Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a serious, long-term illness that affects many body systems. People with ME/CFS are often not able to do their usual activities. At times, ME/CFS may confine them to bed. People with ME/CFS have severe fatigue and sleep problems. ME/CFS may get worse after people with the illness try to do as much as they want or need to do. This symptom is known as post-exertional malaise (PEM). Other symptoms can include problems with thinking and concentrating, pain, and dizziness.
Causes
Scientists have not yet identified what causes myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). It is possible that ME/CFS has more than one cause, meaning that patients with ME/CFS could have illnesses resulting from different causes. In addition, it is possible that two or more triggers might work together to cause the illness.
Some of the areas that are being studied as possible causes of ME/CFS are:
Infections: People with ME/CFS often have their illness begin in a way that reminds them of getting the flu. This has made researchers suspect an infection may trigger ME/CFS. In addition, about one in ten people who become infected with Epstein-Barr virus, Ross River virus, or Coxiella burnetti will develop a set of symptoms that meet the criteria for ME/CFS. People with these infections who had severe symptoms are more likely than those with mild symptoms to later develop ME/CFS symptoms. But not all people with ME/CFS have had these infections.
Immune system changes: It is possible that ME/CFS is caused by a change in the person’s immune system and the way it responds to infection or stress. ME/CFS shares some features of autoimmune illnesses (diseases in which the immune system attacks healthy tissues in the body, like in rheumatoid arthritis). For example, both ME/CFS and most autoimmune diseases are more common in women and both are characterized by increased inflammation. However, other signs of autoimmune disease, like tissue damage, are not found in patients with ME/CFS.
Stress affecting body chemistry: Physical or emotional stress affects the hypothalamic-pituitary-adrenal axis (HPA axis). The HPA axis is a complex network that controls our body’s reaction to stress and regulates a lot of body processes such as the immune response, digestion, energy usage, and mood. This occurs through connections between two glands of the nervous system (hypothalamus and pituitary) and adrenal glands. The glands release various hormones, like corticotrophin-releasing hormone (CRH), cortisol, and others. When these hormones get out of balance, many body systems and functions, like the immune response, can be negatively affected. Cortisol, also called “the stress hormone,” helps to lower inflammation and calm down the immune system. Low levels of cortisol thus may lead to an increase in inflammation and chronic activation of the immune system. Patients with ME/CFS commonly report physical or emotional stress before they become ill.
Changes in energy production: Scientists found differences between people with ME/CFS and healthy people in the way cells in their bodies get their energy. However, more studies are needed to figure out how these findings may be contributing to the illness.
Possible genetic link: Members of the same family sometimes have ME/CFS. Studies done in twins and families suggest that both genes and environment might play a role in ME/CFS. Scientists have not yet found the exact genes or other factors from the environment that may be responsible. More research is needed.
Symptoms
Three primary symptoms are required for diagnosis:
- Greatly lowered ability to do activities that were usual before the illness. This drop-in activity level occurs along with fatigue and must last six months or longer. People with ME/CFS have fatigue that is very different from just being tired.
- Worsening of ME/CFS symptoms after a physical or mental activity that would not have caused a problem before illness. This is known as post-exertional malaise (PEM). People with ME/CFS often describe this experience as a “crash,” “relapse,” or “collapse.” During PEM, any ME/CFS symptoms may get worse or first appear, including difficulty thinking, problems sleeping, sore throat, headaches, feeling dizzy, or severe tiredness. It may take days, weeks, or longer to recover from a crash. Sometimes patients may be house-bound or even completely bed-bound during crashes. People with ME/CFS may not be able to predict what will cause a crash or how long it will last.
- Sleep problems. People with ME/CFS may not feel better or less tired, even after a full night of sleep. Some people with ME/CFS may have problems falling asleep or staying asleep.
In addition to these core symptoms, one of the following two symptoms is required for diagnosis:
- Problems with thinking and memory. Most people with ME/CFS have trouble thinking quickly, remembering things, and paying attention to details. Patients often say they have “brain fog” to describe this problem because they feel “stuck in a fog” and not able to think clearly.
- Worsening of symptoms while standing or sitting upright. This is called orthostatic intolerance. People with ME/CFS may be lightheaded, dizzy, weak, or faint while standing or sitting up. They may have vision changes like blurring or seeing spots.
Many but not all people with ME/CFS have other symptoms.
Pain is very common in people with ME/CFS. The type of pain, where it occurs, and how bad varies a lot. The pain people with ME/CFS feel is not caused by an injury.
Some people with ME/CFS may also have:
- Tender lymph nodes in the neck or armpits
- A sore throat that happens often
- Digestive issues, like irritable bowel syndrome
- Chills and night sweats
- Allergies and sensitivities to foods, odors, chemicals, light, or noise
- Muscle weakness
- Shortness of breath
- Irregular heartbeat (www.cdc.gov).
Treatment of ME/CFS
There is no cure or approved treatment for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). However, some symptoms can be treated or managed. Treating these symptoms might provide relief for some patients with ME/CFS but not others. Other strategies, like learning new ways to manage activity, can also be helpful.
Patients, their families, and healthcare providers need to work together to decide which symptom causes the most problems. This should be treated first. Patients, families, and healthcare providers should discuss the possible benefits and harms of any treatment plans, including medicines and other therapies.
Healthcare providers need to support their patients’ families as they come to understand how to live with this illness. Providers and families should remember that this process might be hard on people with ME/CFS.
Home Remedies for CFS
Ginseng: Ginseng has long been known to prevent stress, which is considered a common cause of chronic fatigue syndrome. Also, ginseng is beneficial for vitality and alertness, so it is commonly used for people suffering from exhaustion, both mental and physical. It also has a wealth of antioxidants, making it good for boosting immunity against any infections that may cause CFS (www.cambridge.org).
Alfalfa: This herb can increase appetite and improve digestion, which provides the body with energy and increased functionality to combat the symptoms of CFS. Alfalfa can improve cognitive ability and reduce anxiety and stress. Since hormonal production may be compromised by CFS, the hormonal boost that comes from alfalfa can counter that and keep the body’s systems functioning normally (www.liebertpub.com).
Astragalus: Astragalus boosts vitality and provides bursts of energy, which counters the general weakness of the muscles and body if you suffer from severe CFS. It also has impressive immune system-boosting effects, working to prevent bacterial and viral infections. Astragalus shortens the recovery period after illness or surgery, preventing the compounded weakness of illness and CFS.
Maca Root: Maca root is rich in B-vitamins, which are known to positively affect the adrenal and pituitary glands, two of the important hormone-producing glands in the endocrine system. By regulating hormones with maca root, you can be sure that your energy levels and organ functionality are at ideal levels.
Supportive Links:
“Diagnosis and Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.” Evidence report/technology assessment 219 (2014): 1.
https://pubmed.ncbi.nlm.nih.gov/30313001/
“The impact of energy modulation on physical functioning and fatigue severity among patients with ME/CFS.” Patient education and counseling 77.2 (2009): 237-241.
https://www.sciencedirect.com/science/article/abs/pii/S0738399109000871
“Beyond myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) symptom severity: Stress management skills are related to lower illness burden.” Fatigue: biomedicine, health & behavior 1.4 (2013): 210-222.
https://www.tandfonline.com/doi/abs/10.1080/21641846.2013.843255
Note: “Western Pharmaceutical” is defined as a system in which medical doctors and other healthcare professionals (such as nurses, pharmacists, and therapists) treat symptoms and diseases using drugs, radiation, or surgery. Quote from National Cancer Institute: http://www.cancer.gov
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