Treating Chronic Fatigue Syndrome requires a multi-pronged approach, and requires serious attention.
The diagnosis of chronic fatigue syndrome should be made only if
- Cognitive impairment like memory loss is seen
- Fatigue due to other medical illnesses have been ruled out after thorough investigations
- Fatigue lasts for six months or more.
A battery of tests is done to check for infection, malignancy and other chronic illnesses.
- Complete blood count is important to check for haemoglobin level and to decide if an infection is recent or chronic. Erythrocyte sedimentation rate (ESR) is low in people with CFS, but high in persons having long-standing infections.
- Hormonal evaluation like thyroid profile and tests to check levels of adrenaline and noradrenaline.
- Liver and kidney function tests, also electrolyte levels to detect electrolyte imbalance.
X-rays, CT scan and MRI of the brain are three important tests — your doctor may recommend one or more of them. They are useful to detect blood clots, tumours and worm infestations that have reached the brain. These tests are normal in individuals with CFS.
Other scans like positron emission test (PET) give information of blood flow to various parts of the brain.
Treatment for chronic fatigue syndrome (CFS)
The treatment is directed towards alleviating the symptoms as the cause is questionable.
- If sleep is a problem, sedatives and mild anti-anxiety drugs are prescribed. Anti-depressants are given judiciously (if depression co-exists), starting with a low dose. If daytime lethargy is a symptom stimulants like Modafinil (a drug used for improving wakefulness) can be used.
- Painkillers are important if headaches or joint pain occurs. Over-the-counter drugs or prescription medication can be given if the former don’t work.
- Antibiotics are only prescribed if a bacterial infection is suspected.
- Anti-allergic drugs are given as some people with CFS have allergies, which can lead to discomfort.
Suggested lifestyle changes for chronic fatigue syndrome (CFS)
- Caffeine, nicotine and alcohol should be avoided. If caffeine cannot be avoided it should be kept to a minimum.
- Sleep should be regulated; excessive daytime sleeping is to be strictly avoided.
- Exercise regularly up to a point where it is comfortable and do not tax yourself as it will lead to more fatigue. As your stamina increases you can increase the time and duration of the exercise.
- Social outings are important and one should not become a social recluse as it will lead to emotional stress, which is bad for you.
- Have a manageable schedule and do not aim to do everything in one day. Listen to your body, as that will be the best indicator of how much and what to do.
Consulting a psychologist may help you come to grips with the situation. Putting things in perspective will reduce depression and anxiety. Joining a support group is also an option if there is one in your locality.
Preventing chronic fatigue syndrome
If you are stressed all the time, are physically inactive and overweight you are more likely to get chronic fatigue syndrome. So take care to lead a balanced life.
Photograph via sxc.hu
Written by Dr Nisreen Nakhoda, General Physician
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