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Chronic Fatigue Syndrome

This is a relatively new syndrome that has been raising its head since a couple of decades. It is symptomatic of the times, when work stress, overwork and coping with the rigors of juggling tough schedules seem to be the order of the day. This malaise is sometimes referred to as Chronic Fatigue Immune Dysfunction Syndrome or CFIDS and its exact cause has not been identified yet. The Human Herpes Virus 6 (HPV-6) has been suspected to be a possible cause, though no clear identification has yet been proved. Inflammation of the pathways in the nervous system is said to be a cause for CFS. CFS occurs commonly among women in the age group of 30 - 50 years. This syndrome may be triggered off by a viral illness that gets complicated by a dysfunctional immune response. This syndrome can creep upon you without your realizing it. It will sap you of your energy and vigor.


Diagnosing Chronic Fatigue Syndrome can be difficult since there is no clear indicator or diagnostic test to identify this syndrome. Symptoms of CFS can be mistaken for hypothyroidism, fibromyalgia or Gulf War Illnesses. Some of the symptoms such as sleep problems and depression can be alleviated with medicines but the syndrome will not be cured. The symptoms may improve over time. It is not always possible to detect CFS easily. Often the symptoms of this condition resemble those of other disorders or infections. Chronic Fatigue Syndrome differs from routine fatigue in that the symptoms are strong and noticeable. Women are more susceptible to CFS, especially during the age bracket of 30 - 50 years. Some of the symptoms of CFS are:

  • Severe fatigue lasting for nearly 6 months
  • Difficulty in concentration
  • Muscle or joint pains
  • Severe headache
  • Vague feelings of depression and tiredness
  • Fluctuations in appetite and weight

Battling Chronic fatigue syndrome involves lifestyle changes such as healthy fitness regimen and right diet. Sleep and stress management therapy can go a long way in alleviating some of the symptoms. Usage of L Cartinine supplements has shown to be effective in treating chronic fatigue. In some cases, anti-depressant medications may help ease symptoms of chronic fatigue syndrome.

Thyroid

Thyroid is a gland in the neck overlying the windpipe that regulates the speed of metabolic processes by producing a hormone with the eponymous name thyroxin. Thyroid is an endocrine gland. The thyroid gland which resembles a butterfly, sits astride the trachea. Its secretion - thyroxin, a hormone that regulates the metabolic activity of the body. Too much thyroxin races the metabolism resulting in weight loss, temperature elevation, nervousness and irritability. On the other hand, too little thyroxin slows down the metabolism rate resulting in deep voice, weight gain and water retention. This can result in retardation in physical growth and mental development in children. Both conditions equally affect hair and skin growth, bowel function and menstrual flow.

The thyroid gland is often enlarged whether it is secreting too much hormone, too little or even when it is functioning normally. The thyroid is controlled by the pituitary gland, which secretes Thyroid Stimulating Hormone (TSH) in response to the amount of thyroxin in the blood. TSH increases the amount of thyroxin secreted by the thyroid and also causes the thyroid gland to grow.




Hyperthyroid Goiter : If the amount of TSH is high, the thyroid will both enlarge and secrete too much thyroxin. The result is termed as Hyperthyroidism with a goiter. Graves' disease is the most common form of this disorder.



Euthyroid goiter : If dietary iodine is insufficient, too little thyroxin will be secreted and the pituitary will sense the deficiency and produce more TSH. The thyroid gland will enlarge enough to make sufficient thyroxin.

Hypothyroid goiter: If dietary iodine is severely low, even an enlarged gland will not be able to make enough thyroxin. The gland may keep growing under the influence of TSH, but it may never make enough thyroxin.

An endocrinologist who specializes in the endocrine system can also be consulted for thyroid problems and diseases. Specialists who deal with thyroid problem are called thyroidologists. Thryoidologist and endocrinologist are specially trained doctors who diagnose and treat diseases affecting the thyroid gland. A thyroid specialist continues specialized education focused on thyroid issues after obtaining a Masters degree in medicine. He is qualified and trained to treat conditions that are complex and involve many systems within the body that may be affected due to thyroid imbalance.


A primary care doctor too often misses the diagnosis of a thyroid disease. Sometimes primary care doctors refer patients to a thyroid specialist when there is problem in the endocrine/ hormone systems. Thyroid specialists treat patients with too much or too little thyroid hormone. The thyroid specialist helps the patients to reach a hormone balance by replacing or blocking thyroid hormone. Thyroid specialists also receive special training to manage patients with thyroid growths or thyroid cancer and enlarged thyroid glands. There are times when the services of a thryoidologist or an endocrinologist become absolutely necessary.


