Chronic fatigue syndrome (CFS) affects as many as 2.5 million Americans. Also called myalgic encephalomyelitis (ME) or systemic exertion intolerance disease (SEID), this puzzling medical condition is not well understood. The symptoms of CFS are enough to make daily life a difficult, but the lack of knowledge about this condition can prevent you from getting the help you need.
For many people living with CFS, receiving a correct diagnosis is a process of trial and error that takes years. Many of the symptoms mimic those caused by other medical conditions or side effects from medications, and your doctor may need to perform several diagnostic tests to rule out other conditions. Unfortunately, your symptoms may also be met with skepticism from friends, relatives, and even health care providers.
But new research is shedding light on biological changes that may be connected to this mysterious illness. Thanks to the efforts of scientists, there's new hope for the development of screening tests that could quickly diagnose CFS. And even though specific tests for CFS are not yet used in medicine, our growing understanding of CFS means new methods of accurately diagnosing this illness may be on the horizon.
CFS goes far beyond just feeling tired. People living with CFS experience debilitating, constant fatigue that interrupts their daily lives. Even though these symptoms can be severe, there is still diagnostic criteria you must meet to be formally diagnosed with CFS.
First, you must have experienced severe, chronic fatigue for a period of six months or longer. Second, this fatigue must interfere with your daily activities and ability to live a normal life. Finally, you must demonstrate at least four of the common symptoms of CFS. Unfortunately, there is no standard test for CFS, and this can make it extremely difficult to arrive at an accurate and timely diagnosis.
For years, scientists have worked to examine the relationship between biological changes in the body and the development of chronic fatigue syndrome. As this research continues, we've arrived at a better understanding of certain changes in the neurological and gastrointestinal (GI) systems that are common among people living with CFS. This new research could be instrumental in the development of new tests to help diagnose CFS.
Many people living with CFS report that their symptoms get worse after physical activity. Recently, a study published in Scientific Reports identified specific cellular changes to cerebrospinal fluid — the fluid that surrounds your brain and spinal cord — that occur after physical exercise. In the study, samples of cerebrospinal fluid from people living with CFS showed significant decreases in the number of certain microRNAs, which are small cellular molecules that promote the production of many cellular proteins used by the body.
In mouse models, a reduction of microRNA was linked to premature cell death and increased immune system activity. Scientists believe a similar process in people living with CFS could promote inflammation in the brain. This inflammation may cause damage to brain cells and could be a key factor in the development of CFS.
As the relationship between cellular factors in cerebrospinal fluid and CFS is explored, it's thought that microRNA levels could be used as part of screening tests to identify individuals at risk for CFS. However, further research to identify "normal" levels of microRNA in people who do not have CFS is needed before any diagnostic tests could be developed.
In addition to changes in cerebrospinal fluid, your gut flora — or the bacteria that live in your gastrointestinal system — could help diagnose CFS more easily than current methods. A study in Microbiome examined differences in the gut flora of people living with CFS compared to those without the condition, and people living with CFS were found to have much lower bacterial diversity in their GI systems. Also, the bacteria that were present were more likely to trigger inflammation and damage to the GI tract itself.
In people living with CFS, damage to the GI tract was associated with microbial translocation, or the presence of certain bacteria outside their normal environment in the gut and intestines. This translocation may cause an immune system response in people with CFS. Researchers concluded that gut bacteria could significantly influence CFS symptoms, and, in the future, doctors may be able to identify individuals at risk for CFS by identifying changes to gut flora.
Even through chronic fatigue syndrome is a complex and perplexing condition, advances in research are helping to further our understanding of certain biological changes that may be common among those with this problem. As our knowledge about CFS grows, new diagnostic methods can be developed to help more people receive the care they need.
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