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Singer's struggle with chronic fatigue syndrome

Stuart Murdoch's experience with chronic fatigue syndrome inspires his songwriting for the band Belle and Sebastian.

Posted: Dec 18, 2018 9:23 AM
Updated: Dec 18, 2018 9:56 AM

Chronic fatigue syndrome, a condition that causes extreme tiredness, could be triggered by an overactive immune system, a study has found.

UK researchers found that an exaggerated immune response can trigger long-lasting fatigue, suggesting this is how the condition -- also known as myalgic encephalomyelitis or ME -- begins.

The study, published Monday, is the first to shed some light into the immune system's role in the development of the condition, a multisystem disorder about which very little is known, according to lead researcher Carmine Pariante, professor of biological psychiatry at King's College London.

Limited insight to date has made treatment a challenge.

Pariante explained that in a lot of chronic fatigue cases, patients remember an infection, such as a very bad cold or other viral infection, in the early stages of developing the condition.

"We had this information for quite a long time but didn't know what was going on in the body of these patients," he said.

Around 250,000 people in the UK and 17 million people worldwide are affected by chronic fatigue, according to British charity Action on ME. An estimated 836,000 to 2.5 million Americans struggle with the syndrome, according to the CDC.

To try to find out more about it, the team modeled a possible route to the condition based on a treatment for chronic hepatitis C infections called interpheron alpha, because the treatment is known to induce persistent fatigue in some people.

Interpheron alpha affects the immune system in a similar way to a strong infection, the study explains.

Researchers measured fatigue and immune activity in 55 patients receiving hepatitis C treatment with interferon-alpha.

Patients were followed up before, during and after the hepatitis C therapy. Of the participants, 18 patients -- about a third -- developed lasting fatigue, defined as fatigue lasting longer than six months after treatment.

The group with lasting fatigue also experienced a greater immune response -- shown by a doubling in the levels of immune system messenger molecules interleukin-10 and interleukin-6.

Immune markers were measured with a blood test during the study.

The team also saw higher levels of these molecules in these patients before treatment had even begun.

"What this data strongly suggest is that people that develop CFS in response to an infection, they do so because their immune system is primed to hyper react," Pariante explained. Why a person's immune system could be primed to hyper react is unclear, but genetics could be a possible reason, he added.

Delayed diagnoses

Patients are often diagnosed with chronic fatigue five, six or even up to 10 years later, according to Pariante, because the diagnosis is based entirely on symptoms, such as headaches, difficulty concentrating and the inability to engage in activities.

By the time they are diagnosed, patients would have been ill for quite some time, making studies into the biology of people who develop the illness difficult, he added.

Dr. Charles Shepherd, medical adviser to the ME Association in the UK, explained in an email that "many doctors still don't know how to diagnose and manage ME/CFS."

Shepherd, who was not involved in the study, said that a lack of research means "that we still don't have any effective forms of treatment."

Many people who have chronic fatigue find pacing helpful in managing their condition, according to the UK's National Health Service. Pacing requires people to balance rest and activity in order to avoid making their fatigue and other symptoms worse.

Shepherd said that the study "adds to the growing weight of scientific evidence which indicates that the body's immune system is playing an important role in the causation of ME/CFS."

The model the team used for the study "is relevant to the two most common causes" of chronic fatigue, Pariante said: a strong infection and a major stressful life event.

The study also found that "having quite severe acute fatigue during an infection, or shortly after infection" makes people more at risk of developing chronic fatigue, he added.

Pariante hopes that once questions about why this happens are understood, future treatments and screening can be identified.

The study's small sample size was cited as a limitation by Pariante. More studies are needed to confirm its relevance to chronic fatigue patients, the paper says.

'Blackness descending'

Skye Wheeler, a 19-year old from Cambourne, Cornwall, is housebound due to her chronic fatigue syndrome.

"You can't get dressed and ready for the day without a blackness descending over your eyes. You can't carry a conversation, let alone even speak," she explained in a statement.

"The bottom of the line is that there is no energy there in the first place to channel through your body to all the right places. The only thing you can do is lie and exist," she said.

The condition affects many body systems, and people who have chronic fatigue syndrome feel debilitating pain and fatigue because their body and brain are unable to recover after even small efforts.

About a quarter of people affected by the condition are severe cases, meaning they are bedridden, house-bound or wheelchair-bound at some point in their illness, according to the ME Association.

Mississippi Coronavirus Cases

Data is updated nightly.

Cases: 482902

Reported Deaths: 9425
CountyCasesDeaths
Harrison33063488
Hinds31021589
DeSoto30610358
Jackson23687348
Rankin21340370
Lee14909220
Madison14166271
Jones13404227
Forrest13160240
Lauderdale11601305
Lowndes10443176
Lamar10214130
Pearl River9098221
Lafayette8241137
Hancock7514112
Washington7102150
Oktibbeha6964124
Monroe6514164
Neshoba6475201
Warren6464164
Pontotoc630393
Panola6250126
Marshall6126123
Bolivar6115144
Union574186
Pike5613136
Alcorn537290
Lincoln5303131
George471472
Scott459196
Leflore4476140
Prentiss446779
Tippah446480
Itawamba4444100
Adams4416116
Tate4394101
Simpson4335112
Wayne433066
Copiah431787
Yazoo423386
Covington415792
Sunflower4148104
Marion4099104
Leake397586
Coahoma3957100
Newton370875
Grenada3556104
Stone350860
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Attala325387
Jasper314162
Winston304691
Clay296473
Chickasaw287065
Clarke282190
Calhoun266141
Holmes262187
Smith250649
Yalobusha221047
Tallahatchie220450
Walthall211058
Greene209045
Lawrence206833
Perry199953
Amite198452
Webster196542
Noxubee178939
Montgomery172454
Jefferson Davis168342
Carroll162137
Tunica153334
Benton142535
Kemper138640
Choctaw127026
Claiborne126834
Humphreys126637
Franklin116728
Quitman103926
Wilkinson101936
Jefferson91333
Sharkey63020
Issaquena1926
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Alabama Coronavirus Cases

Cases: 789054

Reported Deaths: 14022
CountyCasesDeaths
Jefferson1115991765
Mobile708511234
Madison49865633
Shelby36274315
Baldwin36242495
Tuscaloosa33931548
Montgomery33190678
Lee22680220
Calhoun21211410
Morgan19816335
Etowah19300462
Marshall17680274
Houston16823386
St. Clair15442305
Cullman14602258
Limestone14581188
Elmore14480264
Lauderdale13520281
Talladega12958236
DeKalb12199237
Walker10588330
Blount9720157
Autauga9667137
Jackson9385158
Coffee8882175
Dale8609173
Colbert8534184
Tallapoosa6673181
Escambia6591121
Covington6452167
Chilton6385144
Russell607255
Franklin5795101
Chambers5416134
Marion4800120
Dallas4705189
Clarke463279
Pike462397
Geneva4413117
Winston425895
Lawrence4117108
Bibb409381
Barbour347270
Marengo326285
Monroe320053
Butler318290
Randolph305956
Pickens305274
Henry301858
Hale292685
Cherokee289855
Fayette279673
Washington245448
Crenshaw238470
Cleburne235851
Clay228565
Macon220158
Lamar197743
Conecuh182046
Lowndes170758
Coosa170235
Wilcox159736
Bullock149243
Perry136537
Sumter124536
Greene121443
Choctaw73427
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