Sivarama Prasad Vinjamury, MD (Ayurveda), MAOM, Betsy B.Singh, PhD
Chronic fatigue syndrome (CFS) is a disorder characterized by sudden onset of severe unexplained fatigue, lasting 6 months or more.1,2 Associated symptoms include impairment of neurocognitive function, non-refreshing sleep, headache, arthral- gias, postexertional malaise, muscle aches, and recurrent sore throat. Approximately 0.2% to 0.7% of the population in Western countries is affected. It affects over 800,000 Americans of all ages, races, socioeconomic groups, and genders.2-4 Chronic fatigue Syndrome is estimated to cost $9.1 billion in lost productivity annually in the United States.4 The etiology and pathophysiology of CFS is still unknown,1,5 but it is known to be heterogeneous and multicausal. Major causes of CFS, include infection,6 immune dysregulation,7,8 dysautonomia,9 neuroen- docrine dysfunction,10 and genetic disorders.11 A diagnosis of CFS cannot be made on single measurements of immune, endocrine, cardiovascular, or autonomic nervous system dysfunction.12,13 Data suggest that people with CFS manifest changes in immune responses that fall outside normative ranges, but current research does not provide definitive evidence on whether these immune abnormalities are a cause or result of the illness. Therefore, it is still a condition of exclusion, and the diagnosis is made with a thorough history and clinical exam.
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