We all feel tired at times and sometimes this can be severe whre it is referred to as fatigue. Normally rest, proper hydration and adequate nutrition are sufficient for most of us to recover within a day or more and our normal energy levels are restored. Ongoing fatigue, particularly when there is no clearly identifiable cause, could be due to a medical condition. For example, when the thyroid is underactive there may be ongoing tiredness and fatigue.
However, there is a condition where severe and persistent fatigue is one of the defining symptoms. It can be difficult to diagnose because the exact cause cannot be identified and accompanying symptoms are non-specific. This condition is known as chronic fatigue syndrome (CFS). It is a serious illness which should not be confused with episodes of fatigue that we all experience during periods of physical, mental or emotional stress and strain.
What is Chronic Fatigue Syndrome?
Chronic fatigue syndrome (sometimes called immune dysfunction syndrome) is a disorder where a person experiences severe fatigue for no apparent cause and rest does not help. The fatigue is usually present for more than 6 months. A person is unable to function at their optimal level and daily functioning is affected due to the unaccountable tiredness and weakness.
Read more on low energy levels.
Signs and Symptoms
Before a diagnosis of chronic fatigue syndrome can be made, other illnesses which could give rise to similar symptoms has to first be excluded. In addition at least four other symptoms have to be present along with the persistent fatigue for a definitive diagnosis of CFS to be reached. The signs and symptoms that may occur with chronic fatigue syndrome includes:
- Impaired concentration or short-term memory
- Extreme weakness
- Persistent muscle pain
- Joint pains
- Disturbed sleep
- Severe headaches
- Sore throat
- Painful lymph nodes of the neck or armpit
- Fatigue lasting for more than 24 hours even on the slightest exertion, be it physical or mental.
The symptoms vary in severity in different people. There may be periods during which a person is asympomatic but overexertion often precipitates another cycle. There could also be other signs and symptoms which may not be related to chronic fatigue syndrome. These symptoms may be due to other conditions that tend to be more likely in people suffering withc hronic fatigue syndrome. It includes:
- Abdominal pain and bloating
- Weight loss or gain
- Night sweats
- Breathing difficulty
- Chest pain
- Arrhythmias (irregular heartbeats)
- Eye problems, such as photophobia (sensitivity to light), blurring or eye pain
- Dizziness or fainting
- Inability to maintain balance
- Alcohol intolerance
- Psychological problems, such as depression, anxiety, and mood swings.
Causes of Chronic Fatigue Syndrome
No definite cause has yet been identified for chronic fatigue syndrome. There are certain illnesses or conditions which may contribute to its development. Factors which seem to be implicated include:
- Certain viral infections, such as infectious mononucleosis (caused by the Epstein-Barr virus), were suspected to cause CFS, but further research seems to indicate that CFS is more of a post-infective complication of the viral infections than a direct effect of the organisms. It has been seen, however, that the more severe the infection, the greater the chance of CFS developing.
- Immunological dysfunction has been suspected as a causative factor (giving it the name of immune dysfunction syndrome) but there is no conclusive proof to substantiate this theory. An allergy could be a contributing factor but not all chronic fatigue syndrome patients have identifiable allergies.
- A specific nutritional deficiency has not been found to be the cause of CFS, but an improvement in general health and wellbeing is possible by means of a balanced diet.
Who is at Risk of Developing CFS?
The reason why CFS develops is still not exactly known but certain people are at greater risk than others.
- Although men and women can both suffer from CFS, it about four times more common in women.
- It can occur at any age but it is more likely in people in their 40s or 50s.
- A genetic or family history may be present.
Other Illnesses with Symptoms Similar to CFS
There are many other illnesses which may have symptoms similar to CFS or may produce extreme fatigue as a consequence of the disease. It is necessary to eliminate these illnesses before a diagnosis of CFS is reached. In some instances, one of these conditions may co-exist with CFS.
- Chronic infectious mononucleosis
- Myalgic encephalomyelitis
- Systemic infections such as HIV/AIDS
- Sleep apnea
- Depressive disorders
- Eating disorders
- Reaction to certain drugs
- Alcohol abuse
- Drugs or other substance abuse
- Hormonal problems
- Malignancy (cancer)
- Autoimmune diseases
Read more on signs of fibromyalgia.
Treatment of Chronic Fatigue Syndrome
Chronic fatigue syndrome is often difficult to diagnose. Since there is no known cause for the condition, treatment is mostly symptomatic. There is specific treatment protocol for CFS and sufferers may require different therapies. A complicating factor in treating CFS is that symptoms keep varying with time. No single treatment may be effective all the time. The following medical, dietary and lifestyle changes may be used to manage CFS.
- Lifestyle alterations to avoid over-exertion may become necessary.
- Limited physical activity and exercise. A physical therapist may be of assistance.
- Getting enough sleep is necessary and drugs may be prescribed for sleep-related disorders.
- A balanced nutritious diet is essential.
- Nutritional supplements should only be considered if advised or prescribed by a doctor.
- Stress management is an important part of treating and managing chronic fatigue syndrome.
- Counseling may be a helpful treatment modality and support groups could also assist CFS patients.
- Cognitive behavioral therapy (CBT) often helps in adapting to the long-term effects of this condition.
- Medication may be needed to treat symptoms such as muscle or joint pain, insomnia, tiredness, headache, allergies and depression.
The outlook for CFS is more positive when the condition is diagnosed early and treatment is commenced soon thereafter. However, not all people with CFS may experience the same level of improvement and recovery. Total recovery from chronic fatigue syndrome is rare. However, with appropriate manage most people with CFS can function in daily life. There could be sufficient improvement to continue with educational, career and personal responsibilities.