Chronic Fatigue Syndrome

Symptoms

The main symptom of CFS is permanent fatigue that persists for at least 6 months and is so severe that the person is unable to get out of bed.
At the same time, it increases with physical or mental stress, as well as during periods of stress. However, there are no physical signs of fatigue, such as muscle weakness, back or joint pain.
Signs of fatigue in CFS :
•    Not caused by an objective reason,
•    Does not go away after sleep or rest,
•    Interferes with normal life
•    Kept for more than six months.
In addition to fatigue, there are other symptoms, such as sleep disturbances such as insomnia or difficulty falling asleep, problems with memory and concentration.

Symptoms associated with chronic fatigue syndrome:
•    Dizziness;
•    Flies in the eyes;
•    Headache;
•    Numbness, tingling or burning sensation in the face, arms and legs;
•    Flu-like symptoms: sore throat, swollen lymph nodes, chills, increased sweating, cough, nausea, or bloating;
•    Muscle pain;
•    Sensitivity to noise, light, smells;
•    Irritability;
•    Dyspnea;
•    Mood swings.
With chronic fatigue syndrome, both physiological and psycho-emotional symptoms are present: a person is burdened by gloomy thoughts, he refuses hobbies that used to bring joy.
Complications:
As with many chronic diseases that reduce the quality of life, such as cancer or diabetes, people with chronic fatigue syndrome often experience depression, anxiety, and panic attacks.
In addition, people with CFS are more likely to suffer from comorbid disorders. Due to the imbalance of happiness hormones and stress hormones, they often experience causeless body pains, migraines, eating disorders, sleep disturbances, and problems with the gastrointestinal tract.

Causes

Fatigue is a rather subjective feeling that is difficult to measure. It is normal to feel it if a person was engaged in hard physical or mental labor. 
Common causes of fatigue:
•    Chronic alcohol abuse;
•    Unbalanced diet;
•    Sleep for less than 7-9 hours every day;
•    Passive lifestyle;
•    Acute and chronic diseases: anemia, oncological pathologies, heart and lung diseases, autoimmune disorders;
•    Taking certain medications: antihistamines, drugs for pressure;
•    Deficiency of vitamin d, b12.
If a person does not overwork mentally and physically, and also does not have any of the listed causes of fatigue, then chronic loss of energy may indicate chronic fatigue syndrome.
Genetic disorders
Some people have a genetic predisposition to chronic fatigue syndrome. As a rule, this happens if one of the blood relatives also encountered a similar condition.
Scientists are trying to identify genetic variants that may be responsible for the development of this condition. It is believed that the development of CFS involved genes that regulate the work hypothalamus-pituitary-adrenal axis, immune system and energy processes in cells.

The hypothalamic-pituitary-adrenal (HPA) axis is responsible for the body's response to stress. These three components are interrelated and should work in harmony. Therefore, if the functioning of one of them fails, the work of the entire system is disrupted and depression, anxiety disorders, including increased fatigue, can develop.
Infectious diseases
Fatigue in chronic fatigue syndrome is similar to fatigue in prolonged flu or colds, so scientists believe that viruses and other pathogens can cause CFS.
So, about 10% of people who have had infectious mononucleosis caused by the epstein-barr virus, herpes virus infection, lyme disease, covid-19, enterovirus or cytomegalovirus infection, claim that rapid fatigue persists after the illness.
Immune system disorders
Most patients with chronic fatigue syndrome do not have autoimmune disorders or severe pathologies such as hiv that affect the immune system. At the same time, more than 60% of people with CFS have previously been diagnosed with allergies, a common malfunction of the immune system.
It is believed that allergies or other errors in the functioning of the immune system deplete the energy reserves - adenosine triphosphate (ATP) - in the cells, depriving the body of fuel. In addition, some people with CFS have overactive immune system t cells that help fight infections. Research that will reveal the mechanism of such violations is still ongoing.
Changes in the brain
One of the theories of the occurrence of CFS is a violation of the ratio of the happy hormones serotonin and dopamine in the brain. They regulate mood, however, for the system to work properly, hormones must be in balance. If the balance is disturbed, the person may feel inexplicable fatigue.
Another possible reason is long and tiring mental work, in which glutamate, a potentially toxic substance for nerve cells, accumulates in the brain. Researchers believe that rapid fatigue is due to the fact that the brain forcibly slows down its work in order to quickly get rid of accumulated glutamate.

