Unknown and Mysterious Fatigue

Unknown and Mysterious Fatigue

Chronic Fatigue Syndrome is a strange and mysterious malady that has no known cause or origin but continues to puzzle and ravage the humans like no other disease. Here we take a broad look at the way the diseases haunts our life

By Dr Manisha Yadav

CFS is a debilitating illness of unknown origin and cause. It is often thought of as a problem in adults, but it also affects children and adolescents. Between 0.2% and 2.3% of children or adolescents suffer from CFS. It is more prevalent in adolescents than in younger children. In adolescents, CFS is more likely to develop after an acute fluor mononucleosis-like illness, but gradual onset of illness may occur. Currently, the diagnosis is made on the basis of ruling out other conditions that could explain most of CFS symptoms.

Managing CFS can be as complex as the illness itself. Options for treating and managing it may include treating the most disruptive symptoms such as fatigue due to sleep problems, pain, and lightheadedness. CFS symptoms can vary over time and may require periodic re-evaluation. Primary care providers can develop effective treatment plans based on their experience in treating other complex illnesses. Management may require input from a variety of healthcare professionals (e.g. medical doctors, rehabilitation specialists, mental health professionals, and physical or exercise therapists) when available.

People normally feel that fatigue is caused by excessive physical stress, exercise, lack of sleep and nutrition. But there is another angle to this that most people are unaware of. Many serious illnesses may make you tired but there are a few minor health conditions that are found to leave you washedout. Iron deficiency anemia is one of the most common medical reasons to make you feel tired. Your muscles will feel heavy or you will get tired easily, especially if you are pregnant. Depressed people usually feel exhausted due to sadness, loneliness and loss of appetite. Talk to your doctor to feel better and get rid of this problem quickly.

Underactive or over-active thyroid gland is found to make you feel tired. Common in women, this condition usually happens once you get older.

Sleep apnea is clinical condition that results in snoring and difficulty in breathing causing low blood oxygen levels in the body. This makes you to wake up often in the night making you feel exhausted the next day.

If you feel tired while performing normal day-to-day activities or are experiencing trouble with your daily exercise, then this is usually because of an undiagnosed heart trouble.

A few people develop Chronic Fatigue Syndrome after a viral infection. So, it is also known as Post Viral Fatigue Syndrome (PVFS). People suffering from CFS have a slightly impaired immune system, but it is not clear whether this impairment is sufficient to actually cause this disorder.The significance of hormonal abnormalities is still unknown but the evidences point to certain abnormalities in the hypothalamic–pituitary–adrenal axis in the chronic fatigue syndrome.As some patients produce low level of cortisol as compared to a healthy individual,their cortisol levels are still within the acceptable range of what is considered normal. Therefore, cortisol level is not used as a way to diagnose CFS. Neurally mediated hypotension (abnormally low levels of blood pressure) and nutritional deficiency are also cause of chronic fatigue syndrome

Treatment strategies are usually symptomatic that is targeted to relieve the symptoms associated with it, so managing the disruptive symptoms first which are fatigue, sleep disorders, pain, depression, anxiety, dizziness, mood disorder, loss of concentration  and infections. To maintain healthy, adding up of flax seed oil, green vegetables, avoiding coffee and junk and limiting the intake of dairy products are among a few changes in the dietary habit which will help to combat CFS. Improving the quality of life means cognitive behaviour therapy is a moderately effective psychological therapy when is used to treat CFS.It is often used with other therapies to manage activity levels, stress and symptoms.

To treat CFS, a management programme should address major challenges, varying and unpredictable symptoms, a decrease in stamina that interferes with activities of daily life, memory and concentration problems that adversely affect school performance changes in relationships with family members and friends.

So doctors, family members, and patients need to communicate with one another about which symptoms are most disruptive or disabling so they can tailor the management plan accordingly. Treatment can be directed toward the most problematic symptoms as agreed upon by the patient, family members and doctors.

When family members and children communicate with doctors about the child’s lifestyle and behaviours, they can make important distinctions. For instance, whether the child’s lack of usual energy is because of fatigue or the result of normal changes in sleep cycles that may begin at puberty. Such distinctions are important because they affect the management plan for the child.

Many CFS patients, including children and adolescents, experience sleep problems. Common sleep complaints include difficulty falling or staying asleep, daytime sleepiness, frequent awakening, and intense and vivid dreaming. Adult patients report that they feel less refreshed and restored after sleep than they felt before they became ill.

In young children, this problem is detected by a lack of their usual energy. Sleep problems in adolescents with CFS may be challenging to detect, as sleep cycles may begin to change with the onset of puberty, such as staying up later and sleeping in. The demands of school classes, homework, after-school jobs, and social activities also affect sleep patterns.

Doctors can help people with CFS adopt good sleep habits. Patients should be advised to practise standard sleep hygiene techniques.

CFS patients frequently report experiencing post-exertional malaise or post-exertional relapse, which is the exacerbation of symptoms following physical or mental exertion. This relapse typically lasts 12-48 hours after activity and could even last days, weeks, or months. For patients with CFS, managing activity levels is a key part of managing the illness. It is important to find a balance between inactivity and excessive activity, which can aggravate CFS symptoms. This often requires a new way of thinking about daily activities. For example, daily chores and school activities may need to be broken down into shorter time frames. A symptom diary can be very helpful for managing CFS. Keeping daily track of how patients feel and what patients do, may help to find patterns or identify triggers when symptoms start to affect daily activities.

Parents may work with teachers and administrators to redefine expectations of activity and performance for children with CFS. It is true that exercise can benefit children with certain chronic illnesses. While the overall goal is to help CFS patients tolerate exercise again, children with CFS should avoid activity that results in aggravated CFS symptoms. Activity programs aimed at vigorously increasing aerobic capacity are not recommended.

“People normally feel that fatigue is caused by excessive physical stress, exercise, lack of sleep and nutrition. But there is another angle to this that most people are unaware of. Many serious illnesses may make you tired but there are a few minor health conditions that are found to leave you washed out”