| Exercise
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| | sufferers may lose jobs, marriages, and
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| Graded exercise (GE, GA or GET): Several
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| | the ability to work at all, causing
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| rehabilitation programs have been
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| | severe financial loss and distress. A
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| proposed which involve supervised or
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| | lawyer, social worker or counselor can be
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| self-monitored graded exercise or
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| | beneficial in helping the patient
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| activity. Such programs are designed to
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| | determine their best course, and may
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| overcome decontitioning, increase
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| | assist the patient with applying for
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| strength and cardiovascular health. The
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| | work-related disability, social programs,
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| program should incorporate considerable
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| | and other aid.
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| education wherein the sufferer learns to
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| | Behavioral Interventions: A study
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| start at an appropriate level of activity
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| | published in the Journal of the Royal
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| (based upon intensity and duration) which
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| | Society of Medicine has found that
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| is incrementally increased, at a rate
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| | behavioural interventions including
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| which does not substantially increase
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| | cognitive behavioural therapy and graded
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| symptoms. Those who fit a 2003 ME/ICD-CFS
| |
| | exercise therapy are effective treatments
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| definition with post exertional malaise
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| | for chronic fatigue syndrome in adults.
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| may wish to consider whether graded
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| | Nutritional supplementation and dietary
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| exercise is recommended in their case
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| | modification
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| because it can cause serious
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| | Magnesium: In a small study,
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| deterioration in the exertional
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| | supplementation with oral magnesium
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| intolerant, and the 25% ME Group[35]
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| | tablets improved symptoms in those people
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| point out that many severe cases were in
| |
| | with CFS who previously had been
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| fact mild cases before undergoing such
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| | diagnosed with low magnesium levels,
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| therapy.
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| | although in this study additional
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| Self-controlled rest and exercise,
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| | magnesium injections were necessary in
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| "pacing": "Pacing" is being advocated by
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| | some patients. Conversely, other
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| many patients as one of the few really
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| | researchers reported no evidence of
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| effective means of minimising homeostatic
| |
| | magnesium deficiency in people with CFS.
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| disequilibrium. The principles involve
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| | The reason for this discrepancy remains
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| acceptance of the patient's limitations
| |
| | unclear. If people with CFS do consider
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| (by both the patient and any coaches),
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| | magnesium supplementation, they should
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| awareness of the early signals of
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| | have their magnesium status checked by a
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| deterioration e.g. increased cognitive
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| | physician before beginning a regimen of
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| difficulties, pain, clumsiness, muscle
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| | supplementation. It is possible that only
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| weakness, respiratory problems; and
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| | people with a magnesium deficiency may
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| stopping exercise/activity before
| |
| | benefit from this therapy. Some sufferers
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| exceeding limitation or "crashing". A
| |
| | find Magnesium malate 200 to 300 mg per
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| good rule of thumb is to never exert more
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| | day relieves some of the pain and can
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| than 70% of capacity. An understanding
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| | help with sleep problems as well.
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| nurse, doctor or physical therapist may
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| | Magnesium is used in the enzymatic
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| be of help.
| |
| | conversion of food to energy in the Krebs
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| Other exercise: A few patients find
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| | cycle, and can help reduce muscle fatigue
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| health benefits and pain relief from
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| | in some cases.
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| gentle stretching, non-aerobic exercise,
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| | Alpha Lipoic Acid: 200 mg per day of
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| and gentle activity. More able persons
| |
| | Alpha Lipoic Acid may additionally be
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| may find gentle yoga, walking, or t'ai
| |
| | beneficial because it is both a fat and
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| chi to be beneficial. Water-borne
| |
| | water soluble antioxidant, and also helps
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| exercise and swimming is particularly
| |
| | with insulin related hypoglycemic issues.
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| beneficial for some CFS sufferers.
| |
| |
|
| Exercise for the severely affected or
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| | Glutathione: When the body is unable to
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| those who cannot manage the exercises can
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| | properly detoxify itself, inflammatory
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| be detrimental to their health and should
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| | substances like lactic acid, and
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| be avoided.
| |
| | phosphates can build up in the fascia and
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| CAUTIONS: Delayed onset of symptoms,
| |
| | at the neuromuscular junctions causing
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| unforseen demands ("spilled milk"),
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| | the muscle pain and trigger point
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| poorly controlled or treated symptoms and
| |
| | tenderness that are diagnostic of
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| inadequate social/personal caregiving for
| |
| | fibromyalgia/cfids. In addition, there is
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| the severely affected, ensure great care
| |
| | usually a depletion of brain chemicals
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| is required to avoid exertional relapses,
| |
| | called neurotransmitters that can give
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| even without official programs.
