Chronic Fatigue Syndrome

Chronic Fatigue Syndrome

Chronic Fatigue Syndrome & Diagnosis

Why Is Chronic Fatigue Syndrome So Difficult To Treat?

Chronic Fatigue Syndrome & Changes In Brain Chemistry

Virus Linked To  Chronic Fatigue Syndrome & Fibromyalgia

Dark Chocolate May Ease Chronic Fatigue Syndrome Symptoms

Ankylosing Spondylitis

Link Found Between Spinal Arthritis & Inflammatory Bowel Disease

The Low Starch Diet For Ankylosing Spondylitis Sufferers


Can Vitamin Supplements Help CRPS Sufferers?

What causes CRPS to spread?

Foods That Are Known To Aggravate CRPS


Chronic Fatigue Syndrome


Chronic Fatigue Syndrome & Diagnosis

Many people will experience extreme tiredness at some point in their life due to illness, lack of sleep, or stress. This can be overwhelming, but there is a difference between constant lethargy and chronic fatigue syndrome.

Generally, tiredness will go away after getting enough rest, or recovering from an illness, but when it is symptomatic of a more serious underlying condition, extreme feelings of fatigue never ease.

Chronic fatigue vs chronic fatigue syndrome

Chronic fatigue syndrome (CFS) is also known as ME, which stands for myalgic encephalomyelitis.

CFS is a long-term chronic condition that can affect anyone, but is most common in women aged 25-45.

In chronic fatigue syndrome, sufferers will not only experience extreme tiredness, but also many other symptoms.

What are the symptoms?

There are a wide range of symptoms present in CFS, but the most common is extreme tiredness.
Not everyone who suffers from chronic fatigue syndrome will experience all of the symptoms but these can include:

  • Muscle pain
  • Headaches
  • Memory or concentration problems
  • Flu-like symptoms
  • Heart palpitations
  • A sore throat or sore glands
  • Feeling dizzy or sick

Symptoms of CFS tend to fluctuate daily in severity, and a lot of sufferers find that over exercising can make their symptoms worse.

Difficulties of living with CFS

Sufferers of CFS can experience mild to severe symptoms. In severe cases, CFS can affect even the simplest of everyday tasks, from taking a shower, to cleaning the house.

For a long time, many medical professionals did not recognise chronic fatigue syndrome, which made getting an official diagnosis very difficult.

Diagnosing CFS

As there isn’t a specific test to determine CFS or ME, diagnosis is based on symptoms, and ruling out other factors.

However, doctors do have to follow guidelines from the National Institute for Health and Care Excellence (NICE) to diagnose the condition. A GP may give you a medical examination, and offer blood tests to rule out conditions such as anaemia or an under-active thyroid.

The NICE guidelines go on to state that doctors should consider a diagnosis of CFS if symptoms:

  • Have started recently or keep returning
  • Get worse after exercise
  • Stop you from doing things you can usually do

A diagnosis of CFS must be confirmed by a doctor if other symptoms have been ruled out. Symptoms must have lasted for at least four months in adults, and three months in children, for a diagnosis to be made.


Why Is Chronic Fatigue Syndrome So Difficult To Treat?

Chronic fatigue syndrome is a long-term illness that can affect anyone, including children, however, it is more common in women and tends to develop between the mid-20s and mid-40s. As a condition, chronic fatigue syndrome is a real conundrum; the reasons as to why and how it affects certain people remains an enigma.

Unfortunately, there is no test to ascertain whether or not a person has chronic fatigue syndrome. Instead, the diagnosis method involves a process of elimination as to what it is not, rather than what it is.

