May 16, 2006 > When Weariness Becomes Chronic Fatigue
When Weariness Becomes Chronic Fatigue
Most people have days when they feel tired and worn out, unable to keep up with the activities of daily life. For some people, however, that weariness stretches on day after day, week after week, month after month. Chronic fatigue syndrome (CFS) is a complicated disorder, generally causing overwhelming exhaustion - both physical and mental - that is not relieved by sleeping and that persists for more than six months.
"Chronic fatigue is difficult to diagnose because there is no known cause and no specific diagnostic tests are available," says Dr. Hoang Trinh, Medical Director of Washington Hospital's Nakamura Clinic in Union City. "Diagnosing chronic fatigue is basically a process of eliminating other possible causes of the patient's symptoms - a diagnosis of exclusion."
In addition to exhaustion, symptoms associated with CFS can include:
- Muscle and joint pain without the presence of any redness or swelling.
- Impairment of short-term memory or concentration skills.
- Forgetfulness or confusion.
- Sore throat.
- Headaches, particularly of a new type or greater severity.
- Hypersensitivity to lights, sounds, odors, particular foods or medications.
- Depression or mood swings.
- Anxiety or irritability.
- Loss of libido.
- Sleep problems such as "unrefreshing" sleep or insomnia.
- Poor body temperature regulation, perhaps with a low-grade fever or fever-like symptoms.
"There are various theories as to what causes chronic fatigue syndrome, including viral infection, but none of them have been proven," Dr. Trinh notes. "Chronic fatigue often starts with, or is triggered by, another illness. Many people do have a respiratory infection prior to developing chronic fatigue. Their other symptoms eventually subside, but the fatigue continues. Respiratory infections are not standard in every case, however. In order for the physician to diagnose chronic fatigue syndrome, it's important to take a good medical history and perform a full physical exam, ordering specific lab tests to rule out other diseases that could be causing the symptoms."
There may also be a genetic component to CFS. Recent research published in the scientific journal Pharmacogenomics noted that certain genetic sequence variations in five stress-moderating genes showed up consistently in chronic fatigue patients. The researchers also identified at least five subtypes of chronic fatigue syndrome, the criteria for which include the patients' genetics.
The cure for CFS has proved as elusive as the cause. "Presently, there is no cure for chronic fatigue," Dr. Trinh admits. "There are, however, some treatment recommendations that have shown to help alleviate patients' symptoms. General recommendations would include resting as much as possible and eating a healthy diet. I tell my patients to pace themselves - establish which of their daily activities are high-priority and do the important things first. I also recommend a mild exercise program, gradually increasing the level of physical activity to build the patient's stamina and endurance."
Dr. Trinh adds that while sleeping pills have not been proven to help with CFS, they might be useful for patients who experience insomnia as part of their cluster of symptoms. "In addition, patients may wish to consult a psychologist or psychiatrist for help in dealing with the depression or mood swings that often result from chronic fatigue," he says. "It also may be helpful to join a local support group of other people suffering from the disorder."
The Nakamura Clinic is a primary care and urgent care facility that provides services for patients ranging in age from newborns to senior citizens. A family medicine practitioner, Dr. Trinh provides pediatric services, women's health care, treatment of minor orthopedic problems and ongoing care for chronic conditions such as high blood pressure, asthma and diabetes.
The clinic also provides occupational medicine services for work-related injuries, pre-employment health screens and handling of workers' compensation claims.
The Nakamura Clinic is located at 33077 Alvarado-Niles Road on the corner of Dowe Avenue, and is open Monday through Friday from 8 a.m. to 6 p.m. For appointments, please call (510) 487-6000. Most insurances are accepted and Urgent-care patients are accepted on a walk-in basis.