Effective Treatment of Severe Chronic Fatigue:

Abstract

Objectives: To determine the underlying causes of sever chronic fatigue states and the effect of concurrently treating the underlying etiologies. Methods: Sixty-four patients with a median of three years of sever fatigue, which markedly limited their activity, were studied. These patients were characterized by a mix of symptoms including recurrent sore throats, swollen glands, increased thirst, sleeplessness, achiness, and poor memory and concentration without apparent cause. They presented in our office during 1991-1993 and were selected by consecutive sampling. The patients were assessed and treated for the processes noted below. As farigue is purely subjective, the patient determined if they showed worsening, no significant change, significant but incomplete improvement, or much improvement [i.e., fatigue no longer a problem]. Results: 46 patients had at least three or more contributing problems. Fibromyalgia was present in 44 patients. Overt or subclinical hypothyroidism and hypoadrenalism were suspected in 30 and 40 patients respectively. Superinfections associated with immune dysfunction [e.g., bowel parasites or yeast overgrowth] were suspected in 30 cases. Improvement with micronutrient supplementation was noted. Depression, anxiety/hyperventilation and situational stresses were considered to be the primary procsses in 4, 4, and 3 patients respectively. Treatment resulted in complete resolution of fatigue in 57% and significant but incomplete improvement in 39% of the patients. Improvement was seen at a median time of seven weeks. Conclusions: Sever chronic fatigue states are multifactoral processes that, in many patients, respond well to treatment.

KEYWORDS:

• Fatigue
• fibromyalgia
• adrenal insufficiency
• hypothyroidism
• chronic fatigue syndrome