There followed a few paragraphs of general information on the causes and treatment of CFS:
Prolonged fatigue also often occurs as a result of EBV infection or herpes reactivation. It is believed that one cause of CFS is chronic immune activation / autoimmunity and this is directed against adrenergic receptors at least in a subset of patients. In addition to the severe fatigue, almost all patients suffer from cognitive disorders and sleep disorders, and many patients also suffer from a strong sensitivity to stimuli similar to migraine patients during an attack. Many patients also have a sore throat, joint pain, and flu-like symptoms. As a correlate for immune activation, a T-cell activation or immunoglobulin increase is found in some patients. This was not observed in the case of TiredSam.
Many patients suffer from mild rhinitis / sinusitis, frequent infections and irritable bowl syndrome. Often there is also an immunodeficiency, about 1/3 of the patients have a detectable immunoglobulin deficiency, about 15% a lack of complement-activating factor mannan-binding lectin. TiredSam has a slight IgG deficiency, however, he denies having an increased susceptibility to infection. (Quite the opposite, I almost never come down with anything).
A dysfunction of the autonomic nervous system is another common symptom of CFS, which is determined using the COMPASS questionnaire.
Fatigue can also occur in connection with many other diseases (autoimmune diseases, chronic infections, endocrine disorders, cardiovascular disorders, neurological disorders, depression, medication side effects), therefore a diagnosis by exclusion of other diseases should be carried out. (I’ve done all that). No evidence for another cause of fatigue was shown by our laboratory diagnostics for our hero of the story, TiredSam.
The treatment of CFS is currently symptomatic and a "therapy of small steps":
Studies show symptom-oriented treatment leads to an improvement in most patients, although CFS is often a chronic disease. Immunomodulatory therapies have so far only been tested in studies and are currently not approved or reimbursed by health insurance.
In the majority of patients CFS is triggered by an infection, and about half of patients also suffer from frequent and prolonged infections, which often lead to an increase in symptoms. Approximately 25% of patients have an immunoglobulin deficiency.
There are also a large number of treatment recommendations for CFS, but so far few are evidence-based. Our treatment recommendations are evidence-based, however often only on the basis of non-controlled clinical trials. We have little experience with some of the treatment recommendations.
Next section – their specific treatment recommendations …
Prolonged fatigue also often occurs as a result of EBV infection or herpes reactivation. It is believed that one cause of CFS is chronic immune activation / autoimmunity and this is directed against adrenergic receptors at least in a subset of patients. In addition to the severe fatigue, almost all patients suffer from cognitive disorders and sleep disorders, and many patients also suffer from a strong sensitivity to stimuli similar to migraine patients during an attack. Many patients also have a sore throat, joint pain, and flu-like symptoms. As a correlate for immune activation, a T-cell activation or immunoglobulin increase is found in some patients. This was not observed in the case of TiredSam.
Many patients suffer from mild rhinitis / sinusitis, frequent infections and irritable bowl syndrome. Often there is also an immunodeficiency, about 1/3 of the patients have a detectable immunoglobulin deficiency, about 15% a lack of complement-activating factor mannan-binding lectin. TiredSam has a slight IgG deficiency, however, he denies having an increased susceptibility to infection. (Quite the opposite, I almost never come down with anything).
A dysfunction of the autonomic nervous system is another common symptom of CFS, which is determined using the COMPASS questionnaire.
Fatigue can also occur in connection with many other diseases (autoimmune diseases, chronic infections, endocrine disorders, cardiovascular disorders, neurological disorders, depression, medication side effects), therefore a diagnosis by exclusion of other diseases should be carried out. (I’ve done all that). No evidence for another cause of fatigue was shown by our laboratory diagnostics for our hero of the story, TiredSam.
The treatment of CFS is currently symptomatic and a "therapy of small steps":
- Treat infections and other causes of immune activation
- Remedy deficiencies
- Treat the distressing symptoms of the disease
- Avoid any form of over-exertion which leads to a deterioration of symptoms.
Studies show symptom-oriented treatment leads to an improvement in most patients, although CFS is often a chronic disease. Immunomodulatory therapies have so far only been tested in studies and are currently not approved or reimbursed by health insurance.
In the majority of patients CFS is triggered by an infection, and about half of patients also suffer from frequent and prolonged infections, which often lead to an increase in symptoms. Approximately 25% of patients have an immunoglobulin deficiency.
There are also a large number of treatment recommendations for CFS, but so far few are evidence-based. Our treatment recommendations are evidence-based, however often only on the basis of non-controlled clinical trials. We have little experience with some of the treatment recommendations.
Next section – their specific treatment recommendations …
