Chronic Fatigue Syndrome is still a relatively unknown disease, even among doctors.
Researchers are slowly beginning to understand what lies behind the excruciating fatigue.
What is chronic fatigue syndrome?
Chronic Fatigue Syndrome (CFS), also known as myalgic encephalomyelitis, is a disease characterized by chronic fatigue and continuous tiredness.
People with this syndrome must rest for hours or days after daily activities such as a walk or shopping.
Exhaustion often occurs with a delay, making it difficult to correctly associate symptoms with Chronic Fatigue Syndrome.
The difficulty in quickly recognizing this disease brings serious inconvenience to sufferers who complain of poor quality of life for years.
Fatigue can manifest itself in various forms:
- acute fatigue is a physiological mechanism by which the body of a healthy individual protects itself from various types of stress; it is generally related to a single cause and resolves with rest or a change in lifestyle.
- Chronic fatigue, on the other hand, is considered a disease that indicates poor adaptation and is typical of people with other chronic diseases such as multiple sclerosis, rheumatoid arthritis, systemic lupus erythematosus, certain psychiatric disorders, stroke, and cancer.
The extent of fatigue varies from moderate impairment to severe courses in which those affected are bedridden and sometimes too weak to speak.
More than half of patients are unable to work and many are dependent on care.
Symptoms of Chronic Fatigue Syndrome
There are, at present, no specific tests to diagnose this syndrome but you can follow some parameters that can help to discover it.
The diagnosis of chronic fatigue syndrome is made by confirming or excluding other diseases.
Intense fatigue (both mental and physical) must be present continuously for at least six months; this fatigue is not relieved by rest, worsens with small efforts and causes a significant reduction in work, social and personal activities.
In addition, it is important to make sure that this fatigue is not caused by a previous disease, iron deficiency, hypothyroidism and must be different from the common sleepiness or lack of motivation.
One does not feel rested even after sleeping.
In addition, there are often disturbances in concentration, sensitivity to irritation, headaches and muscle aches, sore throat, nausea and swelling of painful lymph nodes.
People with chronic fatigue syndrome often have complaints typical of a chronic flu that lasts for years.
In addition, four or more of the following disorders must have been present for at least six months:
- Impairments in memory and concentration that are so severe as to substantially reduce work and personal activities:
- pain in the cervical and axillary lymph nodes
- muscle and joint pain, without inflammation or swelling of the joints
- unrestful sleep
- weakness after exercise, which lasts for at least 24 hours
Disorders caused by chronic fatigue, as well as those determined by chronic fatigue syndrome, often occur in association with other diseases, in particular:
- fibromyalgia: muscle and joint pain caused by impaired pain processing in the nervous system, often accompanied by what is known as “brain fog”
- restless legs syndrome
- tensive muscle headache
- multiple chemical sensitivity
- irritable bowel syndrome
- temporomandibular joint disorder
- interstitial cystitis
Who’s at risk and causes
Depending on the estimate, between two and nine out of every 1,000 people in the world have CFS.
The disease tends to appear between the ages of 20 and 40, but it can also affect children and adolescents, and is more common in women.
For many, the disease breaks out after a viral illness. Especially after an infection with Pfeiffer’s glandular fever, which is triggered by the Epstein-Barr virus, some patients can no longer get to their feet.
About ten percent still have CFS symptoms six months later.
Shingles or flu caused by herpes viruses can also turn into chronic fatigue.
However, not all patients with CFS had an infection immediately before the onset of the disease.
Some seemed to have been preceded by an injury, surgery, or particular stress.
Is chronic fatigue syndrome psychological?
CFS is not a mental illness.
However, some physicians consider it psychological in nature because sick people lack energy, just like depressed people.
However, recommendations to help depressed people come out of lethargy are harmful to CFS patients. Exercise, for example, makes symptoms worse.
Antidepressants also usually don’t help affected people.
And research shows that before they got sick, CFS patients were no more likely to suffer from a psychiatric illness like depression or schizophrenia than other people.
Causes of chronic fatigue syndrome?
Many of the cases of CFS appear to be caused by a strong immune response. This may explain why the disease is often triggered by a virus.
The immune system then attacks its own body in the heat of the defensive battle.
The autoantibodies that are sometimes found in greater numbers in CFS patients are involved in controlling the autonomic nervous system. This controls, among other things, the heartbeat, breathing and digestion.
This is why CFS is also classified as a neuroimmunologic disease.
“These autoantibodies are directed specifically against the adrenaline receptor.
As a result, too much adrenaline is released and the precise control of the autonomic nervous system is imbalanced, causing a permanent stress reaction,” explains Carmen Scheibenbogen.
There is also evidence that in chronic fatigue syndrome, the cell’s power plants reduce energy production.
Mitochondria convert sugar and oxygen into energy and usually supply it to the body in the form of adenosine triphosphate (ATP).
In an experiment in which scientists led by virologist Bhupesh Prusty of the University of Würzburg administered blood serum from CFS patients to healthy cells, the mitochondria were no longer able to produce enough energy. Some of them were even deformed.
Researchers are already familiar with such a reaction of mitochondria: it can be caused by some herpes viruses.
Why these disorders become permanent in some and the body never recovers has not yet been conclusively clarified.
A genetic risk probably plays a role in the development of Chronic Fatigue Syndrome.
Is chronic fatigue syndrome treatable?
To date, there is no cure.
The recommended approach involves the integration of drug and non-drug therapies and an appropriate lifestyle.
One approach to keeping symptoms under control is dividing the remaining strength with sufficient breaks and relaxation.
Cognitive behavioral therapy can also help people reduce stress and lead full lives despite the disease.