Abstract
Fatigue is a very common complaint with a number of meanings. If the fatigue lasts for more than 6 months, it fulfills the definition of “chronic.” The Center for Disease Control (CDC) has established specific criteria for the diagnosis of CFS. This is characterized by a persistent or relapsing debilitating fatigue for at least 6 months in the absence of a medical diagnosis that would otherwise explain the clinical presentation. CFS represents a heterogeneous group of patients that manifest symptom complexes with varying degrees of fatigue, limited exertional reserve and cognitive dysfunction. This treatise explores the pathogenesis of CFS as it relates to a complex multidimensional systemic process and offers a hypothesis for the disease processes. In particular, an up-regulated immune system, affecting mitochondrial dysfunction is described. These pathophysiologic mechanisms impact and in turn are being impacted by the neuroendocrine system and the HPA axis. In addition, the cardiovascular system involving blood pressure and heart rate anomalies along with neurocognitive pathology is characterized.
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