This is Dr. Lam.
Chronic Fatigue Syndrome is a condition of prolonged and severe tiredness or fatigue
that is not relieved by just rest, and it is not directly caused by other more acute
situations.
To diagnose with this condition, you must have the main symptoms, which are: number
one, prolonged fatigue and tired lasting at least six months, and not relieved by bed
rest.
In addition, the fatigue must be severe enough to restrict activities that normally people
do by at least 50%.
Because the symptoms of Chronic Fatigue Syndrome can be so complex, there are many, many other
various, minor symptoms that go along with it.
For example, fatigue lasting 24 or more hours after an amount of exercise that would normally
be easily tolerated.
This experience, in other words, of the body feeling drained after a normal exercise period.
Number two, there could be a feeling of unrefreshedness after you have a full night of sleep.
In other words, you wake up feeling kind of drained.
Number three, you have symptoms of forgetfulness, or brain fog, including difficulty in concentration,
as well as confusion.
Number four, there could be signs of irritability, as well as anxiety.
Number five, there could be different forms of headache that is different from previous
types of headaches.
Many people have headaches – that is one of the things that are very common – but
this kind of headache that comes with chronic fatigue is very different from the ordinary
headaches that a person usually gets.
Another one: joint pains that sometime can move from place to place, what we call migratory
arthralgias, but it does not come with any joint swelling or redness, but you have pain
of unknown origin in the joints.
One of the important symptoms that also commonly comes up is a lymph node tenderness, especially
in the neck and in the armpit.
Some people can have a mild fever of 101 degrees or less, Fahrenheit.
Of course, muscle ache, or myalgia, is common and not real well-defined in terms of its
consistent place.
Lastly, you can have muscle weakness over multiple locations not explained by any known
disorder.
The exact cost of Chronic Fatigue Syndrome is really not known.
Some people suspect some type of viral etiology, such as Epstein-Barr Virus, or Human Herpes
Virus 6, HHV-6.
However, no specific virus has yet to be identified.
It has been shown, however, that CFS may be caused by inflammation along with the nervous
system, and this inflammation may be some sort of immune response, but again, there
is no specific scientific studies to prove this as a causation factor.
Other factors such as ago, prior illnesses, stress, environmental factors, and genetic
makeup also play a role, and CFS is most common in women, occurring from age 30 to 50.
The Center For Disease Control, the CDC, describes CFS as a distinct disorder with specific symptoms
and physical signs, based on ruling out other possible causes.
It is estimated that a lot of people suffer from this condition, although the exact number
is really not known.
The differential diagnosis of Chronic Fatigue include drug dependence, immune problems,
infections, neurological symptoms such as those associated with multiple sclerosis,
endocrine diseases such as hypothyroidism, as well as heart, kidney, and liver diseases,
and many mind-body conditions with psychiatric and psychological illnesses, particularly
depression.
Also, one that is seldom looked into and not so recognized by conventional medicine is
Adrenal Fatigue, which we will address later.
The diagnosis of CFS must include a few things.
Number one is the absence of other causes of chronic fatigue, excluding depression,
and these four other symptoms that’s listed, as well extreme, prolonged fatigue.
Again, there are no specific test results to confirm the diagnosis of CFS.
Sometimes a brain MRI can show some swelling in the brain, and in the structure of some
of the nerve cells of what we call the demyelization.
As well, sometimes, there could be a high level of specific white blood cells compared
to other types of white blood cells, specifically, CD-4 T-cells versus CD-8 T-cells.
There are also specific white cells, lymphocytes, that contain the active form of EBV or HHV-6,
as we talked about earlier as a viral etiology.
The prognosis of CFS varies.
The long-term outlook is variable, it’s very hard to predict when the symptoms first
are reported, and if it's able to recover within six months to a year, then the prognosis
is better.
Otherwise, many people can go on for years, and a small number of people actually get
worse.
Treatment of CFS can include antiviral drugs, drugs to fight yeast infections, medication
to reduce pain, discomfort, and fever, medication to treat anxiety, as well as medication to
treat depression.
If you have fatigue that lasts more than a few months and fail to resolve, and it’s
getting worse, you should see a doctor and have an investigation.
Now, as we talked about earlier, in terms of the treatment, most of it is symptomatic
relief, and if it a viral cause, then some of the antiviral drugs can be helpful.
Now, if you have Chronic Fatigue, or you’re told that you have chronic fatigue, but you
don't know what the reason is and things are not getting better, than it’s time to consider
other alternatives, things outside the box.
I want to talk to you about Adrenal Fatigue and its relation to CFS today, because it
is so commonly overlooked and seldom paid attention to, not only by conventional medical
doctors, but also in the alternative field as well.
In Adrenal Fatigue, we know that collagens and protein are broken down, and the body
is usually in a catabolic state of function, and this can cause and lead to chronic pain
syndromes with joint pain, chronic fatigue, and fibromyalgia.
In other words, when your adrenals is not working well—and remember, the adrenal gland
is the one that really is the stress control center of the body—if it is not working
well, and it becomes fatigued, then the body’s ability to make cortisol is reduced, and as
a result, the body’s muscle has a tendency to be broken down for both nutrient, as well
inability to deal with the stress and strains of life.
As a result, you can have muscle pain, and pain very similar to that of chronic fatigue,
as well as fibromyalgia, as a matter of fact, on the situation.
The presentation is very confusing, including joint pain of unknown origin, muscle pain
of unknown origin, tremendous fatigue, and these do not get better with time.
If you give antiviral drugs, they will not get better, as well as anti-depressants do
not improve.
Normally, our muscles go through an anabolic and catabolic process.
This is where you have a breakdown and a rebuilding process, but in Adrenal Fatigue this process
is skewed, and there's more breakdown than building up, and as a result, not only the
muscles has broken down by the collagen structure, as well as the joint, also affected.
You know, on top of this, in Adrenal Fatigue you can have metabolites that is not able
to clear out of the body on a timely basis, and they deposit in various joints and muscles,
and cause inflammation.
Inflammation, as we know, is one of the key causes the body has to fight foreign substances
that does not belong.
In the case of metabolites that have been deposited in the muscles or the joint, they
can cause a pain.
It comes as no surprise that secondary fibromyalgia and Chronic Fatigue Syndrome are commonly
associated with Adrenal Fatigue, and especially adrenal exhaustion when it’s in stage 3,
and higher.
Many people come complaining of pain of unknown origin.
If the adrenal glands are involved, then the fibromyalgia, as well as the Chronic Fatigue
Syndrome, is actually secondary to the adrenals, and the good news is, once you’re able to
deal and help the treatment of the adrenal glands to repair and heal itself, then oftentimes
the pain from the fibromyalgia, as well as the chronic fatigue, will eventually go away
by itself, and that’s the beauty of this situation.
In other words, you fix the adrenals, and the CFS will get better.
Of course, Adrenal Fatigue can also have metabolic problems, neurological issues, hormonal system
imbalances, as well as immune system imbalances, and I'd like to encourage you, if you have
this concern, to go to my website, www.DrLam.com.
It's a free, educational website, and look for the article called “Adrenal Fatigue
Related Health Conditions.”
In this article, you will read it in full and you will see a lot of conditions, especially
CFS and how it relates to Adrenal Fatigue.
If you have any questions, you can feel free to write to me directly, or if you need personalized
attention, you can call my office.