Description

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complicated condition.

It causes extreme fatigue that lasts for at least six months. The symptoms worsen with physical or mental activity, but not totally improves with rest.

The cause of ME/CFS is unknown, although there are many theories. Experts believe that it could be caused by a combination of factors.

There is No single test to confirm a diagnosis. You may need a variety of medical tests to rule out other health problems that have similar symptoms. Treatment for the disorder is focused on relieving the symptoms.

Symptoms

The symptoms of ME/CFS may vary from person to person, and the severity of symptoms can vary from day to day. Besides the fatigue, the symptoms may include:

  • Extreme exhaustion after physical or mental exercise.
  • Problems with memory or thinking skills.
  • Dizziness, worsening with movement from the position of lying down or sitting to standing.
  • Muscle or joint pain.
  • Unrefreshing sleep.

Some people with this condition have headaches, sore throat, and pain in the lymph nodes in the neck or armpits. People with this condition may also be more sensitive to the light, the sound, the smells, the food, and medicines.

When to see a doctor

Fatigue can be a symptom of many diseases. In general, talk to your doctor if you have persistent or excessive fatigue.

Causes

The cause of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is still unknown. A combination of factors that may be involved, including:

  • Genetics. ME/CFS seems to run in some families, so some people may be born with a greater likelihood of developing the disorder.
  • Infections. Some people develop ME/CFS symptoms after getting better from a viral or bacterial infection.
  • Physical or emotional Trauma. Some people report that they have had an injury, surgery, or significant emotional stress, shortly before their symptoms start.
  • Problems with the use of energy. Some people with ME/CFS have a problem converting the body's fuel, mainly from fats and sugars into energy.

Risk factors

Factors that may increase your risk of ME/CFS include:

  • Age. ME/CFS can occur at any age, but is most commonly affects young to middle-aged adults.
  • Sex. Women are diagnosed with ME/CFS more often than men, but it may be that women are more likely to report their symptoms to a doctor.
  • Other medical problems. People who have a history of other complex medical problems, such as fibromyalgia or postural orthostatic tachycardia syndrome, may be more likely to develop ME/CFS .

Complications

The symptoms of ME/CFS that come and go, and are often triggered by physical activity or emotional stress. This can make it difficult for people to maintain a regular work schedule or even to take care of themselves at home.

Many people may be too weak to get out of bed at different points during their illness. Some may require the use of a wheelchair.

Diagnosis

There is No single test to confirm a diagnosis of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Symptoms may resemble those of many other health problems, including:

  • Sleep disorders. Fatigue can be caused by sleep disorders. A sleep study can determine if your rest is being disturbed by disorders such as obstructive sleep apnea, restless leg syndrome or insomnia.
  • Other medical problems. Fatigue is a common symptom in various medical conditions, such as anemia, diabetes, and hypothyroidism. Lab tests can check your blood for evidence of some of the main suspects.
  • Mental health problems. Fatigue is also a symptom of a variety of mental health problems, such as depression and anxiety. A counselor can help you determine if one of these problems is the cause of your fatigue.

It is also common for people who have ME/CFS also have other health problems at the same time, such as sleep disorders, irritable bowel syndrome or fibromyalgia.

In fact, there are so many overlapping symptoms between this condition and fibromyalgia, which some researchers believe that the two disorders to different aspects of the same disease.

Diagnostic criteria

The guidelines proposed by the united States Institute of Medicine to define the fatigue associated with ME/CFS as:

  • So severe that it interferes with the ability to participate in the pre-disease activities.
  • Of new or definite onset.
  • Not substantially alleviated by rest.
  • Aggravated by physical, mental or emotional exertion.

To comply with the Institute of Medicine of the diagnostic criteria for this disease, a person would also need to experience at least one of these two symptoms:

  • Difficulties with memory, attention and concentration.
  • Dizziness, worsening with movement from the position of lying down or sitting to standing.

These symptoms must last for at least six months and will produce less than half the time to moderate, substantial, or severe intensity.

Treatment

There is No cure for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The treatment focuses on the relief of symptoms. Most of the harmful or disabling symptoms should be addressed in the first place.

