Chronic fatigue syndrome (CFS) describes a condition that is characterized principally by extremely low levels of energy over a prolonged period, but may be accompanied by a variety of other symptoms. It is also known as post-viral syndrome, post-viral fatigue syndrome, myalgic encephalomyelitis (ME), Royal Free Disease (called after the London hospital where the disease was first identified) and "yuppie flu".
Controversy surrounds this condition because it lacks a clear diagnostic test and the symptoms resemble those of many other diseases. Its many names reflect variations in the condition from one individual to another and from one occurrence to another.
What are the symptoms?
Chronic fatigue syndrome may be diagnosed if:
- the main symptom is extreme tiredness that affects the patient for 50 per cent of the time and has done so for at least six months (some doctors say three months);
- the onset of symptoms can be identified;
- the fatigue is very debilitating and affects the individual both physically and mentally;
- there are other symptoms that may include recurrent Sore Throat and Fever, Cough, Headache, stomach upset, Nausea, loss of appetite, weight fluctuations, swollen lymph glands, swollen fingers, rashes, pins and needles or numbness, muscle twitching, Palpitations, Dizziness, clumsiness, weakness and sensitivity to light and noise.
In addition, there may be susceptibility to chilliness or overheating, blurred vision, sore eyes, tense muscles and, in women, vaginal discharge. The symptoms of chronic fatigue syndrome tend to be worse premenstrually and are also aggravated by drinking alcohol.
Mentally, the patient may experience lack of concentration, poor memory, general confusion, inability to express him or herself clearly and difficulty articulating speech. Emotionally, symptoms include Anxiety, Depression, tearfulness, irritability, inability to cope with stress and panic attacks. Again, these symptoms may be worse in women prior to a menstrual period.
What Causes Chronic Fatigue Syndrome?
There are many theories about the causes of chronic fatigue syndrome but it is far from being fully understood. Those who develop the condition often have a recent history of viral infection, usually an upper respiratory infection - such as a Cold or flu - or a digestive tract problem that includes diarrhoea and vomiting. Instead of making a steady and complete recovery, the patient develops a persistent fatigue that is often accompanied by other symptoms, particularly a low-grade fever, which subsides gradually.
The fatigue is characterised by a very slow recovery of muscle power. So, a moderate amount of exercise that a reasonably fit, healthy person would recover from after a good night's sleep, will necessitate at least two or three days of recuperation for the person affected by chronic fatigue syndrome. Strenuous activity may need a two- or three-week recovery period and any more exertion during that time will delay the recovery still further.
There may be several causes of chronic fatigue syndrome. Malfunctions of the immune system or metabolism especially in muscles are sometimes detected in CFS patients, but other factors are believed to be contributory. These include insufficient rest, mineral and vitamin deficiencies, dysfunctional hormone production particularly involving the adrenal and pituitary glands, poor diet, food allergies, the presence of Candida albicans (which causes thrush), carbon monoxide poisoning caused by faulty gas appliances, environmental pollution and chronic intestinal parasitic infection. The over-prescription of antibiotics can weaken the immune system, as can immunisation. Recently changes in MRI scans have been found in some patients. There have been cases of CFS reported in children of eight or even younger, although many sufferers are women aged between 25 and 45.
Is Stress a Factor?
Stress is a significant factor, especially as a catalyst in the final stages of development and identification of the condition, affecting as many as 80 per cent of patients. CFS is more likely to afflict those people who drive themselves on to achieve at work and in life generally. Psychoneuroimmunological research suggests that this attitude to work, among other things, inhibits the production of T-cell lymphocytes by the immune system. These cells are extremely important when it comes to fending off viruses.
Understanding Chronic Fatigue Syndrome
Despite all these ideas about why and how the disease occurs, it can be difficult to get to grips with the concept of chronic fatigue syndrome. A useful analogy is to imagine the body's energy distributed between two bank accounts - a current account and a deposit account. A person who develops chronic fatigue syndrome has been, in effect, running the current account off the deposit account for a prolonged period so that the latter has become critically low in funds. When the body next falls prey to infection, the extra resources needed by the immune system for recovery are simply not there. The patient therefore becomes chronically tired and develops sub-acute symptoms instead of recovering.
