Chronic fatigue is a term that means fatigue which lasts for a long period of time.
Chronic fatigue syndrome (CFS) is a medical condition characterised by severe chronic fatigue and other symptoms that limit a person’s ability to carry out ordinary daily activities. Quality of life with chronic fatigue syndrome can be severely compromised.
Chronic fatigue syndrome is also known as myalgic encephalomyelitis (ME).
For the diagnosis of chronic fatigue syndrome to be made the fatigue must have been present for at least six months, and other medical causes for the fatigue must have been ruled out.
There is no diagnostic test for chronic fatigue syndrome. The diagnosis is made on the basis of symptoms and the exclusion of other causes of fatigue.
The onset of chronic fatigue syndrome can be either sudden or gradual.
Patients with chronic fatigue syndrome generally have many other symptoms in addition to the fatigue. These other symptoms can include headache, muscle and joint pain, muscular weakness, poor memory and concentration, sleep disturbance, bowel disturbances, low blood pressure, dizziness, palpitations and recurrent sore throats and flu-like symptoms.
Symptoms are usually worsened with minimal physical and mental exertion (this is known as post-exertional malaise). In some cases the fatigue is particularly severe and the patient is confined to bed.
Many patients with chronic fatigue syndrome develop allergies and intolerances as part of the illness. In some cases these are the severe form known as Multiple Chemical Sensitivties (MCS).
Fibromyalgia and irritable bowel syndrome are conditions that are often considered to be related to chronic fatigue syndrome.
Many medical conditions can cause chronic fatigue; these include iron deficiency, underactive thyroid gland, underactive adrenal glands, cancer, hepatitis, diabetes, HIV, sleep apnoea and Lyme disease. These disorders should be tested for and excluded before the diagnosis of chronic fatigue syndrome is made.
Other causes of chronic fatigue can include stress and exposure to toxic chemicals.
Dr Dobie considers that in most cases of chronic fatigue the cause can be identified if the appropriate tests are performed.
Viral illnesses such as glandular fever are a common cause of chronic fatigue syndrome. Most patients with glandular fever make a full recovery after 6-8 weeks, but some patients are left with lingering fatigue that can develop into chronic fatigue syndrome.
Conventional treatment for chronic fatigue syndrome consists of cognitive behaviour therapy (CBT), a graded exercise program and sometimes antidepressants. Dr Dobie finds that these forms of treatment are rarely helpful.
The treatment used by Dr Dobie for chronic fatigue syndrome depends on what he considers to be the primary underlying cause of the fatigue.
Dr Dobie finds that when the fatigue has been triggered by a virus such as glandular fever or Ross River virus, intravenous vitamin C is often helpful. He often adds magnesium, B vitamins and glutathione to the infusions. He also prescribes a wide range of oral nutritional supplements.
Dr Dobie has treated over 1000 cases of chronic fatigue syndrome with intravenous vitamin C and has found it be helpful in about 70% of cases.
Fatigue due to underactive adrenal glands is often referred to as “adrenal fatigue”. If tests indicated that the fatigue is due to underactive adrenals Dr Dobie prescribes treatments to boost the function of the adrenals. In severe cases he might prescribe adrenal hormones.
Dr Dobie considers that many cases of Lyme disease have been misdiagnosed as chronic fatigue syndrome. Lyme disease requires treatment with antibiotics.