Chronic Fatigue Syndrome

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Chronic Fatigue Syndrome. Fibromyalgia.

They are just a couple of the accepted names of health conditions defined by numerous symptoms with no obvious relationship to an existing named disease.

Do we really need to label what is quite simply the impact of Chronic Stress?

If you are scratching your head about what to do about chronic fatigue syndrome (or even trying to decide what it is and if it should exist as a disease name) you are not alone. Chronic fatigue syndrome, abbreviated as CFS, has been known by—if not confused with—many aliases: Myalgic Encephalomyelitis (ME) or Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS), low natural killer cell disease, post-viral syndrome, Epstein-Barr disease, and even “Yuppie flu.”

What is Chronic Fatigue Syndrome?
While trying to determine exactly what CFS is keeps scientists busy, one thing is known: people are suffering. The official statistics suggest that there are over one million people with CFS in the United States alone and that there are many more people (maybe as high as 10 million more) who have the condition, but haven’t been diagnosed.1

According to the Centers for Disease Control, to be diagnosed with Chronic Fatigue Syndrome, the following must be present:

  • Have severe chronic fatigue of six months or longer duration with other known medical conditions excluded by clinical diagnosis; and
  • Concurrently have four or more of the following symptoms:2
    • Substantial impairment in short-term memory or concentration
    • Physical symptoms: sore throat; tender lymph nodes; muscle pain
    • Multi-joint pain without swelling or redness
    • Headaches of a new type, pattern or severity
    • Un-refreshing sleep
    • Post-exertion malaise lasting more than 24 hours

Beyond these symptoms, people with CFS usually have the following in common:

  • Symptoms began with a “flu-like” illness
  • Have experienced some form of significant stress in their lives
  • Are female around 25-45 years old

The severity of Chronic Fatigue Syndrome varies considerably: Some patients are stuck in bed while others suffer only mildly debilitating symptoms.

What Causes Chronic Fatigue Syndrome?
There is no lack of theories about what is causing the epidemic of CFS, with theories ranging from infection to chemical exposure. Some of the most common/accepted causes include:

  • Infectious diseases: Epstein-Barr virus, Human Herpes virus 6, Cytomegalovirus, Coxsackie virus, intestinal parasites, and others.
  • Toxic exposures: Mercury, lead, cadmium, aluminum, Agent Orange, vaccines, and a variety of other toxic chemicals.
  • Immune/Hormonal Imbalance: See below.

Hormone/Immune Link
Studies have demonstrated disruptions in the hypothalamic-pituitary-HPA (HPA) axis in many patients with Chronic Fatigue Syndrome. The HPA axis is one of the main hormonal controls in the body that helps the body remain stable under physiological and psychological stressors. This system has repeatedly been shown to be out of balance in patients with CFS.3, 4

CFS, CFIDS, fibromyalgia…call them what you want. It’s all about CHRONIC STRESS!

There is a close link between the HPA axis and the production of the hormone cortisol. Women with CFS were shown in one study to have low morning salivary cortisol levels5, and this, in turn, can disrupt the immune system, potentially leading to CFS. But what the studies fail to adequately address are all of the drivers of cortisol that exhausted the HPA glands in the first place; everything from molds and parasites to gluten intolerance and pinched nerves. Sources of Chronic Stress which have accumulated and broken down the body’s core functional systems. CFS, CFIDS, fibromyalgia…call them what you want. It’s all about CHRONIC STRESS!

What to do about Chronic Fatigue Syndrome
Which approach to take when dealing with CFS can often be confusing. To add to the confusion, a recent review of 14 studies showed that close to 40 percent of people who did nothing improved without any treatment6. The study, however, also showed that only around 5 percent of people had complete recovery without any treatment; there is room for improvement in those numbers. But what about these treatments? Did they address the whole person, their lifestyle influences, and information gathered from thorough functional diagnostic lab testing? No way. The attitude needs to shift from labeling symptoms with a convenient disease name and narrow treatment approaches to a more integrative and functional approach that sees the body for more than the sum of its parts.

Skip the hype and debate and get to feeling better.

The links below can help you get there.
1 Centers for Disease Control: Chronic Fatigue Syndrome: Basic facts: http://www.cdc.gov/cfs/cfsbasicfacts.htm . Accessed on 7/18/2009
2 Centers for Disease Control: Chronic Fatigue Syndrome: Basic facts: http://www.cdc.gov/cfs/cfsbasicfacts.htm . Accessed on 7/18/2009
3 Fuite J, Vernon SD, Broderick G. Neuroendocrine and immune network re-modeling in chronic fatigue syndrome: an exploratory analysis. Genomics. 2008 Dec;92(6):393-9.
4 Gaab J, Hüster D, Peisen R, et al. Hypothalamic-pituitary-HPA axis reactivity in chronic fatigue syndrome and health under psychological, physiological, and pharmacological stimulation. Psychosom Med. 2002 Nov-Dec;64(6):951-62.
5 Nater UM, Maloney E, Boneva RS, et al. Attenuated morning salivary cortisol concentrations in a population-based study of persons with chronic fatigue syndrome and well controls. J Clin Endocrinol Metab. 2008 Mar;93(3):703-9.
6 Cairns R, Hotopf M. A systematic review describing the prognosis of chronic fatigue syndrome. Occup Med (Lond). 2005 Jan;55(1):20-31