Chronic fatigue syndrome – Diagnosis and treatment

Diagnosis

There’s no single test to confirm a diagnosis of chronic fatigue syndrome. Symptoms can mimic those of many other health problems, including:

• Sleep disorders. Chronic fatigue can be caused by sleep disorders. A sleep study can determine if your rest is being disturbed by disorders such as obstructive sleep apnea, restless legs syndrome or insomnia.
• Medical problems. Fatigue is a common symptom in several medical conditions, such as anemia, diabetes and underactive thyroid (hypothyroidism). Lab tests can check your blood for evidence of some of the top suspects.
• Mental health issues. Fatigue is also a symptom of a variety of mental health problems, such as depression and anxiety. A counselor can help determine if one of these problems is causing your fatigue.

It’s also common for people who have chronic fatigue syndrome to also have other health problems at the same time, such as sleep disorders, irritable bowel syndrome, fibromyalgia, depression or anxiety.

In fact, there are so many overlapping symptoms between chronic fatigue syndrome and fibromyalgia that some researchers consider the two disorders to be different aspects of the same disease.

Diagnostic criteria

Guidelines proposed by the United States Institute of Medicine define the fatigue associated with chronic fatigue syndrome as being:

• So severe that it interferes with the ability to engage in pre-illness activities
• Of new or definite onset (not lifelong)
• Not substantially alleviated by rest
• Worsened by physical, mental or emotional exertion

To meet the Institute of Medicine’s diagnostic criteria for chronic fatigue syndrome, a person would also need to experience at least one of these two symptoms:

• Difficulties with memory, focus and concentration
• Dizziness that worsens with moving from lying down or sitting to standing

These symptoms must last for at least six months and occur at least half the time at moderate, substantial or severe intensity.

Treatment

There is no cure for chronic fatigue syndrome. Treatment focuses on symptom relief. The most disruptive or disabling symptoms should be addressed first.

Medications

Some problems associated with chronic fatigue syndrome can be improved with either prescription or over-the-counter medications. Examples include:

• Depression. Many people with long-term health problems, such as chronic fatigue syndrome, are also depressed. Treating your depression can make it easier for you to cope with the problems associated with chronic fatigue syndrome. Low doses of some antidepressants can also help improve sleep and relieve pain.
• Orthostatic intolerance. Some people with chronic fatigue syndrome, particularly adolescents, feel faint or nauseated when they stand or sit upright. Medications to regulate blood pressure or heart rhythms may be helpful.
• Pain. If over-the-counter medications such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) don’t help enough, prescription drugs sometimes used to treat fibromyalgia might be options for you. These include pregabalin (Lyrica), duloxetine (Cymbalta), amitriptyline or gabapentin (Neurontin).

Therapy

Many people with chronic fatigue syndrome benefit from:

• Counseling. Talking with a counselor can help build coping skills to deal with chronic illness, address limitations at work or school, and improve family dynamics. It can also be helpful for managing depression.
• Addressing sleep problems. Sleep deprivation can make other symptoms more difficult to deal with. Your doctor might suggest avoiding caffeine or changing your bedtime routine. Sleep apnea can be treated by using a machine that delivers air pressure through a mask while you sleep.
• Exercise. Aggressive exercise regimens often lead to worsened symptoms, but maintaining activities that are tolerated is important to prevent deconditioning. Exercise regimens that start at a very low intensity and increase very gradually over time may be helpful in improving long-term function.

Post-exertional malaise

People with chronic fatigue syndrome have a worsening of their symptoms after physical, mental or emotional effort. This is called post-exertional malaise and it can last for days or weeks after the exertion.

People who experience post-exertional malaise often struggle to find a good balance between activity and rest. The goal is to remain active without overdoing it.

You may want to keep a daily diary of your activities and symptoms, so you can track how much activity is too much for you. This may help you avoid pushing too hard on the days you feel good, which can result in a “crash” where you feel much worse later.

Alternative medicine

Many alternative therapies have been promoted for chronic fatigue syndrome, but there’s not much evidence that they work. Patients with chronic fatigue syndrome may be sensitive to medications, including herbal products and supplements. Treatments that are expensive or potentially harmful should be avoided.

Coping and support

The experience of chronic fatigue syndrome varies from person to person. Emotional support and counseling may help you and your loved ones deal with the uncertainties and restrictions of this disorder.

You may find it therapeutic to join a support group and meet other people with chronic fatigue syndrome. Support groups aren’t for everyone, and you may find that a support group adds to your stress rather than relieves it. Experiment and use your own judgment to determine what’s best for you.

Preparing for your appointment

If you have signs and symptoms of chronic fatigue syndrome, you’re likely to start by seeing your family doctor or a general practitioner. It can be difficult to absorb all of the information provided during an appointment, so you might want to arrange for a friend or family member to accompany you. Having someone else hear the information can help you later in case there’s something you missed or forgot.

What you can do

Before your appointment, you may want to write a list that includes:

• Your signs and symptoms. Be thorough. While fatigue may be affecting you most, other symptoms — such as memory problems or headaches — also are important to share with your doctor.
• Key personal information. Recent changes or major stressors in your life can play a very real role in your physical well-being.
• Health information. List any other conditions for which you’re being treated and the names of any medications, vitamins or supplements that you take regularly.
• Questions to ask your doctor. Creating your list of questions in advance can help you make the most of your time with your doctor.

For chronic fatigue syndrome, some basic questions to ask your doctor include:

• What are the possible causes of my symptoms or condition?
• What tests do you recommend?
• If these tests don’t pinpoint the cause of my symptoms, what additional tests might I need?
• On what basis would you make a diagnosis of chronic fatigue syndrome?
• Are there any treatments or lifestyle changes that could help my symptoms now?
• Do you have any printed materials I can take with me? What websites do you recommend?
• What activity level should I aim for while we’re seeking a diagnosis?
• Do you recommend that I also see a mental health provider?

Don’t hesitate to ask other questions during your appointment as they occur to you.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

• What are your symptoms and when did they begin?
• Does anything make your symptoms better or worse?
• Do you have problems with memory or concentration?
• Are you having trouble sleeping?
• How often do you feel depressed or anxious?
• How much do your symptoms limit your ability to function? For example, have you ever had to miss school or work because of your symptoms?
• What treatments have you tried so far for this condition? How have they worked?

Sept. 24, 2020

Blood test may detect myalgic encephalomyelitis/chronic fatigue syndrome

At a Glance

• Researchers developed a blood test that, in a pilot study, accurately identified people with myalgic encephalomyelitis/chronic fatigue syndrome.
• If validated in larger studies, the assay could one day help diagnose the disease and enable researchers to test potential treatments.

