What is chronic fatigue?
Chronic Fatigue Syndrome (CFS) is a disabling, complex and chronic illness affecting many body systems.2,4,5 The cause of this condition is unknown, and there are no specific laboratory tests to diagnose chronic fatigue syndrome. An estimated 836,000 to 2.5 million Americans suffer from CFS, but approximately 90% of people have not been diagnosed due to limited access to healthcare and a lack of education among healthcare providers to provide an accurate diagnosis.2 CFS often makes it difficult to maintain employment, attend school, and participate in family and social life. It may last for years or become a life-long disorder. CFS costs the U.S. economy about $17-$24 billion annually in medical bills and lost incomes. There is no known cure for CFS, treatment is based on symptom management.2 Currently, there are no FDA-approved treatments specific for Chronic Fatigue Syndrome.5
Symptoms of chronic fatigue syndrome.
Symptoms include fatigue present for at least 6 months in adults and for at least 3 months in children and adolescents.4,5 Patients will experience a lowered ability to complete activities that they were previously able to completed.2 Symptoms of sleep disturbance (even after a full night of rest), headache, difficulty concentrating, dizziness, or severe tiredness may occur after physical or mental activity.2 Patients may also experience pain (muscle pain with aches, joint pain without swelling or redness, headaches), tender lymph nodes in neck or armpits, sore throat that often occurs, digestive issues (such as IBS), chills and night sweats, allergies and sensitivities to odors, foods, light, chemicals, or noise, muscle weakness, shortness of breath, or irregular heartbeat. Symptoms may flare and may change overtime.2,5
Who is at risk?
CFS most commonly occurs between 40-60 years of age. This condition affects children, adolescents and adults of all ages. Among adults, women are affected more often than men. It occurs in all ethnic and racial groups and in countries around the world. It is just as common in African American and Hispanic ethnicities as it is among people of white ethnicity; however, people of white ethnicity are diagnosed more often than other races and ethnicities.2 It is unknown whether genetics plays a role in CFS. Many people believe that the onset of CFS originates following a flu-like illness, infection, or Epstein-Barr viral infection. Others report that CFS symptoms started after a time of great physical stress, such as following a major surgery.5
Deriving a diagnosis.
CFS can be difficult to diagnose.4 It is important for your healthcare provider to rule out other conditions that may present symptoms similar to CFS, which requires time and patience. Conditions that may mimic CFS include: sleep disorders, anemia, diabetes, hypothyroidism, heart and lung problems, and other mental health issues, including depression, anxiety, bipolar disorder, and schizophrenia.3 Your healthcare provider will inquire about your current and past medical history, family history, symptom duration and severity, and ask about how symptoms affect your life overall. A thorough physical and mental status exam, as well as blood, urine, and other laboratory tests, may be performed to determine a diagnosis.4
Treatment and therapy options.
It is important for you, your family, and your healthcare provider to work together to develop a management plan to treat your symptoms. Support from family members and friends is essential. Many treatments can be unproven, costly and could be dangerous; therefore, it is important for your healthcare provider to approve any new treatment options (including alternative medicines, dietary supplements, or herbal remedies).4,5 It is best to decide which symptoms are the most impactful to your quality of life to figure out a starting point for treatment options. Learning new ways to manage activity can also be helpful. It is important to avoid over-exertion when feeling better by trying to do too much, which may exacerbate symptoms.4
Depression is a common co-morbidity with CFS. Treating underlying depression can help an individual cope with the symptoms associated with CFS. Antidepressants can help improve sleep and alleviate pain accompanied by CFS. The most effective treatment for CFS involves a dual-therapy approach, including cognitive training and graded exercise. Talking with a counselor or joining a support group may also help individuals feel more in control of their lives. Physical therapy can aid in determining what exercises are best for each person based upon his or her degree of disability. Range-of-motion and stretching exercise daily can help people become more active. Gradually increasing the intensity of exercise over time may help reduce any hypersensitivity to exercise.3 Researchers are also testing a variety of treatments for CFS, including anti-viral medications and immune-modulator medications.5
Diet plays a role.
You can begin making the necessary accommodations to the demands of a chronic illness through diet; however, it is not always the easiest. For many affected by CFS, planning a feasible diet poses numerous difficulties. About two-thirds of individuals with CFS have gastrointestinal symptoms (heartburn, gas, nausea, diarrhea, constipation, and cramps). In many cases, the symptoms are caused by food sensitivities. Others may have co-existing conditions, such as interstitial cystitis or migraine headaches requiring certain dietary restrictions.1 Even if you do not suffer from GI complications, diet is important for chronic illness. Problems caused by disruptions in cell metabolism, malabsorption and food sensitivities make it all the more important for CFS patients to maintain an appropriate diet. Implementing a special diet will maximize the nutrients available to a healing body while minimizing any harmful effects that specific foods or food additives may produce.1
The American Myalgic Encephalomyelitis and Chronic Fatigue Syndrome Society recommend avoiding stimulants (caffeinated beverages such as coffee, tea, soda), alcohol, sweeteners (sugar, corn syrup, sucrose, glucose, dextrose, brown sugar, fructose, aspartame, and saccharin), animal fats, and additives (artificial colors, artificial flavors, preservatives, MSG).1
If you feel that you could be experiencing symptoms of chronic fatigue syndrome, contact your healthcare provider to schedule a consult to thoroughly discuss your symptoms.
©2022HealthSpot References: (1)AMMES (2020). American Myalgic Encephalomyelitis and Chronic Fatigue Syndrome Society: Diet. Retrieved on 05/13/2020 from https://ammes.org/diet/. (2)Centers for Disease Control and Prevention (2018). CDC: What is ME/CFS? Retrieved on 05/13/2020 from https://www.cdc.gov/me-cfs/about/index.html. (3)Mayo Clinic (2018). Chronic fatigue syndrome. Retrieved on 05/13/2020 from https://www.mayoclinic.org/diseases-conditions/chronic-fatigue-syndrome/diagnosis-treatment/drc-20360510. (4)MedlinePlus (2016). Chronic fatigue syndrome. Retrieved on 05/13/2020 from https://medlineplus.gov/chronicfatiguesyndrome.html. (5)U.S. Department of Health and Human Services (2019). Office on women’s health: Chronic fatigue syndrome. Retrieved on 05/13/2020 from https://www.womenshealth.gov/a-z-topics/chronic-fatigue-syndrome.