Chronic Fatigue Syndrome (CFS)

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Chronic fatigue syndrome (CFS) is a debilitating condition. The National Institute of Health and Care Excellence (NICE) estimates that there are up to 1 in 250 individuals suffering with the condition. 

Many years ago, chronic fatigue syndrome used to be regarded as just fatigue. Non-sufferers didn't know anything about the existence of this condition and some would trivialize the symptoms.

CFS does have a psychological and mental health component, but it is mainly biological. The problem with CFS is that sufferers tend to look completely fit and healthy, despite suffering from extreme tiredness and pain.

What Is Chronic Fatigue Syndrome?

Chronic fatigue syndrome, also known as myalgic encephalomyelitis, myalgic encephalopathy, chronic fatigue immune dysfunction syndrome (CFIDS) and post viral fatigue syndrome (PVFS) is characterised by the common symptom of feeling extreme fatigue that cannot be attributed to any medical condition, or substance use.

Chronic fatigue syndrome mostly affects women in their 40s and 50s, although it can affect men and children.

What Causes Chronic Fatigue Syndrome

CFS is caused by a combination of different factors. While scientific research does not provide a clear explanation as to how CFS develops, scientists do agree that it might be linked to abnormalities in the immune and hormonal systems.

Research suggests that people with CFS have immune dysfunctions, particularly affecting natural killer cells. Studies also support that CFS patients have elevated levels of inflammatory components and autoantibodies, such as rheumatic factor and antithyroid antibodies.

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The symptoms of chronic fatigue syndrome can vary from person-to-person and may, at times, disappear and reappear. The most common symptoms are;

  • fatigue
  • extreme exhaustion, discomfort and unease lasting over 24 hours after physical and mental effort with a slow recovery
  • poor concentration (unrelated to drug, or alcohol use)
  • impaired memory
  • unexplained muscle aches and joint pain without evidence of inflammation
  • headaches
  • sleep problems due to frequent awakenings, vivid dreams, periodic leg movements, or early awakenings
  • persistent sore throat
  • unexplained painful and enlarged lymph nodes under the arms, or in the neck area
  • increased sensitivity to light and noise and
  • palpitations without cardiac problems.

Diagnosing CFS

Since it can be quite common to have some degree of fatigue, reaching a diagnosis of CFS can be quite challenging. To differentiate common fatigue from CFS, health experts recommend using well-defined CFS diagnostic guidelines from the National Institute for Health and Care Excellence.

CFS can be diagnosed if a patient suffers from extreme tiredness that cannot be explained by other causes and is characterised by the following;

  • the fatigue started recently, or has been lasting for a long time, or is recurrent
  • the symptoms get worse with activity, or light exercise, such as walking and
  • the symptoms make it difficult to do the things someone used to do.

A diagnosis of chronic fatigue syndrome is confirmed if a patient has had the above symptoms for at least 4 months in an adult and 3 months in a child, or young person.

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While it might seem hard to get rid of chronic fatigue, most people will usually recover with the right support and care. There is no specific treatment for CFS, but rather a set of habit changes.

Tips To Manage CFS

Try to get enough quality sleep and rest. Health gurus and doctors can’t emphasize this enough. Your body was designed to receive its daily dose of relaxation each day. Working for long hours, living off a poor diet and barely taking time off for yourself can have a negative impact on your health. Rest does not only mean physical rest, but also mental rest.

CFS patients often suffer from poor sleep quality despite having slept for very long hours. This means that instead of waking up refreshed, they often wake up feeling tired. Scientists suggest that this may be due to the fact that they cannot reach the deepest state of restorative sleep known as the delta sleep. Fortunately, you can improve the quality of your sleep by adopting some simple, yet effective, lifestyle changes.

Sleep experts recommend;

  • establishing a specific time for sleep and a regular time to wake up every day.
  • Set up a relaxing, peaceful and comfortable sleep environment.
  • Look for pillows that provide extra comfort and are mouldable.
  • Avoid stimulants such as caffeinated drinks, alcohol, or cigarettes before bedtime.
  • Avoid daytime naps.

Eat A Healthy Diet

Eating a healthy diet is vital to keep you active throughout the day. There is limited evidence about the ideal diet for CFS, but the key idea is to consume a healthy, well-balanced meal at specific times of the day to give you an adequate amount of energy.