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex, debilitating disease. People with ME/CFS experience at least six months of profound exhaustion and extremely poor stamina that doesn’t improve with rest. Other symptoms may include joint and muscle pain, sleep problems, tender lymph nodes, a sore throat, headaches, GI issues, and problems with thinking and cognition.

The cause of this disease is unknown. Sometimes it starts after a person has flu-like symptoms. Studies have suggested that infections, stress, or immune system changes may be involved.

One of the main characteristics of ME/CFS is that symptoms get worse within 12 to 24 hours following physical or mental exertion, which is known as post-exertional malaise. When you exert mental or physical energy, cells need to consume ATP, a small molecule that provides energy for cells to carry out their functions. Some studies have found that the ability to use ATP may be impaired in people with ME/CFS.

There are currently no diagnostic tests for ME/CFS. To test whether they could use ATP consumption to identify individuals with ME/CFS, a team led by Dr. Ron Davis at Stanford University developed a technique called a nanoelectronics assay that can measure the electrical responses of cells in real time. Support for development of the device was initially provided by NIH’s National Human Genome Research Institute (NHGRI). Results were published on April 29, 2019, in the Proceedings of the National Academy of Sciences.

The researchers looked at peripheral blood mononuclear cells (PBMCs), a type of immune cell that is easy to isolate from blood samples. They compared PBMCs from 20 people with ME/CFS and 20 healthy controls. They placed the cells in a high salt environment, which creates a type of stress that cells can usually fix using ATP.

Cells from healthy controls had a period of electrical change when exposed to high salt levels, but soon returned to normal. Cells from all 20 people with ME/CFS, in contrast, showed significantly greater electrical changes. This suggests that the healthy cells were able to more effectively handle the stress of a high-salt environment.

Cells from more severely ill people showed the greatest changes, while those from healthy controls showed the lowest. These results suggest that the assay’s signal strength may reflect disease severity.

The team also optimized the assay for potential diagnostic use by comparing immune cells taken from blood plasma, whole blood, and serum. Plasma samples tested within five hours of collection yielded the most reliable results.

“We don’t know exactly why the cells and plasma are acting this way, or even what they’re doing,” Davis says. “But there is scientific evidence that this disease is not a fabrication of a patient’s mind. We clearly see a difference in the way healthy and chronic fatigue syndrome immune cells process stress.”

In addition to allowing an accurate diagnosis, this assay could be used to test how effective drugs are for treating the disease. However, more studies are needed to confirm these findings and ensure the assay is specific for ME/CFS before it could be used in the clinic.

—by Tianna Hicklin, Ph.D.

Funding: NIH’s National Human Genome Research Institute (NHGRI) and the Open Medicine Foundation.

How Chronic Fatigue Syndrome Is Diagnosed

The path to a diagnosis of chronic fatigue syndrome (CFS) can be frustrating. The condition is characterized by its symptoms and there is no single test that can confirm it. Complicating the issue even further is the fact that many CFS symptoms mirror those of other illnesses, including heart, lung, thyroid, and even psychiatric disorders.

As a disease, chronic fatigue syndrome is diagnosed when other possible explanations for how you are feeling have been explored and excluded.

The condition is also called myalgic encephalomyelitis (ME/CFS) or systemic exertion intolerance disease (SEID).

© Verywell, 2018 

Self-Checks

You can’t diagnose yourself with chronic fatigue syndrome, but you can (and are encouraged to) heighten your awareness of your symptoms, their frequency, and possible triggers. This information will greatly help your doctor with the diagnostic process.

Start by getting to know the range of possible chronic fatigue symptoms; you may be experiencing some you might otherwise not think are worth raising to your doctor.

Consider keeping a symptom diary, which may help you find patterns of things things that make you feel better or worse.

Also, think back to an episode of illness or stress that occurred soon before you began to experience the symptoms for the first time and take note of it.

You can further prepare for a visit with your doctor by writing down answers to these likely questions:

• How long have you had these symptoms?
• How do the things you are able to do now differ from what you were able to do before you began to have these symptoms? Do your symptoms prevent you from doing certain activities?
• How do you feel if you try to do activities that now feel difficult?
• What specific activities make you feel worse?
• Does sleeping or resting help you feel better? 
• Do you have any sleep problems?
• What helps you the most when you feel fatigued?
• Do you have any problems thinking clearly?

Evaluation

Your doctor will use all of this information to come to a diagnosis. In fact, even though they will perform tests as part of this process, the history of your symptoms will be the most significant data your doctor will need for determining whether you have ME/CFS. 

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In 2015, the National Academy of Medicine (NAM) defined the chief symptoms that indicate the condition. A person may be diagnosed with ME/CFS if they meet all of the following criteria:

• Six months of profound, unexplained fatigue
• Post-exertional malaise for more than 24 hours after mental or physical exertion: This means you have fatigue and worsening of other symptoms, which can continue for days.
• Unrefreshing sleep: You wake up tired, even with ample sleep. You may also have other sleep disturbances such as insomnia or an inability to stay asleep.
• Either cognitive problems (brain fog) or orthostatic intolerance (dizziness upon standing due to blood pressure irregularities)

There are many other symptoms frequently experienced by people with ME/CFS, including muscle or joint pain, headaches, sore throat, enlarged lymph nodes in the neck or armpits, and a feeling of generally being sick.

Your doctor will complete a full physical examination as part of their evaluation as well.

Labs and Tests

Laboratory tests will not show any unusual results if you have ME/CFS but may show that you have other conditions that are producing your symptoms (either entirely or in part).

The laboratory tests you may expect include complete blood count (CBC), glucose, calcium, electrolytes, BUN, creatinine, erythrocyte sedimentation rate (ESR), and thyroid stimulating hormone (TSH). These are general screens for anemia, infection, kidney function, liver function, inflammation, and thyroid disease.

Your doctor may assess your fatigue, cognitive impairment, and other symptoms with tools or questionnaires such as the CDC Symptom Inventory for CFS, Sleep Assessment Questionnaire, Wood Mental Fatigue Inventory, and PROMIS pain assessment tool.

You are likely to have more extensive tests if your physical examination or symptoms point to other conditions. For example, you might have tests for antinuclear antibodies if systemic lupus erythematosus is suspected, thyroid function tests if you could have hypothyroidism, sleep studies, or tests for adrenal insufficiency. You might be referred to a neurologist, rheumatologist, or sleep specialist for assessment.

