CHRONIC FATIGUE SYNDROME (CFS)

What is CFS?

As the name suggests Chronic Fatigue Syndrome (CFS) is a condition, which is characterized mainly by extremely low levels of energy over a prolonged period. Such low levels may be accompanied by a variety of other symptoms. It is also known as Post-Viral Syndrome, Post-Viral Fatigue Syndrome, Myalgic Encephalomyelitis (ME), Royal Free disease (called after the London hospital where the disease was first identified) and Yuppie Flu.If one wants to have a general idea about CFS he/she can take a useful analogy that the body’s energy is being distributed between two bank accounts - a current account and a deposit account. A person who develops Chronic Fatigue Syndrome has been, in effect, running the current account off the deposit account for a prolonged period so that the later has become critically low in funds. When the body next falls prey to infection, the extra resources needed by the immune system for recovery are simply not there. The patient therefore becomes chronically tired and develops sub-acute symptoms instead of recovering.

As this condition lacks a clear diagnostic test and the symptoms resemble those of many other diseases it is still a topic widely debated in medical circles. As conditions of patients suffering from this disease vary widely the names of this disease also vary. There have been cases of CFS reported in children of eight years of age and women in their early Twenties.

The main symptom is extreme tiredness that affects the patient for approximately 12 hours out of 24 hours for a period of at least six months .It generally becomes easy for the patient to identify the onset of symptoms. The person feels very much exhausted mentally and physically .There can be some associated symptoms like recurrent Sore Throat, Fever, Cough, Headache, Stomach upset, Nausea, Loss of appetite, Weight fluctuations, Swollen lymph glands, Feeling of confusion, Rashes, Pins

SIGNS AND SYMPTOMS:

Chronic fatigue syndrome shares symptoms with many other disorders.
• Fatigue for instance, is found in hundreds of illnesses and 10% to 25% of all patients who visit general practitioners complain of prolonged fatigue.

• The nature of the symptoms, however, can help clinicians differentiate CFS from other illnesses.

Primary Symptoms
• As the name Chronic Fatigue Syndrome suggests, this illness is accompanied by fatigue. However, it's not the kind of f fatigue patients experience after a particularly busy day or week, after a sleepless night or after a stressful event. It's a severe, exhausting fatigue that isn't improved by bed rest and that may be exacerbated by physical or mental activity. It's an all-encompassing fatigue that results in a dramatic decline in both activity level and stamina.

• People with CFS function at a significantly lower level of activity than they were capable of prior to becoming ill.

• The illness results in a substantial reduction in occupational, personal, social or educational activities.

• A CFS DIAGNOSIS should be considered in patients who present with six months or more of unexplained fatigue accompanied by other characteristic symptoms.
These symptoms include:
• Cognitive dysfunction, including impaired memory or concentration malaise lasting more than 24 hours (exhaustion and increased symptoms) following physical or mental exercise

• Unrefreshing sleep, joint pain (without redness or swelling), persistent muscle pain

• Headaches of a new type or severity tender cervical or axillary lymph nodes sore throat

OTHER COMMON SYMPTOMS:

In addition to the eight primary defining symptoms of CFS, a number of other symptoms have been reported by some CFS patients. The frequency of occurrence of These symptoms vary among patients. These symptoms include:

• Irritable bowel, abdominal pain,
• Nausea, Diarrhoea or bloating
• Chills and night sweats
• Brain fag
• Chest pain
• Shortness of breath
• Chronic cough
• Visual disturbances (blurring, sensitivity to light, eye pain or dry eyes)
• Allergies or sensitivities to foods, alcohol, odors, chemicals, medications or noise
• Difficulty maintaining upright position (Orthostatic instability, irregular
Heartbeat, dizziness, balance problems or fainting) Psychological problems (depression, irritability, mood swings, anxiety, and panic attacks) jaw pain weight loss or gain

The severity of CFS varies from patient to patient. Some can maintain comparatively active lives. CFS significantly limits day to day activities.

Majority of the patients of CFS patients are functionally impaired to some degree. Researches show that CFS can be as disabling as Multiple Sclerosis, Lupus, Rheumatoid Arthritis, heart disease, end-stage renal disease, Chronic Obstructive Pulmonary Disease (COPD) and similar chronic conditions.

