Addressing Chronic Fatigue at the Root
Chronic fatigue is something that affects almost 200,000 people around Australia and while we often assume it means nothing more than the feeling of tiredness, being run-down, burnt out or overly stressed – this is not the case.
Chronic fatigue and the fatigue associated with long distance driving are different, (a driver who is feeling run down who doesn’t have chronic fatigue can simply stop and rest up) it may be useful to understand what chronic fatigue is and how it is likely caused.
Chronic fatigue or myalgic encephalomyelitis, or ME/CFS as it is now more commonly known is actually a serious and incapacitating disease that can impact a person’s life drastically. It is characterised by unexplained, intense fatigue for more than 6 months, difficulty remembering or concentrating, muscle pain and weakness, joint pain, sleep disturbances, flu-like symptoms, light headedness, headaches, sensitivity to light and/or sound, tender lymph nodes, sore throats and new sensitivities to food, medicines, chemicals etc.
This condition makes the simplest activities such as shopping or meeting friends difficult or impossible. It also elevates people’s suicide risk.
A recent article on TheConversation.com highlighted the challenge facing most patients in getting a diagnosis. A UK study revealed that less than half of all doctors were confident with the diagnosis or treatment of chronic fatigue and most patients (85%) were going from doctor to doctor for over 2 years before getting a diagnosis.
Researchers are still trying to figure out the underlying causes because most patients tested normal. Some researchers believe the problem could be psychological.
In 2011, the findings of a clinical trial suggested patients could recover through psychological therapy (cognitive behavioural therapy or CBT) and graded exercise therapy. These findings have fuelled debate as to whether ME/CFS might be a disease of the mind.
But a landmark US study examining nearly 10,000 research publications suggested otherwise, concluding that ME/CFS is a serious, chronic, complex and systemic disease.
In Australia, exercise is part of the recommended guidelines as part of therapy however the US Centres for Disease Control and Prevention have stopped these recommendations.
Here’s what we do know,
There are no laboratory tests available to categorically diagnose someone with ME/CFS. But Australian research is playing a leading role in the discovery of possible diagnostic markers. For example, inflammatory blood proteins such as activin B and interferon are increased in ME/CFS. Other studies have shown metabolic waste products from some gut bacteria accumulate in ME/CFS patients and so may also provide diagnostic information in the future.
Women are four times more likely to be diagnosed with ME/CFS than men, but the reason for this is unclear. Also, having a first-degree relative with ME/CFS more than doubles the risk of developing the disease, but the role of genetics is not known.
From the research it’s clear that anyone who has been diagnosed with chronic fatigue syndrome probably shouldn’t be driving long distance, at least until they have their condition under control. This is very different from the fatigue associated with a healthy person simply driving too long without rest breaks or what we commonly refer to in Australia as “fatigued driving”.
Read more about chronic fatigue at https://theconversation.com/what-causes-chronic-fatigue-what-we-know-dont-know-and-suspect-94395