Chronic Fatigue Syndrome Treatment

Plenty of Options

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Chronic fatigue syndrome (CFS or ME/CFS) isn't an easy disease to treat: there's no standard treatment regimen that works for most people, the illness itself isn't well understood, and the medical community is divided over what kind of treatment is most appropriate. Some treatments are even highly controversial among researchers and patients.

What most people can agree on, though, is that the treatment needs to be tailored to the individual.

ME/CFS involves a long list of possible symptoms and physiological abnormalities and everyone has their own unique blend of them.

Treatment regimens can include any combination of the following:

  • Prescription medications,
  • Nutritional supplements,
  • Dietary changes,
  • Lifestyle changes,
  • Cognitive behavioral therapy (CBT),
  • Graded exercise therapy (GET),
  • Other complementary/alternative treatments.

It's important for you to work with your doctor and other members of your health-care team to come up with the regimen that's right for you. Expect a lot of experimentation, including some setbacks, along the way.

Prescription Drugs

Doctors prescribe a lot of different medications for ME/CFS. Usually, these drugs are intended to manage symptoms. Some doctors, however, believe certain medications may make the condition less severe. Generally, the second approach is based on the belief that the condition is caused and perpetuated by persistent infections or other processes that keep the immune system working overtime.

Drugs for ME/CFS can include antivirals, antidepressants (to balance brain chemistry and/or treat comorbid depression), anti-anxiety drugs, sleep aids, and medications to help with symptoms such as pain or fever. Some doctors also prescribe ADD/ADHD medications for ME/CFS.

Most people have to try multiple drugs and drug combinations before finding what works best for them.

Nutritional Supplements

While we don't have a lot of scientific evidence supporting the use of supplements for ME/CFS, many doctors and patients say they are an important part of a treatment regimen.

Commonly recommended supplements are believed to help boost the immune system, raise energy levels, improve cognitive functioning, or help manage other symptoms. As with medications, it can take a lot of experimentation to find the right combination.

It's important to remember that even natural treatments can cause unwanted side effects and interact negatively with other treatments, so make sure to involve your doctor in treatment decisions and keep your pharmacist informed about what you're taking.

Your Diet

As with supplements, there's no solid evidence that any one diet is helpful for everyone with ME/CFS. However, some people with the condition find that they feel better when they eliminate or emphasize certain foods.

A symptom journal and/or elimination diet can help you identify foods that are a problem for you.

Often, simply eating healthier can make a significant difference. If you need help, you may want to talk to your doctor and/or see a nutritionist.

Lifestyle Changes

This is a tough one to approach. Certain things about your lifestyle may not be changeable, even if they're detrimental to you. It can be hard to know where to start.

Typical lifestyle changes can include lowering stress, pacing yourself, and improving sleep habits. Some people find it helps to change jobs, work fewer hours, or quit working outside the home; however, many people with ME/CFS are able to continue working.

The amount of lifestyle changes you need to make depends on how severely ill you are and how your lifestyle impacts your illness. You may not have to change much, or you may have to make sweeping changes.

Cognitive Behavioral Therapy

It's hard to accept health-imposed changes to your life, and psychological counseling helps a lot of people with these issues. Cognitive behavioral therapy (CBT) is aimed at modifying both thoughts and actions to help you find healthier approaches to things and eliminate bad habits.

CBT is controversial because some doctors favor using it as a front-line therapy, while others believe it's more appropriate as a complementary treatment, and still others believe it can be damaging.

Graded Exercise Therapy

Graded exercise therapy (GET) is aimed at improving symptoms and overall health by starting with low levels of exercise and gradually increasing the amount and intensity.

Some research supports the idea that appropriate levels of exercise can help alleviate ME/CFS symptoms. However, ME/CFS involves a symptom called post-exertional malaise, which means that even mild exertion may cause an increase in symptoms. That has made GET controversial as a treatment for ME/CFS.

Complementary/Alternative Medicine

Most complementary/alternative treatment methods aren't well researched for ME/CFS. Some people report success with them, while others do not. These treatments include:

Some doctors and other health-care providers, such as homeopaths and chiropractors, have developed experimental protocols for ME/CFS. While some of these protocols are based on established or emerging science, many are not. Be sure to thoroughly research any treatments you're considering and talk to your doctor about the possible benefits and risks.

Sources:

Centers for Disease Control and Prevention (CDC). "Chronic Fatigue Syndrome: Treating the Most Disruptive Symptoms First." Accessed September 2009

University of Maryland Medical Center. All rights reserved. "Chronic fatigue syndrome - Treatment" Accessed September 2009.

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