Chronic Fatigue Syndrome (CFS)

CFS is a complex set of symptoms the cause of which is unknown. Researchers have identified symptoms of CFS up to the 1930’s. Risk factors include those over 40, although teens have been noted to have overlapping symptoms, and females. Women tend to have more severe symptoms than men. Depression is extremely common. Stress may be a trigger, as well as emotional trauma, and genetic factors. It is non curable, but managed long term.
Overlapping conditions that intersect include Fibromyalgia, multiple chemical sensitivity, eating disorders, chronic headaches, difficulty concentrating, memory problems, bladder pain, irritable bowel syndrome, sleep problems, and jaw pain.

Fibromyalgia is fatigue and muscle aches for long periods of time. It is often confused with CFS. CFS is more severe fatigue, and Fibromyalgia is more chronic pain. Additional symptoms of Fibromyalgia include tenderness to side of the neck, shoulder blade, hips, buttocks, and inside of the knee, sore throat, headache, fever, and depression. It is not curable.

Multiple chemical sensitivity occurs when certain chemical exposures cause specific symptoms.
The chemical products are common everyday items such as fabric softeners, perfumes, and air fresheners. These items may not have affected the individual in the past and symptoms go away once the chemical is removed.

There is no known specific cause for CFS, but may be a combination of viral infections, genes, psychiatric problems, immune or hormonal problems, allergies, or brain anomalies.

Diagnosing CFS is very difficult. According to the center for disease control (CDC), you must have unexplained fatigue for at least 6 months, and is not relieved with rest, and everyday activities are significantly reduced, including work, education, and social activities. You must also have at least 4 of the following during or after the 6 months: changes in concentration, or memory, sore throat, tender lymph glands, muscle aches and pain, joint pain, headaches, poor sleeping, feeling unwell after exertion for more than 24 hours.

Additional symptoms that may be felt include dizziness, nausea, flu like symptoms, and palpitations. There are many blood tests that can be performed to determine cause of fatigue, as well as other medical conditions that cause long term fatigue. These include Mononucleosis, and Epstein-Barr Virus, lupus, rheumatoid arthritis, post-lyme disease syndrome, diabetes, hypothyroidism, cancer, anemia, depression, and bipolar disorder.

If you are feeling the following symptoms without the physical symptoms then it is likely depression: feeling sad every day, weight loss or gain, difficulty or excessive sleeping, very low energy, feeling helpless or worthless, difficulty concentrating, loss of enjoyment or interest in everyday life, or restless.

Due to the severity of CFS, people tend to have difficulty working, and fulfilling responsibilities at home. They often lose their jobs, and often have little support. Memory and concentration is the most difficult symptom for many. Adults often improve or have recovery after about 2 years. Teens tend to miss school frequently, and may take up to 4 years for recovery.

Treatment involves a combination of therapies including eating a healthy diet, antidepressants, physical and cognitive-behavioral therapy, and sleep management.

Cognitive-behavioral therapy involves working with a therapist to change negative perceptions to positive perceptions about themselves and the world around them. It involves setting limits, keeping a diary, pacing activities, addressing negative thoughts, adapting to changes, and developing coping skills. CBT has shown the most successful response compared to other types of treatments.

Additional treatment efforts include balancing times of rest and activity, making tasks more manageable, and avoiding exertion, stress reduction such as deep breathing exercises, meditation, hypnosis, and yoga.

Treatment with medications depends on the individual. NSAID’s (Aspirin, Ibuprofen, etc.) reduce pain and inflammation. NSAID’s are good for a limited amount of time as they can raise blood pressure, and should not be taken by those with kidney disease, or gastric disorders. Other anti-inflammatory drugs, such as, Celebrex, can be prescribed but also have side effects.
Antidepressants can be helpful, but side effects include constipation, and dry mouth. Stimulants, such as, Adderall, and Ritalin, can help with concentration and short term memory problems.

Alternative therapies include vitamins, minerals, and dietary supplements, such as, co-enzyme Q10, Vitamin B12, St. John’s Wort, Melatonin, and Gingko. All of these drugs have been on the investigative end and there is no evidence they are beneficial.

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