Chronic Fatigue Syndrome: Treatment, Causes,the symptoms

Update: October 2018

Chronic fatigue syndrome is a disease when
for at least six months a person constantly feels
�“Broken” morally and physically, and this does not go away even after
long rest. The main cause of the disease is considered infection.
viruses, mainly herpetic group (the main cause
called the Epstein-Barr virus), and the pathology itself is also called
benign myalgic encephalomyelitis, which means
�”Inflammation of the brain and spinal cord, which occurs with pain in
muscles and having a benign (i.e. not ending
life-threatening complications) course. “

The majority of cases are residents of large cities,
who are in the age group of 25-45 years (that is, the most
able-bodied). This is due to the fact that this category
population, seeking to provide a family and achieve career growth,
lead such an exhausting lifestyle that they do not pay attention
на the symptoms развивающихся у них заболевания или не долечивают их,
immediately going to work. The most common signs of chronic syndrome
fatigue can be found in people who are assigned to work
great responsibility and they should be extremely attentive:
paramedics, air traffic controllers, people associated with night
transport (especially – rail) transportation.

Causes of pathology

The basis of chronic fatigue syndrome (CFS) – a violation
interactions between the “commander-in-chief” centers of the vegetative
systems, which worsens the production of substances needed for
development of inhibition in the central nervous system. Disease
possible when against the background of constant stress immunity
infection occurs. Usually causes the development of CFS infectious
disease caused by one of those viruses that, penetrating into
organism, “settled” in certain of its cells (usually – in
cells of the nervous system) for a very long period, becoming
inaccessible for injected medication. It:

  1. Epstein-Barr virus;
  2. cytomegalovirus;
  3. enteroviruses, including Coxsackie viruses;
  4. herpes virus type 6;
  5. hepatitis C virus;
  6. retroviruses.

Provokes the development of the disease overload of the brain,
responsible for the emotions and the intellectual sphere, whereas the plots
�”Included” during active physical work, remain

The risk group includes:синдром хронической усталости

  • residents of large cities. The larger the city, the higher the risk
    development of the syndrome. 85-90% of cases are residents of big cities (large
    a part is registered in the USA and Australia);
  • people living in unfavorable hygienic conditions;
  • Persons of those professions that have great responsibility and
    work in shifts: medical workers, pilots, rescuers,
    dispatcher, railway operators;
  • entrepreneurs;
  • those who suffer from chronic diseases, especially:
    hypothyroidism, cardiac pathologies, autoimmune
  • often ill with viral infections (viruses “love” to suppress
  • adolescents who are actively preparing for university entrance;
  • people with nutritional disorders when it occurs: use
    substandard products, there is not enough micro
    and macronutrients;
  • mental disorders (depression,
    anxiety) and stress, exhausting the person;
  • people leading an unhealthy lifestyle: constantly losing sleep,
    little moving, almost not going out, useless
    time consuming;
  • food allergies;
  • living in adverse environmental conditions;
  • having such mental characteristics: perfectionism,
    constant feeling of stress, fear of losing your job or status,
    suspiciousness and conflict;
  • allergy sufferers;
  • working with heavy metal salts;
  • constantly taking drugs such as antihistamines,
    contraceptive, reducing blood pressure,
  • often taking alcohol or drugs.

Most of the structure of cases falls on women.

That chronic fatigue syndrome is not mental
pathology, and somatic disease, they say various
laboratory indicators. Thus, an increase in
CD3 and CD4 lymphocytes, natural killer cells, interferon,
interleukin-1, tumor necrosis factor. When serological
blood antibodies detected in the blood test
herpes group or some others. With the help of biochemical
research has been established linkage of CFS with the concentration of carnitine in
blood plasma: the less L-carnitine, the lower the efficiency and
worse being a person.

Historical data

Scientists suggest that the disease appeared at the beginning
XX century – when the pace of life accelerated and the volume increased
information that needs to be processed. So, in 1934
the symptoms данного заболевания были зарегистрированы у большого
number of people in Los Angeles, in 1948 – in Iceland, in 1955
– in London, in 1956 – in Florida. But only in 1984, after
the way doctor Cheney characteristic symptoms were described immediately in
200 people in Incline Village (Nevada), and they have the same blood
antibodies to viruses of the herpetic group were determined, the syndrome was
described as a separate disease. Since 1988, the syndrome
chronic fatigue is highlighted in a separate diagnosis.

