The Causes of Chronic Fatigue Syndrome

Chronic Fatigue can result from Several Different Aetiologies

Chronic Fatigue Syndrome can be caused by Several Different Factors

Chronic Fatigue Syndrome is not a single condition. What leads to this condition is still being researched, but there are many factors already known as leading to it, varying from infections, autonomic disturbances, hormonal problems and neuro-psychological conditions. Appreciating the somewhat ill understood nature of this condition is important in coping with it effectively. 

Chronic Fatigue Syndrome is a condition whose causes are still not fully understood. It can result from various causes that may have no similarity with each other, yet the symptoms that are observed may be similar.

Chronic Fatigue Syndrome : An Overview

Chronic fatigue syndrome is a condition of debilitating fatigue that produces severe distress apart from interfering with working as well as daily activities. It is not a single disease, but a condition of fatigue and generalised debility that is diagnosed as chronic fatigue syndrome depending upon the satisfaction of certain criteria.

By definition, it should have persisted or recurred a few times over a period of six months, it should not be a result of a specific medical cause, and is associated with a number of symptoms like headaches, sore throat, muscle ache, joint pains, sleep disturbances, tenderness in lymph nodes and mood and sleep disturbances.

Causes of Chronic Fatigue Syndrome

The causes for chronic fatigue syndrome are still not fully understood. While various researchers and medical experts have attempted to associate this condition with various causes from time to time, there is still no consensus regarding the exact cause or the manner in which those causes lead to chronic fatigue syndrome.

The available information suggests a few likely causes.

(i)   INFECTIONS – Chronic fatigue syndrome commonly develops for the first time as part of some infective disease or event, or it may develop immediately following it. Among the infections that are commonly seen to be associated with it are viruses like Ebstein-Baar virus, Cytomegalo virus, human Herpes virus, retroviruses or enteroviruses. It is also associated commonly with Infectious Mononucleosis (also known as the Kissing Disease), which is caused by the Ebstein-Barr virus . It can also be associated with fungal infections like Candida albicans, or bacterial infections from Mycoplasma species. The Lyme disease or its co-infections can be cause for precipitating chronic fatigue or fibromyalgia.

(ii) IMMUNOLOGIC DISTURBANCES – Many persons diagnosed with chronic fatigue syndrome are known to have immunological disturbances in their earlier life or childhood. Some researchers have suggested the possibility of auto-immune diseases, where the body’s own immunity leads to damage of body tissues. However, the medical evidence available is not enough.

(iii) NEURO-PSYCHOLOGICAL COMPONENTS – The frequency of many neurological and psychiatric symptoms in persons diagnosed as having chronic fatigue syndrome, has suggested that this condition may have a psychiatric component. Depression is a very common feature, observed in almost two third of patients. Other notable symptoms are sleep disturbances and mood deviations, which raise this possibility. In some cases, the sleep disturbances likely triggering the fatigue has been seen to be arising from bladder problems, sinusitis, poor digestion or plain stress.

(iv) DISAUTONOMIA – Another cause thought to be involved in the genesis of chronic fatigue syndrome is a disturbance in the autonomic neurological system, which is responsible for maintaining the upright posture, the tone of the body and the ability of the body to relax. Disturbances in it can create a feeling of fatigue that may interfere with the working.

(v) HORMONAL DISTURBANCES – Another reason that has been considered as a cause of chronic fatigue syndrome is disturbances in the hormonal system of the body, which is controlled by two parts of the brain – the hypothalamus and the pituitary. The pituitary is a gland in the lower part of brain that secretes some hormones which in turn control many other hormones of the body. The pituitary, in turn is controlled by the hypothalamus. This hypothalamus – pituitary axis controls most of the hormones secreted in body, and a disturbance in this axis can create many problems that may manifest as a variety of symptoms including fatigue. It is not uncommon for chronic fatigue disease to be associated with adrenal and thyroid disturbances, indicating the possibility of common origin in the disturbance of  hypothalamus – pituitary axis.

(vi) OTHER CAUSES – A number of other causes have become associated with the Chronic Fatigue Disease, like heavy metal toxicity that could be caused by having food with toxic levels. Shortage of certain vitamins like B 12, which are also known to cause anemias have also been observed as being associated with it. Another associated morbidity with cases of chronic fatigue or fibromyalgia is mitochondrial diseases, which are a group of diseases caused by the mutation of mitochondrial DNA. Food allergies and Irritable Bowel Syndrome are two diseases concerned with the digestive system primarily that have also been seen to be associated sometimes with the Chronic Fatigue Syndrome. In some cases, it is also associated with injuries, in particular head injury, leading to possible associations with neuro-psychological and neuro-endocrinal origins as referred earlier.

Future Research

Study of possible reasons and causes for chronic fatigue syndrome continues. As of now, the Chronic Fatigue Syndrome is seen to arising from several different causes. Thus, it is truly a syndrome, a condition characterized by a set of signs and symptoms, but not a single disease that arises from a single cause and can be cured by addressing that problem. Such lack of single causation is a big challenge for the physician since it makes the identification and confirmation of its causes all the more difficult.