This process includes ruling out:

  • Anaemia (lack of red blood cells)
  • Underactive thyroid gland
  • Liver or kidney problems
  • Mental illness, such as depression or an eating disorder

Guidelines from the National Institute for Health and Care Excellence (NICE) say that doctors should consider diagnosing CFS if a patient has extreme tiredness that can’t be explained by other causes and if it:

  • Started recently, has lasted a long time or keeps coming back
  • Results in a person not being able to do things they used to
  • Gets worse after activity or gentle exercise, such as a short walk

Some of the following symptoms must also be present:

  • Problems sleeping, such as insomnia
  • Muscle or joint pain
  • Headaches, a sore throat or sore glands that are not swollen
  • Problems concentrating or remembering things
  • Flu-like symptoms or feeling dizzy or sick
  • Heart palpitations

The severity of symptoms can vary from day to day, or even within a day.

Once diagnosed, there is no single way of managing chronic fatigue syndrome that works for everyone, and that is why treating it is so challenging.

The most common specialist treatments include the following:

  • Cognitive Behavioural Therapy (CBT): This is usually offered on a one-to-one basis and can help sufferers to feel more in control of symptoms, and gain a better understanding of how behaviour can affect the condition.
  • Graded Exercise Therapy (GET): A personally structured exercise programme aims to gradually increase how long a person can carry out physical activity.
  • Activity management: Individual goals are set for each patient that they find manageable and achievable, with gradually increasing activity levels.
  • Medication: There is no specific medication for treating chronic fatigue syndrome, but certain things will help to relieve some of the symptoms. Over-the-counter painkillers can help with headaches, muscle and joint pain, and stronger pain killers can be prescribed on a short-term basis.

Sufferers may also benefit from making small lifestyle changes, such as introducing a healthier diet and nutritional supplements, as well as trying to get plenty of sleep, rest and relaxation. Most people with CFS get better over time, especially when they adapt to their symptoms and have a strong and understanding support network in place. However, there are people who never make a full recovery.

Living with chronic fatigue syndrome can be difficult. Extreme tiredness, combined with other physical symptoms, can make even the simple of activities a daily battle. It can affect confidence and self-esteem and, for some sufferers, it may be necessary to make some major lifestyle changes, such as giving up work or perhaps moving to a smaller house with less or no stairs.

Chronic Fatigue Syndrome & Changes In Brain Chemistry

New research has provided insight into brain chemistry of those who suffer from chronic fatigue syndrome.

Chronic fatigue syndrome is a long-term illness that causes a wide variety of symptoms. It can affect anyone, including children, however, it is most common in women and has a tendency to develop in those aged 25 to 45-years-old. Gulf War illness is a disease that shows various similarities to chronic fatigue syndrome, causing a series of unexplained chronic symptoms that correlate to those of CFS, such as fatigue, memory problems, and headaches. Both illnesses are often misdiagnosed as depression or other mental health problems. In fact, for decades, there has been controversy surrounding the topic of whether or not these diseases are genuine or simply psychological, which is a belief we battle with frequently as a law firm assisting with chronic fatigue syndrome compensation claims. Now, researchers from a university in Washington D.C. have uncovered molecular changes in the brain that are specific to each of the two conditions. In this blog, we discuss the study in more detail, as well as the results achieved, and explain what they could mean for potential sufferers of each condition.

Much like chronic pain syndrome, there is no cure for chronic fatigue syndrome or Gulf War illness. Causes of each condition remain unknown and there are no definitive tests to diagnose either disease, however, new research has found molecular changes in the brain, which has given hope to patients of CFS and Gulf War syndrome, opening up the possibility of prompter diagnosis and treatment.

Results have come from a study conducted by a team of researchers from Georgetown University Medical Centre, led by professor of medicine, Dr. James N. Baraniuk, who discovered changes in molecular levels in sufferers’ brains. The newfound research provides insight into brain chemistry of both disorders that can now be investigated further.

To find the results, Dr. Baraniuk and his team of researchers examined the cerebrospinal fluid of those with chronic fatigue syndrome and Gulf War illness, as well as healthy participants. For examination, the team extracted the fluid from each participant using a lumbar puncture, post and prior to a session of bicycle exercise. In addition, the brains of each participant was also examined, using functional magnetic resonance imaging (fMRI).