Imaging such as a chest X-ray, MRI, or CT scan is only done if other findings indicate a condition such as heart disease, lung disease, cancer, or multiple sclerosis.

Again, remember that one of these or other issues, and not chronic fatigue syndrome, could alone be the cause of your symptoms, or it could be affecting you ​in addition to ME/CFS.

Differential Diagnoses

To tease this all out, diagnosis of CFS is made by exclusion, meaning a doctor will explore other conditions that may cause fatigue, body aches, swollen lymph nodes, and cognitive impairment.

The list is potentially exhaustive, and the process can be lengthy and sometimes tedious. The evaluation may involve tests for the following conditions:

• Chronic infections, such as mononucleosis or Lyme disease
• Chronic conditions, such as diabetes, anemia, hepatitis, or HIV
• Nervous system disorders, such as fibromyalgia
• Sleep disorders, such as obstructive sleep apnea
• Autoimmune disorders, such as multiple sclerosis or lupus
• Heart or lung impairment
• Endocrine disorders, such as hypothyroidism
• Mood disorders, such as clinical depression

Even if a positive diagnosis of depression is made, it doesn’t necessarily rule out CFS since depression is an almost inextricable symptom of long-term fatigue. As such, the diagnosis needs to be made by a doctor experienced in CFS who is better able to differentiate these conditions.

Frequently Asked Questions

Is there a blood test for chronic fatigue syndrome?

Doctors often order a variety of blood tests, as well as other laboratory tests, when diagnosing chronic fatigue syndrome, but none directly test for ME/CFS. Instead, they are used to rule out other causes of symptoms. That said, in 2019 researchers at the Stanford University School of Medicine developed a blood test capable of detecting certain biomarkers for chronic fatigue syndrome. In a pilot study, the test correctly identified ME/CFS 100% of the time, showing promise as a future way to definitively diagnose the condition.

What kind of doctor should I see if I think I have chronic fatigue syndrome?

Start with your regular physician, as they can rule out other causes of your symptoms. Although there is no medical specialty that focuses on chronic fatigue syndrome, doctors who specialize in disorders that may have symptoms similar to those of the condition can help to home in on what is causing yours. Among the types of doctors your general practitioner might refer you to are a neurologist, a sleep specialist, and a rheumatologist.

What are some of the triggers of ME/CFS?

The causes of chronic fatigue syndrome are unknown but there is a handful of possibilities, according to the Centers for Disease Control and Prevention. Among the triggers that have been investigated are infections (such as Epstein-Barr virus), changes in the immune system, physical or emotional stress, problems with energy metabolism, and genetic factors.

Chronic fatigue syndrome: New test in sight

Scientists have developed a test for chronic fatigue syndrome that detects the reaction of the immune cells and blood plasma to stress. The findings may also help screen effective drugs for the condition.

Myalgic encephalomyelitis, or chronic fatigue syndrome (ME/CFS), is a serious condition that may affect up to 2.5 million people in the United States.

Symptoms include extreme tiredness, difficulty sleeping, trouble with thinking and remembering things, muscle pain and aches, a recurring sore throat, and tender lymph nodes.

Currently, physicians can only diagnose ME/CFS by examining a person’s symptoms and medical history, and by excluding other possible illnesses.

This can make the diagnosis process difficult, lengthy, and inaccurate.

However, the results of a new study may soon change this. Scientists at Stanford University School of Medicine in California have discovered a biomarker for ME/CFS and developed a test that could soon diagnose the condition accurately.

Ron Davis, Ph.D. — a professor of biochemistry and of genetics at Stanford University School of Medicine — devised the test together with his team, which includes first study author Rahim Esfandyarpour.

Prof. Davis and colleagues published their findings in the journal Proceedings of the National Academy of Sciences.

Prof. Davis shares the motivation for his research, saying, “Too often, [ME/CFS] is categorized as imaginary.” He goes on to explain that physicians often misguidedly test liver, kidney, and heart function, as well as take blood samples and immune cell counts from people who seek help for ME/CFS.

“All these different tests would normally guide the doctor toward one illness or another,” says Prof. Davis, “but for [people with ME/CFS], the results all come back normal.” The issue, he adds, is that none of these tests look deep enough.

Instead, their new diagnostic test looks at how a person’s immune cells react to stress. Specifically, the scientists used a nanoelectronic assay, which measures small changes in energy to assess the health of immune cells and blood plasma, to see how the immune cells and blood plasma process stress.

To develop the test, the team took advantage of “advancements in micro/nanofabrication, direct electrical detection of cellular and molecular properties, microfluidics, and artificial intelligence techniques.”

The test detects “biomolecular interactions in real time” by using thousands of electrodes to create an electrical current, and by using small chambers that contain blood samples with only immune cells and blood plasma.

Inside the small chambers, the immune cells and plasma interact with the electrical current, altering its flow.

The scientists used salt to stress the blood samples of some people with ME/CFS and some people without the condition. They then assessed the changes in electrical current.

The bigger the changes, the less healthy the blood sample, explain the scientists; the changes in electrical current reflect the changes on a cellular level. A significant change indicates that the immune cells and blood plasma do not react well to stress and cannot process it effectively.

In the experiments that Prof. Davis and team carried out, all of the blood samples that came from people with ME/CFS showed a clear spike indicating large changes in electrical current, whereas blood samples from people who did not have the condition showed an even course.

“We don’t know exactly why the cells and plasma are acting this way, or even what they’re doing,” says Prof. Davis. However, the findings offer “scientific evidence that this disease is not a fabrication of a patient’s mind. ”

“We clearly see a difference in the way healthy and chronic fatigue syndrome immune cells process stress.”

Prof. Ron Davis

The researchers applied the test to the blood samples of 40 people, 20 of whom had ME/CFS and 20 whom did not.

Their test accurately identified all of the people with ME/CFS without misidentifying any of the people who did not have the condition.

Also, they wish to apply the test to identify effective drugs for ME/CFS. “Using the nanoelectronics assay,” explains Esfandyarpour, “we can add controlled doses of many different potentially therapeutic drugs to the patient’s blood samples and run the diagnostic test again.”

This way, if the test still finds spikes in electrical current after the treatment, it means that the drug didn’t work and the immune cells still respond poorly to stress. However, if the drug smoothes out the spikes, it could mean that they are helping the immune cells and blood plasma process stress more effectively.

Chronic Fatigue Syndrome | CFS

What is chronic fatigue syndrome (CFS)?

