Chronic fatigue syndrome: aetiology, diagnosis and treatment

Abstract

Chronic fatigue syndrome is characterised by intense fatigue, with duration of over six months and associated to other related symptoms. The latter include asthenia and easily induced tiredness that is not recovered after a night's sleep. The fatigue becomes so severe that it forces a 50% reduction in daily activities. Given its unknown aetiology, different hypotheses have been considered to explain the origin of the condition (from immunological disorders to the presence of posttraumatic oxidative stress), although there are no conclusive diagnostic tests. Diagnosis is established through the exclusion of other diseases causing fatigue. This syndrome is rare in childhood and adolescence, although the fatigue symptom per se is quite common in paediatric patients. Currently, no curative treatment exists for patients with chronic fatigue syndrome. The therapeutic approach to this syndrome requires a combination of different therapeutic modalities. The specific characteristics of the symptomatology of patients with chronic fatigue require a rapid adaptation of the educational, healthcare and social systems to prevent the problems derived from current systems. Such patients require multidisciplinary management due to the multiple and different issues affecting them. This document was realized by one of the Interdisciplinary Work Groups from the Institute for Rare Diseases, and its aim is to point out the main social and care needs for people affected with Chronic Fatigue Syndrome. For this, it includes not only the view of representatives for different scientific societies, but also the patient associations view, because they http://www.biomedcentral.com/1471-244X/9/S1/S1Page 2 of 11 (page number not for citation purposes) know the true history of their social and sanitary needs. In an interdisciplinary approach, this work also reviews the principal scientific, medical, socio-sanitary and psychological aspects of Chronic Fatigue Syndrome.

The Newcastle NHS Chronic Fatigue Syndrome Service: not all fatigue is the same

“…[3][4][5] It affects all age groups and is associated with significant functional impairment. 6 Currently, there is no diagnostic test for CFS, making it frequently a diagnosis of exclusion, which is dependent on ensuring fatigued patients do not have another fatigue-associated diagnosis.…”

<b><i>Rhodiola rosea</i></b> in Subjects with Prolonged or Chronic Fatigue Symptoms: Results of an Open-Label Clinical Trial

“…The considerable number of chronic fatigue-related symptoms expected to exist among the adult population, as well as the unfavorable condition that no standard medication is as yet available [4,9], encouraged us to conduct a trial on the effects of Rhodiola rosea in patients who had experienced fatigue over a period of at least 2 months and who thus would form a cohort representing fatigue without further specifications. As chronic fatigue is likely to result from a prolonged lack of fatigue treatment [10], the identification of an efficient and safe fatigue therapy, also in rather mild or prolonged, not yet chronic cases, was regarded to be even more warranted.…”

“…As to date no standard medication is available to effectively treat presentations of fatigue [4,9], the objective of the presented trial was to gain insights into the therapeutic effects of R. rosea in patients who had experienced fatigue over a period of at least 2 months. Other than most of the preceding studies which examined a specified range of fatigue patients such as night-shift workers or examinees, in this trial a narrow subject definition was abandoned in order to find results applicable to a wide range of fatigue patients.…”

Symptom management in inflammatory bowel disease

“…Additional risk factors include fatigue, sleep disturbances, as well as iron deficiency anemia [166]. Nutritional deficiencies should therefore be evaluated for and replaced.…”