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Chronic Fatigue – what is that?

Posted by amber | Meds | Posted on August 14th, 2010

Morning all

Thought I would get going on another explanation of CF , for those who have and those who need to understand.

Here is a brief excerpt from the
Medifocus Guidebook on Chronic Fatigue Syndrome

What is Chronic Fatigue Syndrome?

In the past, chronic fatigue syndrome (CFS) was associated with significant controversy among doctors, researchers, and patients. The major areas of disagreement were attributed to the lack of a standard definition for the disorder; the unknown etiology (cause) of the disorder; the absence of specific criteria to establish the diagnosis; and the lack of effective treatments for the disorder. In fact, until recently many health care providers believed that chronic fatigue syndrome was a “psychological” rather than a “physiological” (organic) disorder.

In 1994, an expert panel convened by the U.S. Centers for Disease Control and Prevention (CDCP) proposed a case definition for chronic fatigue syndrome that since has become widely accepted as the “standard”. According to the CDCP, the primary feature of chronic fatigue syndrome is persistent or relapsing fatigue which is characterized by the following:

  • Lasts for 6 months or longer
  • Is not due to another underlying medical condition
  • Is not due to continuous exertion
  • Is not relieved by resting
  • Interferes with the patient’s overall function and quality of life
  • In addition to chronic fatigue, the patient must exhibit 4 or more of the following symptoms that have lasted for 6 months or longer:
    • difficulty with concentration and/or memory
    • sore throat
    • tender lymph nodes in the neck or armpit region
    • myalgia (muscle pain)
    • arthralgia (joint pain)
    • lack of refreshing sleep
    • new onset of headaches
    • a vague feeling of bodily discomfort (malaise) after exertion

What Causes Chronic Fatigue Syndrome?

Chronic fatigue syndrome has become the focus of considerable research since the 1980s, especially with respect to its underlying cause which is as yet unknown, although the cause is thought to be multifactorial. Research is devoted to uncovering a possible link to an infectious organism, among other possible causes, because of the typical “flu-like” symptoms that many patients experience with the onset of chronic fatigue syndrome.

Possible causes of chronic fatigue syndrome being investigated include:

  • Viral infections
  • Immune disorders
  • Neuroendocrine disorders
  • Metabolic disorders
  • Psychological disorders with a possible link to depressive disorders
  • Psychologically predisposed response to infection or other stimuli occurring in “vulnerable” individuals
  • Impaired hypothalamic-pituitary-adrenal (HPA) axis activation
  • Primary sleep disorder
  • Neurally-mediated hypotension (NMH) – dramatic drop in blood pressure upon standing
  • Cortisol deficiency – cortisol is a natural stress-fighting and anti-inlammatory hormone produced by the adrenal glands

Signs and Symptoms of Chronic Fatigue Syndrome

The diagnostic criteria for CFS, established in 1994 by the U.S. Centers of Disease Control and Prevention, are as follows:

  1. Clinically evaluated, unexplained persistent or relapsing fatigue that:
    • lasts for 6 months or longer
    • is not due to another underlying medical condition
    • is not due to continuous exertion
    • is not relieved by rest
    • interferes with the patient’s overall function and quality of life
  2. Four or more of the following concurrent and persistent symptoms:
    • difficulty with concentration and/or memory
    • sore throat
    • tender lymph nodes in the neck or armpit region
    • myalgia (muscle pain)
    • arthralgia (joint pain)
    • lack of refreshing sleep
    • new onset of headaches
    • a vague feeling of bodily discomfort (malaise) after exertion
  3. The diagnosis of CFS is excluded if any of the following applies:
    • active medical condition that may explain the fatigue
    • previously diagnosed medical conditions that have not fully resolved, such as previously treated malignancies or unresolved cases of hepatitis infection
    • any past or current major depressive disorder with psychotic or melancholic features, bipolar disorder, schizophrenia, delusional disorders, dementia, anorexia nervosa, or bulimia
    • alcohol or other substance abuse within two years before the onset of chronic fatigue and at any time afterward

Goals of Treatment of Chronic Fatigue Syndrome

Because the cause of chronic fatigue syndrome is unknown, currently there is no know cure for this disorder. Consequently, treatment is primarily aimed at better controlling the symptoms of the syndrome. The goals of treatment include:

  • Reducing the severity of fatigue and controlling other symptoms
  • Helping patients gradually increase their level of activity
  • Helping patients to improve their quality of life so that they can better participate in social, recreational, and work-related activities

In general, the treatment options for people with chronic fatigue syndrome include:

  • Drug therapy
  • Cognitive-behavioral therapy
  • Nutritional and lifestyle interventions
  • Complementary and alternative therapies

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