  • A thyroid specialist has to be consulted when a patient is suffering from the hyperthyroid autoimmune - Graves' disease. This is a condition which can be treated only by a thyroid specialist and not by a regular GP. Graves's disease and hyperthyroid management involves a number of therapies, anti thyroid drug use, radioactive iodine treatments and even surgery if necessary.
  • Evaluation and treatment for thyroid nodule can be rendered only by thyroid specialists. Thyroid nodule is evaluated by ultrasound and fine needle biopsy process. This is done to rule out the possibility of thyroid cancer.
  • Thyroid cancer is rare and less than 15000 new cases are diagnosed every year. An expert thyroid specialist is highly recommended to diagnose, evaluate, treat and help in long term follow up and support management of thyroid cancer.
  • Thyroid surgery is performed when the gland becomes so large that is cosmetically disfiguring. This is normally done if a thyroid has markedly enlarged for years. Thyroid surgery should be performed by an experienced thyroid surgeon. Only an experienced thyroid surgeon can handle the complications that can arise due to thyroid surgery.
  • A thyroid specialist can assess hypothyroidism levels. This is done by evaluation of TSH level. S/He considers other options such as symptoms, family history and clinical factors to make a thyroid diagnosis.
  • After a person has been diagnosed for hypothyroidism, a thyroid specialist treats and manages the patient for other signs and symptoms as well. Such symptoms are weight gain, depression, brain fog, hair loss, shortness of breath, intolerance to heat and cold, muscle aches and joint pains, constipation, carpal tunnel, high cholesterol, infertility, Fibromyalgia and chronic fatigue syndrome.


DHEA

DHEA Dehydroepiandrosterone is a steroid hormone that is naturally produced by adrenal or the stress glands in the body. The dominant hormone in the body gets converted into other hormones such as estrogen, testosterone, progesterone and corticosterone.


DHEA levels are high in the 20s and early 30s, the average being about 25mg per day. The level declines with age. Besides the aging factor, decline in DHEA levels can be attributed to diseases such as end stage kidney disease, AIDS, anorexia, adrenal insufficiency and type 2 diabetes.

Intake of medications such as insulin, opiates, corticosteroids and danazol also contribute to DHEA depletion. DHEA - dehydroepiandrosterone (or Androstenolone as it is sometimes called) levels can be maintained through DHEA supplements under medical supervision. The dosage is to be determined by the healthcare provider. The benefits of DHEA supplementation includes improved immunological function, bone mineral density and sexual libido in women, reduced abdominal fat, diabetes prevention and cancer.


With specific reference to DHEA levels and heart health, data indicates that in men and women who die of heart disease, the DHEA levels are significantly less than others of the same age. The aim of DHEA level test is to measure the amount of hormone in the blood stream. When the levels are low, the endocrine function of the body is severely affected. Being the 'feel-good' hormone, a good level of DHEA contributes to a balanced mood.


Extensive research on DHEA levels suggests that healthy DHEA levels can prevent Alzheimer's disease, cancer, osteoporosis, depression, heart disease and obesity. Symptoms of low DHEA levels are extreme fatigue, decrease in muscle mass, decrease in bone density, depression, aching joints, loss of libido and lowered immunity. Doctors test DHEA levels as a diagnostic tool for varied reasons. The test results indicate specific disorders in men, women and children.


  • To check if the adrenal glands are working properly.

  • In women, the test is recommended if there is excessive hair growth or the appearance of male body characteristics.

  • In children who attain puberty at an abnormally early age, the DHEA level test is done to assess any gland disorder.

  • Prevalence of diseases and the process of aging can cause bone loss. By checking the DHEA levels, doctors can recommend measures to improve bone density.

  • Depression, anxiety and mood disorders are linked to hormonal imbalance. DHEA level test is a precursor to treating major depression.

  • Assessment of DHEA levels helps in taking measures to boost immune system.

  • Decreased libido is linked to lower DHEA levels.

  • Low levels of DHEA help predict HIV progression.

  • If afflicted with chronic fatigue syndrome, testing DHEA levels helps in taking necessary steps to improve the condition.

  • To assess if bone density is higher especially in women who have undergone menopause, DHEA level test is recommended.

  • Extensive research on DHEA indicates it as a predictive factor in diagnosing aging-related diseases.

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Collection of Pages - Last revised Date: December 10, 2019