Chronic Fatigue Syndrome

Related Terms

  • Myalgic Encephalomyelitis
  • Post-viral Fatigue Syndrome

Uses

Principal Proposed Natural Treatments

  • None

Other Proposed Natural Treatments

Chronic fatigue syndrome (CFS) has been a subject of controversy for many years. Medical authorities were once quite skeptical regarding whether it even existed. However, in 1988, the Centers for Disease Control and Prevention (CDC) officially recognized CFS. Today, CFS is defined essentially as follows: Unexplained, persistent, or relapsing fatigue with a definite beginning; it is not the result of exertion; it is not relieved by rest; and it results in significant reduction of activities.In addition, at least four of the following symptoms persist or recur for 6 or more consecutive months of the illness:

  • Impairment in short-term memory or concentration
  • Sore throat
  • Tender lymph nodes in the neck or armpits
  • Muscle pain
  • Pain in many joints, without redness or swelling
  • Headache of new pattern or severity
  • Unrefreshing sleep
  • Malaise following exercise, that lasts for more than 24 hours
Frequently, symptoms of CFS follow a viral infection; some individuals with CFS describe their symptoms as a flu that never goes away.The cause (or causes) of CFS remains unknown. Because its symptoms somewhat resemble those of mononucleosis (caused by the Epstein-Barr virus), for a time the disease was called chronic Epstein-Barr syndrome. However, further investigation disclosed that evidence of past or current Epstein-Barr infection is no more common in individuals with CFS than in the general population. Nonetheless, this erroneous and misleading term still crops up in literature on CFS. Other syndromes with a similar pattern of symptoms to CFS include fibromyalgia , multiple chemical sensitivities (MCS), and food allergies ; some consider these conditions to be closely related to each other, but there is no real evidence to support this hypothesis. There is no dramatically effective treatment for CFS. Antidepressants (such as Prozac and Zoloft) may improve energy and mood; older antidepressants (such as amitriptyline) may improve sleep; antihistamines and decongestants can help allergic symptoms that frequently occur in CFS; and nonsteroidal anti-inflammatory drugs (such as ibuprofen and naproxen) may help pain. Other approaches to CFS that have been tried include magnesium injections, 1-3 corticosteroid treatment, 4-9 and a graded (incremental) exercise program either alone or with the antidepressant fluoxetine. 10-13,32 A randomized study involving 641 people with CFS found that those who participated in a graded exercise program had less fatigue and improved functioning compared to those who received two common forms of treatment (specialized medical care or adaptive pacing therapy). 35 For a time, researchers expressed some excitement over initial findings that deliberately raising blood pressure might help individuals with CFS. However, a double-blind, placebo-controlled study of 25 people given a 6-week course of fludrocortisone and increased dietary sodium to raise blood pressure found no improvement in CFS symptoms. 14 One study performed in Hong Kong provides weak evidence that acupuncture might be helpful for chronic fatigue syndrome. 34 Further research included a single-blind study of 127 people with CFS compared acupuncture to sham acupuncture. Acupuncture was associated with improvements in physical and mental fatigue, and physical function. It is difficult to determine how successful acupuncture was because of the studies' limitations. 36Relaxation therapies (guided imagery or visualization, muscle relaxation, autogenic training, and applied relaxation) were shown to have limited evidence of efficacy in a review of 13 randomized trials. The trials included 738 adults with CFS or fibromyalgia.37

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