Syndrome of chronic fatigue
- Symptoms of the Syndrome of chronic fatigue
- Reasons of the Syndrome of chronic fatigue
- Treatment of the Syndrome of chronic fatigue
The Syndrome of Chronic Fatigue (SCF) is a state, gained the greatest distribution in civilized countries. The disease is characterized by the long fatigue which is not eliminated even after long rest.
Symptoms of the Syndrome of chronic fatigue:
Main symptoms of a syndrome of chronic fatigue:
1. Sudden emergence of the exhausting weakness
2. The fatigue progresses and does not pass after rest
3. At the patient working capacity for the last six months almost twice decreased
4. There are no other visible reasons or diseases which can cause enduring fatigue
Small symptoms of a syndrome of chronic fatigue:
1. The progressing or long fatigue which is especially expressed after any exercise stresses which were transferred before easily
2. Low-temperature fever
3. Frequent pharyngalgia
4. Morbidity in lymph nodes
5. Muscular weakness
6. Mialgiya - muscle pain
7. Frustration of a dream (sleeplessness or, on the contrary, drowsiness)
8. Headache of unusual character
9. The migrating joint pain
10. Neuromental disorders: hypersensitivity to bright light, a visual disturbance (spots before eyes), forgetfulness, irritability, indecision, decrease in cogitative activity and ability to concentration of attention
So, the main diagnostic criterion of a syndrome of chronic fatigue is the constant fatigue with decrease in working capacity arising against the background of usual health, lasting not less than 6 months and which is not connected with any other diseases.
Symptoms of a syndrome of chronic fatigue
Symptoms of a syndrome of chronic fatigue are shown not at once. Most often begins with a grippopodobny state (SARS type): fervescence, pharyngalgias, hyperadenosis, headaches. Then quickly, within several hours or days, inexplicable generalized muscular weakness, morbidity of separate muscles, polyarthralgias (joint pain), the exhaustion after exercise stresses which is not recovered independently for days joins. The developed syndrome includes also frustration of a dream, decrease in memory and intelligence, the depressive phenomena and the changed conditions of consciousness which are not secondary, and enter into structure of a syndrome of chronic fatigue.
It is considered to be that the syndrome of chronic fatigue meets at women more often. The risk of development of this syndrome aged from twenty five up to forty five years is highest. Though both the child, and the teenager can get sick. At one time in the USA there was a popular belief that the syndrome of chronic fatigue most often happens at the people who are too zealous at work.
Then even assigned the term which is literally translated very long - "an infection of the wealthy people working by profession and leading a secular life" to a syndrome. In modern medicine it is considered to be that the syndrome of chronic fatigue does not recognize social differences and strikes as workaholics, and those who not really work too much on service.
Duration of a syndrome of chronic fatigue different: at one patients recovery occurs quickly, literally within several months, others experience the progressing deterioration which can last for years. Quite often cyclic disease meets - remissions alternate with the aggravation periods.
Reasons of the Syndrome of chronic fatigue:
The etiology remains to the unknown so far. The big part is assigned to deficit macro - and micronutrients, food allergy, to excessive exercise and mental stresses, a viral infection.
The most convincing is the infectious or virus theory now. According to this theory, as trigger factors of SHU Epstein-Barre's virus, a cytomegalovirus, herpes simplex viruses I, II, VI types, Koksaki's virus, hepatitis C, an enterovirus, a retrovirus can serve. The debut of SHU is quite often connected with an acute grippopodobny disease. Convincing the detection of gerpesvirus and signs of their reactivation which are also given about high frequency are represented. Completely the possibility of existence of still not identified virus is not excluded (most likely, from group herpes viruses), defiant SHU while other known viruses (EBV, CMV, HHV-6, etc.) can play a secondary role, being reactivated against the background of disturbances of the immune status and supporting them.
Numerous data indicate that at SHU both quantitative, and functional immunological disturbances are observed. Among objective indicators describe decrease in IgG at the expense of first of all G1-and G3 classes, number of lymphocytes with a phenotype of CD3 and CD4, natural killers, increase in level of the circulating complexes and anti-virus antibodies of different type, increase in β-endorphine, interleykina-1 and interferon, and also a tumor necrosis factor. At the majority of sick SHU reduction of number and/or depression of function of natural killers is revealed. Thus, it is considered that change of a phenotype of immunocompetent cells and dysfunction of natural killers — the general manifestation of SHU.
