CHRONIC

FATIGUE

SYNDROME

Introduction:

Chronic Fatigue Syndrome-CFS is a debilitating and complex disorder characterized by profound fatigue that is not improved by bed rest and may be worsened by physical/ mental activity. Persons with CFS most often function at substantially lower level of activity than they were capable of before the onset of illness.

Also complain like weakness, muscular pain, impaired memory/ mental concentration, insomnia and post-exertional fatigue lasting for more than 24 hours. In some cases CFS persists for years. The cause has not been identified and no specific diagnostic test is available. Many other illnesses have incapacitating fatigue care must be taken to exclude known treatable conditions before diagnosing CFS.

Definition: Having severe Chronic Fatigue Syndrome of 6 months or longer duration with known medical conditions excluded by medical diagnosis. Concurrently have 4 or more of the following symptoms. Short memory Sore ThroatFatigue MalaiseMuscle Pain Joint PainHeadaches Disturbed SleepTender Lymphnodes

In addition no of other symptoms have been reported by CFS patients likeAbdominal Pain Alcohol IntoleranceBloating Chest PainChronic Cough Diarrhea Dizziness DysponeaDry Mouth EarachesArrhythmias Morning StiffnessJaw Pain PsychosomaticsNight Sweats NauseaWeight Loss Skin ProblemsDry Eyes Anorexia

Most common reported CFS symptoms are sore throat, fever, muscle pain & weakness, forgetfulness and depression.Similar Medical Conditions: No of illnesses have similar spectrumof symptoms as CFS this include Fibromyalgia, Encephalomyelitis, Neurasthenia & Mononucleosis. Chronic fatigue is associated with all of them.

Other clinically defined, frequently treatable illness that can result in chronic fatigue like Hypothyroidism, Sleep Apnea, Depressive Disorders, Schizophrenia, eating disorders, Cancer, Auto Immune disorders, Obesity, Alcohol, drug reactions.Incidence: In developed societies about 6-8 people per 100000 of above 18 yrs of both sexes have CFS needs medical care.

WHO Report-1990 says USA is having more than half million cases of CFSunder medical care similar no of unreported cases. Now the no might have been doubled in 10 years for various socio-economic conditions.

Causes: Remain unknown. May be the result of multiple precipitating factors like viral infections, transient traumatic conditions, stress and toxins.

A. Infectious Agents: Viral & infectious agents might have a role.

B. Immunology: CFS may be due to Immuniological dysfunction like improper production Cytotoxins, altered immune functions. CFS patients are more likely to have a history of allergies than healthy patients.

C H P A (Hypothalamic - Pituitary Adrenal Axis)CNS will play a vital role in CFS. Emotional stress is a predisposing factor. HPA leading to increased release of cortisol and other hormones. This influences the immune system putting impact on various body activities and systems. They may also affect several aspects of behavior.

D. Nutritional Deficiency: Though there is no published data that CFS may be due to nutritional deficiency. Many patients report intolerance of certain foods, OTCMedications, Alcohol, Artificial Sweetener suffering from CFS.Diagnosis: First step is obtaining detailed medical history, complete physical examination of the patient including mental status. Lab tests of Blood, Urine, Stools, Sputum, MRI…If no cause is identified, the physician may render a diagnosis of CFS .

Appropriate Tests for CFS:Alanine aminotransferase (ALT) Alkaline phosphotase (ALP) Blood Urea Nitrogen (BUN) ErythrocyteSedimentationRate (ESR) Thyroid Stimulating Hormone (TSH) Complete Blood Picture (CBP) Transferrin Saturation Glucose Tolerance Test (GTT) IGGE Test

Treatment: A variety of therapeutic approaches have been described as benefiting patients with CFS. Since the etiology is unknown treatment is directed at relief of Symptoms, with a goal of patient attaining overall well being. The treatment should be continued with periodical assessments and making needed changes in food, medications and life style for prolonged benefit. Currently clinicians globally use some combination of the therapies discussed below.

Non-Pharmacologic Therapy: Physical activity in appropriate amount will help a lot for CFS patients for physical & emotionalwell being under expert guidance. Avoid increasing level of fatigue. A regular manageable daily routine is best, rather than a “push-crash” phenomenon leading to over exertion. Massage, Acupuncture, Chiropractic, Self-Hypnosis may give euphoric feeling, but self generated regular activity with exercise with the guidance of doctor will go a long way in CFS

Pharmacological Therapy:

Is directed to the specific symptoms experienced by the patients. CFS patients are sensitive to many medications, especially those influence CNS. Start the medication with low doses and increase gradually is well tolerated. Many a time medications lead to new symptoms which have to be observed closely and corrective remedies has to be taken under medical supervision.

