Chronic Fatigue Syndrome

Nov 14 2000 by Joanne Kabak (drkoop.com Health News)

For people who suffer from chronic fatigue syndrome (CFS), also known as chronic fatigue and immune dysfunction syndrome (CFIDS) and myalgic encephalitis (ME), there are many challenges to deal with, including feeling exhausted, having impaired short-term memory or concentration, pain in the muscles and joints, and disrupted sleep.

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The symptoms associated with CFIDS often lend themselves to treatment both with drugs and lifestyle changes, Kenney says. For example, a patient may use a combination of prescription drugs and techniques such as physical therapy and massage.

In the search for a cause and a cure, people have gravitated to different theories -- from bacterial, viral and environmental causes to neurological ones. "It really is a very confusing picture," Kenney said. "One day you're told you should take this antibiotic. Then you're told no, massage is the best thing. And the next day you're told to have an MRI and consider neurosurgery."

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Getting to the point where you can have good sleep "sometimes helps the pain and the cognitive problems. It may even help some of the flu-like symptoms," she said.

Another symptom that is dealt with early on is pain. "A lot of people have pain in the joints and muscles, and headache pain that can be pretty debilitating. Using a combination of some of the new medicines and techniques like massage, physical therapy and applying hot and cold packs can sometimes help manage pain in a way that helps a person become as active and functional as possible," Kenney said. Not all CFS patients can exercise or be active, however, due to the severity of their condition. A problem with becoming deconditioned and not moving around much is that "you become less and less active and that in and of itself creates problems." Also, she says, if depression is present in a patient in addition to chronic fatigue syndrome, then treating it becomes an important part of the process.

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Focusing Research

Initially, the focus in research had been on finding the cause, Kenney says. Now the research is increasingly viewing the illness "as sort of an end state, a clinical entity that can exist for any variety of reasons," she said. There may be a genetic component to it. Sometimes the syndrome begins after a car accident, a flu that never fully went away, or after the death of a family member. However, CFS that occurs after emotional or physical trauma is much more rare than sudden or gradual onset for no apparent reason. "When a particular set of circumstances exists and the body is compromised by coming in contact with a virus or bacteria, a blow, or life change, the cascade can begin and then the body can't shut itself off," Kenney said.

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Looking for Energy

Dr. Georg D. Birkmayer, a biochemical researcher and the medical director of the Birkmayer Institute for Parkinson's Therapy in Vienna, Austria, has explored the issue of treating chronic fatigue syndrome through increasing energy at the cellular level.

In a double-blind, placebo-controlled study at Georgetown University, he says a substance called NADH was found to help some patients with chronic fatigue. The study was published in the February 1999 Journal of Allergy, Asthma and Immunology. Its conclusion was that "the results of this preliminary study indicate that NADH (Enada) may be an effective therapy in the management of the chronic fatigue syndrome and suggest that further clinical trials be performed to establish its efficacy in this clinically perplexing disorder." The study was done on 26 patients who fulfilled the Centers for Disease Control criteria for chronic fatigue syndrome, and it was reported that the results showed that among that group, four times more patients responded to NADH than to the placebo.

Birkmayer describes NADH as a biological form of hydrogen that reacts with oxygen in cells to produce a form of energy. "Every cell has to have sufficient forms of energy to stay alive," Birkmayer said. "We succeeded in stabilizing NADH and making it in an absorbable form." Simply put, "chronic fatigue is a lack of energy. And NADH increases energy." He says it is sold over the counter as a nutritional supplement under the brand name Enada.

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