CFS often follows a variable course. There are intervals of illness and relative well-being. Some patients experience partial or complete remission of symptoms during the course of the illness, but symptoms generally comes back. Such zig-zag or variable occurrence of symptoms makes CFS especially hard for patients and their health care professionals to manage. When patients are feeling better they overdo some of their activities. Such an overenthusiastic gesture ultimately worsens the sufferings and tiredness. In fact, postexertional malaise is a very prominent feature of this illness.

There are scanty researches regarding the percentage of CFS patients who recover. There is some evidence to indicate that the sooner symptom management begins, the better the chance of a positive recovery. This means early detection and
TREATMENTS are of utmost importance. Researches indicates that delays in
DIAGNOSIS and TREATMENT may complicate and prolong the clinical course of the illness.

CAUSES:

The causes of CFS are not yet understood well. Those who develop the condition often have a recent history of viral infection, usually an Upper Respiratory Tract Infection - such as a Cold or Flu - or a digestive tract problem that includes Diarrhoea and Vomiting. Instead of making a steady and complete recovery, the patient develops a long lasting feeling of tiredness. Most of the times this feeling can be associated with other symptoms like low-grade fever, which subsides gradually.

Once the patient feels this tiredness it takes little longer time to get back to his/her normal necessary muscular power. In other words we can say that the recovery of muscle power is very slow. So, a moderate amount of exercise that a reasonably fit, healthy person can do will help recover earlier. Any activity involving hard work by the patient is likely to take a two- or three-week recovery period to help recover the patient. Any more exertion during that time will delay the recovery still further.

There can be many causes of Chronic Fatigue Syndrome. Malfunctions of the immune system or metabolism especially in muscles are sometimes detected in CFS patients. In addition to this other factors are believed to be contributory. These factors are lack of rest, Mineral and Vitamin deficiencies, Dysfunctional Hormone production particularly involving the Adrenal and Pituitary Glands. Diet poor in nutrition or quantity, Crash Dieting.

The presence of Candida Albicans (a fungus which causes ulcers in mouth), Carbon Monoxide poisoning caused by faulty gas appliances, Environmental pollution and Chronic Intestinal Parasitic infection. The over-dose or long term intake of Antibiotics can weaken the Immune System, as can immunization. Recently changes in MRI scans have been found in some patients.

STRESS:
Stress is a significant factor affecting approximately 75 percent of patients. It works as a catalyst in the final stages of development and identification of the condition. CFS is more likely to afflict those people who drive themselves for going to workplace and in life also. Medical researches suggest that this attitude to work, among other things, inhibits the production of T-cell lymphocytes by the immune system. These cells are extremely important for defending body against attacks of microbes like viruses.

DIAGNOSIS:

Many people suffering from Chronic Fatigue Syndrome look surprisingly well externally. An examination is necessary but it is least likely to reveal conclusive evidence. The lymph glands in the neck, under the arms or in the groin may be tender and swollen; the throat may be inflamed; or muscles may be more or less painful. Many diseases that display similar symptoms to those of CFS have to be ruled out: these include infections such as Brucellosis, Toxoplasmosis, Tuberculosis, AIDS and Epstein-Barr virus (which is responsible for glandular fever); Multiple Sclerosis, Epilepsy, Auto-Immune Disorders, Anaemia, certain forms of Cancer, Drug Addiction, Alcoholism, Depression,Anxiety; Endocrine abnormalities such as Thyroid gland related disorders; Addison’s Disease, Cushing’s Syndrome and Liver Disorders.

EFFECTS OF CFS ON PREGNANCY:

Obvious worry for a pregnant woman could be that she will be unable to cope with pregnancy and the effects of Chronic Fatigue Syndrome. CFS will adversely affect her baby. There is no evidence to suggest that CFS is inherited, although it is possible that some of the factors believed to be instrumental in causing the disease, such as poor diet, allergies, toxic overload, Candida infection and stress, may be passed on. If pregnant women follow the guidelines for recovery, however, this is less likely. Pregnancy does not appear to make the condition worse. In fact, in some instances symptoms seem to improve. It is, however, very important to make plans for after the baby is born so that rest periods can be maintained, especially if there are other children to be looked after.