Caution has to be exercised with NSAIDs, Tricyclic anti-depressants, Anxiolytic agents, Anti-microbials, allergy treatments, anti-hypotensive remedies and drugs used for Cardiac Arrymythia.

Experimental Drugs & Treatments:

Ampligen- is a synthetic nucleic acid designed to stimulate the production of interferon-immune response modifier having anti-viral activity. Majority who received

Well tolerated some reported adverse reactions like liver damage etc and still incompletely characterized. Vitamins, Co-enzymes & Minerals:Preparations are beneficial to CFS patients include adenosine monophosphate, co-enzyme Q-10, Germanium, Glutathione, Iron, Magnesium Sulphate, Melatonin, NADH, Selenium, l-tryptophan, Vit. B12, C, A and Zinc.

Herbal Preparations:Plants are known source of many pharmacological active ingredients. Preparations that have been claimed to have benefit to CFS patients are Astragalus's, Borage seed oil, Brome lain, Comfrey, Echinacea, Garlic, Ginkgo Biloba, Ginseng, Primrose Oil, Quercetin, St. John’s wort and Shiitake mushroom extract are some of the remedies with satisfactory results.

Herbal Drugs for C F SBotanical Species Common Name• Acorus Calamus Vacha

• Adhotoda Vasika Vasaka

• Aaegle Marmeolus Bilwa

• Alium Sativum Lasuna

• Alianthus Exelsa Madala

• Casia Fistula Aragwada

• Carum Carvi Krishna Jeerakam

• Corrandrum Sativum Dhanyaka

• Curcuma Longa Haridra

• Curcuma Zedorika Daruharidra Contd...

1. Cuminum Cyminium Jeera

3. Cyperus Rotundus Musta

5. Ferula Narthax Hingu

7. Glycorriza Glabra Yastimadhu

9. Piper Longum Pippali

11. Piper Nigrum Maricha

13. Plumbago Zeylanica Chtraka

15. Sida Ritusa Bala

17. Sparanthus Indica Mundi

19. Terminalia Chebula Haritaki

21. Tinospora Cardifolia Guduchi22. Gingeber Officinalis Ardraka

It has been observed that there are many reasons in modern society contributing to CFS like Drugs, Diseases, Disorders, Stress & Strain, Life Style, Occupational HazardsDrugs:Pain Killers, Steroids used in wide variety of conditions like Asthma, HRT Drugs, Anti-Diabetics, Anti-Hypertensives, Anti-Arrhythmia drugs, Statins used in Hypercholestremia, Anti-Cancer Drugs, Psychotropic Drugs etc.

Diseases: Like Asthma, IHD, Hypertension, Hypercholestremia, Disorders: Hyper/ Hypo Thyroidism, Diabetes, Hormonal Imbalnces, Obesity, Auto-Immune diseases. Family planning treatments etc.Stress & Strain: Stress & Strain due to financial loss, loss of near & dear, professional failures, accidents etc leads to CFS and needs professional/ spiritual help in facing the stress & strain for people who are undergoing it for various reasons.

Occupational Hazards:People are working in occupations where they have to expend lot of physical energy continuously for years together like lathes, ovens, boilers, high temperature zones leading to dehydration, Chemical industries, Leather tanneries, mines in 100s of meters below the ground, people working in very high altitudes, Para troopers, pilots, combat air crafts, Nuclear exposing, Radiographers, cosmonauts, Sub-marine staff, deep sea divers, mountaineers etc.

Life Style: Sedentary life styles, Lack of exercise, caloric rich food, Obesity, living continuously in ACenvironment (house/ office/ car/ malls/ meets etc) not exposing to open environment and sunlight, living in high altitudes above 12th

floor, frequent prolonged air travel (jetlag)

rat race for success, over ambitious goals, irregular food habits, improper intake of water, glued to computers for 16-18 hours a day, excess watching of TV, exposing to sound pollution, hustle/ bustle of living conditions, environmental pollution etc.

Herbal based remedies are extensively tried in many parts of Europe including Germany, Cuba, China, Japan, Tibet, Korea, Vietnamand of course in India for decades for CFSwith very satisfactory results.

Based on the clinical evidence and remedies suggested in ancient Ayurvedictexts are available having Aswagandha, Bala and Satavari

Spread the wordYou may

Save a LifeBellavistan

Kovur-9848013958