Chronic fatigue syndrome (Myalgic encephalomyelitis)

Some of the common signs and symptoms of chronic fatigue syndrome or myalgic encephalomyelitis include:

• Extreme fatigue that does not go away with rest
• Post-exertional malaise: severe tiredness, dizziness, headache, difficulty concentrating after doing small tasks. Sometimes, these symptoms can take days or weeks to go away.
• Joint and muscle pain
• Sleep problems/insomnia
• Tender lymph nodes
• Sore throat
• Headache
• Gastrointestinal issues
• Loss of memory
• Difficulty in concentrating or brain fog

Chronic fatigue syndrome also shares many symptoms with another medical condition called fibromyalgia (FM): both have quite a few similarities in terms of their clinical presentation, and can co-occur in a person at the same time.

While the exact causes of CFS are not known, doctors and health experts have put the onset of this condition down to the following factors:

• Viral infections: Doctors say that some cases of CFS develop because of viral infections, but which viruses are behind the condition is not fully established. Members of the herpesvirus family including the Epstein-Barr virus (EBV) and human herpesvirus 6, the measles-causing rubella virus and the mouse leukemia virus are thought to be linked to this condition.
• Weakened immune system: Immunodeficiency disorders can prevent your body from defending itself against bacteria, viruses or parasites. Those with a weak immune system are more susceptible to this condition.
• Hormonal imbalances: People with CFS can also have abnormal hormone levels in the different glands of the body. However, how these abnormal levels of hormones affect a person is still not known.
• Stress: High levels of stress are also said to be a contributing factor towards chronic fatigue syndrome in the person.

Some doctors and researchers have also theorized that CFS could be the result of different medical conditions rather than a singular cause or factor. Others opine that CFS could also be genetic, passed down from generation to generation.

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In the absence of a definitive test, the diagnosis of chronic fatigue syndrome (CFS) is not straightforward. A number of symptoms of CFS are also found in other illnesses, which too makes it harder to arrive at the correct diagnosis.

The doctor may ask routine questions about your and your family's medical history to rule out other causes or conditions. A thorough physical examination will be performed besides taking a look at your blood and urine samples and performing some other tests.

It is important for the doctor to know about the persistence of fatigue in the patient's body after physical or mental activity, which is considered to be one of the primary factors behind this condition, and whether or not adequate amounts of rest was able to alleviate the fatigue. A number of heart or lung ailments can also result in fatigue, which must be ruled out.

Depression, anxiety or other mental health problems will also be looked at, which may have been contributing to the resulting fatigue in the body.

While chronic fatigue syndrome (CFS) doesn't have a cure yet, its symptoms can be managed by healthcare practitioners. Certain prescription medications are used to alleviate the symptoms, especially if they are related to muscle or joint pain, lack of sleep or mental health issues.

A combination of therapeutic practices is also used to treat the symptoms of CFS. These may include counselling sessions with a trained therapist, as well as an exercise programme called graded exercise therapy (GET).

Treatment methods have resulted in partial recovery among patients, and children or younger patients have a higher likelihood of making a recovery. But there would be times when the symptoms could become better or worse.

People with CFS are also recommended to make significant lifestyle changes to reduce the symptoms, such as:

• Regulating the intake of caffeine
• Following a proper sleep cycle and avoiding naps during the day
• Practising light exercises such as tai chi as well as yoga are also considered to relieve the symptoms or pain associated with CFS.

Research to find the root causes of chronic fatigue syndrome is ongoing. Scientists are also trying to find a cure for the debilitating disease in the long-term, but this condition remains a complex one with no exact line of treatment or cure, with a low recovery rate.

Making lifestyle changes, regular rehabilitation as well as proper management of the symptoms are important while living with a condition like CFS.