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Chronic Fatigue Syndrome

Overview

Chronic fatigue syndrome is a complex condition in which you always feel exhausted without any apparent medical reason. It is also known as myalgic encephalomyelitis or systemic exertional intolerance disease. It can last from six weeks to a few months or longer. This condition can worsen with mental or physical activity but does not seem to improve with complete rest. It is difficult to determine a single cause of this disease because it may occur due to a combination of different factors. Treatment is focused on relieving symptoms. 

Causes

The exact cause of chronic fatigue syndrome has not been identified yet. It has been theorized that some people may have a genetic predisposition for this disease, which can be triggered later due to multiple factors. Viral infections are considered one of the possible trigger factors. Many viral infections present with fatigue and generalized weakness, so it is possible that they are a cause of chronic fatigue syndrome, although it hasn’t been confirmed yet.

 

It has also been noticed that people with chronic fatigue syndrome have a weak or impaired immune system. Whether or not a weak immune system is a cause is yet to be determined. Other factors such as hormonal imbalance, physical injury, and emotional trauma may also contribute to the development of chronic fatigue syndrome. 

Risk Factors and Epidemiology

The risk of chronic fatigue syndrome may be higher in those infected by Epstein-Barr virus or human herpes virus-6 (HHV-6). These viruses have been noticed to have a link with chronic fatigue syndrome, although other viruses may be involved as well. Those with a weak immune system are also at risk.

 

Chronic fatigue syndrome can occur at any age, but it has often been observed in young or middle-aged adults. It is more predominant among females than males. It may be because women are more likely to report their symptoms than men. According to CDC, there are around 1 million cases of chronic fatigue syndrome in the United States, but 80% of those patients are undiagnosed. 

Signs And Symptoms

The symptoms of chronic fatigue syndrome can vary for different individuals. Some people may have a mild or moderate disease, while others may experience severe symptoms that reduce the quality of their life. Common symptoms of chronic fatigue syndrome include extreme fatigue, exhaustion after physical or mental tasks, headaches, sore throat, enlarged lymph nodes, unexplained joint or muscle ache, poor concentration, issues with memory, dizziness upon standing, poor sleep patterns, and difficulty in performing regular tasks. These symptoms can vary day to day and may repeat in cycles. The symptoms may sometimes disappear entirely and return after a few weeks or months. 

Diagnosis

It is difficult to diagnose chronic fatigue syndrome because its symptoms resemble many other medical conditions. Your doctor will require a history of symptoms’ onset, duration, and severity. If they have persisted for six months without apparent cause, you may have chronic fatigue syndrome. Your doctor will test you for other common diseases that can present with constant fatigue. These tests include complete blood count, thyroid function tests, urinalysis, sleep studies, and relevant imaging scans. If it is suspected that your symptoms are being caused by a psychological issue such as depression, you will be referred to a psychologist or therapist. 

Differential Diagnosis

Chronic fatigue syndrome must be differentiated from multiple diseases that can present with long-term fatigue and weakness. Common conditions include anemia, diabetes, thyroid dysfunction, multiple sclerosis, fibromyalgia, rheumatoid arthritis, polymyalgia rheumatica, osteoarthritis, and systemic lupus erythematosus. 

Treatment

There is no cure available for chronic fatigue syndrome. Treatment options can provide symptomatic relief but cannot treat the disease itself. The symptoms that disrupt your daily routine are prioritized for treatment. If you have constant headaches or pain in other parts of your body, you will be prescribed pain killers to improve your condition. Other symptoms such as nausea or dizziness upon standing can also be targeted with medication. Counseling and therapy can also help in managing your condition. If you went through trauma or are facing mental health issues, such as stress, anxiety, or depression, it is important to understand the underlying cause. Resolving these problems may help in diminishing your symptoms.

Medication

 

Over-the-counter pain killers such as acetaminophen, ibuprofen, naproxen, etc can be used for pain. If they are not enough, you can take prescription medicines such as pregabalin, duloxetine or gabapentin. Antidepressants can aid in coping with depression symptoms and may also relieve sleep issues. 

Prognosis

It is difficult to predict the exact prognosis of chronic fatigue syndrome. Some patients recover to a certain degree with use of medications and therapy. They are able to perform their regular tasks well. The recovery rate is only 5%. However, those with moderate to severe form of disease may face long-term difficulties. Many people with chronic fatigue syndrome have also been observed to have comorbidities such as fibromyalgia or irritable bowel syndrome. 

Prevention

There are no proven ways to prevent chronic fatigue syndrome. If you have experienced constant fatigue and any of the above-mentioned symptoms for almost six months, report it to your doctor. Early detection of symptoms and proper treatment measures can prevent future complications of this disease.