Chronic fatigue syndrome: Things you need to know

Chronic fatigue syndrome is a long-term, complex disorder that affects a wide variety of processes in the body. It causes a wide range of symptoms for each person with the condition that may manifest differently.

Myalgic encephalomyelitis (ME) is also known as this disease. There may be 17 to 24 million individuals with chronic fatigue syndrome ( CFS) worldwide.

To help relieve symptoms, many people who have CFS rely on medical care and may have to develop a new approach to everyday life that decreases the effect of the disease.

There is no easy solution, and treatment appears to concentrate on symptom control.

Symptoms

Chronic fatigue syndrome

CFS is complex and can affect a large variety of systems and functions.

The list of possible signs is long. Similar to other conditions, many of these symptoms can occur, making a detailed diagnosis difficult but necessary.

Core symptoms

First, doctors focus on understanding the main (core) symptoms of CFS. These can vary slightly from person to person, but these three of the following core symptoms need to be noted for a physician to reach a diagnosis of CFS.

Fatigue

Fatigue is an extreme lack of energy. Extreme fatigue is officially recognised by physicians as a substantially diminished capacity to perform tasks that were once normal prior to CFS onset. The exhaustion also lasts for 6 months or longer in CFS.

It is important to remember in the sense of CFS that a doctor does not use “fatigue” at a certain point in the day to refer to a person feeling exhausted or unmotivated. It is likely that people with CFS can not shake this exhaustion. Sleep or rest does not replenish energy and, in some people, can also make symptoms worse.

The fatigue in CFS can be so extreme that everyday work is interfered with.

Post-exertional malaise

Another central CFS symptom is post-exertional malaise (PEM). After physical or mental exertion, PEM is a worsening of symptoms.

They will experience worsening symptoms over the next few hours or days when a person with PEM engages in too much physical or mental activity, and will often feel intense exhaustion as they recover.

It may be described by a person experiencing PEM as having their internal battery drained completely and immediately. It can damage the body when they push themselves too hard. Therefore, to prevent overexertion, individuals with CFS must pace themselves during the day.

Sleep disorders

A range of sleep disorders, including unrefreshing sleep, are also experienced by people with CFS. They wake up tired even after a long night of rest.

There are a number of sleep disorders that may lead to sleep that is not energy-replenishing, including:

  • insomnia, which is trouble falling and staying asleep
  • hypersomnia, which is excessive sleep
  • sleep apnea, in which a person stops breathing as they sleep
  • light sleep, a disorder that means an individual never enters the deeper stages of sleep
  • fragmented sleep, consisting of frequently waking up and falling back asleep
  • phase shifting, in which a person may not be able to fall asleep until sunrise
  • involuntary spasms in the legs or arms
  • restless legs
  • nightmares with vivid dreams that disrupt sleep
  • night sweats

One or more of the following must also be present for the diagnosis of CFS, along with the three above core symptoms that are present:

Cognitive impairment

For people with CFS, problems with thinking processes may arise in several ways.

People with cognitive disability can have trouble with their memory. They may not be able to recall recent conversations or may be losing possessions at all times. All the way through, movies and books can become incredibly difficult to follow.

In a person with CFS, thinking or basic problem solving can severely reduce energy levels.

In familiar settings, such as their own neighborhood, other individuals with this syndrome may become lost. In order to recall basic directions, names, or even written instructions, they can need extreme effort.

In various individuals, CFS may cause various cognitive impairments.

Orthostatic intolerance

These are symptoms, including dizziness, lightness, or feeling faint, that occur when shifting from lying on your back to sitting or standing. This may also make a person feel as if they are seeing spots or having blurred vision.

Other symptoms

The following are other signs that are known to occur in CFS:

Pain

Any type of pain or discomfort, ranging from headaches and cramps to extreme, widespread pain, is experienced by almost all people with CFS.

The pain sensation is most generally described by people with CFS as a general ache or soreness in the muscles and joints. In one region, this pain can emerge and then transfer to another. Also, headaches are common.

Other pain descriptors are also common, including pain defined by individuals as:

  • shooting
  • stabbing
  • burning or tingling
  • throbbing

Light, touch, heat, or cold can also be highly sensitive to someone with CFS. It can cause discomfort to feel these sensations to an severe degree.

Other potential symptoms

There are several other potential CFS symptoms that differ in severity and can shift from person to person.

