Signs & Symptoms of Chronic Fatigue Syndrome

Chronic Fatigue Syndrome, or fatigue syndrome, has long been regarded as a normal, physical malady. It was first described in patients with malaria in the late 1800s. And although medical advances have extended life expectancy, it seems chronic fatigue syndrome has managed to catch up.

The prevalence of fatigue syndrome has tripled in the past 25 years. It may seem this might be a well-documented syndrome. But what if fatigue was not simply a physiological issue at all? Could this be a syndrome with a neurological root? It may be time to revisit the pathologies of the disease and find new ways to identify and treat chronic fatigue syndrome.

The descriptions of chronic fatigue syndrome are confused and vague, which has resulted in disagreement over how to define the disease. Two leading clinical systems exist: the NHC and the ICD. The NHC and the ICD differ in the age and gender of a patient when it is deemed legitimate. Because the NHC is based on the clinic, it is likely older patients with symptoms of fatigue are more likely to be diagnosed with chronic fatigue syndrome.

Since fatigue is commonly tied to aging, the desire to diagnose this syndrome in more recent patients is likely a factor in the persistence of chronic fatigue syndrome.

Chronic fatigue syndrome, in the clinical sense, may also be a syndrome with a neurological origin. Because of its association with fatigue and other neuropsychological deficits, fatigue syndrome is well-known to have an abnormal metabolic response. Based on this, it is hypothesized that this syndrome is a disorder of fatigue syndrome syndrome syndrome.

Treatment 

Prognosis – There is no specific cure for this syndrome, but some treatments may help manage symptoms. Treatments that improve symptoms include:

• Limiting or eliminating sleep disruption (focusing on the timing and quality of sleep)
• Limiting or eliminating caffeine or alcohol consumption
• Treating bacterial infections (as that can contribute to fatigue, cough, or fever)
• Anti-inflammatory and antibacterial medications
• Anti-psychotics, especially if antipsychotic use is frequent (to prevent post-exertional malaise)
• Vitamins (e.g., B6)
• Weight loss (also reducing body mass index and muscle deterioration)

Treatments for fibromyalgia can also help manage this syndrome.[14] Other conditions that have been associated with severe disability and mortality include: lyme disease, Lyme borreliosis, meningitis, chronic inflammatory demyelinating polyradiculoneuropathy, neonatal-onset multiple sclerosis, fatal infantile mesencephaly with neuropsychiatric sequelae, multiple sclerosis, polymyositis, hereditary amyloidosis with progressive supranuclear palsy, lupus, Ehlers-Danlos syndrome, Klein-Ossowo syndrome, Birt–Hogg-Dubé syndrome, lupus erythematosus, fibromyalgia, chronic lung disease, severe obesity, and cirrhosis.

Although fatigue is the primary clinical complaint, fatigue can result from a wide range of medical conditions. Symptoms that are related to illness include:

• Ulcers (both ulcers in general and functional ileus, which is idiopathic [uniquely affects only one section of the intestine]
• Constipation (e.g., due to obstruction, following bowel resection, or rarely due to opioid use)
• Low blood sugar
• Pathological pain
• Unusual taste sensitivity or taste disturbance
• Neurological abnormalities, such as depression (depressed mood), memory problems, incoherence, psychosis, abnormal eye movements, eye lid drift (torsion), hearing loss, trembling or tremor, stroke, brain injury, intracranial aneurysms or meningitis
• Abnormal body posture
• Body movement problems, such as problems with walking, tics, or bulimia
• Neurocognitive abnormalities, such as loss of short-term memory
• Cerebral vasculitis
• Other diseases that can cause unexplained fatigue and other cognitive dysfunction include:
• Diabetes insipidus
• Fibromyalgia
• Psychiatric disorders, such as obsessive-compulsive disorder
• Autoimmune diseases, such as systemic lupus erythematosus
• Intractable epilepsy
• Endocrine disorders, such as Addison’s disease, gonorrhea, premature ovarian failure, insulinoma, Sjögren syndrome, porphyria cutanea tarda, neurocysticercosis, thyroid disease, celiac disease, pituitary apophysitis, and Hirschsprung’s disease.
• Depression
• Sleep disorders
• Unexplained fatigue
• Exertional malaise (E/M) fatigue is defined as an adverse reaction to a bout of physical activity in which one still feels exhausted or fatigued a few hours after the activity.

There are many Symptoms of Chronic Fatigue Syndrome

• Signs of confusion, such as difficulty thinking or speaking clearly.
• Pain and a dull headache
• Facial palsy, neck pain, or a tingling in arms or legs
• Depressed mood
• Sudden onset
• Inability to retain new information
• Paralysis, inability to move an arm or leg
• Increase in urine output or fecal output
• Fatigue that interferes with activities of daily living, or is a significant threat to health. This often happens before the onset of full-blown MS or ALS
• Adverse effects on balance.
• After acute E/M fatigue, a subset of people will have a minor rebound:
• Recurrent and lasting tiredness.
• Fatigue after periods of physical or mental stress or a prolonged sleep deficit.
• Cognitive impairments.
• Tiredness that continues over the course of many weeks, or even months, with no sign of improvement.
• Decreased fitness, endurance, and strength.
• Smoking cessation.
• Rapid deterioration of vision and coordination.
• A complex set of molecular mechanisms causes E/M fatigue, and the mechanism is variable among individuals and is affected by several genetic and environmental factors.[16] Several pathways are involved in this phenomenon, including an interplay between the brain and the nervous system, as well as exercise-induced endocrine stress, increased adrenocorticotropic hormone, physical exertion and other changes in brain function.

