Chronic Fatigue Syndrome (CFS) : Causes, Symptoms, and Treatment

Chronic Fatigue Syndrome (CFS)

This article looks at the definition of Chronic Fatigue Syndrome (CFS), its risk factors and symptoms thereof. It highlights a huge gap in as far as treating CFS condition is concerned. However, until the right treatment is found, we looked at the possible symptomatic treatment methods that patient can choose from, with the help of their doctors. 

There is also a section that looks at children living with Chronic fatigue syndrome as it is of interest to know the symptoms and help the parents/ guardians detect CFS early enough to treat it.  Literature shows that children have a better chance of getting cured from chronic fatigue syndrome, which means early detection put these children at a higher chance of getting healed. 

Moreover, there are some modified treatment and most of these are experimental. More literature must be released highlighting the safety of these drugs and also report on their efficacies. 

What is Chronic fatigue syndrome ? 

Everyone will feel fatigued in their lifetime at one time or another. The problem with fatigue is that it disturbs your normal balance and interferes with your regular activities because you are too tired, too weak, and all you want to do is sleep, but sleeping is also hard to do regardless of the desire to do so. 

Sadly, fatigue can persist for months to a point where sleeping and resting doesn’t relieve the exhaustion. At this stage the nervous and immune system are already compromised. The persistent fatigue lasting for over six consecutive months is referred to as Myalgic encephalomyelitis (ME) or commonly known as chronic fatigue syndrome (CFS). 

There is some association between chronic fatigue syndrome with post-exertional malaise (PEM) which is characterized by the body’s inability to recover from exhaustion regardless of resting. PEM is accompanied by numerous uncomfortable symptoms which affect the physical, mental or emotional state of being. 

Who is at risk of chronic fatigue syndrome

This is a syndrome that affect both young and old people, in all continents. Reviews have shown this condition to be something with a higher prevalence and that is a worrying factor. It is estimated that 17 million people globally are suffering from chronic fatigue syndrome.

Of the worldwide stats, UK have a staggering 250 000 patients, and Scotland is sitting at about 20 000 patients according to the National Health Information Service (2019). 

These numbers are inclusive of children and adults from diverse social and ethnic groups. Women are said to be more susceptible to chronic fatigue syndrome than men. More studies might need to be done to investigate why. 

The Chronic Fatigue Syndrome Symptoms

People with CFS have different symptoms and the duration of these symptoms varies from person to person. The symptoms ranges from mild, moderate or severe and thus affecting the quality of life destructively. 

One person may present with two or more symptoms at a time and some symptoms changes over time. Most reviews documented these as common symptoms of CFS;

  • Overtiredness constantly both mentally and physically. Feeling devastated at all ties. sleep disturbance, un-refreshing sleep 
  • Severe to abnormal exhaustion after a physical workout.
  • Feebleness of muscle and joints accompanied by pain. 
  • Low attention span, forgetfulness, persistent sore throat, headaches, and flu-like signs. 
  • Nausea and sickly feeling. 
  • Being bloated, stomach ache, diarrhoea and constipation and other Irritable Bowel Syndrome. 
  • Abnormal allergies and sensitivity to alcohol, caffeine, some foods or medications.
  • anxiety, low mood and depression

Due to the lack of appropriate diagnostic equipment to test for chronic fatigue syndrome, there is generally poor understanding of the condition. More studies need to be conducted until an appropriate diagnostic tool is found as this will change the lives of affected patients. 

Can this condition be cured?

Not everyone makes full recovery but the majority of sufferers do improve with time. Moreover, symptoms of chronic fatigue syndrome fluctuate between mild to severe periodically. Reviews reports that younger people have higher and better chances of complete healing than adults. It means if treatment is done early enough, children can be cured and thus have a chance of leading a normal life. 

Possible causes of chronic fatigue syndrome

There are fewer studies determining the causes of chronic fatigue syndrome and as a common problem worldwide, this topic need more research. The other challenge is the numerous symptoms affecting the victims which may stem from a primary cause that might be different for each symptom.

