Hope for Chronic Fatigue Sufferers
Chronic fatigue and immune dysfunction syndrome (CFIDS) is a medical condition marked by lingering fatigue with no explained cause. More than one million Americans, including children, have the illness.
A person with CFIDS has fatigue that has lasted for at least six months, according to the Centers for Disease Control and Prevention (CDC). For a diagnosis, the person also must have at least four of the following symptoms: muscle pain; joint pain without redness or swelling; sore throat; headaches of a new type, pattern or severity; tender lymph nodes; problems with short-term memory or concentration. Other symptoms include fatigue that lasts more than 24 hours after exercise or exertion and fatigue that is not relieved by sleep. Researchers don't know the cause of CFIDS, but one leading theory is that the illness is rooted in the central nervous system and immune system. Another possibility is that CFIDS is an outcome of a disease that could have multiple causes.
Some recent research indicates that CFIDS may have genetic components. One recent study suggests that genetic factors are associated with this condition. Researchers have used these findings to predict CFIDS with about much greater accuracy than in the past.
Testing has revealed evidence that the immune system remains activated for long periods of time in people with chronic fatigue syndrome. Many recent studies indicate that patients with chronic fatigue syndrome have defects in the ability of cells in their bodies to make energy. Some studies indicate that certain genes are built differently, and that the activity of genes in white blood cells is different in patients with chronic fatigue syndrome.
Many of these abnormalities seem to come and go, and are not permanent conditions. Furthermore, not all of the abnormalities affect every patient with chronic fatigue syndrome.
A cure for CFIDS remains elusive. Up to 60 percent of those with CFIDS, however, return to near normal activity with no treatment. For the people who don't improve, the strategy is to attack the symptoms.
"We don't know the cause or cure, but neither do we know what causes or cures migraine or irritable bowl syndrome, yet we can make those better because we can treat what we do know about them," says Charles W. Lapp, M.D., an internist and pediatrician with Hunter-Hopkins Center in Charlotte, N.C. Dr. Lapp began treating patients with CFIDS in 1985.
"The first step is to manage sleep with sleep medications," he says. "The next step is to manage fatigue with a combination of antidepressants and stimulant drugs. Antidepressants are used because most patients with chronic illnesses and chronic pain are low in serotonin and dopamine, which makes for sleep disruption, low pain thresholds and irritability. This treatment makes patients feel more motivated and alert.
"The third step is to treat pain, and the fourth is to treat autonomic dysfunction, which has been demonstrated in the majority percent of patients with CFIDS. In all these areas we have reasonable successes."