Article: Chronic Fatigue Syndrome
Chronic Fatigue Syndrome (CFS) is a debilitating condition characterized by 6+ months of crushing and unexplained fatigue that does not improve with rest (1). The exact cause of CFS remains elusive, making it a challenging condition to diagnose and treat.
While medical interventions play a crucial role, lifestyle changes can significantly impact the quality of life for those suffering from CFS. In this blog post, we'll explore the complexities of CFS and delve into lifestyle interventions that have shown promise in managing its symptoms.
Understanding Chronic Fatigue Syndrome (CFS). Diagnosis and exclusion criteria.
CFS is a complex and often misunderstood condition, impacting millions of people worldwide (2). The primary symptoms include severe fatigue, impaired concentration, and un-refreshing sleep (2). The lack of a specific diagnostic test and the varied nature of symptoms contribute to the difficulty in identifying and treating it.
Recent research suggests that multiple factors may contribute to the development of CFS, including viral infections, immune system dysfunction, and hormonal imbalances. Moreover, genetic predisposition and environmental factors may also play a role in triggering or exacerbating the condition (6).
"Over the past several years, the National Institutes of Health (NIH) has expanded its research efforts directed toward this disease. It has initiated an unusually comprehensive multisystem study at theNIH Clinical Center, funded 3 extramural ME/CFS research centers and 1 data coordinating center, awarded supplemental support to 7 existing grants, and held regular telebriefings on the illness" (3).
Diagnosing Chronic Fatigue Syndrome (CFS). CFS is a diagnosis of exclusion, meaning that it is only made in the absence of an alternative diagnosis. Why? Because there are a lot of conditions that can cause fatigue and CFS does not currently have an identifiable confirmatory diagnostic test.
It's important to know that although Chronic Fatigue Syndrome (CFS) has been referred to as Myalgic Encephalomyelitis, this will likely be changing soon. According to the National Academies, "the term 'myalgic encephalomyelitis' is not appropriate because there is a lack of evidence for encephalomyelitis (brain inflammation) in patients with this disease, and myalgia (muscle pain) is not a core symptom of the disease" (2). We will likely be referring to this syndrome as Systemic Exertion Intolerance Disease (SEID) in the future.
"The Institute of Medicine (IOM) committee recommends the name systemic exertion intolerance disease (SEID) for this disease. This new name captures a central characteristic of this disease— the fact that exertion of any sort (physical, cognitive, or emotional)—can adversely affect patients in many organ systems and in many aspects of their lives" (2)
In the absence of an obvious underlying cause for these symptoms, many of us will be diagnosed with Chronic Fatigue Syndrome (CFS). Below is a summary of other causes of chronic fatigue that must be ruled out before a diagnosis of CFS can be made.
Lifestyle Interventions: A Holistic Approach
While there is no cure for CFS, lifestyle interventions can significantly improve the overall well-being of individuals suffering from this condition. It's important to note that these interventions should be personalized, as the severity and manifestation of symptoms can vary widely among individuals.
Balanced Nutrition: A well-balanced diet is fundamental for individuals with CFS. Nutrient-dense foods can provide the necessary energy levels and support overall health. Some studies suggest that an anti-inflammatory diet, rich in fruits, vegetables, and omega-3 fatty acids, may help alleviate symptoms (4). Here at Lifestyle Medicine Maine, I specialize in helping people to transition toward a plant predominant dietary pattern.
Regular Exercise: While excessive physical exertion may worsen symptoms, gentle and regular exercise can be beneficial. Activities like walking, yoga, and tai chi are good places to start (5).
Stress Management: Chronic stress can exacerbate CFS symptoms. Techniques such as meditation, deep breathing exercises, yoga, and mindfulness can help manage stress levels and improve overall well-being (7).
Quality Sleep: Establishing healthy sleep patterns is crucial for individuals with CFS. Creating a relaxing bedtime routine, maintaining a consistent sleep schedule, and addressing sleep disorders can contribute to better sleep quality (8).
What do I think? Chronic Fatigue Syndrome poses unique challenges due to its multifaceted nature. While medical interventions are essential to rule out other causes of fatigue, lifestyle changes can play a pivotal role in managing symptoms and improving the overall quality of life for those of us living with CFS. Adopting a holistic approach that includes balanced nutrition, regular exercise, stress management, and quality sleep can make a significant difference in alleviating the impact of this enigmatic condition. As research continues, a personalized and comprehensive strategy will be crucial in unlocking the mysteries of CFS and enhancing the lives of those affected.
If you are looking for a medical provider who specializes in Lifestyle Medicine, then schedule an appointment with Jessica Krol, FNP, DipACLM of Lifestyle Medicine Maine. While there is no cure for CFS, and patients can experience a spontaneous recovery, there are therapeutic lifestyle changes that we can make along the way to lower the symptom burden. There's no better time to take an active role towards feeling better.
References
How common is chronic fatigue syndrome; how long is a piece of string? White. Journal of Population Health Metrics (2007) https://pophealthmetrics.biomedcentral.com/articles/10.1186/1478-7954-5-6
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Key Facts. Institute of Medicine of the National Academies. (2015) https://nap.nationalacademies.org/resource/19012/MECFS_KeyFacts.pdf
Advances in Understanding the Pathophysiology of Chronic Fatigue Syndrome. Komarof. Journal of the American Medical Association. (2019) https://jamanetwork.com/journals/jama/article-abstract/2737854
Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Systematic Review for a National Institutes of Health Pathways to Prevention Workshop. Smith et al. Annals of Internal Medicine (2015) https://doi.org/10.7326/M15-0114
Exercise therapy for chronic fatigue syndrome. Larun et al. Cochrane Database Systemic Reviews. (2019) https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003200.pub8/pdf/full
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Comprehensive Review. Rivera et al. Journal of Diagnostics (2019) https://doi.org/10.3390/diagnostics9030091
Stress management skills, neuroimmune processes and fatigue levels in persons with chronic fatigue syndrome. Lattie et al. Journal of Brain, Behavior and Immunity. (2013) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3572196/
Dimensions of pure chronic fatigue: psychophysical, cognitive and biological correlates in the chronic fatigue syndrome. Neu et al. European Journal of Applied Physiology. (2014) https://link.springer.com/article/10.1007/s00421-014-2910-1
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