What is Chronic Fatigue Syndrome?
Chronic fatigue syndrome, a condition of unknown cause, characterized by severe, sometimes disabling fatigue and many other symptoms that affect different organ systems. Many people in the population suffer from fatigue at some time, and approximately 25% of patients seen by primary care physicians have fatigue that has lasted longer than a month. However, only very less percentage of people meet the criteria used to define the chronic fatigue syndrome.
It is also known as myalgic encephalomyelitis. Here myalgic refers to muscle pain and encephalomyelitis means inflammation of brain and spinal cord. It is characterized by overwhelming fatigue that interferes with routine work. The persistent fatigue is unrelated to exertion and also not relieved by rest.
Weakness and fatigue
Weakness – weakness is often described as a loss of physical strength, with the feeling that extra effort is required to move. When due to fatigue, the weakness, is usually perceived as generalized, but the profound muscle loss that can occur in cachexia (weakness and wasting of the body due to severe chronic illness), will also cause a generalized weakness, which is invariably due to neurological lesions.
Fatigue – in contrast, fatigue is perceived by patients as more severe and persistent than tiredness. It can be accompanied by a lack of energy, exhaustion, restlessness, boredom, lack of interest in activities, weakness, dyspnoea (difficulty in breathing), pain, altered taste and itching. The concept of fatigue seems to be a combination of physical sensations, affective sensations such as lack of interest, irritability, and cognitive sensations e.g. loss of concentration. Although fatigue is different from drowsiness or weakness, patients use fatigue and weakness interchangeably.
Causes of weakness and fatigue
- Myasthenia gravis
- Guillian-Barr syndrome
- Impaired electrolytes balance in the body
- Sleep disorder
- Eating disorders
- Addison’s disease
- Sexual excess
- Abuse of alcohol or tobacco
- Over exertion
- Overuse of certain medications
- Liver disorder
- Renal disorders
- Constant joints pain
Cause of Chronic Fatigue Syndrome
The cause of the disorder is unknown. The diagnosis can be made only after all other medical and psychiatric causes of chronic fatiguing illness have been excluded. Scientific studies have not been able to validate any pathognomic signs or diagnostic tests for this condition.
It may begin as a flu-like illness with a sudden onset, or it may occur gradually. Because of this, various infectious causes have been proposed; however, there is insufficient evidence to support such causation. Infections proposed include mononucleosis, chlamydia, HHV-6, and lyme disease. About 60% cases occur after a viral illness such as mononucleosis or gastroenteritis.
Investigations have also tried to implicate the Epstein-Barr virus (EBV) as the etiological agent in chronic fatigue syndrome. EBV infection, however, is associated with specific antibodies and atypical lymphocytosis, which are absent in chronic fatigue syndrome. Results of tests for other viral agents, such as enterovirus, herpes virus, and retrovirus, have been negative.
Some investigations have found nonspecific markers of immune abnormalities in patients with chronic fatigue syndrome; for example, reduced proliferation responses of peripheral blood lymphocytes, but these responses are similar to those detected in some patients with major depression.
Several reports have shown disruption in the hypothalamic pituitary –axis in patients with chronic fatigue syndrome, with mild hypothyroidism. Because of this, exogenous cortisol has been used to reduce fatigue but with equivocal results.
Chronic fatigue syndrome may be familial. In one study, the correlation within pairs of monozygotic twins was more than 2.5 times greater than the correlation for dizygotic twins.
Other Causes of Chronic Fatigue Symptoms
- Immune system disorder
- Certain viral infection
- Liver disorder
- Thyroid disorders
- Kidney disease
- Adrenal insufficiency
- Low blood sugar levels
- Low blood pressure
- Low socio economic status
- Women between 40 -50 years of age
Chronic Fatigue Syndrome Symptoms
- Persistent fatigue, not caused by exertion, not relieved by rest
- Memory weakness
- Poor concentration
- Unfreshing sleep
- Muscular pains
- Joint pains
- Shortness of breath
- Sore throat
- Chest pain
- Chronic cough
- Ear ache
- Weight loss
- Weight gain
- Mighty sweat
- Jaw pain
- Allergies to food, medicines, smell, chemical.
- Dry eye
- Blurring of vision
- Tender lymph nodes of neck and armpit
- Fluctuation in appetite
- These symptoms last for at least six months.
Associated sign and symptoms of chronic fatigue syndrome
In addition to the primary symptoms mentioned above, up to 50% of people with fibromyalgia develop associated symptoms which may include:
- Abdominal pain
- Irregular heart beats
- Chronic cough
- Anxiety/panic attacks
- Dyspnoea or shortness of breath
- Stiffness in joints
- Weight loss
Diagnosis of Chronic Fatigue Syndrome
The diagnostic criteria for chronic fatigue syndrome, established in 1994 by the U.S Center for Disease Control (CDC) and prevention, are as follows:
Clinically evaluated, unexplained, persistent or relapsing fatigue that:
- Last for 6 months or longer
- Is not due to another underlying medical condition
- Is not due to continuous exertion
- Is not relieved by rest
- Interferes with the patient’s overall function and quality of life
Four or more of the following concurrent and persistent symptoms:
- Difficulty in concentration and memory
- Sore throat
- Tender lymph nodes in the neck and armpit region
- Myalgia or muscle pain
- Arthralgia or joint pain
- Lack of refreshing sleep
- New onset of headaches
- A vague feeling of bodily discomfort (malaise) after exertion
The diagnosis of chronic fatigue syndrome is excluded if any of the following applies:
- Active medical condition that may explain the fatigue
- Previously diagnosed medical conditions that have not fully resolved, such as previously treated malignancies or unresolved cases of hepatitis infection
- Any past or current major depressive disorder with psychotic or melancholic feature, bipolar disorder, schizophrenia, delusional disorder, dementia, anorexia nervosa, or bulimia
- Alcohol or other substance abuse within two years before the onset of chronic fatigue and at any time afterwards
Chronic fatigue syndrome is hard to diagnose. Diagnosis is mainly based on symptoms, because no characteristic laboratory abnormalities have been verified to diagnose Chronic fatigue syndrome.
