Nutricise.com (May 24, 12:35 AM) We Americans are a tired bunch. We work hard, play hard and rarely give ourselves the rest and relaxation we need to fully recuperate from our busy lives. But sometimes being tired is a sign of a bigger problem, such as chronic fatigue syndrome (CFS). But how do you know if you have it or are just overworked? Doctors say it's hard to tell.
"CFS is a poorly understood disorder," says Joseph A. Bellanti, M.D., a professor of pediatrics and microbiology-immunology and director of the International Center for Interdisciplinary Studies for Immunology at Georgetown University School of Medicine. "Symptoms include profound fatigue that lasts for at least six months, often beginning abruptly after an acute viral infection, although symptoms are also associated with a stressful period of time, such as going through a divorce or dealing with a difficult situation at work."
The disorder affects 3 out of every 1,000 people, according to Bellanti, and it's more prevalent in women—especially between the ages of 30 and 50—than men. "There's a 3 to 1 ratio of women to men," says James F. Jones, M.D., a senior staff physician at National Jewish Medical and Research Center and professor of pediatrics at the University of Colorado Medical School.
Although no one knows what causes CFS, also called the "yuppie flu," there are many theories. Some experts believe it's primarily caused by a dysfunction of the immune system or that CFS is the result of neurally-mediated hypotension (NMH), or very low blood pressure, which is why something as simple as salt can help relieve some of the symptoms. Still others, like Bellanti, believe there is a nutritional or metabolic problem, whereby people have a depletion of ATP, the chemical that stores energy in your body. "In this case, the batteries are literally so low that the brain and muscles are being deprived of energy," says Bellanti. "This can be caused by stress or nutritional deficiencies or chronic viral infection." Most experts agree the cause is probably a combination of all three.
Unfortunately, because no one knows the cause, no definitive diagnostic tests are available. So along with taking into account a patient's medical history and doing a physical examination, doctors must rule out other causes of fatigue to make an accurate assessment. "It's a disorder of exclusion," says Bellanti. "You want to rule out anemia or low thyroid function, which is also very common in women."
According to Jones, one of the ways to help determine if a person has CFS is to see if he or she has at least four of the following eight symptoms:
1. a sore throat
2. tender lymph nodes
3. headaches
4. muscle aches
5. joint aches
6. unrefreshing sleep
7. trouble with concentration and memory
8. increased symptoms with physical activity
Once a diagnosis is made, doctors typically recommend lots of rest, healthy eating, light exercise and stress reduction to help alleviate symptoms. Bellanti says that a number of people with CFS require antidepressants, such as Prozac, to help with feelings of depression. The good news is that the disorder is usually temporary. "For the most part, symptoms are present for six months to a year or two," says Bellanti.