The onset of this syndrome differs with people where to some it suddenly starts whereas for others it occurs gradually over time. Consequently. patients get the condition after they have had an infection, particularly viral infection. Thus the condition is referred to a post viral fatigue syndrome (PVFS). 

Nonetheless, CFS can be triggered by unexpected injuries or traumatic life experiences like rape, unexpected life events or accidental death of a loved one, disability, loss of income and the list goes on and on. 

Patients who underwent some form of surgery are more prone to chronic fatigue syndrome which tend to interfere with recovery. Also, certain lifestyle can predispose people to chronic fatigue syndrome like lack of sufficient sleep, adverse health behaviours, insomnia, etc. 

It is evident that chronic fatigue syndrome can affect people who do not have any identifiable triggers particularly children and younger people. This is just a gap that need research to identify if this condition can be inherited from generations to the younger generations. 

Chronic Fatigue Syndrome in Children

Myalgic encephalomyelitis or chronic fatigue syndrome have a very negative consequence on children, it affects their schooling experience. These some of the impact of CFS in young children; 

  • infrequent school attendance
  • inability to carry out classroom tasks ar even palying outside classrooms.
  • Difficulty in making friends as the child does not have enough energy to play with others.
  • Relationships with peers
  • Affect their cognitive development. 

Children’s’ symptoms of Chronic Fatigue Syndrome

  • Dizzy spells and lightheadedness
  • Sleep problems, it is hard to fall or stay asleep for them
  • Feeling sleepy during the day
  • Nightmares, hallucination and intense dreaming. 
  • Stomach cramping and headaches.
  • Flu-like symptoms. 

Diagnosis of Chronic Fatigue Syndrome Children

There is no test to confirm the condition in young children as with adults. It becomes very difficult to detect the condition in younger children as their sleeping patterns, energy levels, playfulness and behaviour constantly change with age and childhood stages; baby (infant), toddler, grade scholar, teen and young adult. Moreover, the symptoms vary in severity over time while some symptoms come and go. 

As soon as the child has two or more symptoms of chronic fatigue syndrome, parents or guardians MUST take the child to the medical professionals so test can be run quickly. Adults diagnosis is a 6-month long symptoms while for children action is taken immediately. A typical diagnosis will include;

  • Medical history of the family to determine if anyone in the family has ever had chronic fatigue syndrome
  • Mental status examinations to determine if the child does not have any preexisting mental illness.
  • Checking the child’s physique to also ascertain if the child if not fit for their age.
  •  Laboratory test for; blood, urine and other vital specimen. 
  • The diagnosis is so delegate as the child might not be old enough to iterate their symptoms, that’s why a parent or guardian must always be there. The downside is the parent might define the symptoms different from how the child actually feels. 
  • The doctor will have to probe wisely to determine which symptoms the child has. 
  • The guardian or parents are advised to keep a journal documenting important symptoms and changes in the baby’s life that need the doctor’s attention. 
  • Documenting activities the child does which seem to exacerbate the condition. 
  • Diagnosis will include visiting the neurologist, rheumatologist, or a sleep specialist, and these could be taxing on the child and the family. 

Chronic Fatigue Syndrome Treatments

There is no known cure for chronic fatigue syndrome but rather remedies are symptoms focused. The treatment is also patient-based meaning that one remedies might relieve one patient symptoms while worsening another patient’s condition.

As such, the patient will have to work hand in hand with their doctors in order to determine which remedy will work best for their symptoms. This just shows how complex and unpredictable this condition is with symptoms that changes all the time. 

More importantly, patient has the right to decide which treatment is best suited for them and to refuse any treatment they don’t feel comfortable with. It is highly imperative that patients opt for evidence-based treatment from recently published surveys as information changes all the time dynamically. The treatment gets better with time and with newer publications. 

Cognitive behavioural therapy

Patients will need a Cognitive behavioural therapy (CBT) as it manipulates patients mind and foster behavioural change. If CBT is done well, the severity of CFS symptoms and distress is significantly reduced. 

