Chronic Fatigue Syndrome
Chronic Fatigue Syndrome
A variety of studies by CDC and others have shown that between 1 and 4 million Americans
suffer from Chronic Fatigue Syndrome. They are seriously impaired, at least a quarter are
unemployed or on disability because of Chronic Fatigue Syndrome. The earlier a person with
Chronic Fatigue Syndrome receives medical treatment the greater the likelihood that the illness
will resolve. Equally important, about 40% of people in the general population who report
symptoms of Chronic Fatigue Syndrome have a serious, treatable, preveviously unrecognized
medical or psychiatric condition (such as diabetes, thyroid disease, substance abuse). Chronic
Fatigue Syndrome is a serious ilillness and poses a dilemma for patients, their families, and
health care providers.
The cause or causes of Chronic Fatigue Syndrome remain unknown. Conditions that have been
proposed to trigger the development of Chronic Fatigue Syndrome include virus infection or
other transient traumatic conditions, stress, and toxins.
Recently published research suggests that infection with Epstein-Barr virus, Ross River virus
and Coxiella burnetti will lead to a post-infective condition that meets the criteria for Chronic
Fatigue Syndrome in approximately 12% of cases. The severity of the acute illness was the only
factor found to predict which individuals would have persistent symptoms characteristic of
Chronic Fatigue Syndrome at the six-month and one-year period following infection.
It has also been proposed that Chronic Fatigue Syndrome may be caused by an immunologic
dysfunction, for example inappropriate production of cytokines, such as interleukin-1, or altered
capacity of certain immune functions. One thing is certain at this juncture: there are no immune
disorders in Chronic Fatigue Syndrome patients on the scale traditionally associated with
disease. Some investigators have observed anti-self antibodies and immune complexes in
many Chronic Fatigue Syndrome patients, both of which are hallmarks of autoimmune disease.
Physical or emotional stress, which is commonly reported as a pre-onset condition in Chronic
Fatigue Syndrome patients, activates the hypothalamic-pituitary-adrenal axis, or HPA axis,
leading to increased release of cortisol and other hormones. Cortisol and
corticotrophin-releasing hormone (CRH), which are also produced during the activation of the
HPA axis, influence the immune system and many other body systems. They may also affect
several aspects of behavior. Recent studies revealed that Chronic Fatigue Syndrome patients
often produce lower levels of cortisol than do healthy controls.
XMRV is a newly identified human retrovirus that is similar to a group of mouse retroviruses
(called murine leukemia viruses, or MLVs) scientists have known about for years. XMRV refers
to xenotropic murine leukemia virus-related virus. It was first identified in 2006 in tissue samples
from men with prostate cancer. [2A]
As early as October 2009, scientists reported a potential association of XMRV with chronic
fatigue syndrome (CFS). In this study, XMRV was detected in approximately two-thirds of
patients diagnosed with CFS. They also identified DNA of XMRV in the blood cells of some
healthy persons and suggested a potential for XMRV transmission by transfusion or
Recently (Aug 2010), researchers have identified a family of retroviruses in patients with chronic
fatigue syndrome, opening up a potentially promising new avenue of treatment for a debilitating
disease that afflicts as many as four million Americans and 17 million people world-wide. [1A]
Based on other recent research linking the syndrome to a retrovirus called XMRV, some doctors
are already prescribing drugs approved for HIV for fatigue patients. Unfortunately,the syndrome
has no effective treatments yet. The group of viruses identified in fatigue patients, called murine
leukemia virus-related viruses, or MLV, are known to cause cancer and neurological problems in
mice, but whether they cause disease in humans isn't known. XMRV is among several different
members of the MLV family. [1A]
Chronic fatigue syndrome shares symptoms with many other disorders. Fatigue, for instance, is
found in hundreds of illnesses, and 10% to 25% of all patients who visit general practitioners
complain of prolonged fatigue.
A Chronic Fatigue Syndrome diagnosis should be considered in patients who present with six
months or more of unexplained fatigue accompanied by other characteristic symptoms. Primary
symptoms may include sleep problems, muscle and joint pain, cognitive dysfunction, fatigue,
headaches and sore throat. Gastrointestinal complaints, orthostatic instability, depression and
allergies are also seen in many patients. Aggressive symptom management for these and other
disruptive symptoms is indicated.
While symptoms vary from person to person in number, type and severity, all Chronic Fatigue
Syndrome patients are functionally impaired to some degree. CDC studies show that Chronic
Fatigue Syndrome can be as disabling as multiple sclerosis, lupus, rheumatoid arthritis, heart
dissease, end-stage renal disease, chronic obstructive pulmonary disease (COPD) and similar
Chronic Fatigue Syndrome often follows a cyclical course, alternating between periods of illness
and relative well-being. Some patients experience partial or complete remission of symptoms
during the course of the illness, but symptoms often reoccur.
People with Chronic Fatigue Syndrome present with different patterns of primary symptoms.
Treatment, such as pharmacologic therapy, can be directed toward the most problematic
symptoms as prioritized by the patient.
Many Chronic Fatigue Syndrome patients are sensitive to medications, particularly sedating
medications. Nutritional supplements and vitamins are frequently used by people with Chronic
Fatigue Syndrome for symptom relief. On the other hand, acupuncture, aquatic therapy, gentle
massage, meditation, deep breathing, biofeedback, yoga, tai chi and massage therapy have
been found to help some patients and are often prescribed for Chronic Fatigue Syndrome
Who's at risk?
* Chronic Fatigue Syndrome occurs up to four times more frequently in women than in men,
although people of either gender can develop the disease.
* The illness occurs most often in people between the ages of 40 and 59, but people of all ages
can get Chronic Fatigue Syndrome.
* Chronic Fatigue Syndrome is less common in children than in adults. Studies suggest that
Chronic Fatigue Syndrome is more prevalent in adolescents than in children.
* Chronic Fatigue Syndrome occurs in all ethnic and racial groups, and in countries around the
* People of all income levels can develop Chronic Fatigue Syndrome, although there's evidence
that it's more common in lower-income than affluent individuals.
* Chronic Fatigue Syndrome is sometimes seen in members of the same family, but there's no
evidence that it's contagious. Instead, there may be a familial or genetic propensity.
Eleuthero or Siberian ginseng may benefit people suffered from fatigue.
INFORMATION extracted on March 25 2009 from CDC.GOV [A1] Readers Ask: A virus linked to chronic fatigue
syndrome, New York Times.com, October 13, 2009 [A2] Retrovirus XMRV and Hope for Chronic Fatigue Syndrome?
Empowher.com, October 13, 2009 [A3] Scientists finally zero in on a cause for chronic fatigue syndrome,
nydailynews.com, October 13, 2009 [A4] Lombardi VC. Et al, Detection of an Infectious Retrovirus, XMRV, in Blood
Cells of Patients with Chronic Fatigue Syndrome. Science. 2009 Oct 8. 2009 [1a] New Hope in Fatigue Fight wsj.com
2010  CDC.gov
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