RECOVERY FROM CFS

As with the disease itself, controversy surrounds the TREATMENT of Chronic Fatigue Syndrome. Most practitioners recommend rest. Psychiatry - believe that a graded exercise proggramme is much better TREATMENT. Confusion arises perhaps because recovery from CFS is a two-stage operation.

If you are suffering from this condition, you should rest. To return to the bank account analogy, rest is necessary in the first phase of your recovery until the deposit account starts to be replenished. You may have become ill in the first place because you failed to recognize the body’s signals that reserve energy supplies were being depleted. So, you will have to learn what you are capable of in order to determine a level of activity - either in terms of the amount of time that you can sustain an action or the distance you can cover, if you are walking for example. This will enable you to pay back the deposit account and start to recover. At the beginning of your recovery, you should only use 50 per cent of the energy you are capable of expending before you become tired. It may be necessary to take to your bed for a few days or even a week or two. If you can walk 200 metres before getting tired, for example, and then you feel tired or even ill for a couple of days, the next time you should attempt only 100 metres. If this is still too tiring, walk 50 metres the next time. You are thus leaving some energy in reserve with which to repay the deposit account. Once increase the proportion of possible energy you can use before tiring to 75 per cent. You should stay at this level until you reach the second phase of your recovery.

You will eventually get to the point when the deposit account can support the current account again. What this means in practical terms is that if you overdo things, you will not experience such great tiredness or for as long as you would have done before.

You should now consider an exercise programme that gently and gradually increases your level of activity. It is important to avoid the harmful effects of inactivity on muscles and the respiratory and cardiovascular systems. Also, you should not seek to avoid situations or activities that were the apparent cause of your illness.

Walking is good exercise to start with. You should be able to walk about seven or eight kilometers without suffering any ill effects before you can progress to a good form of all-round exercise such as swimming or cycling. You have now reached stage two of your recovery from CFS and the deposit account has at least 60 per cent of its funds restored. You should be thinking more clearly and be able to read or even study for much longer periods than at the outset of your recovery. You should be able to tackle situations in which you would have previously become ill. Do not be concerned about ordinary tiredness. This may well be a sign that your muscles are not doing as much work as they are capable of rather than the fact that they have done too much. If, however, you develop some of the symptoms associated with your illness, such as a fever or swollen glands, then these are signs that you have done too much and that you need to slow down. But even then, you will not sink as low as you would have done before and your recovery will be quicker.

It is always important to remember that most people recover from Chronic Fatigue Syndrome, regardless of how debilitating it was in the beginning. Recovery can be a lengthy process, however, and you will need enormous amounts of energy, determination, patience and time. Consulting a practitioner who specialises in treating CFS can be of particular value. Recovery can be a very frustrating experience. There is an extremely fine line between overdoing it and therefore experiencing a return of the symptoms of your illness and not doing enough so that you become discouraged by a lack of progress.

Decisions about work will be among the most difficult issues you have to tackle. If you have suffered a moderate to severe attack of Chronic Fatigue Syndrome you may only be able to work for half a day at most while you are recovering. Many patients find that going to work in the morning, coming home and resting after lunch, and then doing a little more work from home later in the day means that they avoid having to drive themselves on through a whole day. This sort of struggle when their bodies were telling them to slow down was possibly the reason for their illness in the first place.

Top-class athletes sometimes find that the constant stress of having to maintain fitness levels that enable them to compete eventually causes their immune systems to break down. Alternatively, common viruses may “wear down” the immune system so that another factor, such as environmental pollution, is the final straw in inducing chronic illness. The removal of both mental and physical stress is therefore very important before recovery from CFS can begin. Thismay necessitate the resolution of long-standing conflicts in your life.

TREATMENT:

There are no drugs to deal with most of the viruses associated with CFS (excluding Homoeopathic Medicines), and indeed some of those present are not the cause of the illness but one of the effects. TREATMENT therefore concentrates on strengthening the immune system by a variety of methods.

