Chronic fatigue syndrome: an undefined disease

Chronic fatigue syndrome (CFS) is a somatic disorder combined with certain disorders affecting the psycho-emotional sphere. The syndrome is characterized by a prolonged state of fatigue, weakness, drowsiness (sometimes constantly for 6 months or more), a person feels that he is “broken” physically and morally, including even after a long rest. The first data on chronic fatigue were recorded in the 30s of the last century, when the rhythm of our lives and the volume of information flows with which we have to work increased. The active and able-bodied part of the population aged 25 to 45 years is most susceptible to the disease. Most often, these are residents of megacities who are focused on a career and high social status. They are ready to live at work, ignore poor health and do not continue to treat illnesses.

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Risk groups include:

• young people living at a grueling pace;
• specialists whose work involves a shift schedule requires increased concentration and accuracy - doctors, dispatchers, operators, rescuers, drivers, etc.;
• businessmen;
• living in unfavorable sanitary conditions;
• consuming low quality products;
• persons who often suffer from colds;
• having chronic diseases - hypothyroidism, autoimmune disorders, heart disease, etc.;
• high school students and students;
• prone to stress and depression;
• drinking alcohol and drugs;
• allergy sufferers;
• regularly taking sleeping pills, antidepressants, etc.

The larger the region of residence, the greater the likelihood that fatigue syndrome will develop. The disease most often occurs in women and men who are prone to perfectionism and suspiciousness, subject to stress, and fear of losing their job or lack of money. Women get CFS more often than men

Causes of the disease

Chronic fatigue syndrome is a disease with various etiologies.

The main causes of CFS are infection of the body with herpes viruses and excessive mental and physical overload, as well as the toxic effects of various substances, impaired immune system, and metabolic disorders. Most often there is a combination of several factors. The main infectious agents are the Epstein-Barr virus, enteroviruses, Coxsackie viruses, cytomegaloviruses, retroviruses, etc. Chronic fatigue has a benign course and is completely reversible.

The disease begins due to an “imbalance” of the main centers of the autonomic system, a disruption in the production of mediators responsible for inhibition and excitation. Due to regular overexertion and reduced immune defense, viruses get inside and infect nerve cells. As a result, the centers responsible for emotions and intellect cease to function harmoniously, and those suffering from CFS will face long-term treatment.

Interestingly, the occurrence of fatigue syndrome can be triggered, for example, by repairs. Low-quality building materials, furniture, and household appliances can release formaldehyde into the room. Poisoning with its vapors contributes to the development of CFS.

Bibliography:

1. IACFS/ME: Primer for Clinical Practitioners. Members of the IACFS/ME Primer Writing Committee, Fred Friedberg, Ph.D., Chairperson Stony Brook, 2014, New York, USA.
2. Yunus, M. B. (2007). Role of central sensitization in symptoms beyond muscle pain, and the evaluation of a patient with widespread pain. Best Practice & Research Clinical Rheumatology, 21(3), 481-497.
3. Nakatomi Y, Mizuno K, Ishii A, Wada Y, Tanaka M, Tazawa S, Onoe K, Fukuda S, Kawabe J, Takahashi K, et al. J Neuroinflammation in Patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: An C-(R)-PK11195 PET Study. Nucl Med. 2014 Jun; 55(6): 945-50. Epub 2014 Mar 24.
4. Dr. Miguel B. Royo Salvador (1996), Siringomielia , escoliosis y malformación de Arnold-Chiari idiopáticas, etiología común (PDF). REV NEUROL (Barc); 24 (132): 937-959.
5. Dr. Miguel B. Royo Salvador (1996), Platibasia , impresión basilar, retroceso odontoideo y kinking del tronco cerebral, etiología común con la siringomielia , escoliosis y malformación de Arnold-Chiari idiopáticas (PDF). REV NEUROL (Barc); 24 (134): 1241-1250
6. Dr. Miguel B. Royo Salvador (1997), Nuevo tratamiento quirúrgico para la siringomielia , la escoliosis , la malformación de Arnold-Chiari , el kinking del tronco cerebral, el retroceso odontoideo, la impresión basilar y la platibasia idiopáticas (PDF). REV NEUROL; 25 (140): 523-530
7. M. B. Royo-Salvador, J. Solé-Llenas, J. M. Doménech, and R. González-Adrio, (2005) “Results of the section of the filum terminale in 20 patients with syringomyelia , scoliosis and Chiari malformation .” (PDF). Acta Neurochir (Wien) 147:515–523.
8. M. B. Royo-Salvador (1992), “Aportación a la etiología de la siringomielia ,” Tesis doctoral (PDF). Universidad Autónoma de Barcelona.
9. M. B. Royo-Salvador (2014), “Filum System® Bibliography” (PDF).
10. M. B. Royo-Salvador (2014), “Filum System® Guía Breve.”