According to some authors, SHU is a consequence only of psychiatric pathology: the somatized frustration, "big" or atypical depressions.
In some works as factors of a pathogeny are discussed:
* the raised lactification in response to an exercise stress,
* disturbance of transport of oxygen to fabrics,
* decrease in number of mitochondrions and their dysfunction at sick SHU.
Consider that symptoms of SHU and fibromyalgia, at least partially, are a consequence of disturbance of cellular metabolism. As a result of researches of patients accurate connection between L-carnitine level in a blood plasma and risk of development of SHU is established with SHU. It is revealed that degree of deficit of a L-carnitine is directly connected with degree of manifestation of symptoms of SHU. That is, the less L-carnitine (and its ethers) contains in a blood plasma of the person, the lower it working capacity and is worse health.
However, despite all revealed disturbances at SHU, its pathogeny remains not clear so far.
Treatment of the Syndrome of chronic fatigue:
An integrated approach is the main principle of treatment of SHU. Also observance of the guarding mode and continuous contact of the patient with the attending physician belong to one of important conditions of treatment.
Join in the program of treatment of a syndrome of chronic fatigue:
* normalization of the mode of rest and exercise stress;
* unloading and dietary therapy;
* vitamin therapy by drugs of B1, B6, B12 and C vitamins;
* the general or segmented massage together with hydroprocedures and physiotherapy exercises;
* autogenic training or other active methods of normalization of a psychoemotional background, psychotherapy;
* immunoproofreaders of the general plan with adaptogenny effect;
* other supportive applications (day tranquilizers, enterosorbents, nootropic means, antihistaminic drugs in the presence of an allergy).
Many patients cannot recover completely from SHU even by means of treatment. Some strategy of management directed to reduction of effects of existence of SHU are offered. In attention various techniques of medicinal treatment, various medical therapies, complementary and nonconventional medicine are accepted. Systematic observation showed that the patients having SHU are less susceptible to effect of placebo, and placebo makes on them smaller impact in comparison with the patients having other diseases. SHU is connected with chemical sensitivity, and some patients often react to a small part of that therapeutic dose which is normal in other conditions. In a number of recent clinical tests several immunomodulatory agents were used: antistaphylococcal vaccine Staphypan Berna, lactobacilli, kuibitang and intravenous immunoglobulin. For example, according to the latest data, seemingly, that antidepressants show salutary effect concerning increase in activity of natural killers (NK cells) at depressive patients.
The researchers who revealed deficit of antioxidants, a L-carnitine, vitamins of group B, magnesium consider that addition of the drugs containing these substances can significantly reduce SHU symptoms. Magnesium regulates all processes of production and consumption of energy in an organism, at its chronic deficit there is a fatigue, slackness and breakdown. It is known even that intracellular magnesium for 80-90% is in a complex with ATP, the nucleotide which is a universal carrier and the main accumulator of energy in living cells.
From the point of view of physiology, the fatigue comes after exhaustion in fabrics of energy resources and accumulation of products of a catabolism. Formation of energy (ATP), available to cells, happens in mitochondrions thanks to oxidation of glucose and fatty acids. At the same time deficit of energy comes not because of a lack of substrate, and because of the limited capacity of mitochondrions. Overall performance of mitochondrions in many respects is defined by the number of the transporter of fatty acids — a L-carnitine. At a lack of a L-carnitine oxidation of fatty acids in mitochondrions is slowed down and — as a result — products of ATP decrease.
A number of clinical trials showed efficiency of drugs of a L-carnitine (and its ethers) at SHU. The daily dose made usually 2 g. The strongest effect occurred after 2-4 weeks of treatment. Fatigue decreased by 37-52%. Besides, such objective cognitive parameter as concentration of attention improved.
The profile researches conducted during the period from 2006 to 2008 showed high performance at treatment of a syndrome of chronic fatigue with use of the low-intensive laser care executed by a method of individually dosed laser therapy. Efficiency of laser therapy of sick SHU by this technique makes 86,7%. Efficiency of laser therapy is caused by a possibility of elimination of dysfunction of the central regulating centers of the autonomic nervous system.