Chronic Fatigue

Chronic fatigue

Chronic fatigue syndrome refers to severe, continued tiredness that is not relieved by rest that may or may not is directly caused by other medical conditions. 

Fatigue can be a normal and important response to physical exertion, emotional stress, boredom, or lack of sleep. However, it can also be a sign of a more serious mental or physical condition. When fatigue is not relieved by enough sleep, good nutrition, or a low-stress environment, it should be evaluated. Chronic fatigue syndrome (CFS) is a condition that usually starts with flu-like symptoms and lasts for 6 months or more. It is diagnosed after all other possible causes of fatigue are ruled out. Most people with CFS do not get much relief from rest. 

It is a devastating and complex disorder characterized by overwhelming fatigue that is not improved by bed rest and that may be worsened by physical or mental activity. 

People with CFS most often function at a significantly lower level of activity than they were capable of before the onset of illness.

In addition to these key defining characteristics, patients report various nonspecific symptoms, including weakness, muscle pain, impaired memory, and/or mental concentration, insomnia, and post-exertional fatigue lasting more than 24 hours. In some cases, CFS can persist for years.

The cause or causes of CFS have not been identified and no specific diagnostic tests are available. Moreover, since many illnesses have incapacitating fatigue as a symptom, care must be taken to exclude other known and often treatable conditions before a diagnosis of CFS is made.

As of today, the cause or causes of CFS have not been identified and no specific diagnostic tests are available. To diagnose chronic fatigue syndrome, we usually consider two criteria among the host of all other potential medical conditions:

1. Have severe chronic fatigue for at least 6 months or longer that is not relieved by rest and not due to medical or psychiatric conditions associated with fatigue as excluded by clinical diagnosis; and

2. Concurrently have four or more of the following symptoms: 

  • self-reported impairment in short-term memory or concentration severe enough to cause a substantial reduction in previous levels of occupational, educational, social, or personal activities

  • a sore throat that's frequent or recurring

  • tender cervical or axillary 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 (extreme, prolonged exhaustion and sickness following physical or mental activity) lasting more than 24 hours.

The fatigue and impaired memory or concentration must have impaired normal daily activities, along with other symptoms that must have persisted or recurred during 6 or more consecutive months of illness and must not have predated the fatigue.

The cause or causes of CFS remain unknown, despite a vigorous search. While a single cause for CFS may yet be identified, another possibility is that CFS represents a common endpoint of disease resulting from multiple sudden causes. Some of the possible causes of CFS might be due to infectious agents, immunological dysfunction, stress activating the hypothalamic-pituitary-adrenal (HPA) axis, neurally mediated hypotension, and/or nutritional deficiency such as following conditions: • Anemia (including iron deficiency anemia)

  • Depression or grief

  • Medications such as sedatives or antidepressants

  • Persistent pain

  • Sleep disorders such as insomnia, obstructive sleep apnea, or narcolepsy

  • A Thyroid gland that is underactive or overactive

  • Use of alcohol or drugs such as cocaine or narcotics, especially with regular use

  • Addison's disease

  • Anorexia or other eating disorders

  • Arthritis, including juvenile rheumatoid arthritis

  • Autoimmune diseases such as systemic lupus erythematosus

  • Cancer

  • Congestive heart failure

  • Diabetes

  • Fibromyalgia

  • Infection, especially one that takes a long time to recover from or treat, such as bacterial endocarditis (infection of the heart muscle or valves), parasitic infections, AIDS, tuberculosis, and mononucleosis

  • Kidney disease

  • Liver disease

  • Malnutrition

  • Certain medications may also cause drowsiness or fatigue, including antihistamines for allergies, blood pressure medicines, sleeping pills, steroids, and diuretics.

What is Dr. Jadali’s approach to this devastating disease?

It all starts with a comprehensive evaluation of the patient. A detailed history of the onset and progression of your fatigue along with any other associated contributing conditions such as detailed evaluation of your sleep pattern.

Dr, Jadali has developed an extensive blood work to look into various systems and conditions in your body that could potentially participate and contribute to your fatigue. These blood tests are nothing fancy and are routinely paid by insurance companies but what to test and how to manage the results have made Dr. Jadali’s work very unique. These metabolic workups along with a potential sleep study for selected patients are keys to a correct approach to this condition.

After appropriate deficiencies are identified, numerous treatments are then considered including pharmacological, nutritional, and natural including Bio-Identical hormonal treatments. Vitamin deficiencies may be treated via Intravenous (IV) routes for best absorption.

Hundreds of patients have already experienced the change and currently enjoying their lives.