  • sore throat
  • enlarged lymph nodes
  • muscle twitching
  • rashes
  • canker sores
  • anxiety or panic attacks
  • depression
  • high stress levels
  • dizziness
  • flu-like symptoms
  • saying words wrong
  • low or high body temperature
  • numbness
  • tinnitus
  • extreme symptoms of premenstrual syndrome (PMS)
  • altered senses, such as visual problems
  • lack of sex drive, sexual impotence
  • hair loss
  • weight changes
  • heart palpitations
  • chest pain
  • seizures
  • paralysis

Causes and risk factors

For CFS, there is no single known cause.

In each individual, the cause for the condition can differ, and it may be anything as simple as the flu or intense stress that CFS sets in after. There is still a lot of uncertainty about CFS, and the cause has not yet been confirmed by research.

The risk of CFS, such as stress levels, age , and sex, may be increased by a few factors.

Women are two to four times as likely as men to encounter CFS, according to the Office on Women’s Health.

The influence of changes in the role of the immune system that may have associations with CFS is being studied by some researchers.

Research continues as to the risk factors for CFS as a disease to grow. The disease is not actually triggered by these variables, but there seems to be a relation between them.

Diagnosis

A detailed diagnostic procedure is extremely necessary but challenging for individuals with CFS.

Some symptoms may not be noticed by physicians or may confuse them with the symptoms of other conditions.

By removing the likelihood of other diseases, which can be a long process, a CFS diagnosis also occurs.

In the coming years, diagnostic methods for CFS might improve. Unique molecules occurring at altered levels in the blood samples of people with CFS were identified in a study published in the journal Scientific Reports. At present, however, there is no clear laboratory test to validate a CFS diagnosis.

This study will help make it easier and more specific for future diagnosis of chronic fatigue syndrome.

Treatment

Current methods of treatment will not cure any person with CFS. A course of care for most patients focuses around the diagnosis or treatment of the individual symptoms of the condition.

A number of therapies are available to respond to the wide range of physical symptoms, as symptoms differ from person to person. With any person with CFS, no medication is always successful, but most people have at least a few measures available for their collection of symptoms.

To help manage individual symptoms, physicians can prescribe different medications, usually beginning with treatment for the most problematic symptoms to help restore everyday living. Usually, at the beginning of a course, they will prescribe a low dose of any drug and gradually increase the amount if necessary.

Individuals with CFS tend to be particularly susceptible to chemicals and drugs. Any drug or supplement may trigger an unwanted reaction. Starting with low doses allows the doctor to track any side effects closely and to find the lowest dosage possible to provide relief.

In order to treat CFS, some experimental therapies are also available. A component of CFS can help treat drugs like rituximab and Ampligen. These drugs work on underlying conditions that may have ties to the condition in the immune system.

The effectiveness of each treatment procedure will vary significantly, and depends largely on the individual’s symptoms.

Lifestyle changes

Lifestyle improvements are an important aspect of symptom management for many individuals with CFS.

Many individuals with CFS have to find ways of controlling their levels of operation. They will need to plan and spread out tasks that they know will drain resources from them, and may also have to abandon activities that require a lot of effort.

Methods of controlling daily life with CFS, depending on the symptoms present, include:

  • calendars, journals, or daily planners to help with memory issues
  • therapy to find emotional and psychological coping strategies
  • relaxation techniques, such as breathing exercises, meditation, or massage
  • a well-balanced, nutritious diet
  • specific nutritional supplements, if you are found to have a deficiency in one or more specific nutrients

The stigma around the condition

Until recently, CFS was overlooked by many individuals in both the medical community and broader society.

The disorder was written off by many physicians as unwillingness to be active.

Now the medical community recognizes that CFS is a complex, life-changing disease. Doctors and researchers are developing new ways of diagnosing and managing CFS, as well as enhancing the understanding of how they can self-manage among people with the disease.

Takeaway

CFS is not fully understood by medical scientists yet.

Among a wide variety of other symptoms, the disease affects a wide range of processes and usually induces severe, unshakeable weakness, malaise following physical or mental exertion, and sleep disorders. For each person, the effects of the syndrome are different.

Although the cause is still unclear, the disease is related to the immune system by some researchers.

A detailed diagnosis is important and sometimes complex. Until CFS becomes obvious, a doctor will rule out other conditions.

In order to relieve these symptoms, drugs are available, and research is underway to tackle the disease at its heart. In the meantime, to adjust to the decreased energy, individuals with CFS must carefully maintain their lifestyles.

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