| |
| | rise to brainfog, depression/anxiety, and
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| Cognitive, emotional and stress demands
| |
| | which can lower the pain threshold so
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| also detract from physical activity
| |
| | that pain signals are amplified. By
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| capability. The criteria for exercise
| |
| | restoring intracellular glutathione in
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| intolerance is generally considered
| |
| | the liver and within the immune system,
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| usually at a low level. The distinction
| |
| | the body is able to mobilize and break
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| between "exercise" and "activity"
| |
| | down toxins for elimination by the liver
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| sometimes made is false and arbitrary,
| |
| | and kidneys, and bring the immune
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| especially for the severely affected:
| |
| | disregulation back into a more normal
|
| even modestly sustainable activity can
| |
| | function. Glutathione is also a very
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| become temporarily or permanently
| |
| | powerful antioxidant with the ability to
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| unsustainable if over repeated and for
| |
| | restore other antioxidants that have been
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| those at their activity ceiling, only
| |
| | reduced in the battle against the severe
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| very trivial additional or cumulative
| |
| | oxidative stress that usually accompanies
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| activity may be sufficient to cause
| |
| | these illnesses. Glutathione functions as
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| relapse.
| |
| | a three pronged attack against the
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| Medication
| |
| | underlying disease process, serving to
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| Sleep aids: Sleep aids may be prescribed
| |
| | gradually normalize immune and
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| when a patient complains of poor or
| |
| | neurological function. Increasing
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| irregular sleep, or excessive fatigue.
| |
| | glutathione can be accomplished with
|
| Some patients find sleep aids, whether
| |
| | intravenous infusions of glutathione,
|
| over-the-counter or prescription, to help
| |
| | through oral supplementation with
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| greatly in maintaining a sleep cycle or
| |
| | N-acetyl cystine (NAC),[50] oral
|
| getting "better", more restful sleep. As
| |
| | supplementation with the herb Milk
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| with all CNS acting drugs on ME/CFS,
| |
| | Thistle, and through supplementation with
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| cautious dosage ramping is required and
| |
| | bioactive (un-denatured) whey protein
|
| it may be necessary to try several drugs
| |
| | such as Immunocal, or Imuplus.
|
| in order to find one which is tolerable.
| |
| | L-Theanine: In addition to the central
|
| Pain relievers: Many CFS patients
| |
| | need to treat the underlying glutathione
|
| experience significant amounts of
| |
| | deficiency, several other supplements may
|
| physical, neuralgic pain. This "nerve
| |
| | be helpful in dealing with the pain and
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| pain", like that of phantom limb,
| |
| | discomfort. Most folks with CFIDS/FIBRO
|
| diabetic neuralgia and fibromyalgia, does
| |
| | complain of a very troubling cognitive
|
| not generally respond well to NSAIDS,
| |
| | dysfunction commonly called "Brainfog".
|
| although some patients report that
| |
| | This may be one of the more frightening
|
| naprosyn or naproxen provides some relief
| |
| | symptoms of CFIDS, actually mimicking
|
| due to its muscle relaxant properties.
| |
| | Alzheimer's disease with acute short term
|
| Tricyclic antidepressants, as above,
| |
| | memory problems and extreme difficulty in
|
| offer better relief for some cases of
| |
| | concentrating. The amino acid L-Theanine
|
| nerve pain. Other pain relievers may have
| |
| | is helpful with brainfog/ irritability.
|
| uses as well. Patients experiencing
| |
| | L-Theanine is a natural amino acid found
|
| "other" pain (such as headache or
| |
| | in green tea leaves during the spring
|
| migraine) should receive appropriate pain
| |
| | growing season and seems to act as a
|
| management for those symptoms. Hot water
| |
| | precursor for the neurotransmitters
|
| bathing has also been noted as relieving
| |
| | dopamine, and norepinephrine, which are
|
| fibromyalgia or neuralgic pain, but
| |
| | brain chemicals directly related to
|
| patients with severe ME/CFS, low blood
| |
| | cognitive function. Some research
|
| pressure or dizziness are advised to be
| |
| | suggests that 200 to 300 mg of L-Theanine
|
| cautious about the use of hot tubs or
| |
| | several times a day may be beneficial in
|
| baths. Acupuncture has also been shown to
| |
| | restoring full cognitive function. L-
|
| relieve pain in fibromyalgia cases, and
| |
| | Theanine has an extremely low toxicity,
|
| may be beneficial to CFS sufferers as
| |
| | and doesn't pose the addictive, or
|
| well.
| |
| | tolerance potential of some of the
|
| Therapy
| |
| | pharmaceuticals frequently prescribed to
|
| Cognitive behavioral therapy: Cognitive
| |
| | treat this problem..
