After years of treating the chronic fatigue syndrome as a psychological disorder, leading health organisations now recognise that it is a serious, long-term illness possibly caused by a disruption in how the immune system responds to infection or stress, reported The Independent while crediting New York Times. It shares many characteristics with autoimmune diseases like rheumatoid arthritis but without apparent signs of tissue damage.
Accordingly, doctors now typically refer to it as myalgic encephalomyelitis, meaning brain and spinal cord inflammation with muscle pain, and in scientific papers it is often written as ME/CFS. At the same time, a major shift is underway as far as how the medical profession is being advised to approach treatment.
The long-standing advice to “exercise your way out of it” is now recognised as not only ineffective but counterproductive. It usually only makes matters worse, as even the mildest activity, like brushing your teeth, can lead to a debilitating fatigue, the core symptom of the disease. Both the Centres for Disease Control and Prevention in the United States and the National Institute for Health and Care Excellence in the UK are formulating revised guidelines for managing an ailment characterised by six or more months – and sometimes years – of incapacitating fatigue, joint pain and cognitive problems.
This new thinking is long overdue. It is understandably difficult for doctors to appreciate that a disorder lacking obvious physical abnormalities could have a physical basis, especially when patients debilitated by a chronic disease that no one understands are likely to be depressed and anxious.
For patients struggling to get recognition that they are suffering from a serious physiological illness with real symptoms, the goal remains to have doctors take the problem seriously and prescribe an evidence-based approach to treatment that offers hope for relief.
Medical practitioners who remain disease deniers may think differently after learning about factors that can precede an attack of ME/CFS and the abnormalities now known to often accompany it. For example, one person in 10 who meets the diagnostic criteria for this syndrome reports that it followed an infection with Epstein-Barr virus, Ross River virus or Coxiella burnetii, a bacterium that causes Q fever. The syndrome is also often accompanied by immune system disruptions, including chronically high levels of cytokines that change how the body responds to stress; poor function of natural killer cells that diminish the ability to fight infections, and abnormal activity of T-cells needed for an appropriate response to infection.–Agencies