Chronic fatigue syndrome (CFS) is a serious, long-term illness that affects many body systems. Another name for it is myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). CFS can often make you unable to do your usual activities. Sometimes you may not even be able to get out of bed.

What causes chronic fatigue syndrome (CFS)?

The cause of CFS is unknown. There may be more than one thing that causes it. It is possible that two or more triggers might work together to cause the illness.

Who is at risk for chronic fatigue syndrome (CFS)?

Anyone can get CFS, but it is most common in people between 40 and 60 years old. Adult women have it more often that adult men. Whites are more likely than other races to get a diagnosis of CFS, but many people with CFS have not been diagnosed with it.

What are the symptoms of chronic fatigue syndrome (CFS)?

CFS symptoms can include

• Severe fatigue that is not improved by rest
• Sleep problems
• Post-exertional malaise (PEM), where your symptoms get worse after any physical or mental activity
• Problems with thinking and concentrating
• Pain
• Dizziness

CFS can be unpredictable. Your symptoms may come and go. They may change over time – sometimes they might get better, and other times they may get worse.

How is chronic fatigue syndrome (CFS) diagnosed?

CFS can be difficult to diagnose. There is no specific test for CFS, and other illnesses can cause similar symptoms. Your health care provider has to rule out other diseases before making a diagnosis of CFS. He or she will do a thorough medical exam, including

• Asking about your medical history and your family’s medical history
• Asking about your current illness, including your symptoms. Your doctor will want to know how often you have symptoms, how bad they are, how long they have lasted, and how they affect your life.
• A thorough physical and mental status exam
• Blood, urine, or other tests

What are the treatments for chronic fatigue syndrome (CFS)?

There is no cure or approved treatment for CFS, but you may be able to treat or manage some of your symptoms. You, your family, and your health care provider should work together to decide on a plan. You should figure out which symptom causes the most problems and try to treat that first. For example, if sleep problems affect you the most, you might first try using good sleep habits. If those do not help, you may need to take medicines or see a sleep specialist.

Strategies such as learning new ways to manage activity can also be helpful. You need to make sure that you do not “push and crash.” This can happen when you feel better, do too much, and then get worse again.

Since the process of developing a treatment plan and attending to self-care can be hard if you have CFS, it is important to have support from family members and friends.

Don’t try any new treatments without talking to your health care provider. Some treatments that are promoted as cures for CFS are unproven, often costly, and could be dangerous.

Centers for Disease Control and Prevention

Diagnosing Chronic Fatigue Syndrome – Chronic Fatigue Syndrome Center

The most important thing you need to know about a chronic fatigue syndrome (CFS) diagnosis is that it is a process of exclusion, which means that your doctor has to rule out all of the other possible causes of your chronic fatigue symptoms before you can get diagnosed. Practically speaking, this means that the diagnosis process can be lengthy and involve many different tests as your doctor tries to get to the root of your severe fatigue.

“It’s pretty straightforward. If you see somebody who has been sick for six months and has had a standard medical work-up — there aren’t too many other things that do that. You just need to make sure all your i’s are dotted and t’s are crossed, that somebody doesn’t have sleep apnea or another cause of fatigue,” says internist Alan Pocinki, MD, a clinical associate professor at George Washington University Medical Center in Washington, D.C., who lectures on CFS. “I still find that the average person I see was sick for a year and a half to two years before they got a diagnosis. There are certainly doctors who don’t believe that it’s real.”

Diagnosing Severe Fatigue: Medical Specialists You May See

Dr. Pocinki says that there is no one medical specialty that focuses on chronic fatigue syndrome. Many people find their way to an infectious disease specialist or a rheumatologist in their search for a chronic fatigue doctor. You may see other specialists on your way to a diagnosis, including:

The Many Steps to Diagnosing Severe Fatigue

Getting a chronic fatigue syndrome diagnosis will involve a physical exam and testing. Because pain is a common complaint among people with chronic fatigue syndrome, your doctor will want to examine any painful areas for swelling, tenderness, and range of motion constraints, and test for other possible causes of your pain, such as arthritis.

There is no single diagnostic test that will tell your doctor whether you have chronic fatigue syndrome. Instead, your doctor will order several tests, depending on the symptoms of chronic fatigue that you are concerned about. These tests could include:

• Complete blood count to help rule out leukemia, anemia, and lupus
• Lyme disease
• Thyroid function
• Blood chemistry to make sure sugar levels and other measures of health don’t point toward another possible cause, such as metabolic syndrome
• Urine tests

You may also be referred for psychological testing or even for testing in a sleep medicine center.

Other Conditions That Cause Severe Fatigue

Numerous health conditions can cause severe fatigue, including:

In addition, some medications also can cause chronic fatigue symptoms.

The Symptoms Necessary for a CFS Diagnosis

If your doctor doesn’t find another cause for your chronic fatigue symptoms, you will get a chronic fatigue diagnosis if you have severe fatigue that is not due to your activity level, doesn’t improve with rest, and forces you to cut back on your daily activities.

Also, you will have had four or more of these symptoms for six months or more:

Data suggest that only about one in five people with CFS have been diagnosed. But the earlier you get diagnosed, the sooner you can start managing CFS. Keep asking questions until you get all the answers that you need.

How CFS/ME is diagnosed | Information for the public | Chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy): diagnosis and management | Guidance

Investigating the symptoms

There is no test to diagnose CFS/ME – doctors diagnose CFS/ME based on your symptoms.

The symptoms of CFS/ME are similar to the symptoms of some other illnesses, and to find out what is wrong (make a diagnosis), your doctor will need to do some tests. There is no specific test that can identify CFS/ME, so the diagnosis has to be based on ruling out other conditions that could be causing your symptoms.

Your doctor should consider CFS/ME if you have disabling tiredness (fatigue) that is new or started suddenly, lasts a long time or keeps coming back and cannot be explained by other causes. CFS/ME should be considered if the fatigue means you can’t do the things you used to, if it gets worse after activity or gentle exercise such as a short walk, and if you also have some of the following symptoms:

• sleep problems

• pain in the muscles or joints

• headaches

• sore throat or sore glands that aren’t swollen

• problems thinking, remembering, concentrating or planning

• flu-like symptoms

• feeling dizzy or sick or having palpitations (irregular or fast heartbeats), or

• exercising or concentrating on something makes your symptoms worse.

Your doctor should consult a specialist if they are unsure about the diagnosis, or if you have severe symptoms.

