What is Chronic Fatigue Syndrome?

Chronic Fatigue Syndrome (CFS) is also known as Myalgic Encephalomyelitis and referred to as ME/CFS.

Everyone experiences fatigue from time to time, and it’s estimated that about 25% of all patients presenting to a doctor’s office admit to some level of fatigue. The term ‘Chronic’ is used when the symptoms have had a duration of more than 6 months.

Of all patients complaining of severe and chronic fatigue, it is estimated that about 40%  have a serious, but often treatable, previously unrecognized medical or psychiatric condition (such as diabetes, anemia, celiac disease (severe gluten intolerance), thyroid disease, depression or substance abuse).

If you experience severe and sustained problems with fatigue it is therefore very important to first be evaluated thoroughly by a physician to exclude correctible underlying conditions.

Chronic fatigue syndrome, or ME/CFS, is a debilitating and complex disorder characterized by profound fatigue that is not improved by bed rest and that may be worsened by physical or mental activity. Persons with CFS most often function at a substantially lower level of activity than they were capable of before the onset of illness. In addition to these key defining characteristics, patients report various nonspecific symptoms, including weakness, muscle pain, impaired memory and/or mental concentration, insomnia, and post-exertional malaise (PEM) lasting more than 24 hours. Associated symptoms like multiple chemical sensitivities, digestive dysfunction, hemodynamic (blood pressure and heart rate) instability and increased susceptibility to infections are also common.

A report by the Institute of Medicine (IOM) in 2015 estimate that between  840,000 and 2.5 million Americans suffer from ME/CHF, but only about 1 in 10 of these have been formally diagnosed with the condition.

Anyone can get ME/CFS. While it is most common in people between 30 and 60 years old, the illness also affects children, adolescents, and adults of all ages. Among adults, women are affected more often than men. Whites are diagnosed more than other races and ethnicities. But many people with ME/CFS have not been diagnosed, especially among minorities.

There is currently no lab test or unique bio-marker for ME/CFS.

Over the past three decades there have been more than 20 published sets of criteria for the diagnosis of Chronic Fatigue Syndrome / Myalgic Encephalomyelitis, and despite several published ‘consensus criteria’ there is still unfortunately no universal consensus on how to diagnose the condition. There is, however, agreement that post-exertional malaise (>24 hrs after exertion) is essential to making the diagnosis, and that sleep disturbance/unrefreshing sleep as well.  Other commonly associated symptoms are:
– substantial impairment in short-term memory or concentration (‘brain-fog’)
– sore throat that is frequent or recurring
– tender lymph nodes in the arm-pits or in the neck
– muscle pains and/or multi-joint pain without swelling or redness

What is the Cause of Chronic Fatigue Syndrome (ME/CFS)?

Despite an intensive, more than 30-year search, the cause of ME/CFS remains unknown. Many different infectious agents, autoimmunity and physiologic and psychological causes have been considered, and the search continues.

Much of the ongoing research into a cause has centered on the roles the immune, endocrine and nervous systems may play in the disease process. More recently, interactions among these factors are under evaluation.

A sensational study published in the journal Science  in October 2009 on the association between the retroviurs XMRV and CFS has, however, later been challenged (and the article retracted due to a suspected laboratory contamination – See: ‘the Editorial Expression of Concern’)

This did therefore not provide the answer so many were hoping for.

More recently the potential for an auto-immune etiology of ME/CFS has also been considered. A study published in 2011 demonstrated a significant benefit in using the immune modulating drug: Retuximab.  However, a larger, multi-center randomized and placebo controlled study failed to demonstrate any benefit (the final report is expected to be published in 2018)

On Feb. 10, 2015, the Institute of Medicine released a landmark report that contained a series of recommendations for ME/CFS, one of which called for the name to be changed to Systemic Exertion Intolerance Disease (SEID). link to report

Genetic and environmental factors may play a role in developing and/or prolonging the illness, although more research is needed to confirm this.

