There were days Jyotsna would just rise and shine. On other, not-so-exceptional days, she could barely manage to drag herself out of the bed. Her low level of stamina frustrated her, as did the inability to see any pattern emerging from the erratic energy levels. ?Has the viral fever relapsed because I didn?t take as much rest as I should have? Or is it just mental stress manifesting itself in the physical form?? the 36-year-old sales manager kept contemplating. On most days she would be just dead tired. Her performance at work began to suffer as errors started creeping in the reports she prepared.
Weekends at home were no better. Even the simplest of chores became difficult tasks. Her predicament whether to consult a doctor or not was understandable. ?But then what do I tell my doctor? That I am just too tired all the time.? Tiredness was too trivial a symptom to be paid attention to and its impact too serious to be ignored.
Such a case of prolonged tiredness is something that many of us may relate to, either literally or figuratively. And as experts suggest, the diagnosis could be chronic fatigue syndrome (CFS). ?Most patients complain of fatigue. However, CFS is different,? says Dr Ajay Rastogi, Consultant, Internal Medicine, Fortis Hospital, Noida. ?The kind of fatigue experienced in CFS has no simple explanation. It is not the result of an ongoing exertion, nor does it get alleviated by rest. It randomly keeps on relapsing,? he explains.
Accompanying that is a constellation of other symptoms, adds Dr Punit Pruthi, Consultant Physician, Internal Medicine & Respiratory Care, Asian Institute of Medical Sciences, Faridabad. ?The symptoms could include sore throat, body ache, headache, gastrointestinal problems, bloating, joint pains, difficulty in concentrating etc. In case of CFS, therefore, it is a diagnosis of exclusion. We rule out the possibility of other diseases such as thyroid and endocrine diseases that manifest with the same kind of symptoms through routine clinical tests. There are still no tests for CFS, as most are in the experimental stage. CFS, thus, is the final diagnosis when all other possibilities are eliminated,? adds Dr Pruthi.
The incidence of CFS in India is still unknown because not many people know about it. Secondly, most patients get lost in the follow-up process. ?CFS is more common than many realise. In the US, nearly 2,500 people in a lakh suffer from CFS. I can?t believe it may be any less in India. Increasingly, younger people are suffering from it, though women are more predisposed to the disease than men,? says Dr SP Byotra, Consultant, Internal Medicine, Sir Gangaram Hospital, Delhi. According to Dr Pruthi?s estimate, ?up to 10% of all patients with chronic fatigue fit into the CFS category?.
So, it would be a good idea to consult your doctor if you have been suffering from chronic fatigue. Though it is not a life-threatening disease, it can definitely cause impairment.
Despite the substantial incidence, the cause of CFS still continues to be a matter of scientific controversy. Last October, a research published in the journal Science, discovered that 67% of American patients suffering from CFS were also afflicted by the Xenotropic Murine Leukaemia Virus (XMRV). Strains of the same virus were also inferred in prostate cancer, breast cancer and lymphoma. However, a recent British study, failing to find XMRV in any of the 200 CFS patients tested in Britain, has been unable to replicate the results of the American study. A dead end, indeed, in terms of finding a cure to the syndrome.
The diagnosis of exclusion, therefore, is usually followed by symptomatic treatment. ?Because the cause of CFS is unknown, the treatment programmes are directed at relief of symptoms rather than cure. Our goal is to help the patient regain the pre-existing level of function and well-being,? adds Dr Rastogi.
?CFS can be very frustrating for patients because there are no clear answers to the problems they are suffering from. Over a period of time the problems may lead to depression as well. And in that case, counselling by a psychologist helps a lot. There is also a group of medication available with the help of which we try to modulate the serotonin levels of a patient, but it?s strictly on a case-to-case basis. We treat the predominant symptoms that the patient exhibits. For instance, in case of irritable bowel syndrome, dietary modifications are recommended. Exercise forms a major part of the medication. The bottomline is that most patients get cured,? says Dr Sandeep Budhiraja, Chief of Internal Medicine, Max Healthcare, Delhi.