Because CFS/ME has symptoms similar to many common illnesses that get better on their own, doctors should consider whether a person has CFS/ME if they do not get better as quickly as expected. On the other hand, some other serious illnesses may also have the same symptoms as CFS/ME. So your doctor should take special care to rule these out, particularly if you have any of the following:

• symptoms such as double vision or blackouts that suggest a problem with your nervous system

• painful, swollen joints

• chest or heart problems

• weight loss

• signs of stopping breathing for short periods while asleep (called sleep apnoea)

• persistently swollen glands.

Before making a diagnosis of CFS/ME your doctor should ask you questions about your medical history, do a thorough physical examination, and assess your mental health. They should carry out tests to rule out other causes of your symptoms. These will depend on your symptoms but will include urine and blood tests. Your doctor should consult a specialist if they are unsure about the diagnosis, or if you have severe symptoms.

While you are waiting for a diagnosis or a referral, you should be given advice and help to deal with (or manage) your symptoms so that your everyday life and activities are affected as little as possible.

If a child or young person under 18 years old has symptoms of possible CFS/ME they should be referred to a paediatrician (a specialist children’s doctor) within 6 weeks of first seeing their doctor about the symptoms.

If you have new and/or distressing symptoms at any time, you should talk to your doctor about them.

Questions about diagnosis

• What are the tests you are offering and why am I having them?

• What do these tests involve? Please give me details.

• Where will these tests be carried out? Can I have them at home?

• How long will I have to wait until I have the tests?

• How long will it take to get the results, and how will I be told about them?

Reaching a diagnosis of CFS/ME

Your doctor should diagnose CFS/ME if your symptoms can not be explained by another cause and have lasted for:

Your doctor should reassure you that most people’s condition improves with time, and many people recover and are able to go back to work and do their normal activities. But you also need to know that some people’s symptoms do not improve. For children, the outlook is generally better than for adults.

90,000 Chronic fatigue syndrome. Diagnostics and treatment at the Yauza Clinical Hospital. Moscow.

If a patient has been feeling unreasonable fatigue and malaise for many months, it is worth contacting a doctor to rule out the presence of chronic fatigue syndrome (CFS). In the Yauza Clinical Hospital, if CFS is suspected, complex diagnostics is carried out, including consultations by specialists of various profiles and the studies they have appointed, based on the results of which the treatment is individually selected.It may include psychotherapeutic sessions, restorative therapy, homeopathy, physiotherapy (massage), etc.

Chronic fatigue syndrome – a state of constant fatigue, decreased mental and physical performance, which does not stop after rest and lasts more than six months.

The disease has been known since the mid 80s. Since that time, the number of CFS sufferers in the world has been steadily increasing. It mainly affects women aged 25 to 45 years (up to 80% of cases).

The question of the causes of the disease and the mechanism of its occurrence is not completely clear. Most often it is associated with a past viral or bacterial infection. It can be influenza, acute respiratory viral infections, some types of hepatitis, endocarditis, pneumonia, etc. Often the impetus for the development of the syndrome is the body’s response to surgical treatment, difficult childbirth, severe or chronic stress. The main cause of CFS is currently considered to be the depletion of the human immune system. On the other hand, there is an indication of a lack of L-carnitine in the blood and a deficiency of ATP, as an energy-producing substance.

The most important criteria for the diagnosis of CFS are:

• The duration of the manifestations of the symptoms of the disease is 6 months or more.
• the absence of other diseases that can cause similar symptoms.

Chronic fatigue syndrome is characterized by the progression of symptoms, a gradual worsening of the condition. At the moment, there is no objective, laboratory data confirming the presence of CFS. But in the process of diagnosis, it is necessary to exclude the presence of chronic foci of inflammation and somatic diseases with similar symptoms.

Therefore, in the Yauza Clinical Hospital, in the process of diagnosing patients with suspected CFS, a therapist, immunologist, endocrinologist, rheumatologist, neurologist and doctors of other specialties are consulted.

Treatment

General principles of CFS treatment are aimed at improving the patient’s lifestyle, improving the functioning of the immune system, stabilizing his psycho-emotional state. A significant part of them can be realized only by the patient himself. The task of the doctor is to convince the need to comply with these measures to improve the condition.

• Streamlining the ratio of work and rest, rational physical activity.
• Diet therapy: normalization of diet, rational unloading diet.
• Vitamin therapy, mainly B vitamins
• Massage, exercise therapy, hydrotherapy, for example, swimming.
• Rational psychotherapy, autogenous training, group psychotherapeutic methods.
• Immunocorrectors and / or adaptogens.
• Auxiliary, symptomatic medicines, for example, nootropics, enterosorbents, daytime tranquilizers. Pharmacotherapy should be prescribed and monitored by a doctor only.

Complex diagnostics and treatment of chronic fatigue syndrome at the Clinical Hospital on Yauza will improve the patient’s condition and return him to good health.

Prices for services You can look at the price list or specify by phone, indicated on the website.

90,000 Fatigue, apathy, loss of energy: how to bring back the joy of life?

Do you often experience a lack of energy? Do you wake up frustrated as a result of sleep disturbance, and during the day you are haunted by nervousness and drowsiness? Has your usual positive attitude changed to apathy and irritability? Therefore, if you are constantly falling asleep, and the usual work has become unbearable, you need to take a closer look at your body and consult a doctor. With the right approach and proper treatment, this problem can be solved and the joy of life can be restored.

Causes of fatigue and apathy

• Hormonal failure, namely, decreased activity of the thyroid gland (hypothyroidism). Thyroid hormones are natural “energizers”. They accelerate metabolism, regulate the reproductive and digestive systems, and affect the central nervous system. In addition, patients experience edema, constipation, excess weight, menstrual and sexual dysfunction. With hypothyroidism, you may feel constant drowsiness and fatigue, get cold, and do not tolerate cold well.You may feel as if your body is “going into” hibernation. In addition, it is possible to gain excess weight with an unchanged diet. This pathology is mainly faced by women over 40 years old.
• Anemia or anemia. With this disease, the amount of hemoglobin and the number of red blood cells decrease. Oxygen starvation occurs, tissues “suffocate”, body functions are impaired. Hence, constant fatigue arises, you feel overwhelmed even after a good rest. The smallest physical activity causes a rapid heartbeat, chest pain, a feeling of shortness of breath.Hair falls out more than usual, nails break.
• Internal medicine. Most often, apathy and drowsiness is observed when the following organs are disrupted: kidneys, liver, heart and blood vessels, and the digestive tract.
• Menopause. During menopause, the production of sex hormones decreases, hot flashes, depression, insomnia occur, a headache may be present, and with the same diet, excess weight may be gained. Almost all menopausal women report decreased performance, constant fatigue and irritability.
• Depression, chronic fatigue syndrome and other pathologies.

