CFS, Chronic Fatigue syndrome: Difference between revisions

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[[Lach, Lachesis Mutus|Lach]]
=== Clinic ===
=== Clinic ===


* Also called myalgic encephalomyelitis (ME) or ME/CFS
* Also called myalgic encephalomyelitis (ME) or ME/CFS
* It is a complex, debilitating, long-term medical condition with unknown Causes and mechanisms.
* It is a complex, debilitating, Long-term medical condition with Unknown causes and mechanisms.
* Lengthy exacerbations or flare-ups of the illness following ordinary minor physical or mental activity, known as post-exertional malaise (PEM); greatly diminished capacity to accomplish tasks that were routine before the illness; and sleep disturbances.
* Lengthy exacerbations or flare-ups of the illness following ordinary minor physical or mental activity, known as post-exertional malaise (PEM); greatly diminished capacity to accomplish tasks that were routine before the illness; and sleep disturbances.
* Orthostatic intolerance (difficulty sitting and standing upright)
* [[Orthostatic hypotention]]
* Cognitive dysfunction
* Cognitive dysfunction


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** Brain fog: Problems with thinking and memory
** Brain fog: Problems with thinking and memory
** Orthostatic intolerance
** Orthostatic intolerance
* '''Others'''
* '''Others'''
** Muscle pain, joint pain without swelling or redness, and headache
** Muscle pain, joint pain without swelling or redness, and headache
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** Increased sensitivity to sensory stimuli and pain
** Increased sensitivity to sensory stimuli and pain


=== Entity  ===
* Syncope: RBS, SAHF, LSSV, YF, CXA-B, HSV-1, TBE
* [[Depression]]:EBV, B19, HSV-1, PLV, HBV, RBOL
* Central sensitization: DHF, PLV, HSV-1, HSV-2, CLTV, LSSV


=== Miasmatic analysis ===
[[HSV-1, Herpes Simplex Virus|HSV-1]]


=== Related disease ===
=== Related disease ===
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*[[Fibromyalgia]]
*[[Fibromyalgia]]
*[[Interstitial cystitis]]
*[[Interstitial cystitis]]
*[[Chronic pelvic pain syndrome]]




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* Because it may begin as an influenza-like illness with a sudden onset, various infectious causes have been proposed, but evidence is insufficient to prove such causation.
* Because it may begin as an influenza-like illness with a sudden onset, various infectious causes have been proposed, but evidence is insufficient to prove such causation.
* Infections proposed include mononucleosis, ''Chlamydophila pneumoniae'', '''[[HHV-6, Human Herpes Virus 6|HHV-6]]''', and Lyme disease
* Infections proposed include mononucleosis, ''Chlamydophila pneumoniae'', '''[[HHV-6, Human Herpes Virus 6|HHV-6]]''', and Lyme disease
* Often, the illness will follow a viral illness such as mononucleosis or gastroenteritis.
* Often, the illness will follow a viral illness such as mononucleosis or [[gastroenteritis]].


* '''[[EBV, Epstein Barr Virus|EBV]]'''
* '''[[EBV, Epstein Barr Virus|EBV]]'''
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* Brainstem hypometabolism
* Brainstem hypometabolism


* Autonomic nervous system dysfunction role in CFS
* [[Autonomic Nervous System|Autonomic nervous system]] dysfunction has a role in CFS
* [[Central sensitization syndrome|Central sensitization]] have been observed in CFS.
* have been observed in CFS.
* Evidence points to abnormalities in [[HPA axis]].
* Evidence points to abnormalities in [[HPA axis]].


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!CMV
!CMV
|-
|-
|Mononucleosis
|[[Mononucleosis]]
 
* Tender cervical lymphadenopathy
* Tender cervical lymphadenopathy
* Sore throat
* Sore throat
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| +++
| +++
|-
|-
|Syncope
|Syncope/ Orthostatic hypotension
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|
| ++
| ++
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|-
|Fatigue
|
|
|
|
|-
|
|
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|-
|[[Central sensitization syndrome|Central sensitization]]
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=== Recent researches ===
=== Recent researches ===