Diagnosing CFS
Many people suffering from chronic fatigue syndrome look surprisingly well. An examination is necessary but will probably not reveal conclusive evidence. The lymph glands in the neck, under the arms or in the groin may be tender and swollen; the throat may be inflamed; or muscles may be tender. Many diseases that display similar symptoms to those of CFS have to be ruled out: these include infections such as Brucellosis, toxoplasmosis, tuberculosis, AIDS and Epstein-Barr virus (which is responsible for glandular fever); Anaemia; certain forms of Cancer; endocrine abnormalities such as Addison's Disease and Cushing's syndrome; Thyroid Problems; liver disease; multiple sclerosis; Epilepsy; auto-immune problems; drug addiction; alcoholism; Depression; Anxiety and conversion disorders.
Recovering from Chronic Fatigue Syndrome
As with the disease itself, controversy surrounds the treatment of chronic fatigue syndrome. Most practitioners recommend rest, but some - especially those in the field of psychiatry - believe that a graded exercise programme is the answer. Confusion arises perhaps because recovery from CFS is a two-stage operation.
If you are suffering from this condition, you should rest. To return to the bank account analogy, rest is necessary in the first phase of your recovery until the deposit account starts to be replenished. You may have become ill in the first place because you failed to recognise the body's signals that reserve energy supplies were being depleted. So, you will have to learn what you are capable of in order to determine a level of activity - either in terms of the amount of time that you can sustain an action or the distance you can cover, if you are walking for example. This will enable you to pay back the deposit account and start to recover. At the beginning of your recovery, you should only use 50 per cent of the energy you are capable of expending before you become tired. It may be necessary to take to your bed for a few days or even a week or two. If you can walk 200 metres before getting tired, for example, and then you feel tired or even ill for a couple of days, the next time you should attempt only 100 metres. If this is still too tiring, walk 50 metres the next time. You are thus leaving some energy in reserve with which to repay the deposit account. Once you are confident this is happening you can increase the proportion of possible energy you can use before tiring to 75 per cent. You should stay at this level until you reach the second phase of your recovery.
You will eventually get to the point when the deposit account can support the current account again. What this means in practical terms is that if you overdo things, you will not experience such great tiredness or for as long as you would have done before.
You should now consider an exercise programme that gently and gradually increases your level of activity. It is important to avoid the harmful effects of inactivity on muscles and the respiratory and cardiovascular systems. Also, you should not seek to avoid situations or activities that were the apparent cause of your illness.
Walking is good exercise to start with. You should be able to walk about seven or eight kilometres without suffering any ill-effects before you can progress to a good form of all-round exercise such as swimming or cycling. You have now reached stage two of your recovery from CFS and the deposit account has at least 60 per cent of its funds restored. You should be thinking more clearly and be able to read or even study for much longer periods than at the outset of your recovery. You should be able to tackle situations in which you would have previously become ill. Do not be concerned about ordinary tiredness. This may well be a sign that your muscles are not doing as much work as they are capable of rather than the fact that they have done too much. If, however, you develop some of the symptoms associated with your illness, such as a fever or swollen glands, then these are signs that you have done too much and that you need to slow down. But even then, you will not sink as low as you would have done before and your recovery will be quicker.
It is always important to remember that most people recover from chronic fatigue syndrome, regardless of how debilitating it was in the beginning. Recovery can be a lengthy process, however, and you will need enormous amounts of energy, determination, patience and time. Consulting a practitioner who specialises in treating CFS can be of particular value. Recovery can be a very frustrating business. There is an extremely fine line between overdoing it and therefore experiencing a return of the symptoms of your illness and not doing enough so that you become discouraged by a lack of progress.
Decisions about work will be among the most difficult issues you have to tackle. If you have suffered a moderate to severe attack of chronic fatigue syndrome you may only be able to work for half a day at most while you are recovering. Many patients find that going to work in the morning, coming home and resting after lunch, and then doing a little more work from home later in the day means that they avoid having to drive themselves on through a whole day. This sort of struggle when their bodies were telling them to slow down was possibly the reason for their illness in the first place.
Top-class athletes sometimes find that the constant stress of having to maintain fitness levels that enable them to compete eventually causes their immune systems to break down. Alternatively, common viruses may "wear down" the immune system so that another factor, such as environmental pollution, is the final straw in inducing chronic illness. The removal of both mental and physical stress is therefore very important before recovery from CFS can begin. This may necessitate the resolution of long-standing conflicts in your life.
Treating Chronic Fatigue Syndrome
There are no drugs to deal with most of the viruses associated with CFS, and indeed some of those present are not the cause of the illness but one of the effects. Treatment therefore concentrates on strengthening the immune system by a variety of methods.
- Constitutional homeopathic treatment by a qualified practitioner may help recovery from CFS.