Symptoms

Common signs of CFS:

• persistent fatigue;
• somatic pain, soreness in various muscles and joints;
• constant lethargy and powerlessness, including after a long rest;
• regular headaches throbbing in the temples;
• insomnia, shallow sleep, despite high fatigue;
• rapid fatigue, including during light work;
• high anxiety, fear;
• apathy, absent-mindedness, inability to concentrate;
• depressed mood, tendency to reflect;
• various phobias, sad thoughts;
• depression, hysterics, irritability.

Constant fatigue syndrome hides behind the symptoms of various diseases. Patients often catch colds, complain of sore throats, and chronic ailments get worse. For many, lymph nodes enlarge for no reason, the functioning of the digestive tract is disrupted, and body weight decreases. It often happens that a person struggles with high or low temperature, goes to doctors and does not realize that he has chronic fatigue.

The most commonly used diagnosis in our country is vegetative-vascular dystonia. A diagnosis and a “disease” that actually does not imply anything specific, which means there is no way to treat this “disease”. On the contrary, treatment of chronic fatigue syndrome, although a long and labor-intensive process, is possible.

Diagnostics

All of the above symptoms do not allow the patient to be diagnosed with CFS. The attending physician must exclude all diseases that are characterized by lethargy and high fatigue. The symptoms of some diseases are similar to how chronic fatigue manifests itself. CFS can easily be confused with the initial stages of oncology, with tuberculosis, with parasitic diseases, with exacerbation of chronic ailments.

The doctor makes the diagnosis when other diseases are excluded and no other causes of systematic fatigue are found. The patient is sent for examination, all data is carefully analyzed. In terms of diagnostics, the following examinations are prescribed:

• Ultrasound examination of the abdominal cavity, kidneys, thyroid gland.
• X-ray of the chest organs.
• Laboratory blood tests, including the presence of antibodies to enteroviruses, Herpes simplex virus, Epstein-Barr viruses, etc.
• Fecal analysis for helminth eggs, roundworms, lamblia, etc.
• Tests for HIV, PB, hepatitis.
• MRI of the brain.
• Doppler ultrasound or scanning of the vessels of the neck and head.

Chronic fatigue syndrome is diagnosed in cases where infectious disease specialists have not detected active infectious agents in the patient, and tests have not revealed significant abnormalities. All symptoms of CFS are divided into major signs (B) and minor signs (M). An accurate conclusion that there is chronic fatigue is made in cases where the patient has a combination of 2 B and 6 M or 2 B and 8 M, when the first 3 M signs are absent in a person or there is only 1.

Minor signs:

• Increase in body temperature from 37 to 38 degrees.
• The mucous membrane of the pharynx is inflamed (there is pharyngitis), signs of sore throat and sore throat.
• The cervical lymph nodes and axillary nodes have increased to 2 cm.
• Myalgia.
• The disease developed unexpectedly.
• Severe pain appears in the head.
• Weakness in arms and legs.
• After performing physical work, which the patient could easily cope with before, a feeling of weakness arises that lasts for 2 days.
• Soreness appears in the joints, they ache, but there is no swelling, the skin is not changed.
• Sleep disorder.
• Emotional and mental manifestations change. Apathy, anxiety, absent-mindedness, lethargy appear, thinking is disrupted, and the person is constantly sad.

Big signs:

• Fatigue lasts six months or even more, periodically intensifying. There is no surge of strength after a long rest or after sleep. Efficiency decreases by 2 times.
• Research has been carried out and hormonal disorders, infectious and muscle diseases, as well as mental disorders have been completely excluded.

How to make a diagnosis

A diagnosis of CFS can be made if the following criteria are met. The presence of 2 major signs is required. This is constant fatigue with decreased activity during the day, lasting more than 6 months. However, it does not go away even after proper rest, and can intensify.

The second main criterion is the absence of somatic and mental illnesses. For this purpose, the patient is referred for examinations and consultations with specialized specialists: a cardiologist, gastroenterologist, neurologist, etc. The impact of the psychotraumatic factor is taken into account.

Having these 2 points is not enough. The presence of 6–8 other (minor) symptoms of the disease is also necessary.

With proper and timely treatment, complete recovery occurs. But there is a possibility of relapse under favorable conditions, for example, when exposed to stress factors or after an illness. In rare cases, the syndrome leads to serious consequences.

Lab tests

Chronic fatigue syndrome is a serious disease, not a set of mental disorders. This is confirmed by laboratory diagnostic methods.

• Immunogram. The number of interferon proteins, T-lymphocytes (CD3/CD4), inflammatory mediators (cytokines), specific proteins TNF (tumor necrosis factor), killer cells, etc. increases.
• Serological tests. Allowing to detect the presence of antibodies and antigens in the body to herpes viruses and other infectious agents.
• Biochemistry of blood. Set the amount of L-carnitine. It has been proven that a reduced concentration of levocarnitine impairs attention and performance.