If a state of fatigue haunts you constantly, it is worth checking your health, because it may be a symptom of an illness. See the video for more details.

Prevention of chronic fatigue, apathy, loss of energy

First of all, you should cultivate a culture of health. From a young age, strengthen the body with a healthy lifestyle, adhere to the following rules.

• Physical activity. Get in the habit of running in the morning, exercising, and walking as much as possible. Do you live on the 5th floor? Forget the elevator. Are you going to go to the next street to the store? Give preference to walking. The main enemy of women who are prone to blues and depression is a sofa, a TV and a bag of sweets in the bargain.
• Proper nutrition. An unbalanced diet, snacks on the go, junk food is a real danger of gaining excess weight, which will also lead to depression.Avoid sugary, fried, fast carbohydrates. Lightness in the body – lightness in the soul.
• Quitting bad habits. The dubious pleasure and harm from cigarettes and alcohol are incomparable.
• Minimize stress. Not everyone has the opportunity to change their unloved job, build the boundaries of what is permissible, and improve family relationships. But try to minimize negative emotions in your life. Stress is the main enemy of your health.

Treatment of fatigue, apathy, loss of energy

As a rule, with complaints of drowsiness, irritability and other symptoms, they turn to a therapist or neurologist.But, unfortunately, drug therapy alone is not able to permanently solve the patient’s problem.

In this case, the main principle of treatment is an integrated approach, the rejection of which determines the low effectiveness of therapy.

Exciting symptoms can be of a psychological nature (stress, chronic fatigue, asthenia, etc.). And also become a consequence of disorders in the body, for example, hormonal imbalance, various diseases. To find out exactly, you need to contact a specialist in general.

The endocrine system regulates the work of various organs. Therefore, with hormonal disruptions, various symptoms arise, including of a psychological nature. The task of an endocrinologist is to identify disorders of the endocrine system and prescribe effective treatment.

At the Elena Malysheva Medical Center, a general specialist, endocrinologist, psychiatrist, psychotherapist Alexander Mikhailovich Fomin is receiving appointments.

Dr. Fomin is a certified specialist in various fields of medicine (endocrinology, psychotherapy, etc.)). He has a comprehensive approach to problems, looking for the best solution based on the symptoms and individual characteristics of patients.

Don’t miss your chance to be diagnosed and treated by a world-class specialist!

For more information and registration by phone: 8 (495) 268-12-12.

90,000 10 causes of chronic fatigue and how to deal with it

10 causes of chronic fatigue and how to deal with it

With the modern rhythm of life and a negative information background, it is very difficult to avoid stress and emotional overwork.It is even worse if fatigue builds up and then begins to come not only at the end of the working day or week, but almost constantly. This means that it is time to finally hear the “help signals” that the body sends.

The causes of chronic fatigue

Chronic fatigue syndrome is a disease of civilized countries. At risk are residents of megalopolises, especially people whose work is associated with increased responsibility. These include teachers, doctors, firefighters, entrepreneurs, people in high positions.However, chronic fatigue syndrome can also appear in people of other professions – no one is immune from this unpleasant disease. Poor sanitary and ecological conditions, chronic diseases, viral infections and an unbalanced emotional and intellectual load – all this increases the chances of earning chronic fatigue syndrome even at a young age.

The onset of chronic fatigue syndrome is associated with the development of a specific neurosis of the central regulatory centers of the autonomic nervous system.If left untreated, this syndrome can develop into depression, as well as cause infectious and allergic diseases.

Chronic fatigue symptoms

Normally, any severe fatigue goes away after proper sleep and rest. If a person slept and ate well, but continues to feel sluggish and tired, which prevents him from performing his usual activities, this is more of a pathological condition. The main symptom of chronic fatigue is unreasonable constant fatigue, which reduces performance by several times.However, this is reflected in the psycho-emotional well-being of a person: it significantly limits everyday life and interferes with communication, since moral resources are no longer enough even for loved ones. In addition, chronic fatigue can lead to headaches, memory impairment, insomnia, nausea, and more. Due to the variety of symptoms, the disease is difficult to diagnose.

Chronic weakness and fatigue appear gradually, and a person may not realize for a long time how many opportunities have been lost until he tries to compare his performance in the old days with what is now. Unfortunately, people often attribute the loss of energy to age or life circumstances, thereby ignoring the symptoms and exacerbating the situation.

It is important to pay attention to the following signs of chronic fatigue in time:

• Constant loss of strength and decreased performance.
• Rapid fatigability.
• Mood swings.
• Sleep disorders: drowsiness, insomnia, not invigorating superficial or intermittent sleep.
• Headaches that differ from those before in intensity, character or duration.
• Problems with memory and thinking: impaired concentration, deterioration of mood, difficulty remembering information, irritability.
• Decreased immunity, for example, frequent sore throat, exacerbation of chronic diseases.
• Increased body temperature.
• Enlargement of different groups of lymph nodes: cervical, axillary or others.

The first of the listed symptoms is key, while the rest complement the picture. In advanced cases, chronic fatigue not only reduces the quality of life, but can also provoke life-threatening situations. For example, sudden deterioration in concentration or drowsiness is a common cause of accidents. That is why it is important to start treatment on time for chronic fatigue syndrome.

Treatment and prevention

Chronic fatigue syndrome can and should be treated, but don’t self-medicate.Only doctors who can prescribe outpatient treatment or send to a wellness center are able to correctly determine the diagnosis. People at risk and those who have noticed anxiety symptoms should pay attention to their lifestyle.

1. Rest

Make sure to rest for a couple of weeks at least twice a year. Give yourself a couple of hours in the evenings, and spend time with family or friends on weekends.

2.Physical activity

Correct and regular physical activity helps to strengthen the body, improve mood and cope with fatigue. Swimming, fitness, yoga, aerobics, running, dancing, cycling, and even regular morning exercises will do.

3. Healthy sleep

Try to get at least 6-8 hours of sleep. At the same time, it is very important to sleep precisely at night: melatonin is produced during sleep at night. Deficiencies can cause stress.

4. Wellness procedures and normalization of the psycho-emotional background

To improve the general condition of the body in case of overwork and chronic fatigue syndrome, it is worth taking a course of massage and other health-improving and relaxing procedures.

Complex of analyzes Causes of overwork and fatigue with a 50% discount in Lab4U

Analysis Information

Increased fatigue, general weakness, constant fatigue and malaise are the most frequent complaints from Lab4U users.