The exercise sessions lasted for a total time of 25 minutes and consisted of riding a stationary bike. In order to ensure the participants reached 85% of their maximum heart rate, as predicted using their age, the team of researchers increased the bicycle resistance.

Before exercising, levels of microRNA (miRNA), a small molecule that helps to regular protein production, were the same in all participants. After 24 hours had passed after exercising, however, levels changed in different ways for the three groups of participants. Each group showed a different pattern of change; chronic fatigue syndrome patients had 12 diminished miRNAs after exercise, compared to those who did not exercise. The miRNA levels were different from those altered in depression, fibromyalgia, and Alzheimer’s disease, which provides further confirmation that both CFS and Gulf War illness are distinct diseases.

One subgroup in particular developed jumps in heart rate of over 30 beats while standing, which lasted for two to three days post exercise. Magnetic resonance imaging showed their brands did not activate during cognitive tasks. Contrastingly, other subgroups did not experience any changes to their heart rate or brainstem changes.

“In results, we can clearly see different patterns in the brain’s production of miRNA molecules in the CFS group and Gulf War illness phenotypes,” explains Dr. Baraniuk. “This news will be well received by patients who are suspected sufferers of either of the two conditions, however, are being treated for depression or another mental disorder.”

To summarise, results from this particular study have helped to further prove the fact that chronic fatigue syndrome and Gulf War illness are both genuine illnesses as opposed to psychological like so many have believed for so long. Now, as a result of this study, researchers believe that CFS is caused by the miRNA molecule; its changing levels cause tiring symptoms. Faster diagnosis and treatment options are on the horizon for CFS sufferers, as experts become increasingly knowledgeable on the ins and outs of the condition through further studies.

Virus Linked To  Chronic Fatigue Syndrome & Fibromyalgia

Researchers at the Whittemore Peterson Institute in United States have discovered an infectious virus in a significant percentage of people with Fibromyalgia and Chronic Fatigue Syndrome. The virus, known as Xenotropic murine leukemia virus-related virus (XMRV) is a retrovirus, which means it inserts its DNA right into your cell’s genetic makeup. Once infected, the virus remains permanently in the body and creates an immune deficiency that can leave people vulnerable to a wide range of diseases.

Although XMRV doesn’t appear to replicate as quickly as HIV does, scientists are still unsure how XMRV is transmitted. The infection was found in patients’ blood samples, which raises the possibility that it could be transmitted through blood or bodily fluids.

Researchers are also unsure if the XMRV infection led to a weakened immune system contributing to the disease, or if the disease impacted the immune system and enabled the virus to become established.

There are hopes that the latest findings could lead to new treatments, but there are still more questions than answers and a significant amount of research lies ahead. Since the possible link between XMRV and Chronic Fatigue Syndrome was first identified in 2009, the subject has been controversial, and the link itself remains highly contested by other researchers.

Dark Chocolate May Ease Chronic Fatigue Syndrome Symptoms

Dark chocolate may ease the symptoms of chronic fatigue syndrome, according to new research.

Dark chocolate is rich in chemicals known to increase signals carried around the brain but this is thought to be the first time that it has been found to help symptoms of chronic fatigue syndrome.

Researchers from the University of Hull and the York Medical School tested a group of patients with a severe form of the disease, according to Nutrition Journal.

They ate dark chocolate for eight weeks, followed by a break and then another variety with little cocoa but which tasted the same.

They were asked to eat 15 grams three times a day and not make any other changes to their diet. They reported significant improvement in their wellbeing.

Prof Steve Atkin who led the study says: “This is potentially very encouraging news for those who suffer from chronic fatigue syndrome.”

