CHRONIC FATIGUE SYNDROME

Chronic fatigue is a term that means fatigue which lasts for a long period of time.

Many definitions have been proposed for chronic fatigue syndrome (CFS).  The simplest definition is that CFS is a condition characterised by severe fatigue lasting for more than six months, where common medical causes of fatigue have been excluded.

Patients with CFS often have difficulty carrying out simple activities of daily living.  Quality of life with chronic fatigue syndrome can be severely compromised; in severe cases the patient can be confined to bed.

There is no diagnostic test for chronic fatigue syndrome. The diagnosis is made on the basis of symptoms and the exclusion of common medical 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.

Fatigue in CFS patients is commonly exacerbated by minimal physical or mental exertion – this is known as post-exertional malaise.

Many patients with chronic fatigue syndrome develop allergies and intolerances as part of the illness.  In some cases these are severe enough to warrant the diagnosis of Multiple Chemical Sensitivities (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

  • underactive adrenal glands
  • underactive thyroid gland
  • cancer
  • hepatitis
  • diabetes
  • HIV
  • sleep apnoea
  • major depression
  • Lyme disease
  • iron deficiency
  • heavy metal toxicity.

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 of chronic fatigue 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 antidepressant medications.  These forms of treatment can be helpful in some patients, but antidepressants often exacerbate fatigue.

The treatment used by Dr Dobie for chronic fatigue syndrome depends on what he considers to be the primary underlying cause of the fatigue.

When Dr Dobie considers that chronic fatigue has been triggered by a virus such as glandular fever virus or Ross River virus, he often treats the illness with intravenous vitamin C.  He may add magnesium, B vitamins and glutathione to the infusions.  He also prescribes oral nutritional supplements that help to boost the production of ATP in the mitochondria (the mitochondria are sometimes referred to as the ”powerhouse of the cell”). ATP is the main energy molecule in the body.

Fatigue due to poor adrenal function is sometimes referred to as “adrenal fatigue”.  If tests indicated that the fatigue is due to underactive adrenal glands Dr Dobie may prescribe nutritional supplements (either oral or intravenous) and herbal medicines. 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.

Chronic fatigue syndrome is also known as myalgic encephalomyelitis (ME).

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