Iron deficiency, deficiency of vitamins B12 and vitamin D, anemia, including against the background of inflammatory diseases, disorders of carbohydrate metabolism and thyroid function – those diseases that can be manifested for a long time by fatigue, fatigue, sleep and emotional disorders, general malaise and common pain (headache). , muscular).

The complex is shown to identify the most common causes of overwork. It is recommended to repeat the research every six months.

Material for research
– Venous blood with EDTA, Blood serum, EDTA plasma + glucose stabilizer

Composition and Results

Deadline

Analysis will be ready in
within 3 days excluding Saturday, Sunday and pick-up day. The term can be extended by 1 day if necessary.
You will receive the results by email. mail immediately when ready.

We will send the decryption by e-mail within 1 day, excluding Saturday and
Sunday.

Deadline: 2 days, excluding Saturday and Sunday (except for the day of taking the biomaterial)

Preparation for analysis

In advance

It is recommended to take blood in the morning from 8.00 to 11.00. To check the dynamics of the indicator, choose the same analysis intervals each time.

Talk to your doctor about medication the day before and on the day of the blood test, and any other additional preparation conditions.

Do not take a blood test immediately after radiography, fluorography, ultrasound, physiotherapy.

Taking medications containing thyroid hormones affects the test results for these hormones.Talk to your doctor about whether you need to get tested while taking medication or if you need to stop testing 7 days before the test. It is recommended to take thyroid hormones 3 days after taking preparations containing iodine.

The day before

24 hours before blood collection:

• Limit fatty and fried foods, do not drink alcohol.

• Eliminate sports training and emotional stress.

From 8 to 14 hours before donating blood, do not eat, drink only clean non-carbonated water.

On the day of donation

Before taking blood

• No smoking for 60 minutes,
• Be quiet for 15-30 minutes.

Interpretation of results

Decoding is performed for persons over 18 years old only if it is possible to analyze the results of a complex of analyzes and is not performed when performing some of the analyzes. We can refuse to execute the Transcript at our discretion with a refund.

It allows you to identify the main causes of weakness and general weakness: deficiency conditions and anemia, impaired functioning of the thyroid gland and carbohydrate metabolism.

The decryption is sent to email. mail within 1 day after the analysis, excluding Saturday and Sunday.

Keep in mind that during pregnancy, acute or recent infection, exacerbation of chronic diseases and taking medications, the indicators can fluctuate greatly.

Causes of overwork and fatigue

Healthy people may complain of increased fatigue and prolonged fatigue. They are provoked by work on the night shift, frequent business trips, especially with a change of time zones, overcoming long distances from home to work, late dinners and lack of breakfast. Disturbed biological rhythms increase the depletion of the body’s energy reserves.But one has only to have a good rest, as strength reappears.

Increased fatigue, general weakness, constant fatigue and malaise are frequent complaints presented against a background of various diseases. Along with fatigue, lack of motivation, sleep disorders, sexual function disorders, as well as a decrease in appetite, memory, attention, and physical endurance are noted. In this case, even a long rest does not bring relief.

Do not expect complete exhaustion.Initial laboratory diagnostics will help to exclude many diseases, which are characterized by fatigue and apathy.

The most common deficiency states are iron deficiency and, as a result, iron deficiency anemia. A general (clinical) blood test, TIBC and Ferritin will show iron stores in the body and the presence of anemia. Frequent and severe infections, chronic diseases can be a sign of exhaustion of the body, but they themselves can lead to anemia of chronic inflammation.Leukocyte formula and ESR will show whether there are now inflammatory changes in the body. In addition, against the background of inflammation, ferritin may be normal and iron deficiency can only be suspected by TIBC.

Besides iron deficiency and anemia, fatigue can be due to vitamin B12 deficiency. In addition to participating in the formation of cells and hemoglobin, vitamin B12 is necessary for nerve cells. With its deficiency, nerve conduction suffers.

Fatigue is one of the symptoms of diabetes.Given that type 2 diabetes is getting younger, it is worth checking your blood glucose levels regularly. If it is more than 6.1 mmol / L in the venous blood, an additional examination is recommended (glucose-tolerance test and glycated hemoglobin). On the other hand, malnutrition and frequent and long breaks between meals can lead to hypoglycemia (a drop in blood sugar). This is manifested by weakness, dizziness, and even fainting.

Another common cause of fatigue is thyroid dysfunction.It regulates metabolic processes, mood, sweating, and participates in the production of sex hormones. Most often, hormonal disruptions begin with violations of its function. Most of Russia is in iodine deficiency. To check the functioning of the thyroid gland, TSH and T4 free tests allow.

Low vitamin D levels can also cause fatigue, emotional weakness, and soreness in muscles and bones.

Primary laboratory diagnostics will reveal the main diseases – the culprits of fatigue and fatigue.

Feet fatigue

Contents:

Weakness in the legs is a natural phenomenon after a long journey, a hard day at work or intense sports. If you spend all day on your feet due to the nature of the profession, then this problem will appear almost instantly.

You need to be extremely careful, since leg fatigue often indicates the presence of a serious pathology.For example, this is a symptom of varicose veins in the early stages. Additionally, there is a burning sensation, stiffness, pain, swelling, etc.

The main cause of the symptom is changes in valve function. They weaken and do not resist the force of gravity, so the blood hardly reaches the heart and stagnates in the lower extremities. Gradually, circulatory disorders make themselves felt, because the shape of the veins changes – they twist, stretch, expand and lengthen.

How do you relieve heaviness in your legs?

Taking drugs that thin the blood and strengthen the veins is not justified.If you prescribe your own medication and undergo a course of treatment according to the instructions without medical supervision, then you can aggravate the situation. Temporary relief will result in serious consequences – varicose veins will go into a medium or severe stage, the treatment of which is seriously complicated (removal of inflamed veins and branches is required).

If you notice that leg fatigue appears even after minimal physical exertion and is accompanied by additional symptoms in the form of swelling due to edema, then immediately visit a phlebologist or vascular surgeon.More about phlebologist consultation

How to define a disease without diagnosis?

It is impossible to select a treatment structure without ultrasound and duplex scanning. Read about ultrasound of veins.But you can identify varicose veins by common symptoms:

• Swelling and swelling of the lower extremities.
• Burning.
• Skin pigmentation.
• Weakness in the legs.
• Change in the shape of veins (expansion and lengthening).
• Pain in the thighs and calves during exertion.
• Convulsions at night.

Brown, blue and white spots indicate poor circulation, including subcutaneous hemorrhage. Pigmentation of the tissues can mean the formation of clots in the lumen and a slowdown in blood flow.

