Science topic
Chronic Fatigue Syndrome - Science topic
A syndrome characterized by persistent or recurrent fatigue, diffuse musculoskeletal pain, sleep disturbances, and subjective cognitive impairment of 6 months duration or longer. Symptoms are not caused by ongoing exertion; are not relieved by rest; and result in a substantial reduction of previous levels of occupational, educational, social, or personal activities. Minor alterations of immune, neuroendocrine, and autonomic function may be associated with this syndrome. There is also considerable overlap between this condition and FIBROMYALGIA. (From Semin Neurol 1998;18(2):237-42; Ann Intern Med 1994 Dec 15;121(12): 953-9)
Questions related to Chronic Fatigue Syndrome
Does any observer-rated measure of fatigue exist?
Chronic fatigue syndrome (also called myalgic encephalomyelitis (ME)) is a medical condition which affect a great number people (around 250.000 people have this condition according to the UK Department of Health archives (1)).
There is unfortunately no easy cure for CFS, and sometimes the most successful treatment is one of coping and symptom alleviation. It requires guidance and patient commitment.
However, research has put forward a link between CFS and the disturbance of the drainage of toxins from the brain and muscles (2). As osteopaths, we can definitely work on this aspect, but are there any other aspects where osteopathy can prove its worth?
On what should an osteopath focus specifically besides what I mentioned before when a patient presents himself with CFS?
I am a last year student at the International Academy of Osteopathy and in my two year internship that I have had so far, I found it difficult to have a good result.
(1) Annex 1: Epidemiology of CFS/ME". UK Department of Health. 2012-01-06. Archived from the original on 2012-01-06.
(2) Med.stanford.edu. (2018). Stanford Myalgic Encephalomyelitis - Chronic Fatigue Syndrome | ME/CFS Initiative | Stanford Medicine. [online] Available at: http://med.stanford.edu/chronicfatiguesyndrome.html [Accessed 08 Feb. 2018].
Patient diagnosed with CFS in 2001 was an international flight attendant with an Australian airline and has many of the symptoms of Aerotoxic Syndrome.
It seems there is little known about how to effectively treat nor to therapeutically assist people who suffer what is referred to as CFS/ME. There is high productivity cost involved for the individuals and families of those who live with this condition as it can go on for many years. There is very little research, or treatment funding. I find I often wonder how much is physiological and how much is psychological or anxiety-based? Could aspects of Aspergers, dyslexia or other psychological reactions to environmental stimuli like noise, light or colour frequencies, be having an unidentified negative effect?
Does anyone have any references or literature about fatigue mechanisms which cytokines are involved in it in none-disease subjects? Does anyone have any references about impact of cytokine on exercise/physical activity-induced fatigue or other immune system components and mechanisms which leads to fatigue delay during exercise/physical activity?
As a general practitionner mostly, and holding a vacation in a pain unit in hospital, I frequently ask myself which is the impact of telling to a patient "you have fribomyalgia" on further care, knowing that there is no specific treatment for this syndrome about which we have no proof of a specific disease reality.
I found only one study on Pubmed :http://www.ncbi.nlm.nih.gov/pubmed/12115155?log$=activity
One of our student want to make his end of studies research on this theme, but we don't have the capacity of making a cohort. We are searching if there is a study design that would allows us to help to answer this question, may be somebody here has an idea ?
Several studies have linked SIBO to chronic disease like CFS, breast cancer, prostate cancer, colon cancer, and depression. Other than antibiotics, is there an effective treatment for SIBO? What are the other alternatives?
I have found that a high proportion of chronic fatigue syndrome sufferers have mild to moderate elevations in circulating ACE levels. There is no evidence of pulmonary sarcoidosis. Macrophage abnormalities have not been reported in this setting (as far as I know), but circulatory changes and Orthostatic Hypotension have been. Low blood volumes and reduced cardiac indices have been reported and confirmed. Cytokine abnormalities, increased after exercise may be relevant. My theory is developing, and suggests NF-kB activation, suppressible by Vitamin D and DHEA supplementation, as evidenced by considerable falls in elevated serum ferritin levels, as a Type 1 Acute Phase Response, supporting the possible involvement of chronic TNF-alpha/IL-1b elevations in the circulation or from Kuppfer cells in close proximity to the liver, in these patients. I am trying to unify this concept by identifying a plausible explanation for the above mentioned long term serum ACE LEVELS.
I am referring to the amazing body of research that has been done by the late Dr. Rich Van Konynenburg, and other bodies of work and research done on this subject. It is believed that glutathione depletion causes many of the problems in Myalgic encephalopathy/chronic fatigue syndrome (ME/CFS).
Papers by Dr. Konynenburg examine ways to enhance glutathione, detoxification and energy production in ME/CFS. On the same note, there is a new line of GSH supplements (Liposome Delivery) that avoid immediate breakdown of GSH by digestion system and allows enhanced absorption into the bloodstream. Also people who are interested in detox diets are recommended to take GSH supplements. What is your opinion regarding much controversial health benefits and therapeutic effects of GSH use (defined dosage, etc.)?
A neighborhood magazine featured a story on MTHFR mutants and the regulation of folate. According to the article, Fibromyalgia is on of the syndromes associated with MTHFR gene mutations. Any validity to this?
Transient (acute) fatigue states that are readily modified by rest and/or task moderation are generally adaptive and often beneficial. Continuous exertion whilst fatigued, whether driven by internal or external pressures, is experienced as stressful and known to lead to chronic fatigue. Chronic fatigue is largely maladaptive and is being increasingly linked to adverse health outcomes. Recovery from it may be uncertain, depending on the extent to which cellular level damage it causes, is reversible. The big question is how acute fatigue translates into chronic? Lack of recovery seems to be the key factor. But what are the likely moderators? Some people are more fatigue-tolerant than others, suggesting some psychological factors at play here, over and above the physiological ones (central and peripheral). Can they be captured and measured ? What are their implications in terms of predicting individual acute-to-chronic fatigue trajectories?
Fatigue is one of the most common disease symptoms and drug side effects. What is it? Why can we not treat it?
Excluding cases where the cause is clear, such as poor nutrition, sleep disorders and anemia, what is happening in the huge range of pathologies from autoimmune fatigue, chronic fatigue syndrome, endocrine disorders, etc?
Is it happening on the cellular level or is it do with the chemistry of the brain? Apart from stimulants are there any leads on drugs to target it?