Most nutritionists recommend consuming carbohydrates that have a low glycemic index. Low glycemic index foods prevent energy crashes, as they are broken down by the body very slowly, hence supplying energy at a steady rate throughout the day. High glycemic index foods tend to supply the body with short term energy boosts that are usually followed by sudden energy drops.

There are plenty of nutritious options to select from. Good sources of slow-release low glycemic index foods include whole-grain bread, steel-cut oats, carrots, broccoli, celery, quinoa, barley, basmati rice, sweet potatoes with orange flesh, winter squash, among many others.

Consider Omega-3 Fatty Acids

Omega-3 is a fatty acid used by the body to help brain development, it also prevents inflammation, reduces pain, and decreases the risk of Alzheimer’s.

While there is currently very limited research on the efficacy of omega-3 for CFS, the internet is full of positive testimonials for the use of high doses of omega-3 fish oil supplements for the management of CFS. Scientists believe that it is only a matter of time until this link is confirmed through further studies.

Relaxation Techniques

Enrol in a relaxation program, or try practising different relaxation techniques on a daily basis at home. You could treat yourself with a relaxing massage every weekend to ease body tensions that might have accumulated due to pressure at work.

It is also useful to create a ‘‘healing space’’ for yourself to which you can come back to every time you feel distressed, sad, lost, or just need to clear your thoughts.

Here are some deep relaxation techniques recommended by the NHS;

  • breathing exercises
  • autogenic techniques
  • soft relaxing music without vocals
  • meditation
  • relaxing visualizations and
  • meridian therapies.

Use Memory Aids

CFS can make you more prone to memory loss. Very often, children and young adults with CFS feel discouraged to achieve their goals, as they do not have the physical energy to do so. In this case, it is useful to keep a daily planner to organize your schedule and record important tasks that must be achieved within a specific deadline. This will help you stay more focused and inspired.

Light Exercises

Chronic fatigue syndrome can make it difficult to exercise. Intensive exercises and even daily activities can cause a relapse. Unfortunately, a lack of exercise and prolonged inactivity can lead to other health problems. Experts recommend light exercises, such as regular walks, hand stretches, picking up and grasping objects. You should exercise in cycles of 1 minute followed by 3 minutes of rest. You can gradually increase the levels of activity once you’ve established a proper tolerable baseline. This technique of slowly increasing the intensity of activities is known as Graded Exercise Therapy or GET for short. You may also find it helpful to seek assistance from a physical therapist if you find it difficult to get out of bed, or leave your home. Always take advice from a doctor before starting any new physical exercise.

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Seek Professional Medical Assistance

There is currently no well-defined cure for CFS, but it can effectively be managed with the right treatment strategies. It is advisable to seek medical assistance from healthcare providers if you are unable to carry out your daily activities due to feelings of extreme fatigue.

The NHS provides a very useful self-help guide to help patients recover from CFS. You can find the PDF version by clicking on the following link: Self-help Guide to Recovery for Chronic Fatigue Syndrome and Fibromyalgia

Whether you’re an adult, young adult, or the parent of a child suffering from CFS, it is best to seek support early.

You, or your child, should not give up on finding ways to improve your quality of life. There are various support groups out there, all ready to give you a helping hand – they can be found on the following websites;

Invest in ME website

M.E. Support website

Action for ME website

ME Association website

Phoenix Rising website

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Medical terms are often baffling and difficult to fully understand. To help, we have listed some frequently used terms below.

  • Carbohydrates – one of the basic food groups, mainly sugars, starches and fibres found in fruits, grains, vegetables and milk products
  • Diagnosis – the process of identifying a disease, condition, or injury from its symptoms
  • Hormonal system (also known as the endocrine system) – a network of glands and organs in the body that produce hormones
  • Immune – being resistant to an infection, or toxin
  • Inflammation – the process by which the body fights against things that can harm it, such as infections, injuries and toxins
  • Lymph nodes – are small bean-shaped organs that make up the lymphatic system. Lymph nodes play a major role in filtering lymphatic fluid from harmful microorganisms
  • Natural killer cells – are a special type of cell that can kill tumour cells and cells infected by viruses
  • Stimulants – a drug which speeds up the central nervous system