Tests are mainly system specific – blood tests, liver function test, kidney function test, thyroid estimation, CT scan, MRI to rule out other disorders of central nervous system.
Treatment of Chronic Fatigue Syndrome
Treatment of chronic fatigue syndrome symptoms entirely depends upon underlying cause and condition.
Adequate sleep, rest, healthy diet, supplements should be taken. Psychological counseling should be given if there is any psychological cause. Cognitive behavioral therapy and Exercise therapy are also used to manage the symptoms.
Homeopathy Treatment of Chronic Fatigue Syndrome
Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which the patient is suffering. The aim of homeopathy is not only to treat chronic fatigue syndrome but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several remedies are available to treat chronic fatigue syndrome that can be selected on the basis of cause, sensations and modalities of the complaints. For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. There are following remedies which are helpful in the treatment of chronic fatigue syndrome:
Acetic acid, Anacardium, Ambra gresia, Arsenic album, Ferrum met, Cimicifuga, coca, Coffea, Cocculus, sulphur, Phosphorous, Zincum met, Natrum mur, Phosphoric acid, Alumina, Camphora, Carbo veg, Stannum met, Coca, Muratic acid, Naja, Picric acid, Selenium, Secale cor, Tarantula, Formica rufa, Iodium, Cocculus ind, Acetic acid, China, Nux vomica, Chelidonium, Arnica, Psorinum and many other medicines.
Acetic acid – great debility, intense thirst; great uneasiness due to ulcers in stomach.
Anacardium – great nervous debility; weakness of all senses; rapid loss of memory; loss of sleep; prostration after seminal emission.
Ambra gresia – great prostration and weakness; loss of muscular power; impaired memory; impotence; long continued fatigue after lingering fever.
Arnica Montana – general weakness and fatigue with sleeplessness; sore-bruised feeling all over; must lie down; slowness of thinking.
Arsenic album – great debility and prostration; patient is too weak to move; physical weakness is associated with mental restlessness; patient is very fastidious; he is so weary that he cannot even sleep.
Baptisia – weak feeling as if recovering from an illness; no desire to do anything; parts rested on feel very painful.
Calcarea carb – patient is always tired, aversion to any physical work, indolence. Feels cold. Slow recovery after flu or Mononucleosis. Despair of recovery. Slowness. Profuse, easy perspiration.
Carcinocin – chronic fatigue after infection of mononucleosis.
China – weakness and fatigue from loss of body fluids or after severe exhausting disease; paralytic weakness of the affected parts; weakness with excessive irritability and sensibility; patient is very sensitive to droughts of air.
Cimicifuga – great debility between the menses; exhausted feeling in students; Atony in nervous and muscular system.
Coca – nervous depression, due to overwork, after exhausting disease; sexual excess; mental worry; find himself unable to do any exertion; ailments after abuse of tobacco; loss of energy; inclination to sleep with constant weariness.
Cocculus – bad effects after sleep and mental excitement; weakness with trembling; slight exertion causes prose sweat all over the body; amelioration from lying down.
Coffea – great mental and physical exertion; general debility; fainting from sudden emotions; patient is oversensitive to pain.
Ferrum met – great weakness and lethargy due to anemia; weakness due to faulty nutrition and assimilation; weakness of muscles or muscular system easily exhausted from slight exertion; fainting attacks due to marked debility.
Gelsemium – weakness during and after flu or influenza or Mononucleosis. Patient is always dull and drowsy with drooping of eyelids. Myalgia, Muscular weakness with complete relaxation and prostration.
Phosphorous – great prostration due to exhausted nervous system; after sudden shock or blow.
Phosphoric acid – nervous debility from loss of seminal fluid; from exhausting illness; weakness of back and lags, finds himself unable to walk; burning in spine; dizziness as if he would fall down.
Selenium – great nervous debility and exhaustion from severe acute diseases, inability to perform any kind of physical or mental work; debility after sexual excess; mental and physical weakness is aggravated in hot weather; amelioration from sleep.
Veratrum album – great weakness and prostration after loss of vital fluids; after cholera; muscular and nervous debility with blue hands and cold feet.
Zincum met – it is an excellent remedy for fatigue with mental exhaustion. Weakness after over-stimulation. Trembling and fidgety limbs.
Note: The above homeopathy medicines are just an indicator of how we can treat Chronic Fatigue Syndrome with homeopathy. Please consult a qualified homeopath in person for a full case analysis and to find the best homeopathy remedy for your individual case.