Risk factors:
•    Gender: chronic fatigue syndrome is 2 to 4 times more common in women than in men. Why this happens is unknown, perhaps the matter is in regular hormonal changes;
•    Age: CFS can appear at any time in life. However, 2 peaks are distinguished: in adolescence (from 10 to 19 years old) and in adulthood (from 30 to 39 years old);
•    Violation of circadian rhythms: the internal biological clock can go astray due to shift work or insomnia, as a result, a person experiences a lack of energy;
•    Chronic stress, which gradually depletes the body.

Treatment

The first step in treating chronic fatigue syndrome is to reduce mental stress. Reduce the number of tasks performed by at least 20%. It is better to get rid of those duties that require the greatest mental stress. For some patients, this can be difficult, then psychotherapy sessions are necessary, it is possible to use auto-training and relaxing techniques. The patient must understand that he cannot do this work due to illness. Rational psychotherapy is also aimed at normalizing the psycho-emotional state of the patient, teaching him methods of objective self-assessment, so that he really assesses the emerging overloads and understands the need for rest. Subsequent sessions of psychotherapy can be aimed at developing the patient's ability to effectively relax, deal with stress and relieve nervous tension.

It is important to observe the correct daily routine, the regime of work and rest, the alternation of sleep and wakefulness. Healing procedures are useful: walking, staying in the fresh air, contrast showers , moderate physical activity. The treatment program must include a special set of physical exercises. The load and duration of classes are gradually increased depending on the patient's condition. Walking, swimming, jogging, gymnastics, breathing exercises are recommended.

The patient is recommended positive emotions. Moreover, everyone has their own individual source of such emotions: children, pets, going to the theater, an evening with friends, etc. In the treatment of chronic fatigue syndrome, herbal preparations are used that increase the body's resistance to stress and strengthen the immune system: echinacea, licorice root, tenacious bedstraw, curly sorrel and others. Perhaps the use of aromatherapy .

Proper and healthy nutrition, the use of foods rich in trace elements and vitamins strengthens the immune system and the nervous system of the body, increases resistance to stress. People with chronic fatigue syndrome need to drink more fluids, but alcohol or caffeinated drinks are not recommended. Patients should refrain from eating large amounts of food containing sugar. This can cause a rise in blood glucose levels, followed by a drop in blood sugar below normal, manifested by a feeling of fatigue.

Tests Required for Diagnosis

The diagnosis of chronic fatigue syndrome is based on the following criteria:

A. Big Criteria.

•    Fatigue for six months or more. Periodic or intermittent fatigue, lack of improvement after sleep or long rest. Daily activity is reduced by 2 times.

•    The lack of physical reasons of exhaustion (intoxication, persistent somatic diseases, endocrine disorders, viral diseases, tumour processes), as well as psychiatric diseases.

B. Minor Criteria.

•    Moderate increase in body temperature (up to 38.5 ° C).
•    Pharyngitis.
•    A slight increase (up to 2 cm) and soreness of the lymph nodes in the neck and in the armpits.
•    Muscle pain
•    General muscle weakness.
•    Severe headaches that have not previously been observed in the patient.
•    Poor exercise tolerance (weakness after exercise lasting more than a day), which was previously normally tolerated by the patient.
•    Arthralgia and aches in the joints, not accompanied by their redness or swelling.
•    Sleep disorders.
•    Psycho-emotional disorders: memory and attention impairment, depression, apathy, photophobia, etc.
•    Sudden onset of illness.

Chronic fatigue syndrome is confirmed in the presence of 2 major criteria and 6 minor criteria, if the first 2-3 criteria are present. If the first 3 minor diagnostic criteria are absent or only 1 of them is present, then the diagnosis is made in the presence of 2 major and 8 minor criteria.

In the course of diagnosis, it is necessary to exclude the occurrence of chronic fatigue as an initial symptom of a developing infectious, oncological, somatic, endocrine or psychiatric disease. Therefore, the patient is comprehensively examined not only by a neurologist , but also by an endocrinologist , an infectious disease specialist , a general practitioner , and a rheumatologist . They conduct a blood test for various infections and, first of all, for AIDS. Examine the state of internal organs and systems. When diagnosing chronic fatigue syndrome, it should be remembered that chronic fatigue can be observed as a normal phenomenon for a long period after serious injury or illness.

Useful info

The disease is not life-threatening for the patient and, as a rule, ends in recovery. Recovery of the body can occur spontaneously or as a result of treatment. However, a number of patients had repeated cases of the disease, especially after suffering stressful situations or somatic diseases. In some cases, chronic fatigue syndrome can lead to serious abnormalities in the functioning of the immune system.