Ankylosing Spondylitis


Link Found Between Spinal Arthritis & Inflammatory Bowel Disease

Researchers at the University of Queensland in Australia have found that a form of spinal arthritis is genetically linked to Inflammatory Bowel Disease. Ankylosing Spondylitis (AS) is a common form of arthritis involving chronic inflammation particularly of the spinal and pelvic joints, which causes pain, stiffness, and often disability. At Brian Barr Solicitors, we are knowledgeable of the condition, as expert lawyers handling compensation claims for sufferers. Using our knowledge, we have created a page of useful links for Ankylosing Spondylitis patients, which may provide help to some of our clients, or those who are visiting our website to enquire about our services. AS patients appear to be highly susceptible to Inflammatory Bowel Disease (IBD), including Crohn’s disease. Similarly, the development of AS is common in IBD patients.

In order to test whether genes associated with Crohn’s disease are also associated with AS, Professor Matt Brown and his colleagues searched for known genetic markers of Crohn’s disease in the genomes of more than 2700 AS patients, working with colleagues from England, North America and Canada. The results revealed that both AS and Crohn’s disease share several similar genetic variations, and identified seven genes affecting both conditions.

When the researchers took a closer look at the function of the genes they had identified, they found that four of the genes are known to influence the activation of a recently discovered class of helper T-cells called Th17 cells. Identifying the involvement of these immune cells greatly increases what is known about how AS develops, and points to potential new therapies for this form of arthritis. This study highlights the value of studies that look into individual genes that might be involved in related diseases.

“It seemed likely that common pathogenic pathways may be acting in the development of both diseases” said Matt Brown.

The Low Starch Diet For Ankylosing Spondylitis Sufferers

Although there isn’t one particular diet that will cure the symptoms of ankylosing spondylitis, London based Rheumatologist, Dr Alan Ebringer, believes that sufferers can benefit by following a low starch diet. You can read about his findings here, in an article from the magazine Spondylitis Plus.

Here are some of the foods you should be adding to your diet as well as the ones you should be avoiding, according to Dr Ebringer’s Low Starch Diet.


Meat contains vitamins, minerals and protein and red meat is a good source of iron and vitamin B12. Red meat, pork, lamb and beef should be eaten as part of a balanced diet. Try not to eat too much red meat as it can raise cholesterol, but around 70g a day is fine. Don’t eat processed meats as these are not healthy.

Fruit and Vegetables

Try not to eat too much fruit as it is high in sugar, also some fruit has more starch than others, so limit your intake of bananas, melons, grapes and dried fruits. Vegetables are crammed with vitamins and minerals. Starchy vegetables include potatoes, peas, courgettes, yams, sweetcorn and pumpkin, but you can eat unlimited amounts of all other vegetables, especially the leafy green types such as kale and spinach.


Try and include at least two servings of oily fish a week into your diet. This is because oily fish contains omega 3 fatty acids, which is said to be beneficial to AS sufferers. Salmon and tuna are good examples of oily fish.

Milk and Milk Products

Milk and cheese are good sources of calcium and should be included in your diet. Probiotic yogurt will also help your gut health, which is important. Bad bacteria can grow and flourish, if your gut health is not good; leading to discomfort and constipation or irritable bowel syndrome. Plenty of fibre and probiotic yogurt reduces the amount of bad bacteria, allows healthy bacteria to grow and helps to reduce bowel problems.


Eggs are one of nature’s superfoods. They are packed with nutrients including vitamin B12. They are a good protein boost and low in calories. They don’t contain a lot of saturated fat and guidelines say it is safe to eat one a day. Remember though that scrambled and boiled eggs are healthier than fried eggs.

There are also foods that you can eat, but you need to be careful with the quantities and how often you eat them. They are the following:

Bread and Bread products

Although wholemeal varieties are healthier, bread and bread products still contain starch and therefore shouldn’t be eaten often.


Rice is another food that contains starch, although if you read this article from the Washington Post, you will see that there is a way to reduce the starch in rice.


Potatoes are full of starch, if you do want to eat them, peel them first and soak them for up to four hours. This will reduce the starch content.

The following foods are not included in Dr Ebringer’s diet, but if you want a healthier lifestyle then you should be careful how you eat fats and sugars and drink alcohol.

