Chronic fatigue syndrome: symptoms, causes and treatment.

We review all the characteristics of this rare disease.

Chronic fatigue syndrome is a complex disease, with multiple symptoms and manifestations, and of which little is known about its origin and treatment.It is a complex disease, with multiple symptoms and manifestations, and of which very little is known about its origin and treatment. Hence, it is still a great mystery within the scientific community.

Curiously, in the 70's and 80's it was called yuppie flu, since it affected mainly young workers who lived in the city and whose stress and accelerated pace of life caused them intense exhaustion.

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What is chronic fatigue?

The syndrome of chronic fatigue (SFC) is an alteration that causes in the person a sensation of tiredness or extreme fatigue, which can prevent the person from being able to work.which can prevent the person from being able to perform any usual activity or task.

To distinguish chronic fatigue from severe fatigue, the person must have symptoms for more than six months. In addition, if the person tries to alleviate them by means of rest, or physical or mental tasks, it is very likely that it will even get worse.

This disease is constituted as a chronic condition, extremely complex and its causes are still unclear, interfering with the cardiovascular, endocrine, neurological and immune systems.

To date, it is speculated that this condition affects the cardiovascular, endocrine, neurological and immune systems, it is speculated that this condition affects about 0.5% of the world's demographicThe most affected are women in 90% of the cases. In addition, it often appears together with other diseases such as fibromyalgia or irritable bowel syndrome.

Other names for chronic fatigue syndrome (CFS) are myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) or systemic exertion intolerance disease (SEID).

Symptoms

As noted above, for this fatigue to be considered extreme fatigue syndrome, it must last for at least six months. The patient affected by chronic fatigue syndrome presents, among many others, the following symptoms:

• Intense fatigue
• Hyperthermia or fever
• Photophobia
• Hyperacusis
• Unrefreshing sleep
• Headache
• Muscle pain
• Intolerance to temperature changes
• Deficits in concentration
• Short-term memory loss
• Deficits in spatial orientation

Thus, the symptoms of chronic fatigue syndrome can make themselves felt in many aspects of life and affect both the way in which the person relates to others and the way he/she interacts with elements of the environment in which he/she lives, which has repercussions on his/her achievement of goals, self-image, etc.

Causes

In the past, chronic fatigue was considered a psychosomatic alteration, however, nowadays it is considered as a psychosomatic disorder.However, it is now accepted that it cannot be considered as a psychiatric disorder, but rather as a disease with an organic basis but whose causes are not yet fully understood.

Despite the large amount of research on chronic fatigue syndrome worldwide, the origin of this phenomenon is still far from being discovered. Even so, some research has reached reliable conclusions that oxidative stress is an important element of the disease, although it is not known whether it is a cause or a consequence of CFS.

A 2001 study concluded that an increase in both nitrous oxide (NO) and peroxynitrites were linked to the origin of several diseases, including chronic fatigue syndrome, post-traumatic stress disorder and multiple chemical sensitivity.

With the passage of time and the advance of science, it was hypothesized that a fast pace of life and poor diet, among other causes, could lead to abnormal development of the candidiasis fungus, thus triggering chronic fatigue syndrome. This theory, however, has been widely criticized and rejected.

On the other hand, some studies conjecture that toxic substances in the environment and chemicals in some foods also contribute to weakening the person and causing CFS. in some foods also contribute to weaken the person and cause CFS.

Finally, the influence of sleep quality, recurrent physical and psychological stress or certain disorders such as post-traumatic stress disorder have also been suggested.

Diagnosis

Chronic fatigue syndrome is unique in that it is difficult to diagnose. For a better assessment of the patient's condition, the clinician should start by taking a medical history and by physical examination, in order to rule out any hidden disease behind these symptoms.

Considering that 39% to 47% of CFS patients also suffer from depression, it is necessary to also perform a physical examination.it is necessary that an assessment of the patient's mental state is also carried out. As well as to rule out a possible influence of some drugs by Blood and urine tests.

Despite the difficulties involved in the diagnosis of CFS, there are eight criteria developed over time, and although there is no consensus opinion on which of them is most effective, there are two methods that stand out above the rest. These are the Fukuda diagnostic criteria (1994) and more recent ones developed by the US National Academy of Medicine (2015).

Fukuda diagnostic criteria (1994).

In order to make the diagnosis of CFS according to these criteria the patient must present with:

1. intense fatigue 2.

Chronic and intense fatigue for at least six months and for no apparent reason. In addition, this fatigue does not subside with rest.

2. Rule out other conditions that could cause fatigue.

Exclude any disease that a potential cause of the feeling of fatigue.

3. Present at least four of the following signs for six or more months:

• Memory and concentration deficits
• Sore throat when swallowing
• Muscle pain
• Non-inflammatory joint pain
• Headaches
• Unrefreshing sleep
• Fatigue after exertion with a course of more than 24 hours.

U.S. National Academy of Medicine diagnostic criteria (2015).

These much more current guidelines were the first to highlight the possible organic features of the disease.

According to this organization, to make a valid diagnosis of chronic fatigue syndrome, the patient must have the following symptoms:

• Significant decrease in energy for the performance of any activity, for at least six months and without apparent causes.
• Feelings of uneasiness after exercise.
• Non-restorative rest
• Presenting one of these two symptoms: cognitive jamming or orthostatic intolerance.

Other aspects to be taken into account in the diagnosis is the frequency and degree to which they occur, and at least half of the times, they must be of a major or severe form.

Treatment

Since it is a chronic disease, there is no remedy for it. However, pharmacological therapy to manage symptoms such as muscle pain, sleep disturbance, anxiety or depression, has proven to be effective.has proven to be effective, with symptoms thriving over time.

In other words, health intervention is of a palliative type, to cushion the impact of the disease on quality of life and prevent it from generating additional problems that need not exist with effective management of symptoms and interaction with the environment.

Asimismo, la intervención cognitivo-conductual para trabajar los aspectos emocionales, y una reeducación alimentaria, también pueden resultar exitosos como complemento al tratamiento farmacológico.

Referencias bibliográficas:

• Bested, A. C.; Marshall, L. M. (2015). Review of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: an evidence-based approach to diagnosis and management by clinicians. Rev Environ Health, 30(4): 223-49.
• Haney, E., Smith, M.E., McDonagh, M., Pappas, M., Daeges, M., Wasson, N., Nelson, H.D. (2015). Diagnostic Methods for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Systematic Review for a National Institutes of Health Pathways to Prevention Workshop. Ann Intern Med, 162 (12): 834-40.
• Reeves, W.C., Lloyd, A., Vernon, S.D., Klimas, N., Jason, L.A., Bleijenberg, G., Evengard, B., White, P.D., Nisenbaum, R., Unger, E.R. et. al. (2003). Identification of ambiguities in the 1994 chronic fatigue syndrome research case definition and recommendations for resolution. BMC Health Serv Res. 3 (1): 25.