From hibernation straight into spring fatigue: for many people, an excuse rather than a serious illness. But for an estimated 250,000 people in Germany, the phrase “I’m so excruciatingly tired” is bitter truth: They feel permanently exhausted, both physically and mentally, with symptoms worsening after exertion. Learn all about the causes, signs and treatment of this condition.
What is chronic fatigue syndrome?
In Germany and internationally, the dual name “Myalgic Encephalomyelitis/Chronic Fatigue Syndrome” and “Myalgic Encephalomyelitis/Chronic Fatigue Syndrome” have now become established for the condition, respectively. Initially, ME/CFS has a flu-like course. Patients complain of sore throat and headaches, muscle and joint pain. In addition, there are memory disturbances, which can be severe, and considerable concentration problems. A number of other symptoms, which can vary from individual to individual, such as feverish feeling, palpitations, dizziness, sleep problems and nausea are added. The clincher for the name was the debilitating exhaustion of patients over many years, which could not be eliminated even by sleep and rest. Sufferers lack the energy to perform the simplest tasks of daily life. Whether it’s making coffee or brushing teeth: Even minor efforts can aggravate the symptoms. This is known as post-exertional malaise. This can also occur with a time delay of 24 to 48 hours. In addition to the illness-related discomfort, those affected often have to accept considerable restrictions on their social environment.
Diagnosis and therapy in chronic fatigue syndrome.
The multitude of symptoms and their individual combinations is one of the reasons why the diagnosis of ME/CFS is so difficult. There is no single symptom on the basis of which the diagnosis of ME/CFS can be made. The numerous symptoms are difficult to define scientifically. The diagnosis therefore focuses on severe, prolonged exhaustion that cannot be remedied. Other diseases that cause similarly severe states of exhaustion must be ruled out. These include fibromyalgia (a rheumatic disease), leukemia (blood cancer), or psychological disorders such as depression. Since the symptoms are similar to many other diseases, it can sometimes take a long time before the correct diagnosis is made. Once all other possibilities have been ruled out, internationally accepted diagnostic criteria include the following:
- Permanent mental and physical exhaustion
- Flu-like symptoms, sore throat
- Painful lymph nodes
- Muscle discomfort
- Lack of concentration, forgetfulness
- Visual disturbances
- Sensitivity to stimuli
- Deterioration of the condition after exercise (Post-Exertional Malaise).
Not every symptom occurs with equal frequency and intensity. If many criteria come together and all other possible diseases are safely excluded, it can be spoken of ME/CFS. Studies in the U.S. show that those affected have led a particularly active life before their disease. The disease occurs particularly frequently between the ages of 10 and 19 and between 30 and 39. Women are affected twice as often as men.
Therapy of chronic fatigue syndrome.
Treatment of chronic fatigue syndrome is similarly difficult to diagnose. There is no single medication that helps. On the contrary, the gentlest possible treatment of symptoms is recommended, and the dosage of medication used is often even lower than the usual minimum dosage. Many ME/CFS patients exhibit increased sensitivity to medications. A balanced diet, regular sleep and rest periods, the rehabilitation of diseased teeth and the elimination of existing infections are all part of the treatment plan. There is currently no reliable information on the course of the disease or the chances of recovery. British researchers estimate that 35 percent of all sufferers recover slowly but steadily. However, this, and possibly complete recovery, takes years.
Coping with illness usually requires help
Great emphasis is placed on supportive mental health treatment, because sufferers need competent help in coping with their illness.After the start of treatment, there is often a phase in which the impairments are particularly pronounced: Many patients can then only lie in bed and are unable to care for themselves. The aim of treatment is not to cure ME/CFS, as the symptoms are not psychological. However, with the help of psychological treatment, the remaining energy reserves should be used as sensibly as possible. For those affected and their environment, this means adapting their lifestyle to the disease, which depends on the individual patient’s daily form and assessment. Therapy can also help people cope better with the circumstances brought on by the disease.
ME/CFS: causes and research
The exact causes of myalgic encephalomyelitis/chronic fatigue syndrome are unknown. Researchers discuss numerous variants: Viruses, fungi, or environmental toxins may be the triggers. Hormone disorders and permanent mental or physical overload are also possible. Among other things, researchers are interested in a protein that is normally produced by the body during virus defense. This protein is highly elevated in many, but not all, ME/CFS patients. However, it is still unclear whether this pathway can be used to establish viral involvement in chronic fatigue syndrome. However, some experts believe that it is a disorder similar to an autoimmune disease, which usually occurs as a result of an infection. In an autoimmune disease, the immune system directs itself against the body’s own structures, such as cells or receptors, through a misdirection. Recent studies also indicate a disturbed energy metabolism. Despite the relatively large number of people affected, extensive research on the subject is still pending.
