Tired All the Time?

YOU have been napping in the afternoon, grabbing a little shut-eye on the chauffeur-driven way back home. But you can’t shake off that ...

YOU have been napping in the afternoon, grabbing a little shut-eye on the chauffeur-driven way back home. But you can’t shake off that feeling of lethargy. Physical tests yield clear results, so you just put it down to tiredness. But it could be Chronic Fatigue Syndrome (CFS).

What is the Chronic Fatigue Syndrome?
The disorder is an enigma for doctors. It has no identified cause and no specific diagnostic tests. While doctors in India label it a ‘‘very rare’’ disorder, the US Center for Disease Control and Prevention estimates that 200-250 per 100,000 people are affected by CFS. For the disorder to be labelled CFS, patients in the US must have chronic fatigue for six months or longer, and concurrently display four or more of these symptoms: substantial impairment of short-term memory or concentration, sore throat, tender lymph nodes, muscle pain, multi-joint pain without swelling or redness, headaches of a new type, pattern or severity, unrefreshing sleep and post-exertional malaise.

Are there other symptoms of CFS?
CFS may display these signs with varying frequency: abdominal pain, bloating, chest pain, chronic cough, diarrhoea, dizziness, dry eyes or mouth, earaches, irregular heartbeats, jaw pain, morning stiffness, nausea, night sweats, psychological problems, shortness of breath, tingling sensations and weight loss. But CFS must not be confused with other illnesses displaying similar symptoms.

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So these symptoms do not make it CFS, do they?
To determine CFS, ‘‘the first step is a detailed medical history and a complete physical examination of the patient. Initial tests should include a mental status test, blood tests for BUN (Blood Urea Nitrogen), ESR (erythrocyte sedimentation rate), TSH (thyroid stimulating hormone), besides regular cardiac checks. If none of the diseases is found and the symptoms persist, then CFS can be established,’’ says Dr Ish Anand, consultant neurologist at Sir Ganga Ram Hospital, New Delhi.

Who’s vulnerable to CFS?
No definitive answers to this one either. ‘‘Studies show it is more common among young adults — people in the 20-40 age group — and more among women than men. It also occurs in adolescents,’’ says Dr Samir Parikh, Delhi-based psychiatrist.

What triggers CFS?
The possible causes of CFS continue to be difficult to identify despite vigorous research. ‘‘The weakness is generally noticed following a viral infection,’’ says Dr J N Pandey, head of the department of medicine at AIIMS. ‘‘There is a possibility that multiple causes lead to a common endpoint, in which some viruses or other infections have a contributory role.’’ CFS patients are also likely to have a history of allergies. Physical and emotional stress can also trigger the disease.

How is CFS best tackled?
Doctors insist that the disease is totally reversible; patients grow out of the disease after learning about it and with cognitive behavioural therapy. Mild medication for anxiety is the best treatment.