Chronic Fatigue Syndrome


 

Doctors estimate nearly five million Americans have chronic fatigue syndrome (CFS).

The Division of Viral Diseases at the Centers for Disease Control (CDC)
receives 3,000 calls per month concerning the condition.

In 1987 the CDC convened in Atlanta to organize a group that would develop a working case definition and select an appropriate name for the syndrome. The group of 18 clinicians and investigators with recognized field expertise developed a consensus case definition for research purposes and agreed upon a name – the chronic fatigue syndrome.

Diagnosis of Exclusion

In 1988 the CDC published, "Chronic Fatigue Syndrome: Working Case Definition," in the Annals of Internal Medicine. According to the CDC’s definition, CFS is characterized by at least six months of persistent and relapsing fatigue that reduces average dually activities by more than 50 percent. A patient must be shown to be free of any pre-existing organic or psychiatric disease and the following non-specific symptoms must persist to qualify: chills or low grade fever, sore throat, painful lymph nodes, generalized muscle weakness, myalgia, extreme fatigue, generalized headaches, migratory arthralgia without joint swelling or redness, neuropsychological problems (confusion, depression, photophobia) and sleep disturbances.

This definition came under fire in 1990 at the CFS international conference in Los Angeles because of the exclusion clause in the CDC’s definition.

"The long list of exclusions makes it almost impossible to meet the criteria," said Dr. Don Goldenberg, Professor of Medicine, Tufts University, Boston, "basically no one would have Chronic Fatigue Syndrome by the CDC criteria."

Several psychiatric and chronic systemic conditions may produce illnesses, which resemble CFS. Therefore, physicians must rule out other conditions before labeling a patient as having the syndrome. It is recommended that a thorough search for diseases that can be diagnosed and treated be found.

In Search of a Cause

Studies have attempted to link CFS with a virus or group of viruses including the Epstein-Barr Virus (EBV), Cytomegalovirus (CMV), Herpes Simplex Viruses 1 and 2 and Human Herpes Virus 6 (HHV-6); however, to date none of these have been exclusively associated with the illness.

According to the Nov. 30, 1991, issue of Newsweek magazine, W. John Martin, chief of molecular pathology at the USC Medical Center in Los Angeles, believes he has found a spumavirus, which may cause or be an important factor in the illness. No new findings have been reported concerning Martin’s research.

The CDC hypothesizes that a combination of immunological, infectious, psychological and environmental factors interact to cause CDS symptoms, and that no single cause exists.

"Whether it’s one disease or several, one cause or more is not clear," said Dr. Walter Gunn, the CDC’s primary investigator of the syndrome.

The CDC is conducting a one million-dollar "surveillance program" in which 406 physicians have already interviewed, tested and classified nearly 300 CFS patients in Reno, Atlanta, Grand Rapids and Wichita.

According to the CDC, the onset of the symptoms is an abrupt flu-like or mononucleosis-like illness.

For most patients CFS appears to be a progressive illness—symptoms plateau early and recur with varying degrees of severity for at least six months and for some many years. It has been diagnosed in all ages, but three out of four patients are Caucasian women aged 25-45 years.

Alternative Therapies

Currently no proven scientific treatment for CFS exists; however, patients are being helped through alternative therapies such as antiviral and immunomodulating drugs, vitamins, holistic remedies, diet modifications and activity reduction.

According to Murray Susser, M.D., and Michael Rosenbaums’, M.D., book, Solving the Puzzle of Chronic Fatigue Syndrome, they believe the cornerstone to treating CFS is to boost the immune system through nutritionally oriented therapies.

"The immune system depends on nutrients for its vitality and stability. It also abhors toxins and environmental stimulants that interfere in its functioning and viability," stated Drs. Susser and Rosenbaum in their book.

They cited Zinc as the most potent immunostimulant and Vitamin A,Vitamin B-6,Vitamin C,Vitamin E, Beta-Carotene, Coenzyme Q-10, Selenium and iron as other key nutrients. 

Please view our Ultra Specific Chronic Fatigue Support Pack™

Most experts also recommend enhancing resistance by increasing overall immunity through a balanced diet, proper nutrition, adequate sleep and physical conditioning when possible.

For emotional support, patients can be advised of national and local non-profit support groups for people suffering from CFS. The groups publish periodic newsletters, provide lists of interested physicians and telephone numbers of other affected persons who can provide assistance in dealing with the syndrome.

Index of Articles