Post Covid- Chronic Fatigue Syndrome

Dear Members,

As a go to medical facility for Chronic Complex Conditions, we have seen many challenging conditions that have been ongoing for years "Chronic" ,and that are overlapping with multiple Diagnosis "Complex".

But perhaps one of the most common and most challenging is Chronic Fatigue, and by Chronic Fatigue, i do not mean the Chronic Fatigue syndrome per se (which requires a certain clinical criteria) but i also mean ongoing fatigue that does not fit into the Latter. We all know this feeling of having to push yourself so hard to do anything. I also ask my patients questions to try to distinguish between Exhaustion Vs Fatigue. Many of us do not know the difference, and there is many points of differentiation, but the most important and simpler is this, exhaustion is reversed with rest and rehabilitation but fatigue is not, and this is why it is debilitating. Fatigue goes way deep, it feels like a depletion of a life force rather than just being over worked or under rested.

Conventional approach in medicine has failed the patients of fibromyalgia or Chronic Fatigue Syndrome (CFS) when this disease first appeared, and did not really acknowledge Fatigue as a medical condition but rather sees it as a symptom.

For the longest time, the conventional approach and view on these conditions, made patients think it's all their fault for being too tired, their fault for not keeping up with their pain or worse it' s psychosomatic while they're exaggerating their pain.

For years, patients either lived in silence (with pain) or they suffered the consequence of confiding in their doctors and loved ones. They endured being told to get over it and get back to their routine.

Now 70 years later, are we paying the price?

Recent hypotheses are made about recovered COVID-19 cases. As people are showing symptoms of brain fog, depression, headache, increased pain and fatigue after minimal activity in what is now called "post-COVID-19 syndrome"

The latest research is proposing the cause to be due to the virus crossing the blood-brain-barrier after it invaded the respiratory tract, particularly the nose, via the olfactory pathway". This may explain the lack of sense of smell after the infection resolves.

It was noticed the virus is taking the behavior of CFS in disturbing the lymphatic drainage of the brain which caused accumulation of cytokines.

As the cytokines build up inside the brain, manifestations resembling CFS start to appear due to the effect on hypothalamus which explains the fever, irregularities in sleeping & waking up, fatigue and cognitive impairment.

Note that many CFS patients start having their symptoms after an infectious disease (viral mostly), neurologic, metabolic or immunologic disturbances, two of the famous viruses is EBV and CMV.

Now had conventional medicine approached CFS from a different side, we may have had a clue about how to act correctly with CFS. This is problematic now because, there are thousands of post Covid patients who will manifest with these chronic fatigue and will require treatment and we should have been more prepared than we are now to deal it.

This is why we always always test for chronic infections in our patients, of course besides all the other hormonal and metabolic markers, only infections are more insidious

Please don’t take your infection lightly. Address it and take good care of your health.

Stay safe!

Dr. Magdy

Head Physician

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