A popular misconception is that E/M fatigue is caused by a lack of oxygen to the brain. The majority of individuals diagnosed with E/M fatigue are not having episodes of hypoxia, which would be reported with a decreased hemoglobin and oxygen saturation in the blood, and often the underlying cause of their fatigue remains undiscovered.

Lifestyle
Lifestyle factors are thought to play a role in the causes and symptoms of fatigue. These include:

Physical activity – A lack of exercise or fatigue that cannot be attributed to illness does not necessarily mean that more exercise will improve the situation.

Exercise – The amount of physical activity required to bring about an improvement varies from person to person, and depends on their existing level of fitness, energy levels, and immune system functions. Individuals with E/M fatigue should exercise for at least 20 minutes several times a week, until they are able to meet the exercise recommendations for their age and height.

Lack of sleep – Many people with E/M fatigue struggle to get adequate sleep, with an average of 6.2 hours per night.[19] But these individuals may not need as much sleep as they think, as having less than seven hours of sleep per night is not considered sufficient to promote optimal health, so some people with E/M fatigue may require up to 9 hours per night

Caffeine – The recommended limit for women is 400 milligrams (mg) of caffeine per day, and 400 mg per day for men. In some individuals, caffeine may have adverse effects, and they may wish to limit their caffeine consumption. To avoid excessive caffeine consumption, it is advisable to reduce the amount of coffee or other caffeinated beverages consumed in one day

Time – Another lifestyle factor is that many people with E/M fatigue cannot achieve the recommended amount of exercise for their age and height. This is due to a combination of lack of energy and fatigue.

Sleep – People with E/M fatigue may not sleep as well as they should. They may be tired during the day, but not sleep well at night, which increases their alertness during the day and leads to increased fatigue at night. Increasing the amount of time taken to fall asleep can help to alleviate this problem.

Dehydration – The body needs water to maintain a healthy state, and can become dehydrated in response to exercise, stress, or poor quality sleep. Dehydration can cause sleepiness and fatigue. Dehydration is also a possible cause of E/M fatigue.

Medications – Many medications can increase fatigue. However, they do not cause fatigue in everyone. Studies have shown that almost all medications that cause fatigue should be tried under close medical supervision before they are started. Many chronic and acute medications can cause fatigue in some individuals.

Allergies – A very common allergen is cigarette smoke, which can cause bronchoconstriction and therefore lead to fatigue. It can also aggravate E/M fatigue.

Gender – People with E/M fatigue are more likely to experience fatigue than people without this condition. This can be due to biological factors such as hormonal changes during menopause and sleep disturbances associated with menopause. In addition, some research has suggested that testosterone levels play a role in this condition.
The factors that contribute to the diagnosis of the illness are based on evidence gathered with medical professionals and patients, and do not rely on patient self-diagnosis.

Genetic
The relationship between the genetics and the characteristics of the condition of E/M fatigue is currently unknown.

Neurological findings, however, can complicate the interpretation of neurology. Neurologic changes can occur independently of fatigue and fatigue-related syndromes. If fatigue syndrome is the syndrome, how can one distinguish neurological changes from those of other fatigue syndrome syndromes?

Both new and established chronic fatigue syndrome syndromes suffer from similar symptoms. Moreover, there is evidence to suggest a link between the fatigue syndrome syndrome syndrome and dementia. Patients with mild cognitive impairment are at higher risk of developing the chronic fatigue syndrome syndrome syndrome.

Unlike some other conditions with similar neurological abnormalities, dementia is not a separate syndrome. Rather, dementia is often associated with fatigue. This correlation has further confounded the medical research on chronic fatigue syndrome, giving rise to further confusion regarding the neuropathological basis of chronic fatigue syndrome.

Although chronic fatigue syndrome has not been recognized as a disease with a neurological cause, it may be a syndrome with a neurological symptom. That is, chronic fatigue syndrome may be caused by fatigue syndrome.

The good news is, researchers are able to identify patients who have neurological deficits. This highlights the urgent need for the medical community to continue to track these patients and determine if their symptoms are a result of chronic fatigue syndrome.

The role of fatigue as a major factor in the disease’s appearance cannot be ignored. Even though fatigue itself has become a symptom, its role in driving the disease remains unclear. Therefore, an investigation into fatigue-related dysfunctions is likely to be one of the main goals of future chronic fatigue syndrome research.

Whether fatigue, fatigue syndrome, or both, we are likely to uncover further links between the disease and a wide range of symptoms. And this may eventually lead us to a full-fledged understanding of chronic fatigue syndrome and a comprehensive treatment for this debilitating condition.