Guard against chronic fatigue

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Fast-paced modern life, work pressure, therefore, chronic fatigue syndrome should arouse the attention of all of us.

Chronic fatigue syndrome is a disease? We think yes. Chronic fatigue syndrome is defined as long-standing, severe, disabling fatigue without demonstrable muscle weakness. Underlying disorders that could explain the fatigue are absent. Depression, anxiety, and other psychologic diagnoses are typically absent. Treatment is psychologic support, often including antidepressants, and limited rest. This definition of chronic fatigue syndrome (CFS) has several variants, and heterogeneity among patients who meet the criteria of this definition is considerable. Prevalence is impossible to state precisely; it is usually estimated to be between 7 and 38/100,000 people. However, a recent telephone survey found the prevalence to be many times higher. Prevalence estimates may vary because of differences in diagnostic evaluation, physician-patient attitudes, social acceptability, risk of exposure to an infectious or toxic agent, or definition and case finding. CFS occurs slightly more often in women. In office-based studies, prevalence is highest among whites. However, community surveys indicate a higher prevalence among blacks, Hispanics, and American Indians than among whites.

Chronic fatigue syndrome is more common in females than males and affects all racial and ethnic groups. CFS usually strikes people between the ages of 20 and 40, but it also occurs in teens. A CFS-like illness also has been determined to occur in kids younger than 12. The actual number of children and teens affected by CFS is unknown.

Chronic Fatigue Syndrome Etiology

Etiology is controversial, and the precise cause remains unknown. Psychologic factors may be the cause in an unknown percentage of cases; however, CFS seems to be distinct from typical depression, anxiety, or other psychologic disorders. A chronic viral infection has been proposed as a cause because many patients relate onset of CFS to an acute bout of Lyme disease, mononucleosis, influenza, Q fever, Ross River virus, parvovirus, and other infectious diseases. Epstein-Barr virus has also been proposed as a cause, but immunologic markers of exposure do not appear to be sensitive or specific. Other possible but unproven viral causes include rubella, HIV, enteroviruses, human herpesvirus 6, and human T-cell lymphotropic virus. Allergic reactions have also been proposed; about 65% of patients report previous allergies, and the rate of cutaneous reactivity to inhalants or foods is 25 to 50% higher in this group than in the general population.

Various immunologic abnormalities have been reported. They include low levels of IgG, decreased lymphocytic proliferation, low interferon-γ levels in response to mitogens, and poor cytotoxicity of natural killer cells. Some patients have abnormal IgG, with circulating autoantibodies and immune complexes. Many other immunologic abnormalities have been studied; none provides adequate sensitivity and specificity for defining CFS. Additionally, no consistent or readily reproducible pattern of immunologic abnormalities has been identified.

Other proposed mechanisms include neuroendocrine abnormalities, abnormal levels of neurotransmitters, inadequate cerebral circulation, prolonged bed rest, undernutrition, and elevated levels of ACE.

Data indicate that relatives of patients with CFS have an increased risk of developing the syndrome, suggesting a familial or genetic component.

Some researchers believe the syndrome ultimately will prove to have multiple causes, including genetic predisposition and exposure to microbial agents, toxins, and other physical and emotional traumas.

Chronic Fatigue Syndrome Symptoms and Signs

At least 4 of the following for :

Impaired short-term memory (self-reported) severe enough to substantially reduce occupational, educational, social, or personal activities

Sore throat
Low-grade fever
Tender, enlarged, painful cervical or axillary lymph nodes
Muscle pain
Abdominal pain
Multijoint pain without joint swelling or tenderness (arthralgia)
Headaches that are new in type, pattern, or severity
Unrefreshing sleep
Postexertional malaise lasting > 24 h
Cognitive difficulties (especially with concentrating and sleeping)

Chronic Fatigue Syndrome Treatment

A number of trials have been conducted in recent times to assess the likely benefits of a range of treatments for CFS. To date, no type of therapy has been shown to attenuate the course of the disease. Instead, treatment protocols tend to focus on ameliorating the symptoms of the condition rather than seeking to cure the condition. In general, treatment strategies should be directed at treating the major and disabling symptoms.