Chronic fatigue syndrome (CFS) is a complex condition that has puzzled healthcare professionals for over a decade. However, it now appears that we are one step closer towards better understanding and diagnosing this mysterious disease, as researchers in California have identified a characteristic chemical signature linked to the condition.

A team of researchers at the San Diego School of Medicine utilised a variety of techniques to assess targeted metabolites in blood plasma. The team discovered a characteristic chemical signature for the condition, an unexpected underlying biology that bears close similarities to the state of dauer (a German word for persistence or long-lived) and other hypometabolic syndromes. This could imply that CFS may be the result of the body going into a hibernation-like state.

Led by Robert Naviaux, pofessor of medicine, pediatrics and pathology and director of the mitochondrial and metabolic disease center at the University of California San Diego School of Medicine, the team tested more than 600 metabolites from various biochemical pathways in blood plasma from 84 subjects. It was found that individuals with CFS indicated abnormalities in 20 metabolic pathways.

“Despite the heterogeneity of CFS, the diversity of factors that lead to this condition, our findings show that the cellular metabolic response is the same in patients,” said Naviaux in an address of the study. "And interestingly, it's chemically similar to the dauer state you see in some organisms, which kicks in when environmental stresses trigger a slow-down in metabolism to permit survival under conditions that might otherwise cause cell death. In CFS, this slow-down comes at the cost of long-term pain and disability."

Chronic fatigue syndrome: much more than mere exhaustion

So what exactly is CFS? Also known medically as myalgic encephalomyelitis, CFS is a debilitating condition that causes persistent and severe fatigue. It is often worsened by physical or mental activity, and does not improve with bed rest.

Speaking on the effects of CFS, Colleen Thomas, a consultant at the Singapore General Hospital’s department of internal medicine, said, “Patients may feel extreme tiredness that causes [them] to greatly reduce [their] previous activity levels by 50% or more.”

Severe CFS can interfere significantly with the lives of patients. People diagnosed with CFS often report having difficulty keeping up with the world around them due to drastically reduced mobility and stalled concentration.

In Singapore, it is estimated that around 2 to 5% of the working population suffers from CFS. Anyone can develop this condition, but studies indicate that it may be more common in women than men. Middle-aged adults in their 40s and 50s are most prone to developing the disease.

There is presently no known cause or cure to CFS, but it has been linked to strokes, brain injuries and neurodegenerative conditions like multiple sclerosis. Other studies have also found associations between CFS and psychological conditions such as stress.

How CFS may impact healthcare professionals

In the healthcare sector, there’s never really an easy day, no matter the profession. As healthcare professionals, hectic schedules and long hours can result in a great amount of fatigue. Not to mention, mounting work pressures may also add to rising levels of anxiety, stress and burnout.

Such stress certainly is not good for the body and mind, especially if it is persistent and chronic stress. In fact, it may be placing healthcare professionals at greater risk of developing CFS. According to Thomas, high achievers who experience anxiety and depression are particularly susceptible to the disease.

Perhaps, it is time to take some steps towards CFS prevention. Kenny Pang, a sleep specialist and director of the Pacific Sleep Centre in Singapore, recommends keeping stress levels at bay by leading a healthy lifestyle and trying out methods to reduce stress. At the same time, he states that it is also critical to ensure sufficient sleep each night and improve the quality of rest. MIMS


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