movements, coordination, and increase range-of-motion.

  • Counseling

Emotional support is often associated with increased tolerance and adaptability to the symptoms, which, in turn, increases the adherence of the patients to medications and exercise.

Alternative Treatment
A number of naturally occurring products have been found to be effective in chronic fatigue syndrome. These include magnesium, fish oil, ribose sugar, melatonin, and evening primrose oil.

Conclusion
Chronic fatigue syndrome is characterized by long-term fatigue. It usually affects the person’s ability to carry out daily activities. Various medications and therapies have been indicated in the treatment of the condition.

Read More:
Chronic Fatigue Syndrome: The Conventional View
Chronic Fatigue Syndrome: A Case Study
Chronic Fatigue Syndrome: A Holistic View
5 Foods To Fight Chronic Fatigue Syndrome
Healing Q&A: Can Ayurveda Help With Chronic Fatigue & Insomnia?

References
1. Vergauwen K, Huijnen IP, Kos D, et al. Assessment of activity limitations and participation restrictions with persons with chronic fatigue syndrome: a systematic review. Disabil Rehabil. 2014 Nov 3:1-11. [Epub ahead of print].

2. Zeineh MM, Kang J, Atlas SW, et al. Right Arcuate Fasciculus Abnormality in Chronic Fatigue Syndrome. Radiology. 2015 Feb;274(2):517-526.

3. Bloot L, Heins MJ, Donders R, et al. The Process of Change in Pain During Cognitive Behavior Therapy for Chronic Fatigue Syndrome. Clin J Pain. 2014 Dec 11. [Epub ahead of print].

4. Kallestad H, Jacobsen HB, Landrø NI, et al. The role of insomnia in the treatment of chronic fatigue. J Psychosom Res. 2014 Dec 5. pii: S0022-3999(14)00422-X.

5. Hall DL, Lattie EG, Antoni MH, et al. Stress management skills, cortisol awakening response, and post-exertional malaise in Chronic Fatigue Syndrome. Psychoneuroendocrinology. 2014 Nov;49:26-31.

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