Chronic fatigue: how to treat it
Chronic fatigue syndrome (CFS) is a chronic illness with debilitating symptoms which can make it difficult for sufferers to function on a day to day basis. Chronic fatigue is also known as ME, which stands for myalgic encephalomyelitis. ME and CFS are very similar conditions but they do differ. ME implies that there is immune system involvement and high levels of inflammation that is causing their profound fatigue.
Chronic fatigue syndrome can affect different people in different ways. Some people have mild symptoms and others have very severe symptoms that can prevent them from completing even the most basic physical or mental activity. CFS is a complex illness and there is unfortunately no cure. However, there are therapies that can help you to manage your symptoms and improve your quality of life.
Common symptoms of myalgic encephalomyelitis / chronic fatigue syndrome
Post exertional malaise
Post exertional malaise is characterised by a significant worsening of symptoms after even minimal physical or mental exertion. This can last for many hours or even days and can have a profound effect on daily activities.
Unrefreshing sleep
People with ME/CFS often find that they do not feel rested after sleep, no matter how long they sleep for. This can leave them feeling exhausted during the day.
Anxiety and depression
Anxiety, depression and other mental health issues are common in people with ME/CFS.
Orthostatic intolerance
Orthostatic intolerance is a condition in which the body is unable to tolerate being in an upright position often due to low blood pressure as a result of mitochondrial dysfunction. This can cause lightheadedness, dizziness and fainting.
Cognitive impairment
People with ME/CFS often find it hard to concentrate and have difficulty with memory and thinking. This can be known as "brain fog.
What to do if you suspect you have myalgic encephalomyelitis / chronic fatigue syndrome
If you have chronic fatigue syndrome, it is important to see a specialist who is experienced in treating this condition. CFS is not caused by laziness or lack of motivation. It is also not the same as tiredness. Tiredness can be improved by getting more rest. CFS/ME however, cannot be improved by sleeping or increased rest.
People living with CFS/ME find that certain therapies work better for them than others. It is important to find a treatment that works for you and to stick with it. Treatment can be divided into three main categories:
Medical
Medical treatment for chronic fatigue usually involves a combination of medication and lifestyle advice. The most commonly prescribed medications are antidepressants. Antidepressants can help to improve sleep, pain, and fatigue. Other medications that may be prescribed include painkillers, sleeping pills, and vitamins.
Lifestyle advice
Lifestyle advice usually includes suggestions for helping people get more restorative sleep, eating a more healthful diet, and do some form of physical activity. It is important to pace yourself however, and not try to do too much at once. Pacing means doing a little bit of activity followed by a period of rest. This allows your body to recover from the physical activity before you do more.
Complementary and alternative therapies
Complementary and alternative therapies can help to improve symptoms of CFS/ME. These therapies are not a cure, but they can help to improve your quality of life and give patients more energy. Some people find that certain complementary and alternative therapies work better for them than others.
Self-care
Self-care is an important part of managing chronic fatigue. Self-care means taking care of yourself and doing things that make you feel good. This may include relaxation techniques, massage, and aromatherapy. It is important to find activities that you enjoy and that make you feel good. Doing things that make you happy can help to improve your symptoms.
Chronic fatigue syndrome is a complex and disabling disease and there is not yet a cure. However, there are ways to improve symptoms with appropriate evidenced base therapies.
Chronic Fatigue Specialist
As a naturopath, I take a holistic approach and use a combination of herbal and nutritional medicines to improve fatigue and other symptoms in my patients. Although effective, these therapies are often slower acting which can often be frustrating for those who have been struggling with this condition for some time. My clients usually see consistent and gradual improvements over one to nine months depending on the complexity of their condition.
Where to begin
As CFS/ME is a complex condition, healthcare providers need to prioritise where to begin supporting these patients as it would be less effective and costly to treat everything at once. New patients to my clinic are required to fill out a detailed intake form before our first appointment. This allows me to review this information and complete an in depth analysis of the mechanisms driving their particular presentation. From here, I can prioritse the most beneficial short and long term therapeutic aims to help improve their symptoms. As each person is unique, these aims will be different for each patient. Most patients will begin with some mitochondrial support herbs and nutrients as well as some digestive support such as probiotics. Then depending on the symptom picture we will do a 1-3 month treatment module for one or more of the following underlying causes.
Gastrointestinal infections
Gastrointestinal infections such as candida, helicobactor pylori and parasitic infections are common underlying causes of CFS/ME and symptoms can be substantially alleviated by clearing these infections. A good quality probiotic, gut supporting nutrients and a rotating combination of herbal antimicrobials are the backbone treatments for eliminating these persistent organisms. Herbal antimicrobials, although generally safe to use, should be administered by an experienced practitioner.
Mold exposure
Mold can be a major contributor to chronic fatigue syndrome. Mold is not always obvious as it is often hidden in walls or other places that are difficult to see but there are additional tests available to assess if this is a contributing factor. If you have been exposed to mold in your home or workplace, there are a number of treatments available such as binders, detoxification and liver support, antifungals and other supporting nutrients.
Heavy metal and chemical exposure
Heavy metal and chemical exposure can be a major contributor to chronic fatigue. Workplace exposure is the most likely culprit and unfortunately some people working in these industries get exposed to levels that lead then to chronic fatigue syndrome. There are a number of different tests for heavy metals and chemicals, with varying levels of efficacy. Treatments for heavy metal and chemical exposure illness include binders, minerals, detoxification, elimination and liver support. It is imperative that these therapies are guided by an experienced practitioner as moving too quickly can lead to worsening of symptoms.
Hormonal imbalances
Hormonal imbalances are often a contributing factor to chronic fatigue syndrome. Symptoms can include menstrual irregularities, infertility, weight gain or loss, gastrointestinal changes and mood alterations. By assessing your symptoms I can get an understanding of any underlying hormonal imbalance and where required can use additional testing if this will help to direct the course of treatment. Treatments will vary but will often include herbal adaptogens, and other hormonal supporting herbs and nutrients.
While there is no cure as of yet, there are treatments that can help to improve symptoms. In this blog post, we have outlined some of the most common underlying causes of CFS/ME and the corresponding therapies that can help to address them. If you think you may be suffering from chronic fatigue syndrome, it is important to seek out the guidance of a healthcare professional who can help you to identify the root cause and develop a treatment plan.