Who treats chronic fatigue syndrome and how?

There is no specific treatment for chronic fatigue syndrome. This means that there is currently no one drug, no one pill, that will completely cure the disease.

Therapy consists of regimens that are key to improving the patient's quality of life and supportive pharmacological treatments that help the patient manage the accompanying symptoms of the disease.

Non-pharmacological management

The patient's daily regimen and physical activity should be set up. These should be timed according to the patient's condition.

When managing the disease, it is certainly not advisable to try to overcome fatigue by forcing oneself into physical activity.

During periods when fatigue is easing, it is advisable to introduce regular, reasonable activities such as:

• walking
• light aerobic exercise
• recreational sport
• gardening

Techniques such as deep breathing training, muscle relaxation, massage, yoga and Tai Chi exercises have also been very successful with patients.

Gradually, the intensity and duration of physical activity is increased, of course under the more expert supervision of a doctor or physiotherapist.

The aim of the patient-therapist collaboration is to learn to balance rest and activity so that the patient successfully avoids fatigue flare-ups.

Another effective regimen is to recommend and educate the patient in the principles of rational nutrition and a varied diet so that all essential minerals, vitamins and nutrients are taken in their natural and preferably absorbable form.

Thought and mental control and its influence on the patient's actions and feelings is also essential. It is important to learn to recognise activities and behaviours that make the patient feel tired. Only in this way can the patient minimise it.

So?
The answer to the question "Who treats fatigue syndrome?" is...
Several specialists come together in treatment, from neurologist, psychologist, physiotherapist to trainer or psychiatrist experts.
It depends on the person's overall course and difficulties.

Pharmacological management

Nutritional supplements

Includes supportive treatment through mineral supplementation. This mainly includes magnesium, zinc, selenium, vitamins especially from the B group and vitamin D, but also other vitamins C and E, A.

Pain treatment

Patients very often suffer from headaches, muscle and joint pain. Analgesics and non-steroidal anti-inflammatory drugs are suitable solutions. However, their long-term use can bring a number of complications, such as the development of a gastric ulcer with bleeding.

Opioid drugs are highly addictive. Therefore, they are used only in very severe cases and for the shortest possible time.

Tricyclic antidepressants

Several tricyclic antidepressants have a significant effect in improving sleep, pain management and relieving fatigue.

In this case, lower doses than those used in the treatment of depression are sufficient.

The most effective are the so-called selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)

Agents such as fluoxetine, sertraline, paroxetine are also used to treat depression and anxiety that either accompany the disease process or occur as a consequence of it.

In addition, preparations from the SNRI group have another advantage. In addition to their antidepressant effect, they provide relief from chronic long-lasting (neuropathic) pain.

Corticosteroids

The administration of low doses of corticosteroids can have an effect. However, experience has shown that it is only short-lived and has been associated with adverse effects.

Low doses of hydrocortisone are used.

New methods of treatment

Rintatolimod

Rintatolimod is a newly approved immunomodulator and antiviral drug for the treatment of chronic fatigue syndrome.

So far, it is only approved in Canada and Europe. In the U.S., the drug is not yet approved, due to little information about its effectiveness and safety.

Rituximab

Rituximab is a so-called anti-CD20 monoclonal antibody. It causes the knockout of B-lymphocytes, which play an important role in the development of the disease.

Although it is a treatment that significantly interferes with immune processes, patients taking rituximab suffer from several side effects. These include neutropenia (low numbers of neutrophils, cells of the immune system) and recurrent infections.

Fecal microbiome transplantation

One possible cause of chronic fatigue is a change in the gastrointestinal (gut) microbiota of patients.

Therefore, a unique method of treatment, fecal microbiome transplantation, has been introduced.

The process involves the transfer of feces from a healthy donor into the patient's gut.

It is a relatively safe method that is currently recommended as a supportive treatment for several chronic health problems.

From the available data, it is clear that a high percentage of transplanted patients enjoy a good effect, a decrease in fatigue and an increase in vital energy.