Chronic fatigue syndrome (CFS)—An invisible long-term illness that affects women more than men

We often feel overtired and have an extreme lack of energy and a strong desire to sleep in. But how long does this fatigue last? Well, if this bone-crushing fatigue lasts for months, then it could be a mysterious condition known as chronic fatigue syndrome, also known as myalgic encephalomyelitis, myalgic encephalomyelitis/chronic fatigue syndrome, or ME/CFS. This deep and extreme exhaustion affects women two to four times more often than men, according to numerous studies. However, the cause of this unknown condition, which typically affects women between the ages of 25 and 45, is still unknown. Health experts claim it can also affect adolescents and children.

The US Center for Disease Control (CDC) estimates that 836,000 to 2.5 million Americans suffer from CFS, but the majority of them are undiagnosed. The United States is reported to lose between US$9 to 25 billion each year in reduced productivity and medical costs due to CFS. However, statistics on this condition in India are scarce.

What is Chronic Fatigue Syndrome (CFS)?

Chronic fatigue syndrome (CFS) is a complicated condition characterized by extreme fatigue lasting at least six months and cannot be fully explained by an underlying medical condition. According to doctors, fatigue worsens with physical or mental activity in people who suffer from this condition, but does not improve with rest. Most recently, the condition is called systemic exercise intolerance disease (SEID).

According to doctors and health experts, there is no single test to diagnose chronic fatigue syndrome. It is necessary to perform several medical tests to rule out other health problems with similar symptoms. In addition, the treatment of chronic fatigue syndrome is aimed at improving symptoms. This lack of testing often makes it difficult for doctors to describe this disease.

“Chronic fatigue syndrome is a condition involving profound fatigue that cannot be explained by any medical condition. The duration lasts at least six months and usually there is a lot of pain in the body. The patient suffering from chronic fatigue syndrome does not sleep very refreshed, is always tired and as such there is no medical condition or underlying illness to account for signs of fatigue,” Dr. Ankita Baidya, Consultant – Infectious Disease, HCMCT Manipal Hospital, Dwarka told Financial Express.com.

Decades ago, this complex condition was dismissed as a “psychological disorder” and patients were sent to psychological wards for treatment. Now doctors and health experts around the world recognize this condition as a serious long-term illness.

Possible Cause of Chronic Fatigue Syndrome (CFS)

dr. Ajay Agarwal – Director & HOD, Internal Medicine, Fortis Hospital Noida told Financial Express.com that the exact cause of chronic fatigue syndrome is still unknown, but several hypotheses are that it may be accelerated by a viral infection herpes zoster, Epstein- bar virus, and stress-induced. Meanwhile, Dr. Ankita Baidya that in most cases of CFS there is a history of viral infection.

“Post-COVID we have seen many patients who complain of chronic fatigue syndrome. Immune system imbalance, poor immunity can sometimes result in causing this condition. Hormonal imbalances are the third reason why we can see the prevalence of this condition, but usually the levels of these hormones are not in the range we need to treat them medically,” said Dr. Baidya.

She also emphasized that it has been observed that with various hormonal imbalances, especially involving the pituitary gland or hypothalamus, there has been an association with chronic fatigue syndrome and that sometimes physical or mental stress can also lead to this condition.

This complex condition affects the people who are mostly young, leaving as many as 75 percent of them unable to work and 25 percent completely bedridden. In 2009, a study published in the journal JAMA Psychiatry linked childhood trauma and CFS risk. Recently, several studies have shown that COVID-19 or post-COVID complications can also lead to CFS.

Symptoms of Chronic Fatigue Syndrome (CFS)?

Those who suffer from this mysterious condition can have a hard time performing very basic physical acts. According to doctors, chronic fatigue syndrome, as the name suggests, is usually the most common symptom of fatigue, especially after physical or mental exertion. When a person suffers from chronic fatigue syndrome, he/she feels very tired and the symptoms of fatigue last for more than six months. There are also symptoms such as memory problems and brain fog, headaches, sore throats, enlarged lymph nodes in the neck and armpits, and muscle and joint pain. There are difficulties in focusing and also dizziness when getting up from lying or sitting.

In addition, the diseases that cause similar symptoms, such as anemia, diabetes, and thyroid disease, are ruled out by the doctor before labeling a person as CFS. Some illnesses such as fibromyalgia, irritable bowel syndrome, depression, and sleep disorders can co-exist with CFS.

