CHRONIC FATIGUE SYNDROME – SYMPTOMS- DIAGNOSIS – TREATMENT OPTIONS

In this blog will briefly discuss the different symptoms of Chronic fatigue syndrome (CFS) its clinical diagnosis and different treatment options.

Chronic fatigue syndrome is a medical condition and its diagnosis is based on the clinical picture. CFS there is no specific blood test or any specific laboratory evaluation or imaging study that makes a diagnosis. It may help to understand and evaluate and to rule out other disease process. Example- to rule out anemia or thyroid dysfunction causing the symptoms. According to the Center of Disease control they have stated few criteria for the diagnosis of CFS:

(A) Person has severe fatigue lasting for 6 months or longer and is not relieved with rest and is not associated with other medical or mental illness. This is a key manifestation and in conjunction with other symptoms

(B)One may have 4 or more other symptoms listed below on top of above severe fatigue then person may have Chronic fatigue syndrome

• Enlarged or tender neck or arm pit (axillaries) lymph nodes.
• Frequent sore throat
• Impaired short-term memory or concentration
• Muscle pain
• Multiple join pain but has no swelling or any redness
• Headache new pattern
• Unrefreshing sleep
• Post-expressional fatigue lasting for more than 24 hours.

When above criteria is fulfilled one is considered to have the chronic fatigue syndrome.

Treatment:

There is no one specific treatment that works for all. It needs to be individualized treatment approach. So there are multimodality approach is used. Uses of pharmacological and non-pharmacological treatment options are use. Based on the view of the author integrative medical treatment approach works the best in this kind of situation. Which includes the standard medical approach for evaluation of the CFS and adding other alternative medical treatment modalities. Alternative treatment modalities like Ayurveda (Traditional Indian Medicine), Yoga, Pranayama, Herbs, dietary modification, relaxation, improvement of the sleep and life style may help to improve the symptoms. This is a big topic and will discuss in the blog separately.

ChronicFatigue Syndrome

The three key drugs that are FDA approached for the treatment of Fibromyalgia is Lyrica (pregabalin), Cymbalta (duloxetine) and Savella (milnacipran). It is helpful in controlling the symptoms but do have many side effects on long run, one needs to know about it. Medication may need to control the symptoms in many cased also. The dose needs to be adjusted periodically with clinically been monitored as one gets better. The goal should be to be on the least amount of dose or is off the drug at some point if possible. It may be possible in some patient and some not. As CFS is a chronic disease or condition and long-term efficacy and side effects of the drugs over 10-20 years is not known.

If you or loved one has CFS not all physicians are comfortable taking care of the disease. It is a complex disease. It will be good to talk to your primary care about it and see who would be best for this condition in your area or if chronic fatigue clinics are in your area. One needs to find a physician who can spend time and understand the on going disease process individually and help mange it. Patient also has to do his/her share to improve further. A long-term relationship needs to be developed with the healthcare provider. It takes many months to show improvement so be patiently waiting for a while the treatment is going on. This is specially if one has the symptoms more than 3-5 years.

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CHRONIC FATIGUE SYNDROME AND AYURVEDA- UNDERSTANDING CFS FROM AYURVEDIC PERSPECTIVE

Chronic fatigue syndrome (CFS) is a very complex disease with persistent low-grade energy not improving after adequate rest. The symptoms are there for months or years and do not improve. In this section, let us look at a different perspective away from modern medicine and look at Ayurveda to understand how CFS is manifested and what can be done to improve it. This will give us different in site. Ayurveda can always be integrated with a current medical treatment approach to benefits the patient’s treatment for chronic fatigue syndrome or fibromyalgia.

Patients with sleep apnea with chronic fatigue syndrome or fibromyalgia who are on CPAP or BiPAP and compliant with treatment may still have residual fatigue during the daytime or a low-energy level at the end of the day. Ayurveda can further help in such cases.

The word Ayurveda is Ayu, which means long healthy life and veda which means science, so Ayurveda is the science that explains the long healthy life or it is also called Indian medical science. It is one of the oldest medical systems in the world, which originated in India and documented to mankind. Books written hundreds and thousands of years ago in Sanskrit literature help this understanding. Very good information has been described in Ayurveda as it treats the patient uniquely on an individual basis and not as a group therapy. As no two people with chronic fatigue symptoms are the same genetically, so will the treatment be unique to them as well.

Chronic fatigue syndrome is not a new disease as Ayurveda has described chronic fatigue syndrome and it has been present for centuries. It discusses low-energy level or low bala in the body and how it should be addressed.

Ayurveda describes the body made of five key elements namely, fire, earth, water, air and space. Ayurveda also describes the basic three body types namely, vata, pitta and kapha. Vata is predominantly air, pitta is fire quality, and kapha is earthly quality. Its permutation and combination gives rise to the different body types and body tissues and different energy flow as a basic prakruti or genetics of the person.

A person with body type Kapha, will have chronic fatigue with lethargy, a more sluggish, heavy-set person, long sleeper with low metabolism and slow digestion.

A person with body type Pitta, may have more heat in the body and feels warm or hot, gets heartburn, may have lose bowel movements, skin rash, and generally an active personality with tendency to get angry if things do not happen the way they intended to happen. Fibromyalgia falls in this area, but the involvement is predominantly muscle. Fibromyalgia patients have chronic fatigue and are different than patienst with no fibromyalgia and CFS.

A person with body type Vata, may have irregular sleep habits, difficulty falling or maintaining sleep, constipation, dry skin, mild irritation, joint discomfort, etc. These are the general descriptions, but as all have all three qualities, different things can be seen in a person, but one or two types will be more predominant.

Usually, patients with chronic fatigue syndrome have the vata-pitta or pitta-vata type generally in most cases. This can be analyzed by the ayurvedic pulse diagnosis and other bodily features. If one has chronic fatigue then if one learns Ayurveda, it may help them and in the long run pay it back multiple times as it is a good way of understanding the body type and one can make modifications.

So if one has pitta-vata type and the chronic fatigue is in that subtype than the management would be to alleviate the vata and the pitta factors by improving the digestion, restful sleep and using the herbs that are specific for that body type. Generally, sleeping between 10:00 pm and 6:00 am on a regular basis and doing pranayama or breathing exercises of yoga may further help.

Drugs or foods that cause the heartburn or high acid in the body may need to be analyzed and reduced or eliminated based on a case-by-case basis. The goal should be to be on a low medication list including the vitamins, as they are not able to digest it. The diet should be high in fruits and vegetables and easily digested food. Relaxation and sound sleep is very important and initially the person may have to spend weeks to have increase in the hours to restore the sleep deprivation syndrome. Multiple other things need to be done but with the above few, one can get started.

Generally, it takes 1-2 years and at times 3 years for this to improve based on the medical condition of the person. Slow and steady may win the race to overcome fatigue if a systematic plan is followed. Ayurveda is the key for this understanding.

Source Link:- http://fatiguecare.com/blog/chronic-fatigue-syndrome-and-ayurveda-understanding-cfs-from-ayurvedic-perspective/