Are you tired all the time? The chances are that the answer to that question is yes; after all, we’re all so busy and juggling so many different roles that we all take being semi-exhausted for granted. But, have you considered that you could be suffering from Chronic Fatigue Syndrome?
We turned to Dr Rajendra Sharma who is the author of the award-winning book “Live Longer, Live Younger” and has a number of high profile patients who come to see him in London – including none other than superstar singer Tina Turner (who is positively rocking it at the age of 78 and about to pick up a Lifetime Achievement Award at this weekend’s Grammys).
Here, Dr Sharma gives us an in-depth explanation of what Chronic Fatigue Syndrome is and explains why it’s often misdiagnosed.
Official figures state that the number of people in the UK suffering with Chronic Fatigue Syndrome (CFS) is approximately 150,000. However, other figures suggest that, as a population, we are either being underdiagnosed or misdiagnosed. This means that there are probably many more of us struggling with CFS than we think.
After all, CFS is a label given to those whose chronic tiredness and other symptoms do not fall under any other diagnosis.
Published estimates state that from 0.25% to 2.54% of the population may well have been misdiagnosed (the lower figure comes from UK research and the upper figure from the USA). This means the number of sufferers here in the UK could be closer to 1.6 million people rather than the suggested 150,000. It is possible that CFS is underdiagnosed in more than 80% of the people who have it or is often misdiagnosed as depression.
The main problems in diagnosis are:
1. There is no specific test for CFS
2. Conditions that share the main symptoms of CFS are possibly also being underdiagnosed
3. Underlying causes are not established
4. There are no drugs to treat CFS so little money goes into research
The guidelines for governing diagnosis are by symptoms only. A person must have fatigue lasting more than six months and have at least four symptoms from specific lists.
There are some practitioners who are concerned that almost half of patients referred from primary care with a diagnosis of ME/CFS, actually have something else wrong with them.
So, are we dealing with ‘misdiagnosis on a grand scale’?
Many conditions causing fatigue are identifiable, such as anaemia, low vitamin B12, low vitamin D and low thyroid, (although I consider that under-diagnosis of these is common too, due to practitioners assuming that a result in the reference range is in fact in the ‘population range’ and is not, as is commonly stated, necessarily ‘normal’ for any individual).
Symptoms of CFS mirror many conditions. There’s little doubt that more studies about CFS; manifestations, evaluation and management; are needed.
At this time, conventional therapy for CFS is based on Cognitive Behavioural Therapy (CBT), graded exercise therapy, activity management (involving the setting of individual goals and gradually increasing your activity levels) and an inference that much of the problem is in the mind. When medication is considered, it’s generally symptomatic such as painkillers or antidepressants.
Diet and supplements are rarely considered despite strong evidence of efficacy.
There is evidence of benefit from therapy for mitochondrial dysfunction, (failure of cells to turn oxygen and sugar into energy due to faulty mitochondria) but investigations are not utilised.
Personally, I recommend a range of functional Medicine tests for patients with CFS to identify the underlying cause(s) so that therapy can be individualised. Genetic, immunologic, infectious, metabolic (especially mitochondrial dysfunction), and neurologic aetiologies are all capable of affecting energy production. Bowel inflammation and flora imbalance is also a cause of CFS but rarely investigated or treated despite many research papers.
I believe that natural therapies including high dose supplementation, intravenous nutritional replenishment, mitochondrial therapy, bioidentical hormone therapy and botanical/herbals should be utilised in combination with lifestyle, exercise, dietetic and complementary and alternative therapies.
ABOUT THE AUTHOR
Dr Rajendra Sharma is the author of the award winning “Live Longer, Live Younger”. He practices Integrated Medicine in Wimpole Street, London and in Exeter, Devon.
Did you find this interesting? Here’s how to futureproof your body, this is how to get an A-list workout from the comfort of home, this is how to smash dry January and keep it going into February and here’s how to combat winter depression.