DEAR DOCTOR K: I have CFS. What is the latest information about the condition, particularly treatments?
DEAR READER: For readers who are not familiar with the condition, CFS stands for chronic fatigue syndrome. Fatigue is a universal human experience. In our increasingly pressured and fast-paced lives, many people feel tired a lot of the time. In fact, fatigue is one of the most common reasons people visit their doctor. Yet very few people with fatigue are suffering from CFS. It is relatively uncommon, affecting about 4 to 8 out of every thousand adults in the U.S., and a small fraction of teenagers and younger children.
People with CFS experience ongoing, severe, debilitating fatigue that is not relieved by rest. Other symptoms include: Impaired memory or concentration, sore throat, swollen glands, muscle pain, pain in multiple joints, headaches, and exhaustion following physical activity.
A combination of the following strategies may help manage your symptoms:
• Set priorities. Make a list of things you want to have more energy to do. Eliminate as many nonessential activities as you can. But be careful to guard against becoming too passive.
• Exercise. Begin an exercise program in which you gradually increase your activity level. This can effectively reduce the severity of your symptoms.
• Cognitive behavioral therapy (CBT). CBT is a type of psychotherapy. It helps you identify and change negative thoughts and behaviors. CBT can reduce symptoms.
• Tricyclic antidepressants. Low doses of this type of antidepressant may improve the quality of your sleep, reduce pain, and increase energy.
• Other medications. Nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen (Tylenol) can help relieve headaches, joint pain and muscle pain. Fish oil capsules (3,000 mg per day) may also help reduce CFS symptoms.
There are also several experimental treatments in development. These include drugs to treat abnormalities of the autonomic nervous system, to quiet activated parts of the immune system, and antiviral drugs (for people with certain active viral infections).