Shine light on your invisible illness

Chronic fatigue syndrome (CFS) is a complex disorder characterized by extreme fatigue that lasts for at least six months and cannot be fully explained by an underlying medical condition. Symptoms may include:

• Profound exhaustion
• Unrefreshing sleep
• Post-exertional malaise (PEM)
• Cognitive difficulties
• Orthostatic intolerance
• Widespread pain

Diagnosing chronic fatigue syndrome (CFS) can be challenging due to its complex nature and the absence of a definitive diagnostic test. The process involves several steps to rule out other potential causes of chronic fatigue and to confirm the diagnosis based on specific criteria. Here’s a detailed look at how CFS is diagnosed:

1. Comprehensive Medical History:
   • A thorough review of the patient's medical history is conducted to identify any underlying conditions or previous illnesses that could explain the symptoms.
   • Detailed information about the onset, duration, and severity of fatigue, as well as its impact on daily life, is gathered.
2. Physical Examination:
   • A complete physical examination is performed to check for signs of other medical conditions that might cause similar symptoms.
3. Targeted Testing:
   • Blood tests, urine tests, and other laboratory tests are used to rule out conditions such as anemia, thyroid disorders, diabetes, and infections.
   • Additional tests may be performed to assess liver and kidney function, electrolyte levels, and inflammatory markers.
4. Symptom Evaluation:
   • The presence of characteristic symptoms such as profound exhaustion, unrefreshing sleep, post-exertional malaise (PEM), cognitive difficulties, orthostatic intolerance, and pain are evaluated.
   • The diagnosis typically requires the presence of severe, unexplained fatigue lasting for at least six months, along with at least four of the other specified symptoms.
5. Exclusion of Other Conditions:
   • Conditions such as sleep disorders, major depressive disorder, bipolar disorder, and other chronic illnesses must be ruled out.
   • Sometimes, referrals to specialists such as neurologists, rheumatologists, or infectious disease experts are necessary to exclude other potential diagnoses.
6. Assessment of Post-Exertional Malaise (PEM):
   • PEM is a hallmark symptom of CFS, characterized by a significant worsening of symptoms following physical or mental exertion. This is carefully assessed through patient history and sometimes through specific tests or activity monitoring.

The exact cause of chronic fatigue syndrome (CFS) remains unknown, and it is likely that a combination of factors contributes to the development of this complex condition. Here are some of the leading theories and potential triggers that researchers believe may play a role in CFS:

1. Viral Infections:
   • Some evidence suggests that viral infections, such as Epstein-Barr virus (EBV), human herpesvirus 6 (HHV-6), and enteroviruses, may trigger CFS. However, no single virus has been definitively linked to the condition.
   • In some cases, CFS appears to develop following an acute viral illness, leading researchers to explore the role of persistent viral infections or reactivation of latent viruses.
2. Immune System Dysfunction:
   • Abnormalities in immune system function have been observed in some CFS patients, including chronic low-grade inflammation and altered cytokine profiles.
   • This suggests that an overactive or dysfunctional immune response could contribute to the symptoms of CFS.
3. Hormonal Imbalances:
   • Research has identified potential abnormalities in the hypothalamic-pituitary-adrenal (HPA) axis, which regulates stress response and various hormonal functions.
   • Imbalances in cortisol and other hormones may contribute to the fatigue and other symptoms experienced by CFS patients.
4. Genetics:
   • Genetic predisposition may play a role, as CFS has been observed to occur more frequently in certain families.
   • Ongoing genetic studies aim to identify specific genes or genetic variations that could increase susceptibility to CFS.
5. Physical or Emotional Trauma:
   • In some cases, CFS appears to develop after a significant physical injury, surgery, or emotional stress.
   • The relationship between trauma and the onset of CFS is still being investigated.
6. Environmental Factors:
   • Exposure to certain environmental toxins or pollutants may contribute to the development of CFS in susceptible individuals.
   • The role of environmental triggers is an area of active research.
7. Gut Microbiome:
   • Emerging research suggests that gut microbiome imbalances may be linked to CFS, with some studies finding differences in the gut bacteria of CFS patients compared to healthy individuals.
   • This line of research is exploring how gut health and the immune system interact and potentially contribute to CFS symptoms.

At Biio, we take a holistic, patient-centered approach to managing CFS. Our multidisciplinary team collaborates to create personalised treatment plans that address each individual's unique needs. We focus on a combination of symptom management, pacing strategies, and addressing any coexisting conditions using evidence-based practices.

While there is no universally approved medication specifically for treating CFS itself, various medications can be used to manage its symptoms and coexisting conditions. Treatment often includes medications like low-dose naltrexone for immunomodulation, clonidine for pain and sleep disturbances, and other drugs to address specific symptoms such as sleep aids or hormonal support. Some supplements have shown potential benefits for fatigue.

The timeline for improvement varies from person to person. Some may start to see benefits within a few weeks, while for others it may take several months. Consistency and patience are key, as overexertion can lead to setbacks. Our team will continuously monitor your progress and adjust your treatment plan as needed.

Getting started is simple. Book an initial consultation through our website with one of our experienced health coaches. During this appointment, we'll discuss your medical history, symptoms, and goals for care. From there, we'll create your personalised care plan and connect you with the appropriate members of our multidisciplinary team to begin your journey toward better managing your chronic fatigue.