Fatigue, insomnia & stress
What is Chronic Fatigue Syndrome (CFS)?
by Marcelle Pick, OB/GYN NP
Women often wonder about the difference between Chronic Fatigue Syndrome (CFS) and
fatigue that is ongoing and constant (also sometimes referred to as chronic fatigue).
Chronic Fatigue Syndrome (CFS) is still a poorly understood condition, which has
prolonged and unremitting fatigue as one of its main symptoms. It is distinct from
chronic fatigue in that in CFS the fatigue lasts longer than six months and is accompanied
by additional symptoms.
How is CFS diagnosed?
In 1994, a panel of international researchers came up with the following criteria
for CFS diagnosis:
- Severe chronic fatigue for six months or longer, unrelated to any other known medical
- Four or more of the following symptoms simultaneously:
- Sore throat
- Tender lymph nodes
- Muscle pain
- Diffuse and migratory multi-joint pain without swelling or redness
- Headaches of a new type, pattern or severity
- Unrestorative sleep
- Aching and listlessness lasting more than 24 hours after exertion
Today, the Center for Disease Control estimates that over half a million American
adults suffer CFS. Importantly, it often goes hand in hand with fibromyalgia and
multiple chemical sensitivities (MCS).
According to the CDC, CFS is more common in women, is not contagious, and tends
to affect black women more than white or Asian women. In one San Francisco study,
the condition was greater in people with incomes under $40,000 per year. While CFS
has been the subject of a great deal of research and study, it is difficult to say
with certainty what causes it. In fact, CFS is a useful umbrella term for what may
be a highly individualized and varied condition with many overlapping causes.
What may trigger CFS?
Many patients with CFS can point to a “trigger event,” either a bout with illness
or a traumatic life event that set them on a downward spiral. Most scientists believe
that the trigger somehow compromises the immune system in such a way that pathogens
are able to invade cells and damage mitochondria. Mitochondria are the mini power
plants in every cell in your body. If their function is impaired, the cell is weakened
and can’t do its job. If enough cells are affected, all of the body’s mechanisms
start to wilt.
The SHINE approach
Joseph Teitelbaum, MD, author of From Fatigued to Fantastic, has
made CFS his life’s work.
Dr. Teitelbaum’s integrated approach features the “SHINE” protocol for both CFS
S = Sleep
H = Hormones
I = Infections
N = Nutritional supplements
E = Exercise
He provides an abundance of information at his website, EndFatigue.com.
Infectious agents like Epstein–Barr and Lyme disease have not been proven as of
yet to cause CFS. However, research has not ruled out the possibility that a microbial
threat or nutritional deficiency could be tied to the triggering event.
Some research indicates that the trigger may set off a cascading breakdown in the
central nervous system, specifically the HPA axis — the hypothalamus, pituitary
and adrenal glands. Another theory suggests that chronic low blood pressure, also
called neurally mediated hypotension, may contribute to the condition. What is most
likely is that CFS may not have one single cause, but represents the body’s response
to cumulative physical and emotional stress. Why some people get it and others do
not is still not understood.
The Women to Women approach for CFS
In my experience, patients with CFS improve when they address all of the following:
nutrition, GI function, hormonal balance, adrenal function, detoxification, and
their emotional state.
Women with CFS often find that underlying emotional baggage may be figuratively
“crippling” them with fatigue. Sometimes emotional trauma is too painful for the
waking mind to deal with; instead, the pain and exhaustion are expressed physically.
For this reason, many CFS patients have found success through emotional coaching.
Talk to a trusted friend or doctor, or investigate the Quadrinity Process. A helpful,
and less expensive, method is known as the Emotional Freedom Technique. The truth
is, if you don’t take a conscious step back, your body will ultimately force you
to put the brakes on!
When I talk with women who suffer from CFS, I remind women to be patient with themselves.
Beating your fatigue may be simple or more complicated, but let me reassure you
that you can regain balance in your body. Take pride in whatever measures you put
into place to give yourself support, but don’t expect an instant miracle. It has
probably taken you years to become so tired, so it may take a little time and some
work to recoup your energy. But have faith — you will!
Related to this article:
References & further reading
on fatigue and stress
Last Modified Date: 05/21/2012
Principal Author: Marcelle Pick, OB/GYN NP