How is the disease manifested

The main symptoms of chronic fatigue syndrome –

  • constant fatigue, feeling of weakness that does not pass
    even after a long rest;
  • fatigue – even after doing simple
  • pain in the whole body, especially in the muscles (all muscles can hurt) and
    joints – it hurts one or the other joint;
  • decrease in concentration;
  • deterioration in the ability to analyze and reflect;
  • sleep disorders: a person cannot sleep for a long time, and despite
    constant fatigue, sleeps shallowly, often wakes up;
  • fears, anxiety, anxiety intensified at night;
  • frequent headaches that are most often localized in the area
    temples and have a pulsating character;
  • bad mood, irritability, irascibility;
  • tendency to depression, apathy;
  • phobias may develop;
  • dark thoughts;
  • propensity to frequent colds, which occur mainly
    according to one scenario – with sore throat;
  • more frequent exacerbations of chronic diseases.

Chronic fatigue syndrome is masked by various
somatic diseases. So, people suffering from this
disease, may notice weight loss, irregularities
digestive tract (for example, a tendency to constipation),
unreasonable increase in lymph nodes and their pain. With CFS
body temperature can keep rising or falling for
a long time that causes a person to be examined
from various specialists.

If you have recently made repairs in the apartment / office, bought a new
furniture, replaced appliances, etc. and notice chronic
fatigue may be manifested as chronic poisoning in pairs
formaldehyde, which is contained in all building materials, furniture,
modern fabrics and household appliances (see symptoms of poisoning from
new repair and furniture).

How is the diagnosis made?

The diagnosis of CFS is not made on the basis of the above
symptoms. Only if all diseases are excluded,
accompanied by increased fatigue, weakness, if doctors are not
may find another reason, put such a diagnosis.

Especially it concerns stage 1-2 of oncology. Cancer symptoms on
early stages, when it can still be completely cured, little
different from CFS. You also need to exclude tuberculosis, which
proceeds almost asymptomatically. And other somatic diseases,
proceeding in a sluggish, erased form. Exclude helminth

The diagnosis of chronic fatigue syndrome begins with
that a person undergoes a full examination. When specified
symptoms necessarily need to pass:

  • general blood and urine tests
  • biochemical analyzes
  • feces on helminth eggs (three times)
  • blood for the determination of antibodies to Giardia, toxocars,
    ascardidam and other worms
  • perform an ultrasound of the abdomen
  • chest x-ray
  • it is also necessary to determine in the blood antibody titers to
    Epstein-Barr virus, cytomegalovirus, herpes simplex virus and
  • HIV infection is also excluded
  • diseases of the endocrine organs
  • examining the fundus
  • Doppler sonography of the head and neck vessels is performed, in some
    cases a neurologist may prescribe an MRI or computed tomography

If the data of all the above tests are within the normal range,
and by the titer of antibodies to the herpes viruses, the infectious disease disease
diagnoses and does not prescribe treatment, diagnosis is made
chronic fatigue syndrome.

The diagnosis is established based on the criteria table when

  • 2 large criteria + 6 small,
  • if the first 3 small criteria do not coincide with the existing ones
    person, or there is only 1 small criterion of the top three, for
    diagnosis requires a combination of 2 large + 8 small
Big criteria Small criteria
  • Fatigue is observed for 6 months and longer. She can
    call periodic or periodically increasing. After sleep or
    rest (even long) state does not improve. Reduced daytime
    activity 2 times.
  • Somatic, infectious, endocrine and mental disorders are excluded.
    diseases, as well as poisoning.
  • increased body temperature – up to 38.5 ° C, not higher;
  • pharyngitis (sore throat);
  • increase to 2 cm and soreness of the cervical and axillary
    lymph nodes;
  • muscle pain;
  • the disease began suddenly;
  • severe headaches that were not there before;
  • weakness in all muscles;
  • feeling of weakness lasting more than a day after those physical
    loads that were previously tolerated normally;
  • pain, aching joints, while the joints themselves look
    unchanged: no swelling, no redness over them;
  • sleep disorders;
  • changes in the psycho-emotional sphere: depression, apathy,
    photophobia, deterioration of attention and memory.


It is necessary to treat the syndrome of CFS in a complex, necessarily including
treatment program:

  • compulsory rest;
  • good night’s sleep (at least 8 hours);
  • adequate food, periodic unloading
    days It is not recommended to eat sweets in large quantities:
    such foods dramatically increase blood sugar levels, and then not
    less dramatically reduce it, which can aggravate the condition
    the patient;
  • mandatory inclusion of walking and exercise therapy in the mode
  • massage – general or segmental;
  • taking a contrast shower;
  • indispensable treatment of those diseases that can cause
    constant lack of oxygen in the body (chronic sinusitis,
    vasomotor rhinitis, bronchiectasis) or chronic
    poisoning (carious teeth, chronic tonsillitis and so
  • getting positive emotions from a source that for
    each individual (music, fishing, playing with children or home

Further, depending on the severity of the disease, the doctor decides
prescribe only psychotherapeutic treatment, or connect
drug therapy.

