ABSTRACT Stress is inevitable, but the consequences are modifiable if the pathophysiologic basis of the effects of stress and fatigue are well understood, and enough education and support is provided to the patient. Fatigue being a subjective feeling is a very difficult diagnosis to establish. This leads to a prolonged period of dilemma and delay in treatment. Stress affects the neuroendocrine axis (hypothalamic-pituitary-adrenal axis; HPA axis), and preventive and supportive measure targeted towards normalising or balancing the neurotransmitters with lifestyle management, sleep hygiene, balanced nutrition, targeted amino acid precursors, and hormones, may significantly reduce distress and improve the quality of life of patients suffering from chronic fatigue. Chronic fatigue syndrome is a complex area, which involves many problems, including mitochondrial involvement with altered ATP production, leaking gut syndrome owing to ongoing immunological impairment, and inflammation. However, this article will discuss the relationship of fatigue, stress, adrenal gland hormones and neurotransmitters.
been a range of different nomenclature for the health issues associated with fatigue, but the US Centers of Disease Control and Prevention (CDC) has developed diagnostic criteria1
F :
ATIGUE IS ONE OF THE MOST challenging diagnoses to confirm. It can be associated with viral flu, hormone imbalances, stress, neurasthenia, EpsteinÐ Barr virus infection, effort syndrome or post-viral fatigue syndrome. There has
ÔClinically evaluated, unexplained persistent or relapsing fatigue that is of new or definite onset, not the result of ongoing exertion, not alleviated by rest and results in substantial reduction of previous levels of occupational, educational, social, or personal activities.Õ
Physicians are therefore advised to examine patients
for four or more of the following symptoms that persist or recur during 6 or more consecutive months of illness and do not predate the fatigue: ■ Self-reported impairment in short-term memory or concentration
■ Sore throat ■ Tender cervical or axillary nodes ■ Muscle pain ■ Multiple joint pain without redness or swelling ■ Headaches of new pattern or severity ■ Unrefreshing sleep ■ Post exertional malaise lasting < 24 hours.
Epidemiology Chronic fatigue syndrome (CFS) is four times more commonly seen in women than men. The most commonly affected age group is 25–45 years, and it is more common in developed countries. Fatigue is a common finding, but CFS is not commonly diagnosed.
DR ANOOP CHATURVEDI, BSc, MBBS, DA, MD, DEd, is CEO and Founder of the World Antiaging Network, Houston, Texas, USA
email: contact@
dranoopchaturvedi.com
KEYWORDS anti-ageing, fatigue, neuroscience, neurotransmitters, hormones
prime-journal.com | January/February 2013 ❚ 51
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