TREATMENT OF CHRONIC FATIGUE SYNDROME
Chronic fatigue syndrome also called as Myalgic encephalomyelitis is the term used for enervating fatigue that is not eased with rest. It is characterized by weakening physical symptoms that make it difficult for the person to carry on with their social, personal and work life as normally as they would want to.
Here in this article you will find out all the necessary basic information about this life haltering condition, from what chronic fatigue syndrome is to how you can seek the treatment for it.
According to the criteria established by “The Centers for Disease Control and Prevention”, chronic fatigue syndrome occurs when severe fatigue lasts longer than six months along with the presence of at least four of the physical symptoms following;
- Postexertional malaise
- Unrefreshing sleep
- Impaired memory
- Lack of ability to concentrate
- Muscular pain
- Sore throat
- Tender lymph nodes
- New headaches. (1)
Its clinical diagnosis can only be assured in absence of any other co-existing disease. The complex etiology of chronic fatigue syndrome (CFS) is yet to be made definitive but it is believed to involve dysfunction of adrenal system or immune system. There are evidences of its association with history of childhood trauma and certain genetic markers.
People with chronic fatigue syndrome usually have concurrent depression, pain and sleep disturbances. Therefore they should be properly diagnosed for these conditions as well. (2)
Chronic fatigue syndrome (CFS) is a widespread problem with an estimate of more than 2 million diagnosed cases in America with many more to who have not been diagnosed. (3)
There is no specific test for diagnosis of chronic fatigue syndrome, so it is diagnosed on the basis of symptoms reported by the patient and by ruling out other conditions that could be causing fatigue and related symptoms. The general physician takes the general medical history and asks about the symptoms. He may also ask the patient to have his blood and urine test taken.
The Centers of Disease Control and prevention (CDC) developed a specific diagnostic criterion for chronic fatigue syndrome. According to the theory of this diagnostic criterion, the person must have a viral illness to cause the chronic fatigue. It focused on physical symptoms. (4)
In contrast to The Center of Disease Control and Prevention, the World Health Organization categorized chronic fatigue disease as a neurological disorder. In 1991, the Oxford criteria were developed. According to this, the chronic fatigue syndrome was associated with mental fatigue and physical symptoms. (4)
The doctor must rule out a few important possibilities before diagnosing chronic fatigue syndrome. These possible conditions may be, sleep disorders, medical problems such as anemia, diabetes, abnormal thyroid activity which can be detected in blood tests. Apart from the above mentioned conditions, heart and lung impairments and mental health issues are important contributing factors of fatigue that can make the diagnosis uncertain. (2)
There is no cure approved for chronic fatigue syndrome but the treatments to mitigate the symptoms are present and exercised to help the patient by providing him some relief. The treatment comprises of two features; medication and therapy including cognitive training and graded exercise.
Treating the symptoms using these approaches may provide relief to some patients with chronic fatigue syndrome but not to others. Patients, their families and healthcare providers are required to work in collaboration to decide which symptom needs to be relieved first. The identified problem should be treated on first priority basis.
The doctor should discuss the possible benefits and side effects of the therapy with the patient. The options should also be discussed with the patient so that he can decide whether he would want to go for a medication therapy or non-medication therapy. The family of the patient needs just as much guidance, if not more, as the patient so that they can be supportive to the patient through the course of his treatment.
Patients with ME/CFS often feel less refreshed and restored after sleep than they did before they became ill. Common sleep complaints include difficulty falling or staying asleep, extreme sleepiness, intense and vivid dreaming, restless legs, and nighttime muscle spasms.
People might continue to feel un-refreshed even after the medications help them to get a full night of sleep.
If so, they should consider seeing a sleep specialist. Most people with sleep disorders, like sleep apnea (symptoms include brief pausing in breathing during sleep) and narcolepsy (symptoms include excessive daytime sleepiness), respond to therapy. However, for people with ME/CFS, not all symptoms may go away. Talk to your doctor and see what he suggests best for you. Some prescription sleep medications your doctor can suggest you are;
- Muscle relaxants
All prescriptions have side effects. You should consult your doctor. (5)
Stimulants like the ones used to treat ADHD can be helpful in easing fatigue. This also helps with improving concentration and memory. The patient feels energized and focused which can give them a new drive to carry on with their life with a positive outlook. (6)
Patients who experience severe joint and muscular pain can be given pain killers to relieve their pain. For muscular pain, muscle relaxants and over the counter pain relievers such as acetaminophen, ibuprofen and aspirin can be very effective. In case of joint pain your doctor can prescribe you pain killers for arthritic patients.
ANTIDEPRESSANTS AND ANTIANXIETY:
Adjusting with this condition of constant fatigue can sometimes lead the patient towards depression, stress and anxiety. You must seek your doctor for treatment of these symptoms. (7)
A FRESH TREATMENT:
In a recent clinical trial conducted in 2008 by the research group of Norway’s Helse Bergen University administered their research subject with IV drips of immunosuppressant, Rituximab. The results of the study were exceptionally positive. This suggested that the illness could be due to some sort of immune system dysfunction.
However, the patient suffered some serious side effects the study still was successful in opening new doors for better understanding the condition and its treatment scope. (8)
No matter how devastating this condition may be there is always a way to work your way around it. If you are suffering be positive and seek help. If you know someone who is suffering then be their best support.
1. Chronic fatigue syndrome (CFS/ME) - NHS [Internet]. [Cited 2020 Jun 22]. Available from: https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/
2. Yancey JR, Thomas SM. Chronic Fatigue Syndrome: Diagnosis and Treatment. Am Fam Physician. 2012 Oct 15; 86(8):741–6.
3. Bierl C, Nisenbaum R, Hoaglin DC, Randall B, Jones A-B, Unger ER, et al. Regional distribution of fatiguing illnesses in the United States: a pilot study. Popul Health Metr. 2004 Feb 4;2:1.
4. Yancey JR, Thomas SM. Chronic Fatigue Syndrome: Diagnosis and Treatment. Am Fam Physician. 2012 Oct 15;86(8):741–6.
5. What Medicines Treat Chronic Fatigue Syndrome? [Internet]. WebMD. [Cited 2020 Jun 22]. Available from: https://www.webmd.com/chronic-fatigue-syndrome/medicines-treat-chronic-fatigue-syndrome
6. What Medicines Treat Chronic Fatigue Syndrome? [Internet]. WebMD. [Cited 2020 Jun 22]. Available from: https://www.webmd.com/chronic-fatigue-syndrome/medicines-treat-chronic-fatigue-syndrome
7. Treatment of ME/CFS | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) | CDC [Internet]. 2019 [cited 2020 Jun 22]. Available from: https://www.cdc.gov/me-cfs/treatment/index.html
8. London TPJJ 2016By JLJLAL is a freelance science writer based in, UK. Fresh evidence points to a cause and possible treatments for chronic fatigue syndrome [Internet]. Pharmaceutical Journal. [Cited 2020 Jun 22]. Available from: https://www.pharmaceutical-journal.com/news-and-analysis/features/fresh-evidence-points-to-a-cause-and-possible-treatments-for-chronic-fatigue-syndrome/20201439.article