Patients are trained on how to lead lives that are having less stress as little as possible by improving their problem solving skills. Thus, a typical CBT places emphasis on:

  • Assisting patients to understand their diagnosis.
  • Ensure patients are more accepting of the condition without living in denial or oblivious to the truth.
  • Enable patients to pinpoint issues and feeling that need to be dealt with in order to encourage recovery.
  • Training patients on how to reduce and prevent some symptoms. 

Medicines

There are medications available over-the-counter or through doctor’s prescription that can help treat the symptoms of CFS since the condition does not have a cure. 

Antihistamine; are best medicines for people with sleeping disorder. Patients are also assisted in coming with a sleep schedule that they need to adhere to. These can be bought over-the-counter. 

Eszopiclone (Lunesta), Ramelteon (Rozerem), Zolpidem (Ambien), etc.The doctor can only prescribe these if the non-prescription drugs do not work. Patients must be aware that these can only be used for a short time. This is to avoid side effects that might be harmful to your health in the long run. 

Fludrocortisone (Florinef), Midodrine (ProAmatine), Propranolol XL (Inderal); Patients with dizziness and are light-headed might benefit from using these drugs. 

Antidepressant; this can be used at the same tie with counselling to help patients deal with any unresolved issues leading up to depression.

Stimulants 

These are good to assist patients with memory and concentration problems. The downside of these is, as they give patients energy, the patients might get too excited and overdo things which sadly lead to crashing. Patients who become agitated and irritable after using stimulants might either take lower doses or just avoid using them altogether. 

Pain killers

Patients with CFS are prone to muscle and joint pain and as such the nonsteroidal anti-inflammatory drugs (NSAIDs) like as ibuprofen, aspirin, or acetaminophen over-the-counter. In cases where these do not work, patients could be referred to a pain specialist for stronger medications. 

Dietary Modification for Chronic Fatigue Syndrome

Although diet alone cannot cure chronic fatigue syndrome, eating certain foods are known to worsen or ease the symptoms of the condition. Patients with CFS are prone to weight problems. Due to physical inactivity caused by tiredness and muscle pain these people may gain weight 

Commonly, chronic fatigue syndrome patients may feel they need to eat more in order to gain more strength to control the tiredness. Some medication can also increase people’s appetite. All these factors contribute to weight gain which is not a desired outcome as it might lead to other diseases. 

However, some people may lose weight as a result of; appetite loss, nauseated feeling, inability to buy or cook food. Moreover, irritable bowel symptoms like diarrhea, constipation, abdominal pain can further contribute to weight loss. 

Why is food important

A balanced diet is the main source of energy that is much needed to a person who is already feeling weak and tired. Eating small frequent meals was found to assist CFS patients as it fuels them up throughout the day without over-indulging them.

The truth is eating larger amounts can tire anyone sick or healthy because blood get directed away from the brain and limbs but to your stomach and intestines. 

=> Have a look on our list of good foods to help you reduce fatigue !

Other treatment options for all patients 

Ampligen (rintatolimod), a drug therapy which is still experimental had the crowd buzzing about how effective it was. Users applauded the dramatic physical and cognitive symptoms improvements of the experimental drug. Although the drug is regarded as a “miracle drug” there were still few people who reported the drug did not work for them at all (FDA 2013). 

Intravenous (I.V.) saline, usually given to patients who crashed to help pick them up. 

The antiviral or antibiotic medication; the combination drugs has worked for so many patients.

Non-drug therapies; Graded exercise therapy, chiropractic therapy, pacing, other physical exercises. 

Conclusion 

Chronic fatigue Syndrome is a global problem and it is a good thing that the world is responding to it by offering patients with many treatment options.

The FDA is well-invested to a point where they are giving patients the platform to speak up in order to inform policy makers and identify research gaps while helping to better the lives of the affected patients. 

However, the research must continue until an appropriate treatment is discovered so we don’t ONLY have to treat the symptoms but rather deal with the root cause of this global problem. As it stands, patients have many options to choose from in order to manage the condition until an appropriate treatment is found and that is a sign that management to this condition is getting better with time.  

References :

Food and drug administration, (2003). Chronic Fatigue Syndrome and Myalgic Encephalomyelitis; A series of reports from the U.S. Food and Drug Administration’s (FDA’s) Patient-Focused Drug Development Initiative

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