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Chronic fatigue
syndrome
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- CFS is a debilitating, perplexing,
and complex disorder characterized by profound fatigue
unimproved by bed rest, and that may be worsened by physical
or mental activity. Individuals with CFS must often function
at a substantially lower level of activity than they were
capable of before the onset of illness.
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- The criteria for establishing CFS
stipulates that patients must concurrently have four or more
of the following symptoms: substantial impairment in
short-term memory or concentration; sore throat; tender
lymph nodes; muscle pain; multi-joint pain without swelling
or redness; headaches of a new type, pattern, or severity;
unrefreshing sleep; and post-exertional malaise lasting more
than 24 hours. The symptoms must have persisted or recurred
during 6 or more consecutive months of illness, and must not
have predated the fatigue.
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- Although recent studies have failed
to find an exact cause or establish a clear association with
an infectious agent (e.g., Epstein-Barr virus, mycoplasma,
candida, etc.) or nutritional deficiencies, they have been
helpful in formulating new theories based on findings.
- The findings suggest an autoimmune disorder. Other findings correlate the condition with physical or emotional stress, commonly reported as a pre-onset condition in those with CFS. Stress activates the hypothalamic-pituitary-adrenal axis of the body, leading to increased release of Cortisol and other
hormones, resulting in the symptoms of fatigue reported by
CSF sufferers.
- An abnormality in the central nervous system may produce neurally- mediated Hypotension (NMH),
causing a dramatic drop in blood pressure when standing up,
even for as short a time as a few minutes in CSF patients.
- A less severe condition known as
postural orthostatic tachycardia syndrome (POTS) is also
associated with CFS.
- Regardless of the etiology, a patient with this condition must be (medically) worked up adequately to rule out other diseases (i.e., malignancies, thyroid disease, adrenal disease, AIDS,
etc.).
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- Tricyclic antidepressants (e.g., Elavil, Doxepin) improve sleep and help relieve mild, generalized pain. Antidepressants from the class of seratonin re-uptake inhibitors (SRIs) such as Prozac, sertraline (Zoloft),
and paroxetine (Paxil) may be used for depression.
- Anxiolytic agents (e.g., Xanax) may be administered
to treat panic disorder.
- Nonsteroidal anti-inflammatory
drugs (e.g., Advil) for pain and fever
- Anti-hypotensive therapy (e.g., Florinef) and/or salt and water intake for those with Hypotension
- A variety of medicines may be
prescribed to fight the symptoms of CFS.
- Rest, exercise, proper diet,
avoiding alcohol, drugs and all central nervous system
stimulants (like coffee) are also recommended measures.
- And patience. Healing takes place even when we least expect or understand it. Others have recovered, and so will you.
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