Chronic fatigue syndrome is a rather complicated disorder , characterized by a persistent and apparently unexplained feeling of fatigue. Those who suffer from it do not suffer from any particular pathology and do not benefit from rest.
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The causes of this syndrome are still unknown; experts have formulated various hypotheses, which however have not yet found sufficient scientific confirmation.
In addition to feeling tired all the time, patients affected by chronic fatigue syndrome experience other ailments, similar to the symptoms of the flu .
Unfortunately, there is still no specific cure.
Things
Chronic Fatigue Syndrome: What is it?
Chronic fatigue syndrome – also called chronic fatigue syndrome , CFS or myalgic encephalomyelitis – is a very complex disorder, characterized by a sense of persistent, inexplicable and unmitigated fatigue. In those who suffer from it, in fact, the feeling of prostration does not diminish with rest and does not depend (in the sense that it is not related) to health problems or particularly intense physical activity.
What does myalgic encephalomyelitis mean?
Encephalomyelitis means inflammation of the brain and spinal cord . The term myalgic, on the other hand, comes from myalgia and means muscle pain .
Epidemiology: How common is Chronic Fatigue Syndrome?
According to some sources, in Italy , people affected by chronic fatigue syndrome are between 200,000 and 300,000.
Myalgic encephalomyelitis can affect anyone, however it is more frequent in people between the ages of 40 and 50 , and it has a predilection for females (in 60-85% of cases they are women).
Children affected by it are usually between 13 and 15 years old.
Cause
Chronic Fatigue Syndrome: The Causes
Despite numerous studies on the subject, researchers have not yet been able to identify the precise causes of chronic fatigue syndrome.
The various hypotheses formulated so far have taken into consideration:
- Viral infections. The idea of a link with some viruses arises from the fact that many patients with chronic fatigue syndrome have previously suffered (i.e. before getting myalgic encephalomyelitis) from some viral diseases. The viruses under investigation are the Epstein-Barr virus (responsible for mononucleosis) , the human herpesvirus 6 and the mouse leukemia virus.
- Immune SystemDefects . Some researchers have observed that the immune system of certain individuals with chronic fatigue syndrome functions inadequately. However, it is not clear what the link between the two abnormalities is.
- Hormonal Imbalances. A significant number of patients with chronic fatigue syndrome have abnormal values of hormones of the hypothalamic-pituitary – adrenal axis . It remains to be determined whether the two conditions are the result of each other.
- Psychological issues. Many people with chronic fatigue syndrome have experienced periods of stress or severe emotional trauma in the past . It remains unclear how these situations may have influenced the onset of the disease.
Risk Factors for Chronic Fatigue Syndrome
- Age between 40 and 50 years;
- Female gender;
- Tendency to stress.
Symptoms and Complications
To know more:Symptoms Chronic Fatigue Syndrome
Chronic fatigue syndrome is characterized by a persistent feeling of fatigue (it is the main symptom), accompanied by a series of secondary disorders, always of a chronic nature, which in some respects resemble the flu .
These pathological expressions can be summarized in eight points, namely:
- Memoryand concentration deficit;
- Muscle pain (myalgia) without cause;
- Frequent/recurrent sore throat ;
- Swollen lymph nodes, both on the neck and in the armpits;
- Very severe headaches ;
- Joint pain( arthralgia );
- Unrefreshing sleep ;
- Intense and prolonged tiredness, even after more than 24 hours have passed since the last physical or mental effort.
Characteristics of Fatigue
Patients with chronic fatigue syndrome describe the feeling of fatigue as a feeling of exhaustion, exhaustion . Furthermore, this feeling:
- it does not appear to be alleviated in any way, not even with proper rest;
- tends to worsen dramatically after intense physical or mental activity(usually, in these cases, the consequences are paid one or two days later).
When to See a Doctor?
Due to the characteristics of its symptoms, chronic fatigue syndrome could resemble much more serious (and potentially more dangerous) morbid conditions, such as:
- Lymedisease ;
- Some sleep disorders;
- Major depression ;
- Alcohol addiction;
- Diabetes;
- Hypothyroidism ;
- Mononucleosis ;
- Multiplesclerosis ;
- Systemic lupus erythematosus ;
- Chronic hepatitis .
In light of this, if the feeling of fatigue is prolonged and, above all, if it does not seem to resolve even after a period of complete rest, it is advisable to contact your doctor immediately.
Chronic Fatigue Syndrome: The Complications
When tiredness and fatigue become excessive, the patient feels completely deprived of strength: he cannot carry out the simplest tasks, he has difficulty moving, he finds it difficult to get out of bed and, even, he finds it impossible to leave his home.
All this could isolate him from the social context, lead to depression or induce him to be chronically absent from the workplace.
Diagnosis
How to Recognize Chronic Fatigue Syndrome: Diagnosis
There is currently no specific diagnostic test for chronic fatigue syndrome.
Therefore, to determine whether or not a person has myalgic encephalomyelitis, the doctor first excludes diseases that cause a very similar feeling of fatigue (differential diagnosis) and then analyzes the symptoms described directly by the patient.
Fundamental for this last step is the help of what has been published by the U.S. Centers for Disease Control and Prevention (CDC) regarding chronic fatigue syndrome.
NB: In the United States, the CDC is the national institute of public health. This organization uses doctors, biologists, pharmacologists and other experts to outline the main characteristics (from causes to symptoms, to diagnostic criteria and prevention) of various diseases.
