Chronic fatigue syndrome (CFS)
DEFINITION
Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS),
is a severe, complex, acquired illness with numerous symptoms
related mainly to the dysfunction of the brain, immune and
endocrine systems.
is a severe, complex, acquired illness with numerous symptoms
related mainly to the dysfunction of the brain, immune and
endocrine systems.
DESCRIPTION
The causes of ME/CFS are not yet clearly defined, however,
onset most frequently follows an acute viral infection. ME/CFS may
also be triggered by physical trauma, such as major surgery or a
serious accident or exposure to chemicals, pollutants, heavy metals
or immunization. In some cases symptoms occur within days or weeks
of a triggering event while other people experience a gradual onset
of the illness. It affects people of all ages and ethnic groups and
the illness will last for at least six months (three months is
common for children).
onset most frequently follows an acute viral infection. ME/CFS may
also be triggered by physical trauma, such as major surgery or a
serious accident or exposure to chemicals, pollutants, heavy metals
or immunization. In some cases symptoms occur within days or weeks
of a triggering event while other people experience a gradual onset
of the illness. It affects people of all ages and ethnic groups and
the illness will last for at least six months (three months is
common for children).
SYMPTOMS
The main symptoms of ME/CFS are as follows:
- Persistent or recurring, unexplained mental and physical
fatigue that substantially reduces normal activity levels. - Post-exertional malaise. Following physical and mental exertion
there is a worsening of symptoms that may be delayed 24 hours or
more and recovery after activity is slow. - Dysfunctional sleep. Unrefreshing sleep, inability to fall
asleep, excessive sleep, frequent awakenings, restless legs,
abnormal sleep rhythms. - Pain. Burning, aching and shooting pain in muscles and/or
joints, headaches of a new type and severity, widespread
tenderness. - Cognitive problems, e.g. brain ‘fog’; problems with processing
and recalling information; difficulty with finding the right word,
reading, writing, mathematics and short-term memory; losing track
of things; forgetting names; disorientation; inability to
concentrate on more than one thing; trouble with decision-making;
perceptual and sensory disturbances.
The person will have at least three of these five main
symptoms which will always include fatigue and cognitive
problems.
symptoms which will always include fatigue and cognitive
problems.
Other symptoms may include:
- Light-headedness on standing
- Disturbance of balance and clumsiness
- Sensitivity to light, touch and sound
- Nausea and/or gastrointestinal and urinary problems
- Sore throat and/or tender lymph node
- New sensitivities to foods, medications and/or chemicals
- Intolerance to temperature changes; eg sweating and
feverishness and/or cold extremities - Marked weight change-anorexia or abnormal appetite
- A worsening of symptoms with stressors, e.g. new infection,
travel, anaesthetic.
TREATMENT OPTIONS
Consult your Doctor for an accurate diagnosis and treatment.
There is no known cure for ME/CFS as yet, however there is much
that can be done to improve quality of life. Recovery rates vary in
individuals. People diagnosed with the condition can generally
expect to be unwell for some years. Early diagnosis may lessen the
impact of the illness. The outcome is often better for children
than adults.
There is no known cure for ME/CFS as yet, however there is much
that can be done to improve quality of life. Recovery rates vary in
individuals. People diagnosed with the condition can generally
expect to be unwell for some years. Early diagnosis may lessen the
impact of the illness. The outcome is often better for children
than adults.
Inform yourself as much as possible about ME/CFS and pace your
physical and mental activities throughout the day. See the ME and
Chronic Fatigue Syndrome Support Groups topic for more information.
Rest as needed and be aware of how any new medication or therapy is
affecting you.
physical and mental activities throughout the day. See the ME and
Chronic Fatigue Syndrome Support Groups topic for more information.
Rest as needed and be aware of how any new medication or therapy is
affecting you.
