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Chronic Fatigue Syndrome (CFS)

Updated: Jun 18

Chronic fatigue syndrome, systemic load intolerance disease, myalgic encephalomyelitis, post–traumatic stress disorder - all these names define multifactorial systemic chronic diseases affecting a variety of body systems. Their main manifestation is a pronounced, but unmotivated general weakness, which for a long time deprives a person of the opportunity to actively participate in everyday life.

More than 3,000 scientific studies have shown that chronic fatigue syndrome is not a form of depression or hypochondria, but an independent somatic disease, which, if appropriate measures are not taken, leads to professional and social maladaptation.

Causes of chronic fatigue syndrome

The etiology of the disease is not exactly known. The state of chronic fatigue at the physiological level is a constant lack of energy or a violation of energy metabolism in the cells of the body. The main mechanisms of the syndrome development are the following:

  • excessive accumulation of lactic acid as a result of physical exertion;

  • insufficient oxygen supply to tissues;

  • disorders of cellular metabolism;

  • reduction of the number of mitochondria involved in energy metabolism;

  • change in immune status: an increase in the level of antiviral antibodies, endorphin and interferon, a decrease in the number of natural killer cells - leukocytes that protect the body from the effects of viruses;

  • decreased function of the hypothalamus and pituitary gland;

  • thyroid and adrenal hormone deficiency;

  • dysbiosis of the large intestine.

  • genetic factors.

The main causes of the development of chronic fatigue syndrome

  • Bacterial, viral and fungal infections.

  • Stress, psychoemotional stress.

  • Lack of micro- and macronutrients.

  • Allergic reactions.

  • Immunosuppression.

  • Autoimmune diseases.

  • Physical and emotional trauma.

  • Poisoning with mold, pesticides and other toxins.

  • Steroid use, anesthesia, etc.

The syndrome is classified as a so-called adaptation diseases. It is assumed that a violation of the balanced activity of the neuroendocrine and immune systems of the body arises as a result of the aggressive influence of factors of modern living conditions (informational and psycho-emotional overload, environmental degradation, etc.).

According to statistics, women aged 25 to 40 are most susceptible to chronic fatigue syndrome. The prevalence of diagnosed cases in the population, according to various estimates, can reach 2% and has a steady upward trend.

Symptoms of chronic fatigue syndrome

Doctors distinguish the so-called large and small signs of chronic fatigue syndrome.

Symptoms of unexplained chronic fatigue that are unrelated to mental or physical stress, do not pass after rest and are combined with significant cognitive impairments (violation of short-term memory and / or concentration of attention, confusion) are called large. These symptoms are not associated with other medical or psychiatric conditions and manifest for six months or more. This condition largely deprives a person of habitual activity and ability to work.

Weakness after any (even minor) exercise is a characteristic sign of the disease and is a symptom complex, including fatigue, headache, myalgia, cognitive deficits and insomnia.

The duration of these symptoms is more than 24 hours. This condition can occur even after performing simple tasks (such as walking or maintaining a conversation) and requires significant lifestyle changes.

Minor signs include headache, muscle pain, joint pain, chest pain, soreness of the cervical or axillary lymph nodes (without palpable lymphadenopathy), periodic dizziness, autonomic disorders, nausea, intestinal disorders, lack of appetite, anxiety, uncertainty, apathy, emotional depression, drowsiness during the day and insomnia at night, memory impairment, subfebrile temperature, prolonged discomfort after physical or mental exertion. Many patients have thermoregulation disorders – they do not tolerate cold or heat well. In some cases, there are complaints of sore throat when swallowing, not related to colds. At the acute onset of the disease, neurological symptoms may be noted: problems with the vestibular apparatus, imbalance, hyperreaction to light and sound, soreness in the places of nerve projection.

Chronic fatigue can be accompanied by weight loss (up to 10-12 kg in two months).

Diagnosis of chronic fatigue syndrome

All the symptoms of chronic fatigue syndrome may be present in other diseases, which greatly complicates the diagnosis.

The diagnosis is made after collecting an anamnesis, a standard physical examination, according to the results of the DePaul symptoms questionnaire test and generally accepted laboratory tests, which are prescribed after consultation with the attending physician.

Treatment of chronic fatigue syndrome

To date, there are no registered medications designed to treat this syndrome.

As an option of choice for patients should be considered:

  • cognitive behavioral psychotherapy aimed at changing maladaptive psychoemotional reactions by correcting the behavior, lifestyle and thoughts of the patient;

  • exercise programs with a gradual increase in the load.

General recommended treatment methods:

  • normalization of rest and physical activity, unloading and dietary therapy;

  • physiotherapy (physical therapy, acupuncture, soothing massage, hydrotherapy, etc.);

  • sleep disorders can be regulated through relaxation techniques and improved sleep hygiene;

  • drug therapy based on the results of the patient's examination:

  • vitamin complexes,

  • daytime tranquilizers, antidepressants, sleeping pills,

  • homeopathic medicines,

  • anti-inflammatory drugs,

  • enterosorbents,

  • painkillers.

It is important to cure chronic diseases associated with insufficient oxygen supply to the body (for example, chronic runny nose or nasal congestion, anemia).


Possible consequences of chronic fatigue syndrome:

  • muscle atrophy,

  • severe depression,

  • exacerbation of chronic diseases,

  • neurosis, nervous breakdowns.

  • memory disorders, short-term and long-term amnesia,

  • digestive problems,

  • uncontrolled aggression,

  • diseases of the cardiovascular system,

  • oncological diseases.

Poor health, which generates a minimization of human activity, contributes to the development of a sense of inferiority and leads to social isolation with all negative consequences.

A decrease in the quality of life in patients with chronic fatigue syndrome leads to mental disorders, and in severe cases – to suicidal thoughts.

Prevention of chronic fatigue syndrome

General recommendations:

  • Switch to a balanced diet.

  • Lead a healthy lifestyle, which implies giving up bad habits.

  • Plan your day in advance, allocating time for work and rest.

  • Immediately contact qualified specialists in case of even minimal deterioration of health.

  • Exercise or exercise at home to maintain muscle tone.

  • Practice outdoor activities.

  • Take magnesium preparations, B vitamins, L-carnitine, if their deficiency is revealed according to the results of tests.

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