Prevalence of Fatigue and Chronic Fatigue Syndrome in a Primary Care Practice

Bates, David W.; Schmitt, W; Buchwald, Dedra; Ware, Norma C.; Lee, J; Thoyer, E; Kornish, R. James; Komaroff, Anthony L.

doi:10.1001/archinte.1993.00410240067007

Cited by 222 publications

(48 citation statements)

References 28 publications

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“…The authors claimed to have calculated prevalence figures for both pupils (0.07%) and teachers (0.5%) similar to previously reported figures for the general population 2 3 4. Dowsett and Colby make much of “clusters” of cases, defined as three or more cases in a school.…”

supporting

confidence: 63%

Managing chronic fatigue syndrome in children

Marcovitch

1997

BMJ

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supporting

confidence: 63%

Managing chronic fatigue syndrome in children

Marcovitch

1997

BMJ

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“…cognitive or memory impairment), and at least one symptom from two of the following categories, namely, autonomic, neuroendocrine, or immune manifestations. Although contention surrounds the validity of certain criteria, studies utilising this definition have reported a prevalence of between 0.3 and 1.8 percent [2, 3]. …”

Section: Introductionmentioning

confidence: 99%

Weighting of orthostatic intolerance time measurements with standing difficulty score stratifies ME/CFS symptom severity and analyte detection

Lewis

Kita²,

Ludlow

et al. 2018

J Transl Med

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BackgroundMyalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is clinically defined and characterised by persistent disabling tiredness and exertional malaise, leading to functional impairment.MethodsThis study introduces the weighted standing time (WST) as a proxy for ME/CFS severity, and investigates its behaviour in an Australian cohort. WST was calculated from standing time and subjective standing difficulty data, collected via orthostatic intolerance assessments. The distribution of WST for healthy controls and ME/CFS patients was correlated with the clinical criteria, as well as pathology and cytokine markers. Included in the WST cytokine analyses were activins A and B, cytokines causally linked to inflammation, and previously demonstrated to separate ME/CFS from healthy controls. Forty-five ME/CFS patients were recruited from the CFS Discovery Clinic (Victoria) between 2011 and 2013. Seventeen healthy controls were recruited concurrently and identically assessed.ResultsWST distribution was significantly different between ME/CFS participants and controls, with six diagnostic criteria, five analytes and one cytokine also significantly different when comparing severity via WST. On direct comparison of ME/CFS to study controls, only serum activin B was significantly elevated, with no significant variation observed for a broad range of serum and urine markers, or other serum cytokines.ConclusionsThe enhanced understanding of standing test behaviour to reflect orthostatic intolerance as a ME/CFS symptom, and the subsequent calculation of WST, will encourage the greater implementation of this simple test as a measure of ME/CFS diagnosis, and symptom severity, to the benefit of improved diagnosis and guidance for potential treatments.Electronic supplementary materialThe online version of this article (10.1186/s12967-018-1473-z) contains supplementary material, which is available to authorized users.

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“…Previous studies have shown that 27% of adults, who were weekly assessed, experienced fatigue [1], and 32.5% of patients who visited primary care clinics complained of fatigue [2]. Oxidative stress is thought to underlie fatigue to some extent; serum markers of oxidative stress are associated with symptoms of chronic fatigue syndrome, including asthenia after physical activity and arthralgias [3].…”

Section: Introductionmentioning

confidence: 99%

Intravenous Vitamin C administration reduces fatigue in office workers: a double-blind randomized controlled trial

Suh

Bae

Ahn

et al. 2012

Nutr J

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BackgroundStudies of the efficacy of vitamin C treatment for fatigue have yielded inconsistent results. One of the reasons for this inconsistency could be the difference in delivery routes. Therefore, we planned a clinical trial with intravenous vitamin C administration.MethodsWe evaluated the effect of intravenous vitamin C on fatigue in office workers. A group of 141 healthy volunteers, aged 20 to 49 years participated in this randomized, double-blind, controlled clinical trial. The trial group received 10 grams of vitamin C with normal saline intravenously, while the placebo group received normal saline only. Since vitamin C is a well-known antioxidant, oxidative stress was measured. Fatigue score, oxidative stress, and plasma vitamin C levels were measured before intervention, and again two hours and one day after intervention. Adverse events were monitored.ResultsThe fatigue scores measured at two hours after intervention and one day after intervention were significantly different between the two groups (p = 0.004); fatigue scores decreased in the vitamin C group after two hours and remained lower for one day. Trial also led to higher plasma vitamin C levels and lower oxidative stress compared to the placebo group (p < 0.001, p < 0.001, respectively). When data analysis was refined by dividing each group into high-baseline and low-baseline subgroups, it was observed that fatigue was reduced in the lower baseline vitamin C level group after two hours and after one day (p = 0.004). The same did not hold for the higher baseline group (p = 0.206).ConclusionThus, intravenous vitamin C reduced fatigue at two hours, and the effect persisted for one day. There were no significant differences in adverse events between two groups. High dose intravenous vitamin C proved to be safe and effective against fatigue in this study.Trial RegistrationThe clinical trial registration of this trial is http://ClinicalTrials.govNCT00633581.

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Prevalence of Fatigue and Chronic Fatigue Syndrome in a Primary Care Practice

Abstract: While chronic, debilitating fatigue is common in medical outpatients, CFS is relatively uncommon. Prevalence depends substantially on the case definition used.

Cited by 222 publications

References 28 publications

Managing chronic fatigue syndrome in children

Managing chronic fatigue syndrome in children

Weighting of orthostatic intolerance time measurements with standing difficulty score stratifies ME/CFS symptom severity and analyte detection

Intravenous Vitamin C administration reduces fatigue in office workers: a double-blind randomized controlled trial

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