Treatment methods

Complex treatment is recommended for patients with chronic fatigue syndrome. The treatment regimen includes:

• absolute peace;
• good sleep, at least eight hours;
• balanced nutrition and fasting days, without excessive consumption of sweets, which cause sudden surges in blood sugar and worsen the condition;
• classical and/or segmental massage;
• moderate physical activity, exercise therapy, and walking;
• treatment of all diseases that poison the body and reduce the supply of oxygen to tissues, such as caries, tonsillitis, sinusitis, sinusitis, rhinitis, etc.
• relaxation and activities that give pleasure - dancing, volleyball, horseback riding, hunting, etc.

Depending on the patient’s condition, the doctor may use only psychotherapeutic treatment methods or combine medications and physical therapy.

Drug therapy:

• Psychotropic medications to cope with depression, activate NK cells and improve the immune system in chronic fatigue syndrome.
• Daytime anxiolytics (tranquilizers), these drugs have a minimal hypnotic effect, while they perfectly relieve anxiety and other symptoms of CFS.
• Preparations with levocarnitine, since chronic fatigue sometimes occurs with a decrease in this substance in the body
• Nootropics, drugs that stimulate the functioning of brain structures.
• Immunostimulants that increase general immunity and have antiviral effects.
• A group of immunoglobulins and antiviral drugs.
• Complexes with magnesium. It has been established that a deficiency of this compound does not allow cells to generate energy, which contributes to the development of increased fatigue.
• Vitamin preparations containing B vitamins that improve the functioning of the nervous system.
• NSAIDs to relieve muscle pain.

Physiotherapy methods:

• Treatment with magnets.
• Massage sessions.
• Stimulation of active points (acupuncture).
• Hydrotherapy.

Post-infectious asthenia

The causes of post-infectious asthenia are intoxication of the body, stress from the disease, long-term drug treatment, lack of oxygen in the body, hypoxia. When treating an infection, the body expends a lot of energy, which causes an imbalance in physiological processes and malaise. Signs of post-infectious asthenia are:

• fatigue, tiredness and weakness, sleep problems, daytime sleepiness;
• irritability, moodiness, aggressiveness;
• shortness of breath, sweating;
• cognitive impairment.

With post-infectious asthenia, it is important to restore the body after hypoxia, restore the supply of oxygen to the body and metabolism.

Post-Covid syndrome

A special type of post-infectious asthenia is post-Covid syndrome, included in the International Classification of Diseases as an independent disease.

If before the disease the patient worked a lot with his head, had little rest and almost did not exercise, his chances of developing post-Covid asthenia are high. To overcome asthenic syndrome, you need to sleep 8-9 hours according to the regime of early bedtime and early awakening, reduce your workload, walk more and eat a balanced diet. Alcohol should not be consumed during asthenic syndrome.

By restoring your daily routine, introducing breathing exercises and other health practices that do not burden the body, you can get out of asthenic syndrome on your own. The main thing is not to rush into business immediately after an illness, to endure the rehabilitation period, gradually increasing the load on the body.

Prognosis and prevention

Chronic fatigue syndrome must be treated promptly. In patients who do not consult doctors, symptoms worsen, immune defenses are destroyed, and multiple somatic diseases appear.

If the causes of CFS are eliminated, comprehensive treatment is carried out, and all medical recommendations are followed, then a complete cure occurs. For preventive purposes, it is recommended to lead an active lifestyle, do not get overwhelmed at work, go out into nature more often, eat well and relax in absolute silence.

It is important! Do not turn a blind eye to the alarming symptoms of CFS; be sure to make an appointment with neurologists at the CELT clinic for diagnosis, identification of the causes and treatment of the disease.

Make an appointment through the application or by calling +7 +7 We work every day:

• Monday—Friday: 8.00—20.00
• Saturday: 8.00–18.00
• Sunday is a day off

The nearest metro and MCC stations to the clinic:

• Highway of Enthusiasts or Perovo
• Partisan
• Enthusiast Highway

Driving directions

Brain defense system

The hypothalamus is an important control center of the brain; it is very energy-consuming and is the first to shut down in moments of energy shortage. Fortunately, these “shutdowns” do not damage it, and when it resumes producing the required level of energy, its functions are restored.

Here are a few triggers that can cause the hypothalamus to shut down:

In case of unexpected manifestations of the disease:

• viral, parasitic and bacterial infections;
• injuries;
• current pregnancy or recent birth;
• poisoning and intoxication of the body;

With the gradual development of the disease
:

• a large number of fungi of the genus Candida;
• hormonal imbalance;
• autoimmune diseases;
• chronic stress at work and in personal life;
• sleep disorders such as sleep apnea or restless legs syndrome.

No matter how much these “overloads” irritate us, they are necessary to protect the brain from “burnout” under excessive load. This is simply the body's attempt to protect itself from greater harm under extreme stress.