|
| therapy Together with graded exercise,
| |
| | Passion Flower: The herb Passion flower
|
| which is often an integral component,
| |
| | tincture may be helpful in diminishing
|
| this is a controversial therapy as the
| |
| | the muscle pain, and insomnia, and
|
| Canadian Expert Consensus Panel
| |
| | depression that can be an ongoing
|
| Guidelines and the Gibson Report state.
| |
| | challenge for folks with CFIDS/Fibro.
|
| It is said CBT should not imply that CFS
| |
| | Other
|
| is a psychiatric condition, but rather
| |
| | Lifestyle Adjustments: Many CFS
|
| the protracted course of the illness may
| |
| | authorities recommend making use of
|
| cause depression, anxiety and mental
| |
| | medical treatments where appropriate, but
|
| distress. In addition, it is maintained
| |
| | focusing on minimizing symptoms through
|
| CBT may teach patients various "coping
| |
| | lifestyle adjustments such as pacing,
|
| strategies" to help them deal with
| |
| | control of stress, and good support.
|
| cognitive impairments such as a
| |
| | Importantly, acceptance rather than
|
| deterioration of short-term memory or
| |
| | "fighting" to be as healthy as the
|
| abbreviated attention span, although it
| |
| | patient was before CFS onset will lead to
|
| is difficult to see how changing one's
| |
| | less frustration and fewer relapses.
|
| schemas, as CBT theory contends, would
| |
| | Adjustments to daily living -- working
|
| effect improvement in these serious
| |
| | less, making dietary changes, and more
|
| pathological symptoms. Some patients and
| |
| | efficient use of time and energy -- can
|
| patient groups dispute such claims,
| |
| | improve a patient's outlook; but, more
|
| pointing out that CBT is invariably
| |
| | importantly, relieve some symptoms as
|
| described as an "exposure therapy" e.g.
| |
| | well. Due to the nature of ME/CFS in
|
| UK mental health charity MIND [2], that
| |
| | finding its own "exertional level", such
|
| virtually all the conditions commonly
| |
| | adjustments if resisted, tend to become
|
| listed as being suitable for CBT are
| |
| | enforced. This may also include the use
|
| behavioural and that the 2002 UK CMO's
| |
| | of assistive devices; many CFS patients
|
| Report describes CBT as "a tool for
| |
| | find that a cane, walker, wheelchair,
|
| constructively modifying attitude and
| |
| | mobility scooter or power chair will
|
| behaviour." CBT should always be used in
| |
| | greatly improve their ability to perform
|
| conjunction with medical care and
| |
| | tasks. Simpler assistive devices -- a
|
| treatment, as it is not a substitute for
| |
| | kitchen stool rather than standing at the
|
| such, and cannot treat the physical basis
| |
| | stove, a phone programmed to remember
|
| of CFS. Some patients and advocates
| |
| | phone numbers -- can also greatly improve
|
| suggest that there are “good” and
| |
| | the quality of life for CFS patients.
|
| “bad” forms of CBT, and it is
| |
| | Location: Some CFS patients find relief
|
| important for patients to decide whether
| |
| | in moving to warmer climes. This is a
|
| CBT is advisable in their case; others
| |
| | difficult and expensive treatment option,
|
| point out that, as supported by
| |
| | not always feasible or available.
|
| Carruthers and Van de Sande in their
| |
| | Deaths
|
| Overview of the Canadian Consensus
| |
| | CFS may increase the risk of an early
|
| Guidelines (, that to avoid such
| |
| | death, especially from organ failure or
|
| confusion supportive counselling should
| |
| | cancer. In a preliminary 2006 study it
|
| not be mis-termed CBT. Those who fit a
| |
| | was reported that CFS patients are likely
|
| 2003 ME/ICD-CFS definition with post
| |
| | to die at a younger than average age for
|
| exertional malaise may wish to consider
| |
| | cancer, heart failure, and suicide.
|
| whether graded exercise and/or CBT is
| |
| | Interestingly, in June 13 2006, a coroner
|
| recommended in their case because the two
| |
| | "of Brighton and Hove Coroners Court, UK,
|
| can cause serious deterioration in the
| |
| | recorded the cause of death of a
|
| exertional intolerant, and the 25% ME
| |
| | 32-year-old woman as acute anuric renal
|
| Group point out that many severe cases
| |
| | failure (failure to produce urine) due to
|
| were in fact mild cases before undergoing
| |
| | dehydration as a result of CFS. The
|
| such therapy.
| |
| | deceased woman [...] had suffered from
|
| Counselling: Many CFS patients face the
| |
| | CFS for six years." Previous cases have
|
| stress of economic and legal problems,
| |
| | listed CFS as the cause of death in the
|
| which can cause a serious deterioration
| |
| | US and Australia
|
| and paralysis of the patient. CFS
| |
| |
|