ME/CFS is not caused by depression, although the two illnesses often coexist, and many patients with  ME/CFS have no psychiatric disorder.

Prognosis

Some patients suffering from CFS/CFIDS/ME have reported spontaneous recovery after several months of illness.  The prospect of recovery, however, decreases significantly the longer the patient has the illness.

Anecdotal reports exists of patient recovering after the use of a variety of therapeutic modalities – these have included antiviral drugs, antibiotics, immunoglobulin injections to mention a few – but when studied in randomized, controlled trials they have been no better than placebo.

 

Proven Therapies

Graded exercise therapy has been demonstrated to improve the functional level of patients with CFS, and prolonged rest have certainly not been shown to be helpful.  The challenge is, however, the well known ‘post-exertional fatigue’, which for many makes attempts at exercise-therapy very unattractive.

Cognitive Behavioral Therapy (CBT) has been shown to help patients with ME/CFS cope better with their disability and function at a higher level, but generally not achieve full recovery.

The average length of  a course of CBT is 16 weeks; attending a session one-to-two times weekly.
The patient must be highly motivated as the therapy requires active participation in therapy.

 

References:
Centers for Disease Control
www.cfids.org
Best Practice – British Medical Journal
Science (referenced above)
The Institute of Medicine (referenced above)

 

A Theory of Chronic Fatigue Syndrome that offer Hope of Recovery:

Lightning Process LogoThe Lightning Process® is designed on the theory that people who experience a significant physiologic stress (like a severe infection or significant emotional trauma) may for some unknown reason experience of a prolonged state of ‘overwhelmedness’ which in some way profoundly affects their psycho-neuro-immunology.  We have nearly all experienced the profound fatigue that can be associated with a serious case of the flue or gastro-enteritis.  Those of us who have been served some devastating news (like news of the unexpected death of a very close friend or relative) have also experienced how shocking news can instantly zap you of physical and mental energy.  For some unknown reason some of us are unable to navigate out of this overwhelming fatigue and end up with prolonged, disabling effects that completely destroy our lives.

The Lightning Process® aims to ‘reprogram the brain’.  Well aware of the enormous potential of the brain to reorganize and compensate for functional losses (neuroplasticity) the Lightning Process® employs a variety of techniques to give the clients tools to re-direct physiological and mental energy which often results in dramatic improvements.  After only 3 intensive days some patients experience a recovery they could only dream about.  The effects are often so dramatic that they may appear ‘magical’, but there is no supernatural element to the recovery – but well researched and proven techniques that redirect physiological energy to restore health.  For most patients it may take longer, and it may take several weeks to months to rebuild physical endurance which have suffered from months to years of sedentary life-style. The ‘brain-fog’ and hypersensitivity to sound and light (which some experience) may, however, dramatically improve in a matter of days.

Here is a link to a published review article discussing the scientific basis for the ‘sustained arousal’ concept – which may help explain why the Lightning Process® has such impressive results:

“Vegard B. Wyller et al.  Can sustained arousal explain the Chronic Fatigue Syndrome”

 

To benefit from this form of training you need to:

  1. Have been examined by a physician and found not to have potentially curable conditions like severe anemia, hypothyroidism, active infection, depression etc.
  1. You have to be highly motivated – as the training requires you to actively use the techniques you are taught to achieve recovery.

 

How Phil Parker (the originator of the training program) explains the ‘Lightning Process®’:

What does the Lightning Process do?

Key components of the training include participants learning exactly how their brain and body have become trapped in a number of damaging unconscious responses, which have blighted their health and stunted their lives. Then using a powerful combination of techniques uniquely developed using the philosophies and research of NLP, osteopathy, self hypnosis and life coaching, they will be extensively trained as to how to successfully replace those old unhelpful responses and start to regain their health, sense of self and their future.

 

How does it achieve that?

Using the Lightning Process® technique of combining particular body movements and postures with a set of precisely targeted questions many people have got their health back into balance, quickly and successfully recovering from real illnesses that had troubled them for years.

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