* An association between CFS and abnormalities of the [[HPA axis|'''HPA axis''']] has been described, and other adrenal steroid abnormalities have been suggested.  
* An association between CFS and abnormalities of the [[HPA axis|'''HPA axis''']] has been described, and other adrenal steroid abnormalities have been suggested.
* DHEA and its sulphate ('''[[DHEA-S]]'''), apart from being a precursor of sex steroids, have other functions associated with memory, depression and sleep.
* DHEA and its sulphate ('''[[DHEA-S]]'''), apart from being a precursor of sex steroids, have other functions associated with memory, depression and sleep.
** It has been suggested that CFS may be associated with a state of relative DHEA(-S) deficiency.
** It has been suggested that CFS may be associated with a state of relative DHEA(-S) deficiency.
** Therefore we investigated basal levels of DHEA(-S), the cortisol/DHEA molar ratio and the responsiveness of DHEA to stimulation by CRH.
** Therefore we investigated basal levels of DHEA(-S), the cortisol/DHEA molar ratio and the responsiveness of DHEA to stimulation by CRH.
* Recent studies have also suggested that low dose hydrocortisone may be effective at reducing fatigue in CFS. We therefore also assessed these parameters prior to and following treatment with low dose oral hydrocortisone.
* Recent studies have also suggested that low dose hydrocortisone may be effective at reducing fatigue in CFS. We therefore also assessed these parameters prior to and following treatment with low dose oral hydrocortisone.
* '''DHEA levels are raised''' in CFS and correlate with the degree of self-reported disability.  
* '''DHEA levels are raised''' in CFS and correlate with the degree of self-reported disability.
* Hydrocortisone therapy leads to a reduction in these levels towards normal, and an increased DHEA response to CRH, most marked in those who show a clinical response to this therapy.
* Hydrocortisone therapy leads to a reduction in these levels towards normal, and an increased DHEA response to CRH, most marked in those who show a clinical response to this therapy.
* Note that in [[PCOD, PCOS, Poly Cystic Ovarian Disease (Syndrome) remedies|PCOS]], we have also high level of DHEA.
* Note that in [[PCOD, PCOS, Poly Cystic Ovarian Disease (Syndrome) remedies|PCOS]], we have also high level of DHEA.
=== Entity  ===
* [[Syncope]]: RBS, SAHF, LSSV, YF, CXA-B, HSV-1, TBE
* [[Depression]]:EBV, B19, HSV-1, PLV, HBV, RBOL
* Central sensitization: DHF, PLV, HSV-1, HSV-2, CLTV, LSSV
=== Miasmatic analysis ===
[[HSV-1, Herpes Simplex Virus|HSV-1]]
=== Remedies ===
* [[Lach, Lachesis Mutus|Lach]]

Revision as of 22:20, 29 April 2023

Clinic

  • Also called myalgic encephalomyelitis (ME) or ME/CFS
  • It is a complex, debilitating, Long-term medical condition with Unknown causes and mechanisms.
  • Lengthy exacerbations or flare-ups of the illness following ordinary minor physical or mental activity, known as post-exertional malaise (PEM); greatly diminished capacity to accomplish tasks that were routine before the illness; and sleep disturbances.
  • Orthostatic hypotention
  • Cognitive dysfunction


Signs and symptoms

  • Main
    • Fatigue which last six months or longer.
    • Physical or mental activity agg
    • Sleep problems; people may still feel weary after full nights of sleep, or may struggle to stay awake, fall asleep or stay asleep.
    • Brain fog: Problems with thinking and memory
    • Orthostatic intolerance


  • Others
    • Muscle pain, joint pain without swelling or redness, and headache
    • Tender cervical lymphadenopathy
    • Sore throat
    • Chills and night sweats
    • Allergies to foods, odors, chemicals, lights, or noise
    • Shortness of breath
    • Irregular heartbeat
    • Increased sensitivity to sensory stimuli and pain


Related disease


Cause

  • Because it may begin as an influenza-like illness with a sudden onset, various infectious causes have been proposed, but evidence is insufficient to prove such causation.
  • Infections proposed include mononucleosis, Chlamydophila pneumoniae, HHV-6, and Lyme disease
  • Often, the illness will follow a viral illness such as mononucleosis or gastroenteritis.


Pathophysiology

  • Brainstem hypometabolism


Entities

CFS entities EBV HIV HSV-1 CMV
Mononucleosis
  • Tender cervical lymphadenopathy
  • Sore throat
 +++ +++ +++
Syncope/ Orthostatic hypotension +++ +++
Adrenal insufficiency +++ ++ +
Depression ++ ++
Fatigue
Central sensitization


Recent researches

  • An association between CFS and abnormalities of the HPA axis has been described, and other adrenal steroid abnormalities have been suggested.
  • DHEA and its sulphate (DHEA-S), apart from being a precursor of sex steroids, have other functions associated with memory, depression and sleep.
    • It has been suggested that CFS may be associated with a state of relative DHEA(-S) deficiency.
    • Therefore we investigated basal levels of DHEA(-S), the cortisol/DHEA molar ratio and the responsiveness of DHEA to stimulation by CRH.
  • Recent studies have also suggested that low dose hydrocortisone may be effective at reducing fatigue in CFS. We therefore also assessed these parameters prior to and following treatment with low dose oral hydrocortisone.
  • DHEA levels are raised in CFS and correlate with the degree of self-reported disability.
  • Hydrocortisone therapy leads to a reduction in these levels towards normal, and an increased DHEA response to CRH, most marked in those who show a clinical response to this therapy.
  • Note that in PCOS, we have also high level of DHEA.


Entity

  • Syncope: RBS, SAHF, LSSV, YF, CXA-B, HSV-1, TBE
  • Depression:EBV, B19, HSV-1, PLV, HBV, RBOL
  • Central sensitization: DHF, PLV, HSV-1, HSV-2, CLTV, LSSV


Miasmatic analysis

HSV-1


Remedies

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