- The stimulation and detoxification of the body's metabolic processes is important in supporting the immune system. Measures include the control of hypoglycaemia, hyperventilation and the proliferation of candida infection. Eating whole foods is recommended, especially organically grown ones, in order to eliminate chemicals and dietary toxins from the body. Dietary planning such as the twice a week rule is helpful. (All foods belong to one of five types and you should eat food from each group no more than twice each week.) A special diet that includes alfalfa tablets, acidophilus capsules and psyllium husks can help to cleanse the colon, but it is wise to consult a doctor before embarking on this. Drinking up to 10 glasses of water each day (filtered or boiled unless you are sure that your water supply is good) is also recommended.
- Gentle exercise that stretches the muscles, callisthenics or yoga will stimulate the lymphatic system.
- The Alexander Technique may be of benefit to chronic fatigue syndrome patients, many of whom have back and joint problems.
- Stimulation of the circulatory system by means of dry-skin brushing is also recommended. Sit with your legs higher than the level of your bottom and, using a (bristle) bath brush and a flicking motion, brush the skin up to the chest (do not brush the face or any areas of skin eruption). Do this for two minutes, before rather than after a bath.
- Food allergies need to be identified and eliminated. They can be detected by a method known as Enzyme Potentiated Desensitisation (EPD). Extracts of foods are combined with an enzyme that stimulates the immune system to respond to the foods. This is administered by injection or by scratching the skin.
- Two dietary supplements have been shown to help those with CFS: a mixture of fish and plant oils, such as marine oils and gamma-linolenic acid (GLA); and magnesium. Other supplements may be recommended, including multivitamins and minerals, vitamins B5, B6, C, D and E, iron, copper, zinc and selenium, and beta carotene. A combination of pycnogenol, malic acid, CoQ10 and carnitine has been found to be beneficial in some people.
- Conventional medicine prescribed for CFS includes antidepressants, which can be of value in the short term for the treatment of any depressive disorder that may accompany CFS.
CFS and Pregnancy
A pregnant women may worry that she will be unable to cope with pregnancy and the effects of chronic fatigue syndrome and that the complaint will adversely affect her baby. There is no evidence to suggest that CFS is inherited, although it is possible that some of the factors believed to be instrumental in causing the disease, such as poor diet, allergies, toxic overload, candida infection and Stress, may be passed on. If a pregnant women follows the guidelines for recovery, however, this is less likely. Pregnancy does not appear to make the condition worse; in fact, in some instances symptoms seem to improve. It is, however, very important to make plans for after the baby is born so that rest periods can be maintained, especially if there are other children to be looked after.
Homeopathic Treatment
As we have seen, recovery from chronic fatigue syndrome involves a sustained campaign of energy replenishment and lifestyle changes. Some patients benefit greatly from healing or bio-energy treatments. By far the best course of action from the point of view of homeopathic treatment is to consult an experienced practitioner for constitutional treatment. However, in the meantime, specific remedies can be self-prescribed in the 30c potency and taken twice a day for up to 14 days.
- Natrum mur.
For swollen, painful glands in the neck; muscular pain; all-over aches that are worse for stress; difficulty in articulating; great tearfulness, especially premenstrually; premenstrual depression and irritability; confusion; dizziness; itchy scalp and hair loss; headache with fever; pain going from the back of the head to the front; tired eyes; blurred vision; digestive acidity; flatulence; numb fingers; irritable bowel syndrome; thrush.
Generalities: in women, all symptoms may be worse and there is weakness and weariness premenstrually; muscular tension.
- Calcarea
For swollen glands in the groin and swollen, painful glands in the neck; constant chilliness; painful joints; weakness after the slightest exertion; poor memory; depression; great anxiety; great tearfulness; panic attacks; confusion; itchy scalp; pain going from the back of the head to the forehead; burning pains in the sides of the head; bloated stomach; cramping abdominal pains; numb fingers; aching arms; insomnia; thrush.
Generalities: in women, all symptoms may be worse premenstrually.
- Arsenicum
For constant chilliness; painful joints and muscular pain; all-over aches and burning pains with stiffness, all of which are worse for stress; weakness after the slightest exertion; panic attacks; great anxiety; depression; poor memory; dizziness after the slightest exertion; headache with fever; migraine; sore, tired eyes; blurred vision; numb fingers and toes; aching arms; insomnia; breathlessness; irritable bowel syndrome.
Generalities: fainting in the morning.
- Belladonna
For swollen glands in the groin; swollen, tender glands in the neck; muscular pain and painful joints; all-over aches and burning pains that are worse for stress; constant sore throat; confusion; great anxiety; difficulty in concentrating; poor memory; difficulty in articulating; dizziness; headache with fever; pain in the temples; migraine; burning pain in the sides of the head; sore eyes; flatulence; cramping abdominal pains; insomnia; thrush.