Drugs

Some problems associated with ME/CFS can be improved with certain medications. Examples include:

  • Pain. If medications such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), don't help enough, prescription drugs are sometimes used to treat fibromyalgia may be options for you. These include pregabalin (Lyrica), duloxetine (Cymbalta), amitriptyline or gabapentin (Neurontin).
  • Orthostatic intolerance. Some people with this condition, in particular adolescents, he feels dizzy or nauseous when you are standing or sitting in an upright position. Medications to regulate blood pressure or the heart rate may be useful.
  • Depression. Many people with chronic health problems, such as ME/CFS , are also depressed. The treatment of depression can make it easier for you to address to the problems associated with a chronic illness. Low doses of some antidepressants, can also help improve sleep and relieve pain.

Stimulation for post-exertional malaise

People with ME/CFS have a worsening of their symptoms after physical, mental, or emotional effort. This is called post-exertional malaise. It usually begins within 12 to 24 hours after the activity, and can last for days or weeks.

People who have post-exertional malaise often have difficulty finding a good balance between activity and rest. The goal is to stay active without overdoing it. This is also called the pace.

The goal of the stimulation is to reduce post-exertional malaise, instead of returning to the same level of activity that you had when you were healthy. As you improve, you may be able to safely participate in most activities without activation post-exertional malaise.

This can help to keep a daily log of your activities and symptoms, so that you can control the amount of activity that is too much for you.

Addressing sleep problems

Lack of sleep can cause other symptoms more difficult to treat. Your health care team may suggest that you avoid caffeine or change your routine to go to sleep. Sleep apnea can be treated through the use of a machine that delivers air pressure through a mask while you sleep.

Alternative medicine

Many alternative therapies have been promoted by myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), but very few have the evidence that they work. Patients with this condition may be sensitive to medications, including herbal products and supplements. The treatments are expensive or potentially harmful and should be avoided.

Coping and support

The experience of ME/CFS varies from person to person. Emotional support and counseling can help you and your loved ones deal with the uncertainty and restrictions of this disorder.

Talking with a counselor can help build coping skills to deal with a chronic disease, address the limitations in the job or in school, and improve the family dynamic. It may also be useful if you are dealing with the symptoms of depression.

You may find it helpful to join a support group and meet other people with your condition. Support groups are not for everyone, and you may find that a support group is adding to its stress-relieving instead of him. Experiment and use your own judgment to determine what is best for you.

Preparing for your appointment

If you have signs and symptoms of ME/CFS , which is likely to start by seeing your family from the health professional.

What you can do

Before your appointment, you can write a list that includes:

  • Its signs and symptoms. Be careful. While fatigue may be affecting the most, other symptoms such as memory problems or headaches are also important to share.
  • Key of the personal information. The recent changes of the main stress factors in your life can play a very real role in your physical well-being.
  • Health information. List of any other condition you are being treated, and the names of the medications, vitamins or supplements that you take regularly.
  • Questions to ask your health care team. Creating your list of questions in advance can help you make the most of your time during your appointment.

For the chronic fatigue syndrome, some basic questions to ask your health care team include:

  • What are the possible causes of the symptoms or condition?
  • What tests do you recommend?
  • If these tests do not realize the cause of my symptoms, what additional tests might I need?
  • On what basis would you make a diagnosis of ME/CFS ?
  • There are treatments or lifestyle changes that could help my symptoms?
  • Do you have any printed material that I can take with me? What sites do you recommend?
  • What activity level you should aim for while we are in search of a diagnosis?
  • Do you recommend that I also see a mental health provider?

Do not hesitate to ask questions during your appointment, as it will happen.

What to expect from your doctor

Your health care team is likely to ask a series of questions, such as:

  • What are the symptoms and when they started?
  • Does anything make your symptoms better or worse?
  • Do you have problems with memory or concentration?
  • Are you having trouble sleeping?
  • How has this condition affects your mood?
  • How your symptoms limit your capacity for work? For example, have you ever had to miss school or work because of your symptoms?
  • What treatments have been tried up to now for this condition? How have they worked?
Symptoms and treatment of Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)