Practices such as yoga promote good body mechanics and improve
balance. Ask your Doctor about sleep hygiene practices that may
help to improve sleep quality. Any treatments or self-help
techniques must address the underlying biological factors of your
illness. Some alternative therapies such as massage, hydrotherapy
and acupuncture can have remedial benefits. Always consult your
Doctor before trying any new therapy.
balance. Ask your Doctor about sleep hygiene practices that may
help to improve sleep quality. Any treatments or self-help
techniques must address the underlying biological factors of your
illness. Some alternative therapies such as massage, hydrotherapy
and acupuncture can have remedial benefits. Always consult your
Doctor before trying any new therapy.
Useful information on the condition can be found in the
Canadian Consensus document – A Clinical Case Definition and
Guidelines for Medical Practitioners. This is available on
http://www.mecfs.org.au/information.html You may wish to show this
to your Doctor.
Canadian Consensus document – A Clinical Case Definition and
Guidelines for Medical Practitioners. This is available on
http://www.mecfs.org.au/information.html You may wish to show this
to your Doctor.
DIET HINTS
- Eat a balanced, nutritious diet of fresh food and eat meals at
regular times. - Adequate daily intake of fluids is essential. Try to drink 8
glasses of water each day. - Your diet should include fresh vegetables and carbohydrates
with a low glycaemic index such as pasta, legumes (except broad
beans) and wholegrain breads and cereals. Low fat protein e.g lean
meat, chicken, fish etc, is recommended along with small amounts of
healthy fats from nuts and seeds, fish and vegetable oils. - Avoid highly refined foods such as cakes, pastries,
confectionary and sugary drinks. Limit additives and processed
foods. Avoid alcohol and caffeine. - Avoid foods that are not well tolerated i.e foods which cause
bloating, nausea, diarrhoea or constipation. - Your Doctor may refer you to a Dietician for specialist
advice.
VITAMINS/MINERALS/HERBS
Use supplements only after first checking with your doctor.
Nutritional supplements may only be of value if your dietary intake
is inadequate and one multivitamin is often sufficient.
Nutritional supplements may only be of value if your dietary intake
is inadequate and one multivitamin is often sufficient.
- Valerian, calcium and magnesium salts, or aromatherapy can be
useful for sleep disturbance. Aromatherapy should be tried only by
those without chemical sensitivities. - St John’s Wort may be effective in mild depression but should
not be used for marked depression or taken with other
antidepressants. - Lavender and thyme essential oils may be helpful for relieving
anxiety. - Echinacea is traditionally used for infectious conditions and
is thought to stimulate the immune system. - Wild oregano and olive leaf extract may also have antiviral
effects. - Panax ginseng and Siberian ginseng are herbs thought to
increase stamina, reduce mental fatigue, support the adrenal glands
and improve mood. - Zinc is important for thymus gland function (involved in immune
system regulation) as well as cellular immunity. It is also
important in viral infections. - Vitamin C and bioflavonoids are thought to have an anti-viral
activity and enhance white cell function. Vitamin C may also aid
recovery from viral infection and support the adrenal
glands. - Selenium and Coenzyme Q10 are antioxidants important in energy
production. - Magnesium and potassium may improve symptoms of muscular
weakness, fatigue, nervous depletion and adrenal gland
function. - B group vitamins may improve fatigue and symptoms of nervous
debility.
ORGANISATIONS & SUPPORT GROUPS
See the ME and Chronic Fatigue Syndrome Support Groups topic
on the Healthpoint.
on the Healthpoint.
PHARMACIST’S ADVICE
Ask your Pharmacist for advice.
- Follow the Diet Hints and consider taking the supplements in
this topic. - Ask your Pharmacist if your medication may be contributing to
your symptoms. - Avoid stress and have adequate rest and relaxation.
- Quit smoking. Ask your Pharmacist for advice. Smoking places a
burden on your general health and may contribute to fatigue. - Avoid drinks containing caffeine such as coffee, tea, energy
drinks and cola. Caffeine may interfere with energy levels.
REFERENCE SOURCES
- Canadian Consensus document – A Clinical Case Definition and
Guidelines for Medical Practitioners. 2003 - South Australian ME/CFS Management Guidelines for General
Practitioners.
Both of these are available at
http://www.mecfs.org.au/information.html
http://www.mecfs.org.au/information.html