Chronic Fatigue Syndrome is one of the most misunderstood medical diseases of the modern age. Many doctors have previously dismissed the condition or have considered it a case of depression or other mental illness while patients frequently avoid seeking medical assistance and attempt to cope alone with a problem that can be quite dehabilitating but often hard to accept and discuss with others.
Although researchers estimate that 500,000 to 800,000 individuals are afflicted with Chronic Fatigue Syndrome in the United States alone, approximately 85% go undiagnosed for a number of reasons.
Often, medical practitioners are unfamiliar with or do not recognize the condition. Many patients feel dismissed when attempting to discuss feeling of excessive fatigue with an uniformed medical practitioner. Frequently patients hesitate to seek help for an low energy condition or feel put off after concluding that symptoms may be viewed as simple laziness by those not familiar (including often doctors, employees, and family members) with the disease. In fact, some doctors compare the severity and impact of CFS to conditions such as heart failure or other serious illnesses which are more recognized and taken much more seriously.
The financial impact of CFS can be quite devastating nationally as well as personally. Lost wages related to CFS is estimated at 9 billion per year with an average loss of family income of $20,000 per year related to the illness. Individual family financial losses do not include the money spent on medical treatment and drugs (often quite costly) and don’t account for the financial and social losses such as decreased tax dollars, decreased community service contributions, and hours and services lost on the job.
Chronic Fatigue Syndrome
While everyone gets tired from time to time, individuals with CFS experience fatigue that is so extreme that some describe the feelings as having been run over by a truck repeatedly or as having raced back-to-back marathons or as having stayed up for days on end.
Even after a full night of sleep, a CFS sufferer may feel no more rested than if he or she had stayed up all night working a manual labor job. In fact, many individuals with CFS do have disturbed sleep patterns (like insomnia), but even the solid sleepers do not seem to be refreshed in any way by the extra winks. A person with CFS may fall into bed exhausted at night and wake up feeling just as tired if not more so the next morning.
With the extreme fatigue comes feelings of muscle weakness, difficulties with concentration, and often oddly patterned headaches of varying degrees in many victims. Many CFS sufferers also complain of overall feelings of pain and tenderness similar to flu symptoms, so CFS is often lumped with fibromyalgia though the two conditions are not one and the same. They are, however, often tandem conditions. It’s not unusual to get a dual diagnosis and to find information on the conditions lumped together in the research and readings available.
There are a few noted differences in the onset and markers of the two conditions. CFS generally appears first as a rather flu type illness though may be gradual or rather sudden. Fibromyalgia is more often associated with some type of injury or trauma—either physical or emotional. In addition, patients diagnosed with fibro often have abnormal readings on serotonin levels (pain signals) and more specific body pains than CFS suffers who tend to have more generalized feelings of discomfort.
Other Patterns Noted in CFS Victims
Lower than Average Brain Oxygen Levels – While most individuals experience increased brain oxygen during and after exercising, CFS may, in fact, experience oxygen decreases. Instead of feeling that “runner’s high,” the person with CFS will just feel exhausted as heck even after mild exertion.
Altered Blood Flow to Muscles – Exercise should increase blood flow, but some tests suggest that CFS have sluggish blood push when exercising. Again, this leaves a patient feeling totally wiped out rather than refreshed after taking a walk or vacuuming the house.
Poor Recovery Times – While most people feel back to normal within a few hours after high levels of exertion, those with CFS may need a day or two or even more to bounce back from even mild physical activities. A trip to the grocery store may mean almost total bed rest the next day. A vacation can set the CFS patient back for a week or more.
Sensitivities – Though many people are sensitive to or bothered to chemicals, fumes, and drugs, CFS tend to have more extreme reactions. Temperatures variations also tend to worsen CFS fatigue and other symptoms.
Reactions to Certain Foods – Many CFS patients react negatively to the consumption of sugar, caffeine, alcohol, artificial sweeteners (especially Nutrasweet) and tobacco as well as diary and wheat products.
Unusual MRI Results – Some CFS patients test for swelling in the brain or nerve cell destruction though this is not true for the majority of sufferers.
Abnormal Blood Test Results – High levels of CD4 T white blood cells or active forms of EBV or HHV-6 may also be detected in suffers of CFS.
It’s important to note that none of the patterns noted by researchers have been proven to indicate CFS. While some suffers may reflect some of these problems, others do not. These are just some problems that may be experienced by those individuals stricken with Chronic Fatigue Syndrome.
Diagnosis of CFS
One of the major difficulties with CFS is that the cause or causes or unknown. Typically, the condition is diagnosed after ruling out other problems which include similar symptoms.
When a patient complains of extreme fatigue, medical practitioners typically run tests to rule out the following problems prior to considering a diagnosis of CFS.
