CHRONIC FATIGUE SYNDROME

WHAT IS CHRONIC FATIGUE SYNDROME?

Human bodies are designed to function in a way where everyday tasks such as going to work, feeding yourself, and getting out of bed are not something to struggle with. However, things like lack of sleep, chronic illness, stress, cancer, and other issues may lead some people to feel an overwhelming sense of fatigue with their normal daily tasks (1).  Many people with elevated fatigue levels have an underlying cause or condition that may be treated. However, other people have debilitating fatigue that has no known cause; this condition is referred to as chronic fatigue syndrome (2).

Chronic fatigue syndrome is a disorder in which a person has extreme fatigue and sleep abnormalities.  Chronic fatigue syndrome is complicated to classify due to the widespread symptoms and difficult to identify the cause (3).  It is believed that most people suffering from chronic fatigue syndrome are undiagnosed by their doctors (4). It has been stressed by researchers at DePaul University that there needs to be a unified criterion and diagnostic list which will help these undiagnosed persons receive help (5). Until there is a general agreement on a standard of care criteria, this disorder will remain underdiagnosed, difficult to treat, and highly frustrating for sufferers.

RISK FACTORS OF CHRONIC FATIGUE SYNDROME

Due to the unexplained nature of chronic fatigue syndrome, little is known about its underlying cause. It has been theorized that there may be predispositions that could possibly increase some person’s risk of developing this disorder. It is theorized that these predispositions may lead to this disorder after a triggering event; possible trigger events include (6):

• Viral infection
• Poor immune health
• Imbalance of hormones

Additional risk factors that have been identified include (7):

• Age: 40 to 50 years
• Gender: Female
• High stress or issues coping with stress

SYMPTOMS OF CHRONIC FATIGUE SYNDROME

Although chronic fatigue syndrome criteria is still being debated, the core symptoms that are associated with this disease are:

• Hypersensitivity to normal daily activities (2)
• Extreme exhaustion lasting greater than 24 hours after exercise, either physical or mental (8)
• Memory loss and cognitive issues (4)
• Unrefreshing sleep (8)
• Trouble concentrating (9)
• Sore throat (9)
• Enlarged neck and/or armpit lymph nodes (9)
• Unexplained muscle or joint pain (9)
• Headaches (9)
• Ataxia or distorted motor function (4)

The hypersensitivity and extreme exhaustion must be persisting with a duration of 6 months or longer to be considered Chronic (8).  Persons with chronic fatigue syndrome reported that they may not have all of the above symptoms and that they fluctuate in severity (10). This was mostly noted by patients who followed a peak and valley cycle of activity to rest (10).

For more information on chronic fatigue syndrome and diagnosis:  1. Talk to your doctor  2. Visit the Mayo Clinic website  3. Visit the Centers for Disease Contol and Prevention website  4. Visit the Office of Women’s Health website

CHRONIC FATIGUE SYNDROME FACTS AND STATISTICS

Although there is no unified theory of what causes chronic fatigue syndrome, this disorder affects roughly 0.2% – 2.6% of the world’s population (11). Due to the nature of this disorder, it is believed that 84 – 91% of persons with this disorder have not been diagnosed (7). It is estimated that for diagnosis to occur, an affected person will have a 5-year medical journey of diagnostic rule-out (9).

MEDICAL TREATMENT OF CHRONIC FATIGUE SYNDROME

There are conflicting ideas on the best treatment plan for the 150 million persons globally who suffer from this disorder. This conflict is in part due to the limited understanding of the cause of chronic fatigue syndrome. This lack of understanding drives the standard treatments to symptom management (2).  Current management of symptoms aims at decreasing the burden fatigue, mental impairment, depression, and anxiety on persons with this disease (11).

Medication symptom management is possible for fatigue, sleeping problems, pain, depression, stress, anxiety, dizziness, and concentration problems (2). Medications used include:

• Stimulants
• NSAIDS
• Sleep aids (both over the counter and prescription)
• Antidepressants
• Anti-anxiety medications
• Attention-deficit/hyperactivity disorder medications
• Complementary nutritional supplement (based on lab tests)

The aforementioned medications are stated in classifications and not specific prescriptions. This is because all pharmacological treatments are utilized to manage symptoms and not treat chronic fatigue syndrome. Thus, all medications being prescribed are dictated by individualized doctors and can be any within the classifications listed.

Studies are currently investigating the utilization of pharmacological treatments that reduce the oxidative stress of a patient such as coenzyme Q10 and NADH (12) and moxibustion (13). However, these medications are still in clinical trials and need to be further subjected to clinical trials before standardized use and should not be utilized without doctor’s supervision.

NATURAL WAYS TO HELP FEEL LESS FATIGUED

Practices to Help Feel Less Fatigued:

• Guided and scaled exercise (14)
• Cognitive behavioral therapy (15)
• Better sleeping habits and rituals (16)
• Balanced diet (2)
• Acupuncture (17,18)
• Meditation (2)
• Massage (2)
• Breathing and relaxation therapy (2)
• Yoga or Tai Chi (19)
• Waon therapy (20)

Natural Supplements That Help Feel Less Fatigued:

• Cocoa (21)
• L-Theanine (22)
• Rhodiola root extract (23,24,25,26)
• Holy Basil (27)
• Astragalus (28)
• DHEA (29)
• Evening primrose (30)
• L-Carnitine (31,32,33,34,35,36)
• Ribose (37)

REFERENCES

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