1. Chronic fatigue syndrome

2. Meet Martha Martha, 32, is a Manager with a BPO. She has a busy routine. She has been coping with a busy lifestyle for over a decade now. However recently, she has started having severe muscle aches and migraines. Initial diagnosis pointed towards work-related stress, but the problem persisted despite medications and ample rest.

3. Meet John John, 24, is a Chemical Science student. Lately he has developed severe concentration problem. He tends to forget things and gets confused. His behavioural patterns have also changed drastically, and he has become irritable and disturbed. Lack of concentration and mood swings have impacted his academics in bad way.

4. What Does the Doctor Say? Hi! I am Dr. Jessica. John and Martha have been taking medication and adequate rest. However, there is no improvement in their condition. A deeper reason could have been ignored! The initial symptoms look like those of “Chronic Fatigue Syndrome”.

5. Chronic Fatigue Syndrome: Definition Chronic fatigue syndrome refers to severe, continued tiredness that is not relieved by rest and is not directly caused by other medical conditions. Let’s begin with the definition of chronic fatigue syndrome (CFS).

6. Causes The exact of chronic fatigue syndrome (CFS) is yet unknown. However, studies suggest that the condition could be caused by: Epstein-Barr virus or human herpes virus-6 Inflammation in the nervous system Faulty immune response

7. Factors that Affect The occurrence and severity of the disease depends upon the following factors.  Age  Previous illnesses  Stress  Genetics  Environmental factors

8. Risk Group Women in the age group of 30-50 are more prone to the disease. However, the disease is not limited exclusively to this group.

9. Symptoms The symptoms of CFS are similar to those seen in the cases of Martha and John. Let’s take a look at the symptoms. Click to view complete list. The condition starts with symptoms similar to flu (mild fever, tiredness, body ache). However, the symptoms persist sometimes for at least six months. Warning bell is extreme tiredness (fatigue), which is: New Long lasting Not relieved by bed rest Severe

10. Complete list of symptoms Symptoms Here is a complete list of symptoms of CFS. Forgetfulness Confusion Muscle aches Sore throat Sore lymph nodes in legs and underarms Extreme tiredness Joint pain (but no swelling/redness) Lack of concentration Mild fever Severe headaches Irritability

11. Diagnosis: Ruling out Other Causes Severe tiredness is the major sign of CFS. However, tiredness and aches could be because of other factors as well. Hence, it is necessary to rule out the following factors.  Other medications  Infections  Immune or autoimmune disorders  Muscle or nerve diseases (such as multiple sclerosis)  Thyroid disorders  Depression  Tumors In case the listed conditions are ruled out and still fatigue lasts, doctors start considering CFS.

12. Diagnosis: After Ruling out Other Causes Once the other factors that may cause severe fatigue are ruled out, doctors usually conform the presence of following three parameters. At least four CFS- specific symptoms Absence of other causes of severe fatigue Extreme, long-term fatigue

13. Diagnosis: Tests Although tests do not seem to help much in diagnosing CFS, brain MRI and WBC count have shown abnormal results in CFS patients.

14. Treatment The treatment of CFS is typically divided into four categories. Cognitive Behavioral Therapy Healthy diet to cope with fatigue Medicines to curb tiredness & aches Adequate sleep

15. Treatment (Contd.) Patients with CFS are advised to maintain healthy lifestyle and active social life. They should adapt themselves according to their medical condition.  Rest when you feel tired  Manage time for activity, rest and sleep  Break tasks into manageable chunks

16. Treatment (Contd.) Alternative therapies such as yoga and hypnosis work in an excellent way.

17. Summary Chronic fatigue syndrome (CFS) refers to severe, continued tiredness that is not relieved by rest and is not directly caused by other medical conditions. CFS may be caused by viruses, inflammation in nervous system or immune system disorders. Women in the age group of 30-50 are more prone to the disease. Warning bell is extreme tiredness (fatigue), which is new, long lasting, severe and not relieved by medicines or rest. Although tests do not seem to help much in diagnosing CFS, brain MRI and WBC count have shown abnormal results in CFS patients. The treatment of CFS includes cognitive behavioral therapy, medications, healthy diet and adequate sleep.

18. Thank you