Differential diagnosis
Before considering chronic fatigue syndrome, a doctor must ensure that the persistent feeling of fatigue is not due to:
- Sleep disorders, such as obstructive sleep apnea syndrome , restless legs syndrome , or insomnia ;
- Serious and chronic health problems, such as anemia, diabetes and hypothyroidism ; In this case, laboratory tests on the patient’s blood
are of fundamental importance ; - Psychological and mental illnesses, such as depression, anxiety , bipolar disorder and schizophrenia . In this case, it is useful to seek the advice of a specialist in the field.
Diagnostic Criteria
According to the US CDC, persistent fatigue may be related to chronic fatigue syndrome (in an adult) if:
- It has been ongoing for at least 6 months, is not directly a consequence of intense physical exerciseand is not linked to any particular morbid condition;
- It significantly reduces any type of activity performed by a person;
- It is associated with at least 4 of the 8 points reported in the chapter dedicated to symptoms.
NB: in young patients, it is sufficient that the feeling of fatigue has been present for 3 months.
Therapy
Currently, there is no specific treatment that cures chronic fatigue syndrome. However, there are remedies and therapeutic strategies aimed at alleviating the symptoms .
For some time now, there has been a debate about the actual effectiveness of these remedies and strategies, as not all patients derive equal benefits from them; in some cases, there is also a worsening of the symptoms.
Cognitive Behavioral Therapy
The aim of cognitive-behavioral therapy is to teach the patient to understand the illness he suffers from and to recognize its symptoms, so that he can control them in some way.
Typically, this therapy is used for mental illnesses, but doctors have noted that it is also effective against chronic fatigue syndrome; in fact, some patients with myalgic encephalomyelitis who have been treated with cognitive-behavioral therapy have shown that they can “accept” their situation and “react” well to the symptoms, without being influenced by them.
However, readers should be reminded that there have also been cases where symptoms have worsened rather than improved.
Pacing approach to physical activity management
Pacing is a self-management strategy of available energy that prevents the patient with chronic fatigue syndrome from overdoing activity or exercise. This approach reduces the likelihood of triggering so-called post-exercise malaise, also known as PEM, and can help reduce the symptoms of the condition.
A cornerstone of the pacing approach is that the activity performed is always sustainable, in order to keep the symptoms under control.
Appropriate pacing involves alternating between sustainable activity and rest.
For pacing, experts recommend using a daily diary, in which to note down the activities performed (with duration, intensity, etc.) and the effect that these have had on a physical level even after a long time; as is known, in fact, PEM could manifest itself even after 24-48 hours, making it sometimes difficult to identify the real cause of the problem.
Here are some tips on how to adjust pacing:
- Use a diary to record your activities and any symptoms that appear over the next few days. This strategy can help you identify your limitations. For patients with less severe ME/CFS, using a pedometer can help you measure the amount of physical activity you undertake each day; a heart rate monitor can also be helpful, to monitor your activity levels and know when to rest.
- Break activities into small chunks, with rest breaks between them . Again, the diary is important because it allows the patient to monitor symptoms while changing activity levels. The goal is to understand what is sustainable to avoid falling into PEM.
- Alternate physical activity with cognitive activity. This approach allows for the best distribution of the energy load. It is essential that the patient identifies the most strenuous activities and plans extra rest before and after. Too strenuous activities all on the same day should definitely be avoided.
- Find ways to save energy during activities.
- Listen to your body. When your body sends signals of tiredness, you have to stop and rest, even if your head says you could continue.
- We must be realistic. It is impossible to implement the pacing strategy perfectly and it is important that the patient realizes this. For example, managing children for patients who are parents could make it difficult to manage energy.
Pacing should be understood as a strategy to control symptoms. - It must be remembered that emotions also consume energy. Periods of stress or emotional upheaval drain energy, which means the patient has less energy available for other things.
- If you have been over-exercising or have had other unforeseen events that have reduced your energy levels, you should get more rest. Repeated over-exercising can cause a severe and long-lasting relapse, leading to a worsening of many ME/CFS symptoms.
Pacing is not a cure for ME/CFS and does not treat the cause of the disease.
Antidepressant Drugs
Suffering from chronic fatigue syndrome could lead to social isolation and depression. If this occurs, your doctor may prescribe antidepressant medications , such as amitriptyline ( a tricyclic antidepressant ).
Warning : Treatment based exclusively on the use of antidepressant drugs is not very effective and is not recommended. It is necessary, especially in cases of depression, to rely on an expert psychotherapist.
NB: Amitriptyline is contraindicated in case of heart problems .
Painkillers
Patients with severe muscle and joint pain can take painkillers , but only with a doctor’s prescription.
To know more:Chronic Fatigue Syndrome – Drugs and Treatment »
Tips and other Remedies
When performing various physical activities, a good strategy to avoid adverse effects is to proceed step by step, with patience and perhaps writing down your sensations in a diary
. Furthermore, it is very useful to alternate a few days of exercise with a few days of rest , diligently respecting this alternation, without ever overdoing it, even in moments when the feeling of tiredness seems to have faded.
Chronic Fatigue Syndrome: Natural Remedies and Solutions
For patients with chronic fatigue syndrome, doctors usually recommend:
- Avoid particularly stressful situations;
- Avoid alcoholic beveragesand coffee;
- Don’t overdo it with sugarsand artificial sweeteners;
- Avoid any foodor drink to which you are intolerant;
- Eat lightly, but several times a day;
- Set aside time during the day to relax;
- Always go to bed at the same time and avoid, if possible, taking long naps during the day.
Prognosis
Chronic Fatigue Syndrome: Can It Be Cured?
Since there is no specific cure for chronic fatigue syndrome, people who suffer from it rarely recover completely.
The fact that the precise causes are not known makes the therapeutic process even more difficult.
As for children, it seems that in young patients chronic fatigue syndrome has a better prognosis, with a higher percentage of recoveries.