Drug dependence
Endocrine diseases (such as hypothyroidism)
Infections
Muscle or nerve diseases (such as multiple sclerosis)
Other illnesses (such as heart, kidney, liver diseases)
Other immune or autoimmune disorders Psychiatric or psychological illnesses, particularly depression (because the severe fatigue of CFS itself may bring about depression, a diagnosis of depression does not rule out CFS; however, fatigue related to depression alone must be ruled out in order for CFS to be diagnosed
Tumors
Once other more easily identifiable conditions are ruled out, criteria as developed by the Centers for Disease Control and Prevention are applied. To be considered as suffering from Chronic Fatigue Syndrome, a patient must match the following two definitional standards as documented on the web site and in printed materials available through the governmental agency:
1. Have severe chronic fatigue of six months or longer duration with other known medical conditions excluded by clinical diagnosis, and
2. Concurrently have four or more of the following symptoms:
substantial impairment in short-term memory or concentration
sore throat
tender lymph nodes
muscle pain
multi-joint pain without swelling or redness
headaches of a new type
pattern or severity
unrefreshing sleep
post-exertional malaise lasting more than 24 hours.
In addition, the symptoms must have persisted or recurred during six or more consecutive months of illness and must not have predated the fatigue.
Treatment for Chronic Fatigue Syndrome
Since CFS has remained such a mystery and since the condition has only been given serious consideration and attention over the last couple of decades, treatment options are limited and also varied.
Rest
Rest is the most common way to deal with the condition. Though many patients try to tough it out and will push to do more than physically able, this approach tends to worsen the condition. If a CFS patient ignores fatigue cues, he or she often ends up bed bound afterwards.
Complete bed rest is counterproductive and complicates an already problematic condition. Muscles deteriorate and energy levels and stamina are further reduced. Muscle and joint pains become more pronounced, and the overall feeling of unwellness is further complicated. A patient can become a virtual invalid if not making any effort at exertion.
Medical specialists recommend that CFS patients play it by ear. Rest when necessary but continue to stay as active as physically possible.
Break home tasks down into steps. Complete what you can. Rest and finish up later. If you can only wash a few dishes at a time, do that. Take a break and watch a television program or read a magazine. Then, wash a few more dishes. There is not rule that says that every dish must be washed at one time.
Establish a modest and low impact exercise program that is not too taxing and is also enjoyable. A daily walk around the block or a low impact water aerobics class (make sure water temperatures are comfortable—usually in the 90 degree range for those with CFS) may be tolerated well. If a patient isn’t up to exercise one day, he or she should not toss in the towel. Ride it out. Pick back up on the program the next day or when able.
Eat Well and Supplement as Needed
Eat a balanced diet, and consider a general vitamin supplement. If you haven’t reviewed the nutritional pyramid since high school, then look up the guidelines and make needed dietary adjustments. If you are too tired to think about or prepare healthy meals, then consider consuming liquid meal products for added nutrition. Some individuals also quality for free (or low cost) delivery of healthy meals through programs like “Meals on Wheels.”
Adding Vitamin B12 can also help with energy levels. These can be purchased over-the-counter at drugstores or big package stores like Wal-Mart or at many online companies.
Evening Primrose Oil and Omega-6 Fish Oil may reduce inflammation and help on pain reduction for those who are suffering with aches and pains in addition to low energy levels. Another product that proves helpful for some is Aloe Vera gel which mixed with fruit juice or other favorite beverage.
Medications
Current prescriptions are used to treat CFS symptoms and not the condition but often include anti-depressant or anti-anxiety medications or pain medications.
At one point, most doctors chalked CFS up to a mental problem and determined that patients were exhausted because they were depressed or stressed. No study has backed up this earlier non-scientific evaluation made arbitrarily by a good number of medical professionals.
So, while treating for depression/anxiety will not cure CFS, it may help some sufferers who are, not surprisingly, quite unhappy when unable to do the things they would like to do. If a parent wants to go see his child play ball and is unable to get up off the couch, drive down and sit though seven innings, then he is quite likely to feel emotional pain.
Pain medications can help with specific body pains (most often seen in fibro patients) but also with the general aches noted by most CFS patients. Most CFS patients use over-the-counter pain medications like aspirin or ibuprofen. When swelling or inflammation is involved, many find that standard aspirin is most effective. If pain is quite severe, doctors may prescribe narcotic pain medications. This should be a last resort. Though the medications tend to be quite effective in reducing pain, they also tend to reduce energy. For patients already feeling sluggish and with little energy to get up and around, narcotics can further complicate problems. Narcotics are also addictive. Use them sparingly if at all.
Prognosis for CFS
Many patients find relief from Chronic Fatigue Syndrome in six months to a year (about 50%) while many run one to ten years with the condition. In some cases, the symptoms simply ease up while in other cases, they go away completely. Some patients deal with CFS on a continuing basis and fall in the chronic category. There is no real cure, and it’s quite impossible to determine whether a patient will get well spontaneously, show improvement or remain extremely sick.
Researchers are currently searching for answers and hopefully better treatments for those suffering from CFS. Some studies have looked at connections to Epstein-Barr, enteroviruses, poliomyelitis and fungal conditions like Candidia albicans though no connection has been made in these early attempts to trace down the root causes of the rather modern medical malady.
Although little in really known about CFS, the condition does hit women more often than men. Age of onset tends to be in the 30s or 40s though the general range has been listed as 18 to 60 years. Some children have been diagnosed with CFS though that’s very rare. There is no indication that Chronic Fatigue is genetically predisposed or that it’s contagious.