Food allergies need to be identified and eliminated. They can be detected by a method known as Enzyme Potentiated Desensitisation (EPD). Extracts of foods are combined with an enzyme that stimulates theimmune system to respond to the foods. This is administered by injection or by scratching the skin.

• Constitutional Homoeopathic TREATMENT by a qualified practitioner may help recovery from CFS.

• The stimulation and detoxification of the body’s metabolic processes is important in supporting the immune system. Measures include the control of Hypoglycaemia, Hyperventilation and the proliferation of Candida infection. Eating whole foods is recommended, especially organically grown ones, in order to eliminate chemicals and dietary toxins from the body. Dietary planning such as the twice a week rule is helpful. (All foods belong to one of five types and you should eat food from each group no more than twice each week).

• A special diet that includes Alfalfa tablets, Psyllium husks can help to cleanse the colon, but it is wise to consult a Doctor before embarking on this. Drinking up to 10 glasses of water each day (filtered or boiled unless you are sure that your water supply is good) is also recommended.

• Gentle exercise that stretches the muscles, Callisthenics or Yoga will stimulate the lymphatic system.

• The Alexander Technique may be of benefit to Chronic Fatigue Syndrome patients, many of whom have back and joint problems.

• Stimulation of the circulatory system by means of dry-skin brushing is also recommended. Sit with your legs higher than the level of your bottom and, using a (bristle) bath brush and a flicking motion, brush the skin up to the chest (do not brush the face or any areas of skin eruption). Do this for two minutes, before rather than after a bath.

• Two dietary supplements have been shown to help those with CFS: a mixture of fish and plant oils, such as marine oils and Gamma-Linolenic acid (GLA), and Magnesium.

HOMOEOPATHIC TREATMENT:

As we have seen, recovery from Chronic Fatigue Syndrome involves a sustained campaign of energy replenishment and lifestyle changes. Some patients benefit greatly from healing or bio-energy treatments. By far the best course of action from the point of view of Homoeopathic treatment is to consult an experienced practitioner for constitutional treatment. However, in the meantime, specific remedies can be self-prescribed in the 30c potency and taken twice a day for up to 15 days (unless otherwise specified).

• Natrum mur: For swollen, painful glands in the neck; muscular pain; all-over aches that are worse for stress; difficulty in articulating; great tearfulness, especially premenstrually; premenstrual depression and irritability; confusion; dizziness; Itchy scalp and hair loss; headache with fever; pain going from the back of the head to the front; tired eyes; blurred vision; acidity; flatulence; numb fingers; Irritable Bowel Syndrome; Thrush, in women, all symptoms may be worse and there is weakness and weariness premenstrually; muscular tension.

• Calcarea For swollen glands in the groin and swollen, painful glands in the neck; constant chilliness; painful joints; weakness after the slightest exertion; poor memory; depression; great anxiety; great tearfulness; panic attacks; confusion; Itchy scalp; pain going from the back of the head to the forehead; burning pains in the sides of the head; bloated stomach; cramping abdominal pains; numb fingers; aching arms; Insomnia; Thrush, in women, all symptoms may be worse premenstrually.

• Solanum Lycoper.: Specific medicine for bad effects of viral fevers should be taken in 200th potency for 5 days, three times.

• Arsenicum: For constant chilliness; painful joints and muscular pain; all-over aches and burning pains with stiffness, all of which are worse for stress; weakness after the slightest exertion; panic attacks; great anxiety; depression; poor memory; dizziness after the slightest exertion; headache with fever; Migraine; sore, tired eyes; blurred vision; numb fingers and toes; aching arms; Insomnia; breathlessness; Irritable Bowel Syndrome, fainting in the morning.

• Belladonna: For swollen glands in the groin; swollen, tender glands in the neck; muscular pain and painful joints; all-over aches and burning pains that are worse for stress; constant sore throat; confusion; great anxiety; difficulty in concentrating; poor memory; difficulty in articulating; dizziness; headache with fever; pain in the temples; Migraine; burning pain in the sides of the head; sore eyes; flatulence; cramping abdominal pains; Insomnia; Thrush, in women, premenstrual weakness and weariness.

