Tiredness is not a symptom that defines any one particular disease. Rather, tiredness can be a symptom of many different diseases and conditions. Causes of tiredness range from lack of sleep and over exercise to medical and surgical treatments. The lack of energy (lethargy) associated with tiredness can sometimes cause difficulty with normal daily activities, leading to problems with attentiveness and concentration. Fatigue, in medical terminology, refers to the state of reduced capacity for work or accomplishment following a period of mental or physical activity. For example, muscles fatigue if the are called upon to repetitively work for an extended period. Most of the causes of tiredness are also associated with fatigue. Myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS) is a condition where you have long-term disabling tiredness (fatigue). Most people with also have one or more other symptoms such as muscular pains, joint pains, disturbed sleep patterns, poor concentration or headaches. The cause is not known. However, there is controversy about the nature of this condition. There is no test to diagnose the condition. The diagnosis is made in people who have a certain set of symptoms (which can vary in their type and severity). There is even controversy about what to call this condition. Many people, including some doctors, now think that ME represents a number of different conditions rather than just one condition.
This would explain the considerable variety of different symptoms and the severity of symptoms. Some experts think a viral infection such as glandular fever can trigger the condition. Certain bacteria have also been suggested as a cause of CFS in some people, including types of bacteria responsible for pneumonia. However, while tiredness is normal after a viral infection, this doesn’t explain why symptoms persist and get worse in CFS. Also, many cases of CFS don’t start after an infection, and this theory doesn’t explain why the condition sometimes develops gradually. Members of the team of health professionals who drew up the National Institute of Health and Care Excellence (NICE) guidelines for CFS couldn’t agree that this classification is the right decision, and 84% of members of the Association of British Neurologists surveyed in 2011 said they didn’t view CFS as a neurological condition. Despite a vigorous search, scientists have not yet identified what causes CFS. While a single cause for CFS may yet be identified, another possibility is that CFS has multiple causes. Conditions that have been studied to determine if they cause or trigger the development of CFS include infections, immune disorders, stress, trauma, and toxins.
Various types of infections have been studied to determine if they might cause or trigger CFS:
Epstein-Barr virus infection, also known as mononucleosis
Human herpes virus 6 infection, a virus that can cause problems for people with impaired immune systems, such as AIDS patients or organ transplant recipients taking immune-suppressant drugs
Enterovirus infection, a type of virus that enters through the gastrointestinal track and can have no symptoms, mild flu-like symptoms, or rarely severe and even deadly symptoms
Rubella, a viral infection also known as German measles
Candida albicans, a fungus that causes yeast infections
Bornaviruses, which cause borna disease, an infectious neurological syndrome
Mycoplasma, a cause of atypical pneumonia
Ross River virus, which causes Ross River Fever, a mosquito-borne tropical disease
Coxiella burnetti, the agent that causes Q fever
Human retrovirus infection, such as HIV, the virus that causes AIDS, or xenotropic murine leukemia virus-related virus (XMRV), a gammaretrovirus
Could One Type of Infection Lead to CFS?
Researchers from around the world have studied if a single type of infection might be the cause of CFS, analyzed the data, and not yet found any association between CFS and infection. Researchers are still analyzing samples from CFS patients using the latest molecular methods to search for previously unknown infections (pathogen discovery). To date, these studies suggest that no one infection or pathogen causes CFS and that the illness may be triggered by a variety of illnesses or conditions. In fact, infection with Epstein-Barr virus, Ross River virus, and Coxiella burnetti will lead to a post-infective condition that meets the criteria for CFS in approximately 10-12% of cases. People who had severe symptoms when they became infected were more likely than those with mild symptoms to later develop CFS symptoms. The possibility remains that there may be a variety of different ways in which patients can develop CFS. Studies have looked to see if changes in a person’s immune system might lead to CFS.
The findings have been mixed. Similarities in symptoms from immune responses to infection and CFS lead to hypotheses that CFS may be caused by stress or a viral infection, which may lead to the chronic production of cytokines and then to CFS.Antibodies against normal parts of the body (auto-antibodies) and immune complexes have been seen in some CFS patients. However, no associated tissue damage typical of autoimmune disease has been described in CFS patients. The opportunistic infections or increased risk for cancer observed in persons with immunodeficiency diseases or in immunosuppressed individuals is also not observed in CFS.T-cell activation markers have been reported to be different between groups of CFS patients and healthy persons, but not all investigators have consistently observed these differences.Allergic diseases and secondary illnesses such as sinusitis could be one predisposing factor for CFS, but not all CFS patients have allergies. Many patients do, however, report intolerances for certain substances that may be found in foods or over-the-counter medications, such as alcohol
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