Generalities: in women, premenstrual weakness and weariness.
- Lycopodium
For swollen glands in the neck; painful joints and muscular pain; all-over aches and stiffness that are worse for stress; constant sore throat; poor memory; difficulty in articulating; difficulty in concentrating; anxiety; tearfulness, especially premenstrually; premenstrual irritability and depression; dizziness; itchy scalp and hair loss; pain in the temples; sore, tired eyes; bloated stomach; flatulence; cramping abdominal pains; numb fingers; aching arms; irritable bowel syndrome.
Generalities: in women, all symptoms may be worse premenstrually.
- Pulsatilla
For swollen glands in the groin and neck; painful joints and muscular pain; all-over aches that are worse for stress; difficulty in articulating; great tearfulness and depression, especially premenstrually; dizziness that is worse premenstrually; headache with fever; pain in the temples; migraine; sore eyes; blurred vision; flatulence; cramping pains; breathlessness; numb fingers; aching arms; irritable bowel syndrome; thrush.
Generalities: fatigue that is better for eating but worse premenstrually; muscular tension.
- Lachesis
For swollen glands in the groin and neck that are worse for stress; constant sore throat, especially on the left side; confusion; depression; poor memory; difficulty in articulating; difficulty in concentrating; premenstrual dizziness; hair loss; headache with fever; pain going from the back of the head to the forehead; sore eyes; numb toes; aching arms; insomnia; irritable bowel syndrome.
Generalities: in women, all symptoms may be worse premenstrually.
- Nux
For constant chilliness; painful joints; all-over aches that are worse for stress; confusion; premenstrual irritability; difficulty in concentrating and articulating; dizziness; headache with fever; migraine; sore eyes; blurred vision; flatulence; cramping abdominal pains; irritable bowel syndrome; thrush.
Generalities: fainting in the morning; muscular tension.
- Mercurius
For swollen glands in the groin and swollen, tender glands in the neck; painful joints and muscular pain; all-over aches; constant sore throat; weakness after the slightest exertion; offensive-smelling perspiration; intolerance of heat and cold; confusion; panic attacks; great tearfulness; poor memory; pain going from the back of the head to the forehead; sore eyes; flatulence; numb toes; aching arms; insomnia; dribbling on the pillow during sleep; thrush.
- Phosphorus
For swollen glands in the neck; constant chilliness; painful joints that are worse for stress; weakness after the slightest exertion; confusion; panic attacks; premenstrual tearfulness; poor memory and difficulty in concentrating; dizziness; hair loss; burning pains in the sides of the head; tired eyes; flatulence; irritable bowel syndrome.
Generalities: fatigue that is better for eating; muscle tension.
- Sepia
For swollen glands in the neck; all-over stiffness that is worse for stress; weakness after the slightest exertion; numbness in the throat; premenstrual irritability; tearfulness; difficulty in concentrating; poor memory; difficulty in articulating; hair loss; migraine; sore, tired eyes; digestive acidity; flatulence; thrush.
Generalities: fatigue that is better for eating and worse premenstrually; muscular tension.
- Causticum
For constant chilliness; muscle pain and painful joints; all-over stiffness; weakness after the slightest exertion; premenstrual irritability; great tearfulness; anxiety and depression; difficulty in concentrating; poor memory; blurred vision; aching arms.
Generalities: fatigue that is better for eating; great weakness after the loss of a loved one.
- Kali carb.
For swollen glands in the groin and neck; constant chilliness; painful joints; numbness in the throat; panic attacks; anxiety; difficulty in articulating; hair loss; pain in the temples; pain going from the back of the head to the forehead; migraine; blurred vision; bloated stomach; flatulence; breathlessness; insomnia; irritable bowel syndrome.
Generalities: in women, all symptoms may be worse premenstrually.
- Carbo veg.
For swollen, tender glands in the neck; all-over aches and burning pains; confusion; anxiety; difficulty in concentrating; hair loss; pain going from the back of the head to the forehead; sore eyes; bloated stomach; flatulence; abdominal cramping pains; thrush.
Generalities: fainting in the morning.
- China
For painful joints; weakness after the slightest exertion; great anxiety; depression; headache with fever; pain in the temples; pain going from the back of the head to the forehead; migraine; digestive acidity and bloated stomach; flatulence; insomnia.
Generalities: premenstrual weakness. |
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