The formation of hard areas on the veins is a serious reason to see a specialist. If the vein is solid over a long section, then this may mean the attachment of a floating thrombus to the wall.Thrombosis can be fatal due to heart attack or stroke.

Night cramps in the calf muscles cause a lot of discomfort and interfere with sleep. To get rid of pain, you need to be examined by a phlebologist.

A complete ban on physical activity and intense work imposes swelling and burning pain in the calves and thighs. A person cannot independently get to the office or perform elementary tasks, so treatment must be started immediately.

Do not forget that pathology affects the quality of life and can lead to complications such as gangrene or heart attack. People are frivolous about varicose veins and regard the disease solely as a cosmetic defect, which is a serious mistake.

Where to start treatment?

First, make an appointment with a competent phlebologist to assess the condition of your veins and valves. In the First Phlebological Center, imported equipment is used for this, which guarantees 100% accuracy in duplex scanning and ultrasound.Only after this is the method of treatment and pharmacological preparations selected. You can make an appointment through the electronic feedback form or by phone at a convenient time.

Treatment of chronic fatigue syndrome in Kiev

Fatigue is a natural reaction of the body to stress, overload, indicating that it needs rest. Chronic fatigue syndrome is a feeling that occurs without a reason and does not go away after a good rest, patients feel tired in the morning.Those suffering from this disease are often susceptible to other neurological diseases: neuroses, panic attacks, migraines, etc.

CHRONIC FATIGUE SYMPTOMS

Women are more prone to chronic fatigue, who suffer from it 3 times more often than men. The syndrome is caused by a number of reasons: stress, hard work, infections, chronic diseases, hormonal disruptions, improper lifestyle, unhealthy food.

In addition to the main symptom that gave the name of the disease – constant fatigue, the patient has a number of characteristic symptoms.Most often, patients complain of:

• pain in muscles and joints;
• tremor;
• weakness;
• insomnia;
• headache;
• memory impairment, impaired concentration;
• irritability;
• apathy.

Complaints of sore throat, swollen lymph nodes, bowel dysfunction, sudden change in appetite and excessive drowsiness are possible. An important feature that allows you to recognize the chronic fatigue syndrome is that the symptoms do not go away even after a few days of good rest.

CAUSES OF CHRONIC FATIGUE

Chronic fatigue syndrome is widespread among residents of large cities. The reason for the development of this disorder can be:

• constant psychological stress;
• wrong diet;
• Inadequate sleep;
• inactive lifestyle;
• hormonal imbalance;
• Gastrointestinal Disorders;
• viral infections.

Sometimes chronic fatigue occurs with prolonged use of medications.

DIAGNOSTICS AND TREATMENT OF CHRONIC FATIGUE SYNDROME

If you suffer from chronic fatigue, it is important not to self-medicate, but immediately consult a specialist, since there are a lot of possible causes of chronic fatigue and only an experienced doctor can determine exactly which of them caused the problem …

In 70% of patients with chronic fatigue, the examination reveals hidden diseases. It can be diseases of the endocrine, nervous, respiratory, vascular systems.Therefore, to search for the causes of chronic fatigue, it is best to contact a family doctor – a specialist who will give a preliminary assessment of the state of health and coordinate examinations with specialized specialists: endocrinologist, neurologist, cardiologist, etc.

This will save time and money, allowing the patient to undergo only the necessary examinations under the supervision of the specialists needed in a particular case. To clarify the diagnosis, the doctor may prescribe:

• ECG;
• ultrasound;
• blood and urine tests;
• Checking hormone levels, etc.

Based on the information collected, the doctor will make a preliminary diagnosis and prescribe the most effective and safe course of treatment for the patient.

To improve the general condition of the body, the doctor may recommend vitamin complexes, physiotherapy exercises, ozone therapy, etc.

Diagnosis: renal failure

Drug treatment

If you need dialysis – hemodialysis or peritoneal dialysis – your doctor will prescribe individually tailored drugs for you.You should always know all the medicines you are taking. This means that you must know their names, what they are for and how to take them. Whenever you have problems with your medications or any questions, do not hesitate to contact your doctor or nurse at your center. Impaired renal function and hemodialysis can significantly affect the effect of medications. Check with your doctor before making any changes to your medication intake.

The following are the drugs that are most commonly prescribed.

Antihypertensive drugs

Most patients suffer from high blood pressure (arterial hypertension). Blood pressure needs to be regulated by limiting salt and fluid intake. If hypertension persists, the patient is prescribed antihypertensive therapy. However, it must be remembered that no drugs can affect the excess intake of sodium (salt) and fluid into the body, which means that they do not remove the cause of the increase in blood pressure.

Vitamin D

Vitamin D enters the body with food and sunlight and must undergo activation stages in the liver and kidneys. Vitamin D makes it easier for the body to absorb calcium from food. Calcium is essential for maintaining healthy bones and the transmission of nerve impulses. People with kidney disease take vitamin D in a pre-activated form so that it can be used by the body.

Iron

Iron is a vital structural component of hemoglobin, a key component found in normal red blood cells (red blood cells) and carrying oxygen.Without iron, it is difficult for the body to create a sufficient number of full-fledged red blood cells. The management of patients with iron deficiency includes recommendations for taking special medications, however, most often, iron supplements are administered intravenously directly during the dialysis procedure or after it.

Erythropoietin (EPO or EPO)

Erythropoietin, often referred to as EPO, is a hormone produced in bulk by the kidneys. EPO stimulates the red bone marrow to produce red blood cells.Since the synthesis of erythropoietin is reduced in patients with chronic kidney disease, the level of red blood cells in the blood decreases, leading to anemia. Synthetic erythropoietin can be injected intravenously or under the skin as a substitute for erythropoietin produced by the body in order to maintain the level of red blood cells necessary for normal functioning and well-being.

Phosphate binders (phosphate binders)

Our kidneys normally excrete phosphates from food.In chronic renal failure, this process is disrupted. Therefore, the level of phosphate in the blood and in cells increases, which leads to extraosseous calcification of soft tissues, for example, the skin or blood vessels of the eyes, which can lead to irritation of the skin and eyes. Other possible negative effects are vascular calcification, which leads to the development of diseases of the cardiovascular system. Dialysis can only help to reduce excess phosphate, but does not affect its intake. Thus, it is required to regulate its level in the body through a low phosphate diet and properly selected phosphate binders.Such drugs “bind” phosphate and reduce its absorption into the blood from the intestines.

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