Dealing With Chronic Fatigue Syndrome

The truth is, you’re barely making it through the day. You can’t remember the last time you woke up feeling rested, and your body aches. But the barrage of tests your doctor ordered has ruled out the usual culprits, a lengthy list including everything from sleep disorders and diabetes to anaemia, lymphoma and depression.  

When all else has been eliminated, what you may be left with is a diagnosis of Chronic Fatigue Syndrome (CFS). While medical professionals are still unable to identify the exact cause of this debilitating condition, its central symptom is severe fatigue that lasts for at least six consecutive months. It may become worse with physical or mental activity, but does not improve with sleep or rest.

Those who suffer from CFS may also suffer from headaches, sore muscles and joints, and problems with memory or concentration, among other things. It is estimated that about a million Americans and a quarter of a million people in the UK have CFS, which is also known as Myalgic Encephalomyelitis (ME).

The impact of stress
The current clinical strategy is to manage the symptoms of CFS by alleviating some of its associated factors, such as chronic stress. Ampligen (rintatolimod) is an experimental drug that has been studied for its efficacy against CFS.

From a Traditional Chinese Medicine (TCM) perspective, stress-related factors are said to affect the liver, kidney and spleen.

“We talk about these organs in terms of their functions, not in terms of their anatomy,” explains Singapore-based Eu Yan Sang physician Lim Soo Ling. “The liver is responsible for the circulation of qi. Stress affects the liver, which in turn stagnates the circulation of qi.”

Qi is the body’s vital energy or life force, and is fundamental to maintaining a balance between yin and yang, two opposing but complementary forces that co-exist in the body. When yin and yang are in balance, a person is in perfect health. A disruption in the levels and/or flow of qi, therefore, leads to illness which manifests in four ways: qi deficiency, blood deficiency, yang deficiency and yin deficiency.  

Dealing with deficiencies
While the two primary treatments of stress-related fatigue are acupuncture and herbal prescriptions, TCM practitioners need to know which type of deficiency — qi, yin, yang or blood — the patient suffers from in order to treat it effectively. The type of manifestation will dictate the herbs prescribed, and for acupuncture, the acupuncture points targeted. Generally speaking, cordyceps, a mushroom found in the high altitudes of China, Nepal and Tibet, and valued as a natural stamina and endurance enhancer, has proven successful in mitigating the symptoms of CFS.

Acupuncture, meanwhile, uses fine needles to manipulate the flow of energy, correcting imbalances and producing a calming effect. Tui na – or medical massage – and cupping can provide secondary relief to the body’s agitated state.

Qi gong, a gentle exercise that integrates focussed movement, physical postures, breathing techniques and meditation, has also been found to be an effective alternative or complementary therapy for CFS.

In 2012, researchers at the University of Hong Kong  conducted a randomised controlled trial where CFS sufferers between 18 and 55 years of age were assigned randomly to either a qi gong intervention programme or a control group.

The results of the study showed an improvement in the chronic physical fatigue symptoms and mental functioning of those in the qi gong group compared to those in the control group. While the study had several limitations, including the fact that the participants had not undergone a medical examination prior to their participation, and chronic disorders may have remained undiagnosed, the results are promising.

Beyond TCM therapies, Graded Exercise Therapy can also help. This is a structured, mutually agreed upon and monitored programme based on gradual increments of exercise and physical activity. The therapy helps establish regular patterns of activity and can improve energy levels, physical fitness, strength, and sleep. It also helps patients set manageable goals and encourages balance in their daily lives.

Beyond the physical, patients and their caregivers should also address other factors that may be linked to fatigue. “Emotional factors that may cause long-term stress – guilt, pain from past hurts, self-destructive habits, and unresolved relationship problems, among others – should be explored,” Ms Lim says. “Although herbal and acupuncture treatments may be helpful in relieving physical symptoms, it is important to discover and confront the root cause of the fatigue.”