Fats and Sugars

Processed foods contain a lot of sugar and should be avoided if possible. Cooking at home with fresh ingredients is much healthier than eating pre-packed, tinned or takeaway foods. Any food with a high sugar content, together with trans- fats, saturated fats, preservatives and sodium aren’t good for you.


Alcohol contains sugar which could cause inflammation, so it is best to limit your alcohol intake or abstain totally. Too much alcohol can cause damage to your stomach lining, which means the nutrients aren’t absorbed as they should be. You should also be careful that alcohol does not have an adverse effect on your medication.




Can Vitamin Supplements Help CRPS Sufferers?

Unfortunately, CRPS is an incurable disease, however, certain vitamins are said to help reduce pain caused by the condition for certain sufferers.

As a result of considerable research, it is now widely accepted in the medical profession that Vitamin C can reduce the risk of complex regional pain syndrome (CRPS) following a limb fracture or limb surgery. In this blog, we discuss whether or not vitamins really do have the ability to alleviate symptoms for those sufferers who have already been diagnosed with the debilitating condition. Continue reading to find out more.

Scientists do not know exactly what it is that causes complex regional pain syndrome to develop and, as the condition is currently incurable, there is no definitive successful treatment. Instead, there are particular remedies and potential treatments that have been found to make symptoms caused by the condition more bearable.

In over 90 percent of cases, CRPS is triggered by a clear history of trauma or injury. As a condition, CRPS is lifelong and affects every aspect of a sufferers life.

Around 58% of CRPS sufferers find relief through prescribed painkillers and it is now commonly accepted that the best way to treat chronic pain caused by CRPS is with a multi-pronged, long-term approach. This can include a combination of GP-approved medication, relaxation techniques, holistic treatments, and vitamins.

Although there is no conclusive evidence regarding the effective use of vitamins to alleviate the many symptoms of CRPS, there is a wide-ranging argument that introducing additional vitamins into a daily regime can only help.

Increased sensitivity to pain is widely acknowledged to be triggered by a nervous system disorder. As vitamin B12 is essential for a healthy nervous system, replenishing vitamin B12 levels through supplementation has been found to be extremely beneficial.

Vitamin B and Magnesium have also received favourable feedback in terms of helping people live with the CRPS, as well as Calcium and, to some extent, fish oil supplements. However, it is always important to remember that no two individuals will react the same way to vitamin supplements; what may work well for one person may not necessarily have the same effect for another.

The many medical benefits of Vitamin C have long been known. In 1942, the important role of Vitamin C in fracture healing was documented. As well as promoting bone formation, Vitamin C has since been shown to improve the mechanical strength of the new bone (callus) that forms during the bone unification process. Studies indicate that, while Vitamin C does not absolutely prevent the development of CRPS following limb fractures or limb surgery, it does significantly reduce that risk. A 500mg of Vitamin C daily for at least 50 days following limb fracture or surgery remains a worthwhile measure.

There can be no replacement for a nutritional diet and a healthy lifestyle, however, if you’re struggling to meet your ‘Five-a-Day’ target of fresh fruit and vegetables and feel you may be lacking in nutrients as a result, adding vitamin supplements to your daily routine can only be a good thing for your overall health.

What causes CRPS to spread?

Complex regional pain syndrome (CRPS) is a greater than normal reaction of the body to an injury. It is a poorly understood condition in which a person experiences persistent and debilitating pain that is extremely severe. In this blog, we take a closer look at the condition and discover what causes CRPS to spread.

Complex regional pain syndrome (CRPS) is a chronic pain condition. Although most cases are triggered by an injury, the resulting pain is much more severe and long-lasting than normal. It causes intense pain, usually in the arms, legs, hands or feet. The main cause of CRPS is unknown, therefore, there is no cure. Many cases gradually improve to some degree over time, however, some cases of CRPS never disappear completely, leaving the affected person to experience pain for many years.

