Chronic Fatigue Syndrome

The pathophysiology of chronic fatigue syndrome (CFS) is not well understood.
it is uncertain as to whether CFS is an autoimmune disorder.
The Institute of Medicine, in a February 2015 report, proposed new diagnostic criteria for CFS and renaming of CFS as “systemic exertional intolerance disease (SEID).”
Chronic fatigue syndrome affects between 836,000 and 2.5 million individuals in the United States,14 with an estimated total economic cost of $17 to $24 billion.15 As many as 25% of those with CFS are homebound or bedridden, sometimes for extended periods.16
A man and woman are sleeping on the table
Cognitive behavioral therapy (CBT) and graded exercise therapy (GET) are the conventional standard of care for treatment of CFS.
SHINE is an acronym that can be used as a mnemonic for guiding treatment of CFS—treat the sleep disturbance, hormonal imbalances, infections/immune system dysfunction, nutritional deficiencies and insufficiencies, and exercise to tolerance. This acronym was created by Dr. Jacob Teitelbaum to summarize his treatment approach. The details of treatment guided by this approach are outlined in Dr. Teitelbaum’s book, From Fatigued to Fantastic!
There is published evidence of the efficacy of treatment guided by the SHINE approach. The first publication was a report of a case series.28 The second, an RCT,29 showed that at a median follow-up of 101 days, 16 patients in the active treatment group were “much better,” 14 “better,” 2 “same,” 0 “worse,” and 1 “much worse.” In comparison, at a median follow-up of 98 days, 3 patients in the placebo group were “much better,” 9 “better,” 11 “same,” 6 “worse,” and 4 “much worse” (p < 0.0001 Cochran-Mantel-Haenszel trend test).
Source: “Text book of Intgrative Medicine”
In Integrative medicine, we make a decision based on personal and family history, physical exam and lab results and make a personalized plan applying nutirtional changes, exercise, hormonal balance as well as appropriate supplements and herbs along with detoxification when indicated

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