New hope for diagnosing chronic fatigue, an under-recognised illness in India

India Today

2 days ago

If you've been feeling exhausted for weeks or months, even after getting plenty of rest, it might be more than just stress or anaemia. In fact, it is one of the most misdiagnosed and under-diagnosed conditions called chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME/CFS), a complex and under-recognised illness that affects women more often than men, but is often missed or mistaken for other conditions.advertisementUnlike regular fatigue that improves after a good night's sleep, CFS leaves you drained even after hours of rest.'CFS goes beyond normal tiredness or burnout. The fatigue persists or worsens after rest, and even minimal physical or mental effort can exacerbate symptoms, a condition called post-exertional malaise,' said Bhargavi Ramanujam, Senior Consultant, Neurology at PSRI Hospital.
Other symptoms may include disturbed sleep, brain fog, muscle and joint pain, sore throat, swollen lymph nodes, headaches, and poor concentration.Because these symptoms overlap with depression, thyroid problems, post-viral syndromes and other illnesses, many people go through months — even years — without the right diagnosis.'There are no definitive lab tests to diagnose CFS. It's usually a diagnosis of exclusion, meaning doctors first rule out other conditions,' explained Dr. Ramanujam.A NEW HOPE FOR DIAGNOSISResearchers at Cornell University have found a potential way to detect ME/CFS using cell-free RNA, these are tiny traces of genetic material left in blood when cells die.These RNA fragments act like an "activity log", revealing changes in the immune system, tissue injury, and other processes.By analysing these fragments and applying machine-learning models, the team identified key biomarkers that distinguish CFS patients from healthy individuals.'By reading the molecular fingerprints that cells leave behind in blood, we've taken a concrete step toward a test for ME/CFS,' said Iwijn De Vlaminck, associate professor of biomedical engineering at Cornell.In the study, published in Proceedings of the National Academy of Sciences, blood samples from CFS patients showed signs of immune system dysregulation, including changes in plasmacytoid dendritic cells, which are immune cells linked to antiviral responses and T cell exhaustion.The test currently detects CFS with 77% accuracy. While not perfect, it's a promising step toward a long-awaited diagnostic tool.AWARENESS MATTERS IN INDIAIn India, fatigue in women is often attributed to iron deficiency or anaemia, and supplements are prescribed without exploring other causes.This can delay a CFS diagnosis. While the US and UK have recognised and studied the condition extensively, even offering disability benefits, India has no official estimates, no dedicated research funding, and little clinical awareness.advertisementThe CDC estimates that 836,000 to 2.5 million Americans have CFS, costing the US economy $9 to $25 billion annually in lost productivity and healthcare.In India, many patients are left undiagnosed, unsupported, and sometimes dismissed as being 'lazy' or 'overstressed'.LIVING WITH CFSThe exact cause of CFS is still unknown, but experts believe it may be triggered by viral infections, immune or hormonal imbalances, or extreme stress.There's no cure, but treatment focusses on managing symptoms and improving quality of life, including activity pacing (avoiding overexertion), better sleep hygiene, pain management, good nutrition, and stress reduction and even cognitive behaviour therapy, in some cases.Most importantly, patients need to feel heard and validated.As Dr. Ramanujam emphasises, 'CFS is real. Recognising and understanding it can make a world of difference to those living with it.'- Ends