One of the first and most commonly asked questions about CRPS is does it spread? The simple answer to that is, yes. Usually, CRPS starts out in one limb, moving to another originally uninvolved limb or another part of the body. In most cases, CRPS will stay on the same side of the body – right arm, to right leg – or spread to an opposite limb – right arm, to left arm. Although it is rare, CRPs can occasionally spread across the body diagonally – right arm, to left leg.

Anything can cause a spread for a CRPS patient. The reasons why remain unclear. As a result, care needs to be taken each time any procedure is required, such as an operation, dental work or even giving blood.

Unfortunately, it would appear the risk of a spread increases with every limb that is affected. Spreads are not only limited to limbs, as it can affect any part of the body. This can include:

  • All internal organs
  • Face
  • Mouth
  • Back (especially when undergoing surgery for a spinal cord stimulator)
  • Eyes
  • Neck
  • Genitals
  • Breasts
  • Abdomen

Highly simplified – if it has a nerve, CRPS can spread to it.

In a small number of cases, thought to be 8% or less, CRPS has spread to the entire body. More common is for CRPS to spread to an entire limb. For example, an original injury may have occurred in a finger, but CRPS has encompassed the entire limb. This is referred to as contiguous spread.

Although there is no known cure for CRPS, a combination of physical treatments, medication, and psychological support can help and there is plenty of advice available for those living with chronic pain.


Foods That Are Known To Aggravate CRPS

Some foods are a great source of the vitamins and nutrients your body needs. On the other hand, however, there are also some foods that are known to cause great harm, particularly for those who suffer with complex regional pain syndrome. If you are a CRPS sufferer and want to know which foods you should think twice about eating, continue reading.

Suffering from CRPS is the same as suffering from chronic inflammation. As a result, anti-inflammatory foods are beneficial, as they naturally help to reduce inflammation and the triggers of inflammation. As a result, foods known to cause inflammation should be avoided by all CRPS sufferers.

The following foods are known to cause inflammation:

  • Sugar – It may be hard to give up desserts, but it is advised if you have CRPS. Foods particularly high in sugar include pastries, chocolate, soda, and fruit juice.
  • Saturated fats – These fats are known to trigger adipose (fat tissue) inflammation. Dairy foods, such as butter and cream, meats, such as fatty cuts of beef, pork and lamb, processed meats, such as salami, sausages and the skin on chicken, and lard are examples of foods high in saturated fat.
  • Trans fats – Known to cause systemic inflammation and are found in fast foods, cookies, donuts, etc.
  • Omega 6 – The body needs a healthy balance of Omega 3 and 6. An excessive consumption of Omega 6, which is found in oils, such as sunflower, grapeseed, soy, peanut, and vegetable, as well as in many salad dressings, can trigger the body to produce pro-inflammatory chemicals.
  • Refined carbohydrates – White flour products, such as breads, rolls, crackers, as well as white rice, potatoes, and many cereals contain refined carbohydrates.
  • Monosodium glutamate – MSG is a flavour-enhancing food additive most commonly found in Asian food and soy sauce, which can trigger two important pathways of chronic inflammation and affect liver health.
  • Gluten and casein – Those with joint pain are likely to find relief by avoiding gluten, which is found in wheat, barley and rye, or casein, most commonly found in dairy products.
  • Alcohol – As well as causing inflammation, alcohol is also known to weaken liver function.

The foods listed above are some of the most harmful when it comes to inflammation. Therefore, if you are a sufferer, they should be avoided at all costs to not only improve the pain you feel, but also improve your overall health. Maintaining a healthy diet is important for anyone, particularly those who suffer with CRPS, since it affects every aspect of a person’s life, both physically and mentally.

In order to maintain a healthy, balanced diet, it is important that you try to follow the below recommendations, as provided by the NHS:

  1. Eat your 5-a-day
  2. Switch to wholegrain rice, pasta and bread
  3. Give dairy alternatives a try
  4. Eat beans, pulses, fish and non-fatty meats for protein
  5. Choose unsaturated oils and spreads and eat in small amounts
  6. Drink plenty of water