12th May is observed as World Chronic Fatigue Syndrome Day every year. The aim of this day is to spread awareness about the condition.
It is quite common to experience fatigue post a strenuous physical activity or a stressful day at work. This type of fatigue lasts for a few hours or a day and is mostly relieved after a good night’s sleep or rest. But if your fatigue becomes so severe that interferes with your daily activities or fails to subside even after taking rest and continues to remain the same even after a month, then it’s a cause of concern. This is because you could be suffering from a condition known as chronic fatigue syndrome (CFS). Here’s what you need to know about this condition which should never be ignored.
What Is Chronic Fatigue Syndrome (CFS)?
According to the Centre For Disease Control and Prevention (CDC), chronic fatigue syndrome is a serious, long-term complicated illness which is characterized by extreme fatigue that is not relieved by rest[1]. In most cases, it is reported to cause at least six months of extreme fatigue and limits the functional capacity of the person causing various degrees of disability. CFS mainly affects young adults from 20 to 40 years, however, it is also seen to cause symptoms in childhood, adolescence and in the elderly.
The exact cause of this condition is unknown. However, there are different hypotheses that have been considered to explain the origin of the condition but with no conclusive evidence[2]. It is reported to be caused due to:
-Immunological disorders such as autoimmunity (a condition in which the immune cells attack the body’s own cells)
-Post-traumatic stress
-After infection by bacteria, virus or parasites
-Problems with the nervous system (which could be due to changes in hormones and neurotransmitters)
-Abnormal gene expression
Studies[3] have reported that there are no ethnic or racial factors which can up the risk of this disease. However, genetic factors are known to increase susceptibility to the disease in some people. Moreover, there are reports that being a female can make you more prone to the disease. A recent report by the U.S. The Centers for Disease Control and Prevention (CDC) revealed that female: male ratio of CFS is 4:1[3]. It occurs most often in the age group of 40 – 59 years and in the elders but it can happen even in kids and teenagers.
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What Are The Symptoms of CFS?
Also known as myalgic encephalomyelitis (ME), one of the key symptoms of CFS is intense fatigue which can affect your ability to function at home, work or school by around 50%. Fatigue is defined as the early onset of tiredness post an activity[2]. It is categorized as recent, prolonged and chronic fatigue based on how long it causes the symptom. Recent fatigue is when you have fatigue for less than one month, prolonged fatigue when it is more than a month and chronic when it is more than six months.
Fatigue is often confused with other symptoms namely weakness and asthenia, hence it is important to know what these symptoms mean[2]. Asthenia is defined as the lack of strength or feeling of inability to carry out daily chores. The symptom tends to aggravate during the end of the day and mostly improves with proper sleep. The second one is weakness which causes a reduction or loss of muscular strength, which leads to muscular diseases.
In addition to fatigue, it is associated with a wide range of symptoms that include:
-Unrefreshing sleep
-Dizziness
-Poor memory
-Difficulty in concentrating
-Arthralgia (joint pain) with no swelling or redness
-Muscle pain
-Headache
-Anxiety
-Intolerance to physical exertion
How Is CFS Diagnosed?
CFS is a long term condition with significant and unpredictable symptoms and uncertain duration. If you experience extreme fatigue which persists for more than six months, does not improve with rest and cannot be explained by any underlying health problem, then it could be diagnosed as CFS. Although it is believed that the immune system, energy metabolism, and nervous system do play a key role in CFS, there are no laboratory tests that can help in the diagnosis of the condition. Hence, the diagnosis is based on the symptoms of the disease and by ruling out other possible causes of chronic fatigue such as hypothyroidism, hepatitis, heart disorders, side-effects of medications, obesity, or psychiatric illness such as depression.
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How Is CFS Treated?
As the root cause of the disease is not known, the treatment is aimed at alleviating the symptoms and improving the quality of life. This includes:
Lifestyle changes: You may need to limit or slow down your physical activity so as to save energy to perform the key tasks at home and office. Also, avoid stress as it can improve your overall emotional and physical well being.
Exercise: It plays a key role to help you deal with the symptoms of CFS, however, the pace should be kept minimal. Say no to high-intestine exercises or activities. If you feel exhausted after any physical activity, stop exercising and consult your doctor to know if you can exercise or not.
Cognitive behavioral therapy: As CFS can affect your cognitive function, therapies that boost your memory and concentration can help mitigate the severity of the symptoms. This is why cognitive behavioral therapy and counseling are considered to help in treating CFS.
Medications: Medications such as antihistamines and antidepressants are advised to relieve the symptoms of allergies and depression as per your doctor’s advice. Also, the use of non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen are recommended to ease the headache, muscle pain, and joint pain. Do consult a doctor for medications which can be prescribed for you.
It is important to know that you may require a combination of the treatment options to deal with chronic fatigue syndrome. Moreover, CFS cannot be prevented as the exact cause is unknown and hence, it is important to strictly abide by the treatment options to improve the symptoms and the condition.
(The article is reviewed by Dr. Lalit Kanodia, General Physician)
Recommended Reads:
6 Practical Ways To Fight Fatigue and Bring Back your Energy
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References:
1. May 12 is ME/CFS and Fibromyalgia International Awareness Day. The Centre For Disease Control and Prevention (CDC) U.S.
2. Avellaneda Fernández A, Pérez Martín A, Izquierdo Martínez M, et al. Chronic fatigue syndrome: aetiology, diagnosis and treatment. BMC Psychiatry. 2009 Oct 23;9 Suppl 1:S1.
3. Griffith JP, Zarrouf FA. A systematic review of chronic fatigue syndrome: don’t assume it’s depression. Prim Care Companion J Clin Psychiatry. 2008;10(2):120-8.
4. Rowe PC, Underhill RA, Friedman KJ, et al. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Diagnosis and Management in Young People: A Primer. Front Pediatr. 2017 Jun 19;5:121.
5. Castro-Marrero J, Sáez-Francàs N, Santillo D, Alegre J. Treatment and management of chronic fatigue syndrome/myalgic encephalomyelitis: all roads lead to Rome. Br J Pharmacol. 2017 Mar;174(5):345-369.