• Lycopodium: For swollen glands in the neck; painful joints and muscular pain; all-over aches and stiffness that are worse for stress; constant sore throat; poor memory; difficulty in articulating; difficulty in concentrating; anxiety; tearfulness, especially premenstrually; premenstrual irritability and depression; dizziness; Itchy scalp and hair loss; pain in the temples; sore, tired eyes; bloated stomach; flatulence; cramping abdominal pains; numb fingers; aching arms;Irritable Bowel Syndrome.

• Pulsatilla: For swollen glands in the groin and neck; painful joints and muscular pain; all-over aches that are worse for stress; difficulty in articulating; great tearfulness and depression, especially premenstrually; dizziness that is worse premenstrually; headache with fever; fatigue is better for eating but worse premenstrually; muscular tension. Pain in the temples; Migraine; sore eyes; blurred vision; flatulence; cramping pains; breathlessness; numb fingers; aching arms; Irritable Bowel Syndrome; Thrush.

• Lachesis: For swollen glands in the groin and neck that are worse for stress; constant sore throat, especially on the left side; confusion; depression; poor memory; difficulty in articulating; difficulty in concentrating; in women, all symptoms may be worse premenstrually, premenstrual dizziness; hair loss; headache with fever; pain going from the back of the head to the forehead; sore eyes; numb toes; aching arms; Insomnia; Irritable Bowel Syndrome.

• Nux Vomica: For constant chilliness; painful joints; all-over aches that are worse for stress; confusion; premenstrual irritability; difficulty in concentrating and articulating; dizziness; headache with fever; Migraine; fainting in the morning; muscular tension sore eyes; blurred vision; flatulence; cramping abdominal pains; Irritable Bowel Syndrome; Thrush.

• Mercurius: For swollen glands in the groin and swollen, tender glands in the neck; painful joints and muscular pain; all-over aches; constant sore throat; weakness after the slightest exertion; offensive-smelling perspiration; intolerance of heat and cold; confusion; panic attacks; great tearfulness; poor memory; pain going from the back of the head to the forehead; sore eyes; flatulence; numb toes; aching arms; Insomnia; dribbling on the pillow during sleep; Thrush.

• Phosphorus: For swollen glands in the neck; constant chilliness; painful joints that are worse for stress; weakness after the slightest exertion; confusion; panic attacks; fatigue that is better by eating; muscle tension, premenstrual tearfulness; poor memory and difficulty in concentrating; dizziness; hair loss; burning pains in the sides of the head; tired eyes; flatulence; Irritable Bowel Syndrome.

• Sepia: For swollen glands in the neck; all-over stiffness that is worse for stress; weakness after the slightest exertion; numbness in the throat; premenstrual irritability; tearfulness; difficulty in concentrating; poor memory; difficulty in articulating; hair loss; Migraine; sore, tired eyes; digestive acidity; flatulence; Thrush, fatigue is better by eating and worse premenstrually; muscular tension.

• Causticum: For people having intense sympathy for suffering of others, constant chilliness; muscle pain and painful joints; all-over stiffness; weakness after the slightest exertion; premenstrual irritability; great tearfulness; anxiety and depression; difficulty in concentrating; poor memory; blurred vision; aching arms. Fatigue that is better after eating; great weakness after the loss of a loved one.

• Kali carb: For swollen glands in the groin and neck; in women, all symptoms may be worse premenstrually, constant chilliness; painful joints; numbness in the throat; panic attacks; anxiety; difficulty in articulating; hair loss; pain in the temples; pain going from the back of the head to the forehead; Migraine; blurred vision; bloated stomach; flatulence; breathlessness; Insomnia; Irritable Bowel Syndrome.

• Carbo Veg.: For swollen, tender glands in the neck; all-over aches and burning pains; confusion; anxiety; difficulty in concentrating; hair loss; pain going from the back of the head to the forehead; sore eyes; bloated stomach; flatulence; abdominal cramping pains; Thrush, fainting in the morning.

• China: For painful joints; weakness after the slightest exertion; premenstrual weakness, great anxiety; depression; headache with fever; pain in the temples; pain going from the back of the head to the forehead; Migraine; digestive acidity and bloated stomach; flatulence; Insomnia.