Chronic Fatigue Syndrome
Chronic Fatigue Syndrome (CFS) is characterized by unexplained moderate to severe persistent, relapsing, debilitating, disruptive fatigue of at least 6 months duration often accompanied by pain and not relieved by rest.
CFS was a previously recognized diagnosis where at least four other symptoms must be present, including painful lymph nodes, post-exertion malaise (feeling extremely run down after physical activity), nonrestorative sleep (doesn't feel like you've slept), muscle and joint pain, sore throat, poor memory, difficulty concentrating, depression, mood swings, and headaches of new severity and type. Other common symptoms are allergies, digestive disturbances, weakness, swelling, fever, night sweats, severe PMS in women, herpes breakouts, shingles, and swollen lymph nodes.
There is no single causative factor in CFS, though it is thought it may be initiated by chronic immune activation by at least on of the following infections: Epstein-Barr Virus (EBV) (one cause of Mononucleosis), mycoplasma, Coxsackie Virus, Human Herpes Virus-6 (HHV-6), Cytomegalovirus (CMV), measles, and Human T-Lymphotropic Virus-11 (HTLV-11). In fact, recently new evidence links CFS to a common pathogen that can cause acute respiratory or gastrointestinal infections, known as Enterovirus.
Researchers obtained stomach biopsies from 165 chronic fatigue syndrome patients. According to the study results published online September 13, 2007 in the Journal of Clinical Pathology, 82 percent of the samples contained enterovirus protein. Gastrointestinal complaints are considered common among chronic fatigue syndrome patients. The study also found evidence that enterovirus infection was chronic in a subset of chronic fatigue syndrome patients. There was also microscopic evidence of chronic inflammation in 157 of the 165 samples. Previous studies have linked persistent enterovirus infections with chronic myocarditis, type 1 diabetes, and neuromuscular conditions.
Enteroviral persistence remains controversial though, according to researchers. It is commonly preceded by and acute viral or bacterial throat infection thought to adequately lower one's immunity to allow Epstein-Barr Virus, Cytomegalovirus or others to proliferate like enterovirus. Thus, CFS looks similar to mononucleosis which lasts longer and is more severe.
While there is a strong infectious connection that must be ruled out in CFS there are other associations that have been noted, including allergies, chronic low dose organophosphate toxin exposure (insecticides, in particular), altered fatty acid metabolism and oxidative stress. In fact, Many CFS patients are allergic, and CFS and allergy patients often share similar immune status. It has been proposed that the simultaneous influences of allergic inflammation and immune activation may interact to produce symptoms of CFS.
What Can be Done?
Addressing factors such as proper nutrition, removing toxic exposure and other environmental insults where possible, detoxification, stress modification, adequate rest, and eliminating food allergies can help decrease the total "insult" load in people with CFS.
Allergies and inflammation appear to play an important role in CFS, so modulating these processes and shunting the immune system's attention to true infectious agents when present is a treatment goal. Individualized treatments may include eradication of infectious agents, removal of toxic exposures, detoxification, and support of antioxidant systems, repair nutritional deficiencies, decrease overall inflammation, and give treatments to improve energy, stamina, stress resistance, sleep patterns, mood, concentration, and memory.