Chronic fatigue can be a confusing term, as it can refer to both a symptom and a specific medical condition. Here's a breakdown:
Symptom: Chronic fatigue is a feeling of excessive tiredness that lasts for at least 6 months and doesn't improve with rest. This can be a symptom of various underlying medical conditions, such as:
- Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): This is a complex, long-term illness characterized by severe fatigue, post-exertional malaise (worsening symptoms after physical or mental activity), and other cognitive and physical symptoms.
- Thyroid disorders: Hypothyroidism (underactive thyroid) can cause fatigue, along with other symptoms like weight gain and difficulty concentrating.
- Anemia: This condition occurs when your blood doesn't have enough red blood cells, leading to fatigue, shortness of breath, and pale skin.
- Sleep disorders: Sleep apnea, insomnia, and restless leg syndrome can disrupt sleep and lead to daytime fatigue.
- Mental health conditions: Depression and anxiety can also cause fatigue and decreased energy levels.
Medical Condition: In specific cases, chronic fatigue itself can be diagnosed as a medical condition called Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). This condition is characterized by specific criteria, including severe fatigue, post-exertional malaise, and cognitive difficulties, that are not explained by any other underlying medical condition.
Prevalence in the United States
Estimating the exact number of Americans with chronic fatigue is challenging because it can be a symptom of various conditions. However, some studies suggest that ME/CFS affects approximately 1-2.5 million Americans.
Symptoms of Chronic Fatigue Syndrome
Common symptoms of ME/CFS include:
- feeling extremely tired all the time – you may find it very hard to do daily activities
- still feeling tired after resting or sleeping
- taking a long time to recover after physical activity
- problems sleeping, such as waking up often during the night
- problems with thinking, memory and concentration
Other symptoms include:
- muscle or joint pain
- headaches
- a sore throat
- flu-like symptoms.
- feeling dizzy or sick
- fast or irregular heartbeats
Causes of Chronic Fatigue
The exact causes of chronic fatigue are not fully understood, and it likely results from a complex interplay of factors. Some potential contributors include:
- Viral infections: Some theories suggest that viruses like Epstein-Barr virus (EBV) might trigger ME/CFS in susceptible individuals.
- Immune system dysfunction: Abnormalities in the immune system might play a role in ME/CFS.
- Genetic factors: Certain genes might make some people more susceptible to developing ME/CFS.
- Psychological factors: Stress, anxiety, and depression can worsen chronic fatigue symptoms.
Preventing Chronic Fatigue
Unfortunately, there is no guaranteed way to prevent chronic fatigue. However, focusing on healthy lifestyle habits can help reduce your risk of developing some underlying conditions that contribute to fatigue, such as:
- Getting enough sleep: Aim for 7-8 hours of quality sleep per night.
- Eating a healthy diet: Consume a balanced diet rich in fruits, vegetables, whole grains, and lean protein.
- Exercising regularly: Engage in moderate-intensity exercise most days of the week.
- Managing stress: Practice relaxation techniques like yoga or meditation.
- Maintaining healthy relationships: Strong social connections can boost your emotional well-being.
- Seeking regular medical checkups: Address any underlying medical conditions that might contribute to fatigue.
Treating ME/CFS
Treatment for ME/CFS aims to relieve the symptoms, i.e. conditions. Treatments include:
- cognitive behavioral therapy
- energy management
- medicine to control symptoms such as pain and sleeping problems.
Some people with ME/CFS will improve over time, especially with treatment.
Many people with ME/CFS will need to adapt their daily routine and pattern of activities on a long-term basis. There may be periods when your symptoms get better or worse.
Important Note:
If you are experiencing chronic fatigue, it's important to consult a doctor to rule out any underlying medical conditions and discuss appropriate management strategies. They can help you determine the cause of your fatigue and recommend the best course of treatment.
Recent Findings
A study investigated the clinical characteristics of young people with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) following infectious mononucleosis (IM) caused by Epstein-Barr virus (EBV). They recruited 25 young people (12 adolescents and 13 young adults) who fulfilled the Canadian consensus criteria for ME/CFS following EBV-IM. The researchers assessed the frequency and severity of symptoms, physical functioning, and health-related quality of life (HRQoL) at the time of diagnosis and 6 and 12 months later.
They found that young adults had more severe symptoms and poorer physical functioning and HRQoL than adolescents throughout the study. After one year, more than half of the adolescents no longer met the diagnostic criteria for ME/CFS, while none of the young adults did. Adolescents who recovered showed improvement in physical functioning, symptom frequency and severity, and HRQoL, while young adults showed little improvement.
The researchers also found that EBV serology and EBV DNA load were not associated with distinct clinical features of ME/CFS, and there was no evidence of inflammation. The median time from symptom onset to ME/CFS diagnosis was 13.8 months.
These findings suggest that ME/CFS following EBV-IM is a more severe and persistent illness in young adults than in adolescents. There is a need for better biomarkers and more effective treatments for ME/CFS, especially in adults.
Reference:
Rafael Pricoco et al, Front Pediatr. 2024 Jan 18:11:1266738
