January 23, 2005
Chronic fatigue syndrome
Study shows link to inactive children
[US News] By Elizabeth Querna
Imagine having a hangover that never went away, or feeling exhausted even after the simplest errand. Chronic fatigue syndrome has been described as an "incapacitating tiredness" and afflicts more than half a million Americans. Still, little is known about what causes the disease–doctors usually diagnose it only when other conditions are ruled out. Now, scientists from the Royal Free and University College Medical School in London say there might be a link between childhood activity level and chronic fatigue syndrome as an adult.
What the researchers wanted to know: What childhood habits might cause adult chronic fatigue syndrome?
What they did: The researchers used data from a large, multisubject survey that is currently following more than 10,000 British people born at the beginning of April 1970. When the participants were 5, 10, 16, and 29 years old, the researchers checked in on them with a variety of surveys about their healthand physical and educational development. When the children were 10 years old, parents and teachers were interviewed about things including parental illnesses, parents' mental health, students' educational achievement, and the amount of physical activity children had in school. At 29, the participants were asked whether or not they had chronic fatigue syndrome.
What they found: The people who told the researchers they had chronic fatigue syndrome were more likely to be from a high socioeconomic background and not to have regularly played a sport when they were 10 years old. This result is at odds with an earlier study, which concluded that children who exercised a lot had a higher risk of developing chronic fatigue. Previous research has shown that children whose parents have had a long illness or a mental illness are more likely to develop chronic fatigue; this study found no link between to those parental issues. Overall, fewer than 1 percent of the study participants reported having chronic fatigue syndrome.
What it means to you: Chronic fatigue syndrome remains a mystery, but each study that chips away at the causes and mechanisms of the disease helps. This study, in contrast to others, supports the idea that having an active lifestyle, even as a child, helps to prevent later health problems–including chronic fatigue.
Caveats: Chronic fatigue syndrome is notoriously hard to diagnose, and many people go for years without knowing that they have it. This study asked people if they had chronic fatigue syndrome but not if they had been medically diagnosed with it. The study likely missed some people that do actually have it but aren't aware that they do, and may have picked up a few people who are often tired (either from stress or from another condition) but do not have chronic fatigue syndrome.
Find out more: Several organizations support chronic fatigue syndrome research and patients. One is the American Association for Chronic Fatigue Syndrome http://www.aacfs.org and another is The CFIDS Association of America. http://www.cfids.org There is also a good description of the condition on the National Institutes of Health website. http://www.niaid.nih.gov/factsheets/cfs.htm
If you want to learn more about the study that is giving researchers this trove of information, check it out at: www.cls.ioe.ac.uk
Read the article: Viner, R. and Hotopf, M. "Childhood Predictors of Self Reported Chronic Fatigue Syndrome/Myalgic Encephalomyelitis in Adults: National Birth Cohort Study." British Medical Journal. Oct. 23, 2004, Vol. 329, No. 7472.
tract online: http://bmj.bmjjournals.com
January 14, 2005
Chronic Fatigue Syndrome
January 12, 2005 KidsHealth.org
Sixteen-year-old Samantha is always exhausted. For months she's had swollen glands and weakness. She has difficulty concentrating in school, frequently has headaches, and finds it hard to get out of bed most mornings. Although Samantha's parents suspect she's involved in too many activities, they have also begun to worry because her grades have plummeted and her symptoms have worsened.
When Samantha and her parents visit the doctor to try to find out what's wrong, the doctor takes a detailed history of Samantha's symptoms, paying careful attention to how long they have been going on. After a full physical examination and several blood tests, it is determined that Samantha has a condition known as chronic fatigue syndrome (CFS).
What Is Chronic Fatigue Syndrome?
Chronic fatigue syndrome is a noncontagious disease that was first recognized as a physical illness in the 1980s and remains the subject of a great deal of controversy. Even now, as increasing numbers of people are being diagnosed with the disease, there are still many people inside and outside the health professions who doubt its existence or maintain that it's a psychological ailment.
But several years of research have confirmed that CFS is indeed a physical illness - just one that's not fully understood. According to the U.S. Centers for Disease Control and Prevention (news - web sites) (CDC), it is estimated that as many as half a million people in the United States have a CFS-like condition.
The hallmark of CFS is symptoms of overwhelming fatigue and weakness that make it extremely difficult to perform routine and daily tasks, like getting out of bed, dressing, and eating. The fatigue does not get better with bed rest. The illness severely impacts school, work, and pleasurable activities, causing physical and emotional symptoms that can last for months or even years.
Chronic fatigue syndrome is more common in females than males and it affects all racial and ethnic groups. Most people experience this illness between the ages of 20 and 40, but the disorder also occurs in adolescents. A CFS-like illness has also been determined to occur in children younger than 12. The actual number of children and teens affected by CFS illness is unknown.
What Causes Chronic Fatigue Syndrome?
The cause of CFS is not yet known. Current research is exploring the possibility that people with CFS may have a dysfunction of the immune and central nervous systems. Scientists are also studying various metabolic abnormalities and risk factors (including genetic predisposition, age, sex, prior illness, environment, and stress) that may affect the development and course of the disease.
Some researchers have suggested that a virus causes CFS, but this theory has not been proven. At one time, researchers thought that Epstein-Barr virus (EBV) played a role in the development of CFS, but many people who are diagnosed with CFS have no evidence of EBV infection. However, a viral cause for CFS is still suspected because the symptoms of CFS often mimic a viral infection, such as chronic infectious mononucleosis. Researchers today are hard at work trying to prove a possible viral link to CFS.
Other theories suggest that one of the following factors may be to blame for CFS:
iron-poor blood (anemia)
low blood sugar (hypoglycemia)
a body-wide yeast infection
psychiatric or neurological problems
Because the symptoms of CFS are so vague and can vary widely from person to person, the CDC developed a detailed case definition in 1993 to help doctors diagnose the condition. According to that definition, a person must have both of the following in order to be diagnosed with CFS: a person must have severe, chronic fatigue for at least 6 months or longer, with other known medical conditions having been excluded by a doctor's diagnosis, and at the same time, an individual must have four or more of the following symptoms:
forgetfulness or difficulty concentrating
tender lymph nodes in the neck or armpit
muscle pain or multi-joint pain with swelling or redness
headaches of a new type, pattern, or severity
unrefreshing sleep and vague feelings of illness or depression after exerting oneself, lasting more than 24 hours
In addition, any of the above symptoms associated with the fatigue must have occurred for at least 6 or more months in a row. Also, continuous fatigue should have been the first noticeable symptom of illness.
Other symptoms of CFS can include mild fever, blurry vision, chills, night sweats, diarrhea, and fluctuations in appetite and weight.
Difficulty Diagnosing CFS
Chronic fatigue syndrome is hard to diagnose because a single diagnostic test does not exist, and there is no identifiable cause of the illness. Another problem is that symptoms of CFS often mimic other disorders such as viral infections, kidney disease, cardiac disease, depression, and neurological illnesses. CFS is a diagnosis of exclusion, which means that doctors first have to make sure that a person's fatigue and other symptoms are not caused by another illness, a sleep disorder, or hormone problems such as hypothyroidism.
"We all get tired, depressed, and run down," says Joel D. Klein, MD, an infectious diseases specialist. But CFS is different from normal feelings of fatigue and low energy. "Symptoms of CFS often develop suddenly and include a strong, noticeable fatigue which comes and goes or remains for months," Dr. Klein explains.