Chronic Fatigue And Immune Dysfunction Syndrome Chronic Fatigue Syndrome

Chronic fatigue syndrome, also known as CFS, is a poorly understood condition that results in severe fatigue and other symptoms.

What is going on in the body?

The cause of chronic fatigue syndrome is not known, although many theories exist. It is a chronic condition with an unpredictable course. It is not diagnosed until other medical conditions that cause fatigue are excluded. Treatment is limited by a lack of understanding of the disease process itself.

What are the causes and risks of the condition?

The cause of chronic fatigue syndrome is unknown. It is most likely that a combination of factors, rather than one single factor, brings about CFS in an individual. The list of possible factors includes the following:

Low blood pressure caused by the autonomic nervous system may cause CFS. It is more prevalent in people with CFS than in the general population.

Immune disorders, such as allergies or an autoimmune disorder, may cause CFS. An autoimmune disorder is a condition in which the person creates antibodies against his or her own tissue.

Infection alone does not cause CFS. However, an infection may be one of multiple causes that bring about CFS in an individual.

Nutritional deficiencies may play a role in causing CFS. However, there is no definitive proof.

Stress stimulates centers in the brain, known as the hypothalmic-pituitary-adrenal axis. These centers produce cortisol and other hormones. Overstimulation from stress may influence the immune system to bring on CFS.

New research findings suggest that autoimmune disorders may be triggered by a transfer of cells between the fetus and the mother during pregnancy. The study involved women with scleroderma, an autoimmune disorder involving the skin. These women have more fetal cells in their blood decades after a pregnancy than women who don’t have scleroderma. While further research is needed to substantiate these findings, the study does offer an explanation for the much higher incidence of autoimmune disorders in women than in men.

What are the signs and symptoms of the condition?

The Center for Disease Control, or CDC, has established criteria for a diagnosis of chronic fatigue syndrome. First of all, the individual must have a recent history of fatigue. The fatigue must be severe and last, whether constant or not, for at least six months. This fatigue is not relieved by rest. It forces people to reduce their level of activity. Many people describe a sudden onset of fatigue triggered by a physical stress, such as an illness or injury.

At the same time, the person must have at least four of the following eight symptoms for CFS to be diagnosed:

feeling bad or having discomfort after any type of exertion

impaired memory or concentration

joint pain affecting multiple joints

muscle pain

new headaches, meaning the headaches did not occur before the person started to have severe fatigue

sore throat

tender lymph nodes in the armpit or neck

unrefreshing sleep

How is the condition diagnosed?

The most important part of the diagnosis of CFS is to rule out other causes for fatigue. There are many medical illnesses that can cause fatigue. These include infections, hormone imbalances, immune system diseases, and even cancer. To rule out other conditions, a medical history and physical exam are performed. Multiple blood tests and a urine test are then done. Further tests, such as X-ray tests, may be ordered.

There is no one test that can make a diagnosis of CFS. The diagnosis of CFS is generally made when no other cause can be found for a person’s fatigue and other symptoms.

What can be done to prevent the condition?

There are no known effective measures to prevent chronic fatigue syndrome.

What are the long-term effects of the condition?

The long-term effects of CFS relate to the person’s severe fatigue. Affected people may be unable to work or go to school. They may lack the energy to form or keep relationships with other people. This can result in depression and a feeling of hopelessness. Friends and healthcare providers may also have a negative attitude toward a person with CFS.

What are the risks to others?

Chronic fatigue syndrome is not contagious and poses no risks to others.

What are the treatments for the condition?

Treatment must be tailored to fit each person with chronic fatigue syndrome, depending on symptoms and response to different therapies. There are two types of therapy: behavior therapy and drug therapy.

Behavior therapy may include:

attending support group meetings

avoiding caffeine and alcohol

anxiety \ \ depression \ \eating disorders such as anorexia nervosa and bulimia \ \ alcohol and drug abuse problems\ cognitive behavioral therapy, to help the person change perceptions and beliefs about his or her health status

eating a balanced diet

moderate exercise, being careful to avoid overexertion

receiving regular, individual counseling

relaxation methods, such as meditation, biofeedback, and hypnosis

Drug therapy may include:

antidepressants, such as fluoxetine, sertraline, paroxetine, venlafaxine, and bupropion

antihistamines, such as astemizole and loratidine

blood pressure medications, such as fludrocortisone and atenolol

decongestants for nasal or sinus congestion

muscle relaxing medications to relieve muscle spasms

nonsteroidal anti-inflammatory drugs, also called NSAIDs, such as naproxen, ibuprofen, and piroxicam

tricyclic medications to relieve pain and promote sleep, including doxepin, amitriptyline, desipramine, and nortriptyline

Because chronic fatigue syndrome is difficult to treat and the course of the disease is unpredictable, many people with CFS use alternative therapies to relieve or reduce symptoms. Some of these therapies include:

acupuncture

chiropractic treatment

craniosacral therapy, which addresses the flow of cerebrospinal fluid within the body

hydrotherapy, which is also called water therapy

massage therapy

tai chi, which combines exercise and balance

therapeutic touch

yoga

What are the side effects of the treatments?

NSAIDs can cause stomach upset and allergic reactions. Antidepressants may cause problems sleeping, headaches, or stomach upset.

What happens after treatment for the condition?

The course of CFS is very difficult to predict. Fortunately, most people eventually get better with or without treatment, though a cure is often not possible. People may return to normal activities whenever they feel able.

How is the condition monitored?

Affected people are in the best position to monitor the condition. Any new or worsening symptoms should be reported to the healthcare provider.