In this blog will briefly discuss the different symptoms of Chronic fatigue syndrome (CFS) its clinical diagnosis and different treatment options.
Chronic fatigue syndrome is a medical condition and its diagnosis is based on the clinical picture. CFS there is no specific blood test or any specific laboratory evaluation or imaging study that makes a diagnosis. It may help to understand and evaluate and to rule out other disease process. Example- to rule out anemia or thyroid dysfunction causing the symptoms. According to the Center of Disease control they have stated few criteria for the diagnosis of CFS:
(A) Person has severe fatigue lasting for 6 months or longer and is not relieved with rest and is not associated with other medical or mental illness. This is a key manifestation and in conjunction with other symptoms
(B)One may have 4 or more other symptoms listed below on top of above severe fatigue then person may have Chronic fatigue syndrome
Enlarged or tender neck or arm pit (axillaries) lymph nodes.
Frequent sore throat
Impaired short-term memory or concentration
Multiple join pain but has no swelling or any redness
Headache new pattern
Post-expressional fatigue lasting for more than 24 hours.
When above criteria is fulfilled one is considered to have the chronic fatigue syndrome.
There is no one specific treatment that works for all. It needs to be individualized treatment approach. So there are multimodality approach is used. Uses of pharmacological and non-pharmacological treatment options are use. Based on the view of the author integrative medical treatment approach works the best in this kind of situation. Which includes the standard medical approach for evaluation of the CFS and adding other alternative medical treatment modalities. Alternative treatment modalities like Ayurveda (Traditional Indian Medicine), Yoga, Pranayama, Herbs, dietary modification, relaxation, improvement of the sleep and life style may help to improve the symptoms. This is a big topic and will discuss in the blog separately.
The three key drugs that are FDA approached for the treatment of Fibromyalgia is Lyrica (pregabalin), Cymbalta (duloxetine) and Savella (milnacipran). It is helpful in controlling the symptoms but do have many side effects on long run, one needs to know about it. Medication may need to control the symptoms in many cased also. The dose needs to be adjusted periodically with clinically been monitored as one gets better. The goal should be to be on the least amount of dose or is off the drug at some point if possible. It may be possible in some patient and some not. As CFS is a chronic disease or condition and long-term efficacy and side effects of the drugs over 10-20 years is not known.
If you or loved one has CFS not all physicians are comfortable taking care of the disease. It is a complex disease. It will be good to talk to your primary care about it and see who would be best for this condition in your area or if chronic fatigue clinics are in your area. One needs to find a physician who can spend time and understand the on going disease process individually and help mange it. Patient also has to do his/her share to improve further. A long-term relationship needs to be developed with the healthcare provider. It takes many months to show improvement so be patiently waiting for a while the treatment is going on. This is specially if one has the symptoms more than 3-5 years