These include: Many names have been proposed for the illness. [60] Reviews of CFS literature have found autonomic abnormalities such as decreased sleep efficiency, increased sleep latency, decreased slow wave sleep, and abnormal heart rate response to tilt table tests suggesting a role of the autonomic nervous system in CFS.
Osler's Web: Inside the Labyrinth of the Chronic Fatigue Syndrome Epidemic. [17] The US FDA has denied commercial approval, called a new drug application, citing several deficiencies and gaps in safety data in the trials, and concluded that the available evidence is insufficient to demonstrate its safety or efficacy in CFS. The CDC states:[7], "Any activity or exercise plan for people with ME/CFS needs to be carefully designed with input from each patient. [92], There is no approved pharmacological treatment, therapy or cure for CFS[7][87] although various drugs have been or are being investigated. A good outcome was associated with not attributing illness to a physical cause, and having a sense of control over symptoms. Ferri FF. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. Cognitive symptoms are mainly due to deficits in attention, memory, and reaction time. The NICE guideline covers illness management aspects of diet, sleep and sleep disorders, rest, relaxation, and pacing. [156][157], A 2015 report from the Institute of Medicine proposes the illness be renamed "systemic exertion intolerance disease" and suggests new diagnostic criteria for it. Sometimes it is diagnosed as post viral fatigue syndrome (PVFS). Although the cause of the illness remained unknown, several attempts were made to update this definition, most notably in 1994. The report concluded that although counseling and graded exercise therapy (GET) have shown some benefits, these interventions have not been studied fully enough to recommend them for all persons affected. This site complies with the HONcode standard for trustworthy health information: verify here. [126]:5 A large clinical trial known as the PACE trial found APT was no more effective than usual care or specialized medical care. Physicians, researchers and patient advocates promote different names[21] and diagnostic criteria, while evidence for proposed causes and treatments is often contradictory or of low quality. In: Goldman-Cecil Medicine. Those whose illness appears stable may gradually increase activity and exercise levels, but according to the principle of pacing, must rest if it becomes clear that they have exceeded their limits.
[8][124]
[10] The CDC estimates CFS occurs up to four times more often in women than in men. [121] In 2019, a large UK survey of people with ME/CFS reported that CBT was ineffective for more than half of people, and Graded Exercise Therapy caused deterioration in most people. [165][167], Some in the medical community do not recognize CFS as a real condition, nor does agreement exist on its prevalence. The presence of allodynia (abnormal pain responses to mild stimulation) and of extensive tender points in specific locations differentiates FM from CFS, although the two diseases often co-occur. [7][16] The CDC recommends the use of pacing (personal activity management) to reduce the worsening of symptoms resulting from mental or physical activity. This has led some to believe that stress-related visceral responses underlie CFS. While standing or sitting upright; lightheadedness, dizziness, weakness, Muscle pain, joint pain without swelling or redness, and headache, Tender lymph nodes in the neck or armpits, Allergies and sensitivities to foods, odors, chemicals, lights, or noise. The cause of chronic fatigue syndrome is still unknown. CFS/ME can also affect your mental and emotional health, and have a negative effect on your self-esteem. Persons who feel better for a period may overextend their activities, and the result can be a worsening of their symptoms with a relapse of the illness.[38]. [81], No characteristic laboratory abnormalities are approved to diagnose CFS; while physical abnormalities can be found, no single finding is considered sufficient for diagnosis. Most people with CFS get better over time, although some people do not make a full recovery. 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from May 2020, Wikipedia articles needing clarification from May 2020, Articles with failed verification from June 2020, Articles with dead external links from July 2020, Creative Commons Attribution-ShareAlike License. [10][18][9] It has been estimated that 836,000 to 2.5 million Americans and 250,000 to 1,250,000 people in the UK have CFS. CFS/ME can affect anyone, including children. Many people refer to the condition as CFS/ME. [2]:265 The rationale behind the use of CBT to change beliefs about the illness is disputed. If studies based on the Oxford criteria were excluded, there would be insufficient evidence of the effectiveness of GET on any outcome. CFS is also known as ME, which stands for myalgic encephalomyelitis. [32] Reported impairment is comparable to other fatiguing medical conditions[33] including late-stage AIDS,[34] lupus, rheumatoid arthritis, chronic obstructive pulmonary disease (COPD), and end-stage kidney disease. This content does not have an Arabic version.
[2]:183 There is agreement that CFS has a negative effect on health, happiness and productivity, but there is also controversy over many aspects of the disorder. [171][172] Historically, many professionals within the medical community were unfamiliar with CFS, or did not recognize it as a real condition; nor did agreement exist on its prevalence or seriousness.
[104] Use of a heart-rate monitor with pacing to monitor and manage activity levels is recommended by a number of patient groups and the UK's 2007 NICE guideline. The same review found biological factors such as CD4 and CD8 activation and liver inflammation are predictors of sub-acute fatigue, but not CFS,[58] however these findings are not generally accepted due to the use of the Oxford criteria in selecting patients. Myalgic encephalomyelitis and postviral fatigue states. [103], Pacing, or activity management, is an illness management strategy based on the observation that symptoms tend to increase following mental or physical exertion,[7] and was recommended for CFS in the 1980s. "[185], Much contention has arisen over the cause, pathophysiology,[51] nomenclature,[186] and diagnostic criteria of CFS. Accessed Feb. 4, 2020.
Appropriate medical intervention for these conditions may be beneficial. [203], On 29 October 2015, the National Institutes of Health declared its intent to increase research on ME/CFS. [3] The illness can occur at any age, but most frequently in persons between the ages of 40 and 60. Treatment for chronic fatigue syndrome focuses on improving symptoms. [22], The United States Centers for Disease Control and Prevention (CDC) recommends these criteria for diagnosis:[12], Additionally, one of the following symptoms must be present:[12], Many, but not all people with ME/CFS report:[12], The CDC proposes that persons with symptoms resembling those of CFS consult a physician to rule out several treatable illnesses: Lyme disease,[23][failed verification] "sleep disorders, major depressive disorder, alcohol/substance abuse, diabetes mellitus, hypothyroidism, mononucleosis (mono), lupus, multiple sclerosis (MS), chronic hepatitis and various malignancies.