Tuesday, May 26, 2009

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DR. GOTT

Chronic fatigue syndrome difficult to treat

By Peter H. Gott, M.D.

DEAR DR. GOTT: Have you ever heard of chronic fatigue syndrome? I have been diagnosed with this, but it seems there is no cure. I am on no medication for it. I ache, have no energy, and am very tired.

I have high blood pressure, which is controlled with medication. I also have had chronic lymphocytic leukemia (CLL) for the past 11 years. I am not taking any medication for this condition, as it is under control.

I am an 82-year-old female and have been busy with crafts, exercises and many other activities. I used to volunteer at my local hospital, but for the past six months, I have been homebound.

Is there anything to help with this syndrome? My doctor doesn't seem to have an answer.

DEAR READER: Chronic fatigue syndrome (CFS) is a complicated disorder that causes extreme tiredness that doesn't improve with sleep or rest. It may worsen following physical or mental activity. The disorder may appear after an infection, during or after severe stress, or it may develop gradually.

Symptoms include sleep disturbance, loss of memory and concentration, headaches, sore throat, pain that moves from one joint to another without swelling or redness, mildly enlarged and painful armpit or neck lymph nodes, unexplained muscle soreness and extreme exhaustion that lasts more than 24 hours after mental or physical exercise.

The exact cause of CFS is unknown, but there are several proposed possibilities, including low blood pressure (mild and chronic), depression, viral infection, history of allergies, iron-deficiency anemia, dysfunction in the immune system, low blood sugar and changes in the levels of hormones produced by the adrenal or pituitary glands or the hypothalamus.

There is no specific treatment for CFS. Currently, relief is aimed at the underlying cause (if one can be found) and symptoms. This includes moderating daily activities, cognitive behavior therapy, antihistamines or decongestants for allergy-like symptoms, antidepressants and more. There are several experimental therapies such as Attention Deficient Disorder (ADD) and Attention Deficient and Hyperactivity Disorder (ADHD) medication, antiviral drugs, acupuncture, corticosteroids and immune-boosting medications.

You say that you have had CLL for 11 years but are not on medication. I am sure that you are closely monitored for this condition, but perhaps you should be rechecked (if you haven't been already), as extreme fatigue can be a symptom. If the leukemia is worsening, the fatigue could be a warning sign.

Also, overtreatment of hypertension can lead to blood pressure that is too low, which can cause fatigue and other symptoms.

If your doctor doesn't have answers to your questions, then he or she should make a concerted effort to get you those answers or refer you to another physician with experience in diagnosing and treating chronic fatigue syndrome. You may wish to show your physician my answer to your question as a way to get the ball rolling so you can get the help you need.

To provide related information, I am sending you copies of my Health Reports "Hypertension" and "Sleep/Wake Disorders." Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a check or money order for $2 per report to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

Dr. Peter Gott is a retired physician and the author of the book "Dr. Gott's No Flour, No Sugar Diet," available at most chain and independent bookstores, and the recently published "Dr. Gott's No Flour, No Sugar Cookbook."

Copyright 2009, Newspaper Enterprise Assn.