By Dr Sajimon George BAMS, AAA, ATMS
Chronic Fatigue Syndrome (CFS) is a disorder characterized by the sudden onset of severe unexplained fatigue, lasting six months or more.
Associated symptoms include impairment of neurocognitive function, non-refreshing sleep, headache, arthralgia, post exertion malaise, muscle aches and recurrent sore throat.
The etiology and pathophysiology of CFS is still unknown, but it is known to be heterogeneous and multicausal. It is often associated with the beginning of acute infection.
Major causes of CFS, include, lack of immunological functions, neuro-endocrine dysfunction, and genetic disorders. Although the condition can affect any age group, it most commonly starts between the early 20s and mid 40s. Like many auto-immune conditions, it is twice as common in women.
This is a condition which affects not only the working capacity of a person but also will impact the social behavior of a person, because this condition of “always tired” brings a lot of irritation in behavior.
Once the body and sense organs are not happy and feeling uneasy, the signs and symptoms appear in this condition comes under Jwara. It is a complex and complete disease because it has a wide coverage of the diseases.
Thorough understanding will reveal that Jwara will be present in the pathogenesis of every disease. This is why Jwara is given first and foremost role while discussing pathology or treatment of any disease irrespective of the nature.
CFS presents as an overwhelming feeling of fatigue that follows any form of physical exertion, together with issues involving memory and concentration. It is also a collection of multi-system dysfunctions involving the neurological, endocrine and immune systems.
The degree of severity may differ from person to person. Some cases of CFS suffer from symptoms that have been aggravated due to certain factors like stressful events. Some CFS cases suffer continuously from various symptoms even with the absence of any aggravating factors.
It is a disabling condition that can destroy the affected individual’s work, home and social life and financial status.
Chronic fatigue syndrome is a condition, which resembles Vathika Jwara (Jwara caused by Vata Dosha) advancing to deeper dhatus and finally affecting ojus. Body ache, stiffness in the body, body pains specially in evening hours and before bed, flatulence, constipation and not feeling well for the whole day are the common signs and symptoms of these two conditions.
Vataja Jwara is caused by the Vata vitiating diet and lifestyle. Avoiding etiological factors (nidana parivarjana) is the primary step for the treatment of any disease in Ayurveda.
Chronic fatigue syndrome is no exception. Diet and Lifestyle modification according to clinical presentation make it easy to get rid of the problem permanently.
In this condition low or weak gastric fire leads to the formation of Ama in the body. Ama is the root cause of all diseases in the body. Ama first affects Kapha dosha. Later due to the nature of etiological factors, Pitta or Vata dosha may also involve in the pathogenesis of CFS.
When Vata is the main Dosha involved, all functions that belong to Vatha Dosha in the body also become imbalanced including the nervous systems, sleep, bone tissue etc.
Gradually Ojus is also affected. Ojus is the essence of digested food. It provides psychological stability and endurance. At the deepest levels of consciousness, Ojus is the material power that the body uses to provide nourishment to higher states of consciousness.
In other words, Ojus is the subtle glue that cements the body, mind and spirit together, integrating them into a functioning individual. When Agni is not working properly, as in this disease, production of Ojus is impaired.
Ayurvedic medicine treats Chronic Fatigue Syndrome by rectifying the malfunctioning of digestive fire.
Ayurveda believes in removing the root cause of disease rather than just treating the symptoms. As a holistic health system comprising diet, yoga, detoxification, herbal remedies, meditation and daily lifestyle, Ayurveda improves not only a person’s health, but also their well being, behavior and state of mind.
This plays an important role in treating Chronic Fatigue Syndrome because the root cause lies not only in the physical aspect of the disease but the mental aspect also plays a vital role.
Ayurveda has gifted us with a very unique detoxification procedure called Panchakarma which involves five main procedures:
These procedures are done only after assessing bala or the health of a patient. Sleeping is very important in health. Complete elimination of Ama or toxins produced by malfunctioning Agni or digestive fire is achieved with this method. Judicious usage of these procedures also improves sleep patterns by their action on the psychosomatic elements.
Vamana or Therapeutic Emesis – This procedure is useful in Kapha predominant complaints. But utmost care should be given not to aggravate Vata.
Virechana or Therapeutic Purgation – This procedure will be very effective in case of deranged Pitta.
Vasthi or Medicated Enema – Useful in deep Vata vitiation.
Rakthamokshana Blood Letting – Useful when symptoms of Blood – Rakta dhatu is present.
Nasya or Nasal administration of medicines – Specifically useful when upper body and brain functions are affected by the progress of the disease.
These formulations are given after the above mentioned purification procedures have been completed. Depending on dosha predominance, suitable drugs are used for reaching equilibrium.
After giving alleviating drugs, formulations with a rejuvenating nature are given. These help in building Ojus and Dhatus.
Ayurveda does not recommend much exercise for cases of fatigue. The reason is that exercise will burn Ojus and may increase rather than decrease the feelings of fatigue.
Gentle stretching exercises of yoga are preferred to strenuous exercises. Breathing exercises are also very important.
There are hormonal changes and other biochemical responses to stress that can aggravate the nervous system and the immune response. Sleep disturbance increases fatigue which in turn increases one’s susceptibility to stress.
Meditation, Yoga, Pranayama and studying of spiritual philosophy are all recommended for supporting personal healing and relaxation of the mind.
One of the most important factors for balancing Vatha and maintaining stability is to have a lifestyle that does not disturb the natural rhythm of the body. When we eat, sleep and exercise in constantly fluctuating and disturbing patterns, the body loses its natural balancing cycles. Therefore regularity in our daily routine can be extremely effective in reducing Vatha imbalances.
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