Worldwide fatigue is the most common symptom that is presented to a health practitioner. There are different levels of fatigue which are given different labels. The precise cause of fatigue in any one individual is rarely able to be determined therefore the terms used are often interchangeable.

Fatigue is a symptom, not a condition

Symptoms can be grouped into three categories.

Acute fatigue

Persistent fatigue

Chronic fatigue syndrome /Myalgic Encephalomyelitis.  ME/CFS or M.E.

 

Acute fatigue  –  Persistent fatigue

Fatigue can be associated with many conditions and there can be multiple contributing factors.

Biological

Age and gender
Medicines
Infection
Thyroid or other metabolic /endocrine and hormone disorders
Cardiac and or respiratory conditions
Malignancy
Sleep disorder( organic)
Pesticides

Psychological

Anxiety
Depression
Post-traumatic stress disorder
Sleep disorder (non-organic)

Social

Family and relationship problems
Bereavement
Occupational stress
Unemployment

Lifestyle

Drug and alcohol abuse
Sleep deprivation
Overwork
Sedentary lifestyle
Inappropriate diet
Chronic stress

In coming to a diagnosis it is important that a thorough evaluation is undertaken to identify and exclude treatable conditions that cause fatigue.

Chronic Fatigue Syndrome (CFS/ME)

  1. CFS is a diagnosis of exclusion of other diseases. There is as yet no specific biomarker to confirm the diagnosis
  2. Clinically characterised by severe and disabling new-onset fatigue with at least four additional symptoms: impaired memory or concentration, sore throat, tender cervical or axillary lymph nodes, muscle pain, multi-joint pain, new headaches, unrefreshing sleep or post-exertion fatigue.
  3. It is a neuro-immune-endocrine dysfunction. Central sensitisation is the most likely common pathophysiological substrate for this, and other fatigue -like syndromes.

Up until recently, a psychologically-based model was widely held to be the basis for the aetiology of fatigue associated syndromes.  ME/CSF is not a mental health disorder.  It is due to biological disruptions and imbalances. Research is uncovering molecular, neurological, endocrine and immunological deficits in many patients leading to the potential for biologically based therapeutic interventions.

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