In addition, CFS can lead to a range of sleep disturbances when a person feels very sleepy but cannot sleep or does not feel refreshed after sleeping. They may experience problems such as:

1. intense and vivid dreams
2. restless legs
3. nocturnal muscle spasms
4. sleep apnea

A person suffering from CFS may also experience conditions such as:

1. tenderness in the lymph nodes, especially the neck or armpits
2. Gastrointestinal Problems
3. Chills and Night Sweats
4. Food Allergies
5. sensitive to light, touch, heat or cold
6. muscle weakness
7. shortness of breath
8. irregular heartbeat
9. irritability and mood swings
10. Anxiety or Panic Attacks
11. Numbness, tingling and burning sensation in hands, feet and face
eye pain
12. a slight fever
13. Vision Problems

“An important sign is that if you feel very tired, very weak, even after sleeping, you are not refreshed and still have a weakness. Another sign could be the unwillingness to do a lot of things and not having the energy to do things. Sometimes, if you suffer from dizziness, muscle aches or muscle aches. So see your doctor for chronic fatigue syndrome or any other medical condition that needs treatment,” said Dr. Baidya to Financial Express.com.

Chronic Fatigue Syndrome (CFS) in India

According to a study published in the British Medical Journal, as chronic fatigue was frequently reported by women in this community survey from India, the strongest associations with chronic fatigue were for psychosocial factors indicative of poor mental health and gender inequality.

According to experts, the diagnosis of CFS in India is quite difficult due to a lack of awareness and insufficient research. Several researchers pointed out that medical textbooks around the world contain few, if any, descriptions of this condition.

However, experts emphasize that while there is insufficient data on how many people in the country actually suffer from CFS, many people are affected by CFS and do not know what to do about the ongoing exhaustion.

Diagnosis and Treatment of Chronic Fatigue Syndrome (CFS) in India

Because there is a lack of specific tests to diagnose CFS, patients are often forced to go untreated and live with pain for years. There are cases where a doctor has seen only 4-5 cases of CFS in a decade in India.

In general, a diagnosis is made after taking a complete history, examination, and examinations of the affected person that rule out other medical or psychological conditions that may resemble CFS. According to doctors and health experts, there is no specific cure or treatment for CFS. However, symptoms that are most problematic are addressed first.

“Two things are important in the diagnosis of CFS. One is this major symptom of chronic fatigue. The second is that sleep does not relieve the symptom of fatigue and it is not refreshing, there are various body aches and pains that cannot be explained by any other health condition. Sometimes dizziness, vomiting, sometimes a typical history of viral infection. After this, they developed chronic fatigue syndrome. So all of this actually leads us to the fact that the patient may have chronic fatigue syndrome,” Dr. Baidya to Financial Express.com.

She also pointed out that by ordering certain lab tests to rule out any mental health disorder, lab abnormalities, or any other health condition that actually leads to fatigue and then labeling it as chronic fatigue syndrome.

“So treatment is usually important. One of these is psychological counseling. The second is by providing adequate nutritional supplements. Vitamin supplements such as various antioxidants like vitamin E and vitamin D sometimes help to overcome the weakness and improve overall well-being. A good, healthy diet and regular exercise, yoga and meditation can also help the patient slowly and gradually come out of chronic fatigue syndrome, she added. In addition, since the causes of CFS are still unknown, there is no way to prevent it.

Does COVID-19 lead to chronic fatigue?

dr. Baidya also stressed that chronic fatigue syndrome can affect anyone, in any age group or gender, but it tends to be more commonly seen in middle-aged women and adults.

“We had seen many cases during COVID-19, especially after the third wave, where the patient developed chronic fatigue syndrome as a major complaint after recovery,” she said.

According to a study published in Molecular Psychiatry, after being infected with COVID-19, a majority of people complain of persistent shortness of breath and fatigue, even months after the onset of the illness.

Doctors around the world have reported that chronic fatigue is one of the most commonly reported symptoms in people with long-term COVID-19, and experts argue that the increasing number of people dealing with fatigue due to COVID-19 has “a significant social impact.” can have”.

Scientists around the world investigating possible health problems after COVID-19 have found similarities between long-term COVID-19 and CFS. A 2021 study published in the journal The Lancet revealed that after six months with long COVID, participants showed common symptoms such as fatigue, cognitive dysfunction and post-exertional malaise (PEM).

At the moment there is no cure for CFS, but researchers hope that extensive research into long-term COVID can provide some crucial insights for people with CFS/ME.

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