Helix Health

Chronic Fatigue Syndrome CFS/M.E.

Chronic Fatigue Syndrome (CFS) is a chronic or relapsing / remitting condition. It is also known as M.E. (Myalgic Encephalomyelitis/ Encephalopathy), Post Viral Fatigue Syndrome (PVFS) or Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS). True recovery from CFS / ME is rare and although some improve to the point where they can resume their normal working lives, others remain housebound or even bed bound for life. The disease affects all ages and both sexes, although it is more prevalent in adult women.

Symptoms

• Chronic Fatigue The fatigue experienced by CFS sufferers are usually uncharacteristically severe, excessive and persistent.
• Post-exertional fatigue
• Brainfog
• Malaise and/or post-exertional malaise
• Chronic Pain, including myalgia (muscular pain), arthralgia (joint pain without swelling, i.e. non-inflammatory), neuropathic (nerve pain with or without paraesthesias, i.e. sensations of tingling, numbness or burning) or head pain (headaches or migraines).
• Muscle weakness, thought to be neurally mediated, rather than muscular in origin.
• Recurrent sore throat with or without swollen or tender lymph nodes
• Sleep Disturbances are a very common and take many different forms - insomnia, hypersomnia, early morning waking, disrupted sleep with frequent waking and Restless Legs Syndrome.
• Gastrointestinal Tract (Digestive) Symptoms
• Temperature disturbances (intolerance of temperature extremes, feeling hot or cot with normal body temperature, chronic low body temperature, frequent mildly elevated temperature)
• Dizziness, including vertigo, rotational dizziness, dizzy spells and vestibular problems
• Postural hypotension, i.e. low blood pressure accompanied by lightheadedness on standing
• Sensory hypersensitivity (photophobia, phonophobia, sensitivity to strong smells or tastes)

Serious Neurological Symptoms

Serious neurological symptoms are seen in a small minority of those suffering from CFS. These include:

• Double Vision
• Blackouts
• Atypical convulsions
• Speech problems, including loss of speech
• Swallowing difficulty, including loss of swallowing resulting in nasogastric feeding

Intolerance

Intolerances are very common and include:

• Alcohol intolerance
• General Medication Sensitivity, particularly an intolerance of psychotropic drugs like antidepressants, antipsychotics and sedatives
• Multiple Chemical Sensitivity
• Gluten Intolerance
• Lactose Intolerance

Causes

The cause of Chronic Fatigue Syndrome (CFS) still remains unknown. Much of ongoing research is centred around possible immune, endocrine, neurological and cardiovascular causes.

• Immunological: Abnormalities is common but generally non-specific and no relationship has been established. Patterns suggest some form of immune dysregulation. In some sufferers, allergic reactions can be triggered or exacerbated.
• Neuro-endocrine: Hypoactivity of the hypothalamic-pituitary-adrenal (HPA) axis has been reported in several studies. This abnormality could be responsible for symptoms of fatigue, thermo dysregulation and sleep disturbances.
• Central Nervous System : The nature of the symptoms associated with CFS suggest a possible dysfunction of the CNS. These findings are inconsistent and no clear theory has emerged as of it. CNS dysfunction could be caused by blood flow abnormalities affecting the brain, particularly the brainstem. Vestibular dysfunction could explain the symptoms of dysequilibrium, i.e. dizzy spells, vertigo, fainting, balance and coordination problems.
• Autonomic Nervous System: The ANS is largely implicated through the autonomic abnormality of neurally mediated hypotension. Covert cardiac dysfunction and low blood volume possibly resulting in lower cardiac stroke volumes have been implicated, but findings are still inconsistent since low fluid and salt intake could also cause orthostatic dysfunction. Lower cardiac stroke volumes could also be the result of inactivity due to severe fatigue, rather than a causative factor.

Diagnosis

In The U.K., no diagnostic criteria for CFS has been accepted. Current diagnostic criteria was designed as inclusion criteria for research studies and is thought to be useful only as rough guide, rather than fixed rules. A diagnosis of CFS is based on recognising the typical symptom pattern associated with CFS (usually as illuminated by diagnostic criteria) combined with the exclusion of other possible / alternative conditions. Different diagnostic criteria have evolved over the years, beginning with the 1988 US Centres For Disease Control And Prevention (CDC) Criteria, better known as the Holmes criteria. The CDC Criteria was revised in 1994 and the new version is known as the 1994 Fukuda criteria. There is also the 1990 Australia or Lloyd criteria, and the 1991 UK "Oxford Criteria." Closely connected are the 1990, London criteria (derived from Dowsett & Ramsay) for M.E. (myalgic encephalomyelitis) and the World Health Organisation (WHO) ICD-10 categories of "Neurasthenia / Fatigue Syndrome", "Post-viral Fatigue Syndrome / Benign Myalgic Encephalomyelitis".

A brief outline can be seen in the table below:

CDC Criteria

The CDC Criteria is currently the most influential set of diagnostic criteria used to formulate and support a formal diagnosis. The criteria is as follows:

(i) Chronic Fatigue: Clinically evaluated, unexplained fatigue (persistent or relapsing) is of a new and definite onset and is not the result of exertion and not alleviated by rest. Fatigue severe enough to result in a substantial reduction in previous levels of activities, both occupation (educational), social and personal. Fatigue present for six months or more.
(ii) Concurrent Symptoms: The presence of four or more of the following symptoms. Symptoms must be either persistent or relapsing and onset must not have predated the fatigue.

• substantial impairment in short-term memory or concentration
• headaches of a new type, pattern, or severity
• unrefreshing sleep
• sore throat
• tender lymph nodes
• muscle pain
• multi-joint pain without swelling or redness
• post-exertional malaise or fatigue lasting more than 24 hours

There is no cure for Chronic Fatigue Syndrome and medical treatment is aimed at managing the condition. Flexible and appropriate application of therapeutic strategies are particularly important in CFS, since rigidity and inappropriate application often lead to detrimental effects or no effects. Patient often respond differently to treatment and what may be beneficial for some could be harmful to others. Treatment strategies should be devised to best suit the individual. Currently treatment strategies include

• Graded exercise
• Cognitive behavioural therapy (CBT)
• Counseling, including basic lifestyle management counseling
• Symptom control - prescribing for individual symptoms, like prescribing painkillers for chronic pain, anti-emetics for nausea or sedatives for insomnia.

Complementary Medicine has proven particularly beneficial in combination with standard medical treatment for chronic illness. The efficacy of herbs or supplements for Chronic Fatigue Syndrome has not been proved in controlled studies. Massage therapy, deep-breathing exercises, muscle-relaxation techniques and moving therapies like yoga and Tai Chi has been shown to be beneficial by reducing anxiety reduction and improving mood.

The Helix Health Approach

At Helix Health, complementary therapy is not simply prescribed for Chronic Fatigue Syndrome, but used to enhance general health, particularly the areas functioning less well in CFS. An individual assessment is done for each individual and therapy plans are bound to be unique. Common issues that frequently arise in those that have been diagnosed with CFS include:

• The Nervous System: Neurological Disorganisation
• The Endocrine System: Adrenal Stress or Exhaustion, Sugar Handling Stress
• The Digestive System: Food Allergies, Gut Dysbiosis, Liver Congestion
• The Cardiovascular System: Poor circulation
• The Musculoskeletal System: Musculoskeletal Dysfunction

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Maintain A Healthy Lifestyle: Eat a healthy diet, drink plenty of water, stop smoking, limit caffeine, alcohol and sugar intake, get adequate rest, get enough sleep, pace yourself, reduce your stress, exercise regularly and appropriately, find a hobby that you enjoy doing and always make time for it.