For the treatment of chronic fatigue syndrome are assigned such

  • антидепрессанты, которые не только устраняют
    symptoms of depression, but also significantly improve the immune status of such
    patients, activating the activity of NK-cells. For the treatment of CFS
    appointed “Azafen”, “Zoloft”, “Serlift”, “Prozac”
  • дневные транквилизаторы. These are drugs
    which eliminate anxiety and anxiety, while not causing
  • L-карнитин, который в митохондриях клеток
    engaged in the production of ATP, obtained by the oxidation of fatty acids.
    His appointment is justified, because there is a decrease in the CFS
    the concentration of this amino acid in the blood;
  • препараты магния. With their appointment come from
    the fact that fatigue and fatigue may be due to a lack of
    magnesium, 80-90% of which is intracellular. It is the connection
    This electrolyte with ATP allows you to transfer and accumulate in
    energy cells;
  • витамины B-группы, обеспечивающие улучшение
    messages of the nervous system with the muscular;
  • nonsteroidal anti-inflammatory drugs. They are appointed
    to eliminate pain in muscles and joints;
  • иммуномодуляторы. With frequent colds
    diseases, chronic bronchitis, bronchial asthma. It can
    be broad-spectrum drugs (for example,
    �“Polyoxidonium”, “Levamisole”, “Timalin” or “Sodium Nucleinate”) or
    only antiviral (interferons);
  • противовирусные препараты и иммуноглобулины.
    They are prescribed by an infectious disease physician when elevated blood levels are detected.
    antibody titers to viruses or DNA determination of these viruses in
  • ноотропные средства, повышающие адаптивные
    brain abilities and stimulating his work. This is “Glycine”,
    �”Semax”, “Aminalon”.

When is the question how to cope with chronic
fatigue, physiotherapeutic

  1. Водные процедуры. They relax, take off
    muscle tension and pain.
  2. Магнитотерапия. Exposure to magnetic field
    relaxing effect on the muscles, has an analgesic effect,
    restores the endocrine and immune systems.
  3. Лазерное облучение крови помогает активировать
    self-regulation mechanisms, stimulates the nervous system.
  4. Акупунктура. Impact of a specialist on
    biologically active points leads to any desired effect, in
    including relieving tension from spastic muscles, improving
    work of the nervous system, normalization of the nutrition of muscles, joints and
    internal organs.
  5. Массаж, который расслабляет «зажатые» мышцы,
    improving nutrition in them.

Home treatment includes not only pills,
but also autogenic training sessions. This is such a technique.
psychotherapy that a person can perform independently. She is
suggests deep relaxation, against which a person
inspires certain thoughts, such as indifference to
annoying factor or stimulation of your own defenses and
positive qualities. First self-training sessions are best.
with the participation of the psychotherapist.

At home, you can use and aromatherapy.
It is recommended to use lavender, jasmine and sandalwood oils.
tree, chamomile, bergamot, ylang-ylang.

Traditional medicine recommends the use of such tools:

  • Mix 100 g of honey and 3 tsp. apple cider vinegar, take 1
    tsp everyday;
  • Разведите в стакане воды по 1 tsp honey and apple cider vinegar,
    add 1 drop of iodine. Drink a glass of this drink for
    of the day
  • Pick some dandelions with leaves and a few stems.
    nettle, take 100 g of these ingredients (with flowers and
    leaves), chop, mix with 1 tbsp. wormwood and calamus. Further this
    mix it is necessary to fill in 0,5 l of vodka and insist 10-12 days. Take
    по 1 tsp/сутки, предварительно растворяя ее в 50-100 мл воды.
  • Brew in 200 ml of water 1 tbsp. Hypericum, insist on an hour,
    Take 1/3 cup before each meal.
  • Drink ginger tea. To do this, cut a small piece
    ginger root, rub it on a fine grater (or crush with a knife,
    to stand out juice), pour boiling water into the slightly cooled tea
    add honey and lemon.


The disease is not considered life threatening and may even go away.
without treatment. True, there is a risk that with more
severe stress or as a result of any somatic illness,
CFS will re-develop, leading to impaired immune function.

Forecastировать затяжное течение заболевания, без наступления
full recovery, it is possible in people over 40 years old, or if his
development caused the appearance of depression. If during the first two
years, the symptoms regress, it gives you the opportunity to hope for a complete


In order to avoid the development of chronic fatigue syndrome
devote time and attention to following the rules:

  • take breaks after every 1-1.5 hours of work;
  • move more;
  • periodically rest in complete silence, go to
  • give up bad habits;
  • engage in any feasible sport;
  • do not eat fast food, and include in the diet at least 800
    grams of vegetables, fruits or berries.

Автор: Кривега Мария Салаватовна врач-реаниматолог

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