What is chronic fatigue syndrome? It is not just ordinary fatigue

We all know fatigue. After a hard day, sometimes we're glad to see the bed.

Fatigue is a very unpleasant subjective feeling leading to exhaustion of the whole organism.

However, we should not take it negatively right away, because it has its informational value, just like pain.

If it were not for fatigue, we could overload the organism to such an extent that serious damage to health could occur.

Thus, fatigue can also be defined as a signal from our body that both alerts us and warns us of the complete exhaustion of the last energy reserves, both mental and physical.

Total exhaustion is very dangerous because it can end in death. Therefore, sleep is the natural reaction of the body, which exhaustion forces us to do.

Tip: Burnout syndrome. Do you have it too?

Chronic fatigue syndrome - what do we mean by it?

Chronic Fatigue Syndrome, CFS, is a syndrome, a set of multiple symptoms, characterised by excessive to extreme yet prolonged fatigue with no apparent cause. Common, explainable causes could be overwork, insomnia, excessive physical activity, and cancer.

Fatigue in CFS lasts for a long time (months, years). However, it must last for at least half a year to meet one of the criteria for a diagnostic conclusion of chronic fatigue syndrome.

The condition does not improve even with sufficient rest, which over time impairs a person's mental health and physical performance.

Interestingly, epidemic outbreaks have been recorded (Los Angeles 1934, London 1955...). Yet it cannot be said that CFS is contagious, although it is often joked about.

Women are much more often affected than men, and mostly between the ages of 25 and 45.

Treatment depends on the duration of the syndrome. It is most effective if started in the first five years. With each passing year, the chances of a complete cure decrease.

Basic criteria for CFS

A definition of chronic fatigue syndrome cannot be pronounced without the typical criteria that the syndrome must have. Not every fatigue (even if it lasts a week or a month) immediately indicates a chronic disease that needs to be treated.

With normal fatigue, it is enough to eliminate the triggering factor or to indulge in relaxation (a walk in nature, a holiday, rest). With chronic fatigue syndrome, it is not so simple.

In addition to fatigue, this syndrome manifests itself in other symptoms. Some of these are certain, others are more rare and occur in only a small percentage of patients.

It is completely wrong for the environment and sometimes even doctors to condemn patients with this condition in advance, to label them as simulacra. Despite the banal appearance of the condition, in reality, the patient with this diagnosis suffers greatly.

Imagine for just one day that you wake up so exhausted that you can't even manage normal activities. Now imagine that this fatigue lasts for a week, a month, a year... Is this unimaginable?

Sleep does not bring redemption to these patients and it seems to last and will last forever. CFS is hard to fight when you are too tired to fight. Some few patients develop complete resignation because they cannot go on.

Criteria that CFS must meet:

• Sudden onset of problems not preceded by excessive exertion (hours, days).
• in some cases the onset of fatigue is preceded by flu-like symptoms
• extreme fatigue (any other causes must be ruled out)
• fatigue is persistent or fluctuating
• the condition lasts for more than half a year (sometimes years)
• impairs the mental health of the patient (impaired concentration, apathy, nervousness, irritability)
• impairs the patient's physical activity and performance by 50% or more (non-performance, failure to complete an activity)
• subfebrile, sometimes fever accompanied by chills
• enlargement of lymph nodes, soreness
• the condition does not improve with rest and sleep
• sleep disturbances occur (insomnia, excessive sleeping during the day)
• associated headaches, muscle and joint pains (as in influenza)
• dizziness, nausea, vomiting
• short-term memory disorders are not uncommon with long duration
• visual disturbances, visual field loss, photophobia are often present

Presumed causes of this mysterious syndrome

Chronic Fatigue Syndrome is considered one of the most mysterious chronic diseases of modern times. It is also often referred to as the most mysterious chronic disease of civilization ever. Its causes are assumed but not confirmed.

The most likely cause is thought to be an infectious agent in the lead up to or during an attack of the disease, hence the term CFIDS (chronic fatigue and immune dysfunction syndrome).

There are dozens of names, and each one seems to be correct. Each name includes one or more of the symptoms by which it outwardly manifests itself.

Presumed causes of fatigue syndrome:

1. Infectious disease - most likely Epstein-Barr virus (EBV) and herpes virus
2. immune disorder - dysfunction
3. allergy - overreaction of the organism, increased reactivity to an allergen
4. hypotension - chronically low blood pressure
5. stress and depression - or a combination of these and other psychological conditions

Which common features do patients with this syndrome have in common?

The above hypotheses are based on the most common common features of the patients and ongoing research.

In most patients, the condition is preceded by an infection. Sometimes the infection is present even during the symptomatic period of the syndrome.

The vast majority of patients are women, up to four times more than men. However, there is no clear link to a specific gender.

More than half of the patients suffer from some form of allergy - food allergy, pollen allergy, drug allergy.

Another common feature is education, which is either high school or university. A large proportion of these women work excessively, have two or more jobs and are under constant pressure or suffer from a sense of frustration that causes excessive stress and depression.

Diagnosis is differential and treatment is individual

By differential diagnosis we mean a diagnosis that is based on differentiating between other possible causes of illness. The aim is actually to identify a specific illness by excluding other illnesses that may also be manifested by fatigue. There are many of these.

In fact, fatigue is a common symptom of a wide range of diseases. Therefore, it is not always easy to search for the underlying cause. For this reason, the patient usually has to undergo a series of examinations that will give the doctor more information.

Several specialists are involved in the diagnosis of CFS because its symptoms simulate a wide variety of disease states. CFS is therefore considered a multidisciplinary problem, which is why the whole diagnostic process can take too long.

There is no cure for CFS. So what do we treat?

The treatment is symptomatic and highly individualised. Patients are treated for the symptoms that the disease causes, but these vary from person to person. Only the main symptoms, which are among the basic criteria of the syndrome, are common.

Most patients are prescribed medication to help them sleep at night or analgesics for headaches, muscle or joint pain. Some patients require treatment to support their immunity.

Some patients with CFS also complain of complaints such as abdominal pain, diarrhoea, sore throat, difficulty breathing, coughing, tingling in the limbs and other parts of the body, dry mouth, dry throat, dry and burning eyes, chest pain, heart rhythm disturbances, or even sensitivity to noise and various odours. This is when pharmacotherapy is directed in this direction.

A change in lifestyle is the key

The most important aspect in the treatment is the prevention of fatigue syndrome. This involves knowing the suspected causes and avoiding risk factors. Avoiding stress, not overloading the body, eating healthily and getting enough exercise are important.

The risks described above cause not only CFS, but also most of the diseases of civilisation. Therefore, by changing our lifestyle we prevent not only chronic fatigue syndrome, but also other diseases of this century.

The consequences can be serious

The consequences of this disease can be so severe that they can destroy the life of the carrier. Problems occur at two levels, which interact with each other. The progression of one level sets the stage for the progression of the other.

The psychological state worsens with permanent fatigue. Patients first have problems concentrating. These are quickly replaced by disinterest and apathy, as they have no energy to engage in anything. But this causes them to lose social ties and become isolated.

Isolation also worsens the condition as it is one of the risk factors for depression. Depression ends in burnout, self-harm, addictions and even suicide.