What we treat

Chronic Fatigue syndrome (CFS) and Myalgic Encephalomyelitis (ME) are illnesses characterised by disabling physical and mental fatigue, sleep difficulties, headaches, sore throat, concentration and memory difficulties, and muscle and joint aches and pain. These symptoms aren't relieved by rest and are usually accompanied by many other debilitating symptoms. It is also largely misunderstood and have been falsely blamed on mental health and poor fitness.

Chronic widespread pain and fibromyalgia syndrome (FMS) are disorders of pain regulation with central sensitisation. Several tender trigger points define FMS, but recently, a composite of the following has been used to identify the syndrome:

- Pain for >3 months affecting four of five specified body areas, and;

- A raised widespread pain index and symptom severity scale score for fatigue, waking unrefreshed and cognitive symptoms.

Other symptoms commonly reported include depression, anxiety, headaches, migraines, diffuse abdominal pain with changes of bowel habit (irritable bowel syndrome) and urinary frequency. The pathogenesis of these syndromes is not clear, but hyperexcitability of the central and peripheral nervous systems, changes in function of pain receptors, altered pain perception and somatization have been hypothesized. There is functional magnetic resonance imaging evidence of altered pain and increased activity in brain areas that code for the sensory intensity of various stimuli. These conditions impair quality of life but are not life-threatening.

Orthostatic intolerance is the umbrella term for a range of different conditions including orthostatic hypotension and POTS, in which an individual has difficulty with the upright posture, particularly standing. The most dramatic problem people with orthostatic intolerance suffer is fainting, but in between fainting episodes they may feel dizziness, weak, lightheaded, experience palpitations, abnormal sweating, and experience problems with concentration.

Postural Tachycardia Syndrome (POTS) is a form of chronic orthostatic intolerance for which the hallmark physiological trait is an excessive increase in heart rate within 10 minutes of standing or head-up-tilt (HUT) which is sustained in the absence of orthostatic hypotension. Patients with POTS experience cardiac and non-cardiac presyncopal symptoms chronically (≥6 months). POTS is not considered to be a unique disease but rather the common phenotype of a number of heterogeneous, overlapping pathophysiological processes.

OI/POTS can present alongside other conditions, such as chronic fatigue syndrome / myalgic encephalomyelitis, chronic pain / fibromyalgia, hypermobility type Ehlers Danlos Syndrome, migraine, bowel irregularities, and autoimmune disorders but can also be a stand-alone condition.

Symptoms of OI/POTS can include:

Palpitations

Non-cardiac related chest pain

Shortness of breath

Cognitive dysfunction

Postural dizziness (from lying/sitting to standing)

Postural vision spots or blindness

Sensitivity or intolerance to the heat, humidity, and/or fluctuations in temperature

Nausea, over-fullness and a lack of appetite, food intolerances

Swelling and/or discoloration in the feet after sitting or standing still for prolonged periods

Cold hands and feet

Salt cravings

Headaches

Pre-syncope

Restless legs

Irregular sweating patterns

Fatigue

Light-headedness whilst showering or abnormal fatigue after showering

Intolerance to alcohol

Exercise intolerance

These symptoms can be exacerbated by numerous factors including dehydration, heat exposure, prolonged recumbency, alcohol, and menstruation.

Hypermobile Ehlers-Danlos syndrome is an inherited connective tissue disorder that is caused by defects in a protein called collagen. It is generally considered the least severe form of Ehlers-Danlos syndrome (EDS) although significant complications can occur. Common symptoms include joint hypermobility, affecting both large (elbows, knees) and small (fingers, toes) joints; soft, smooth skin that may be slightly elastic (stretchy) and bruises easily; and chronic musculoskeletal (muscle and bone) pain. While hypermobile EDS is regarded as a genetic condition, the genetic cause is unknown as the gene(s) responsible have not been identified. Inheritance is autosomal dominant.

RHEUMATOID ARTHRITIS
Rheumatoid Arthritis is a chronic inflammatory disorder affecting many joints, including those in the hands and feet.

In rheumatoid arthritis, the body's immune system attacks its own tissue, including joints. In severe cases, it attacks internal organs.

Rheumatoid arthritis affects joint linings, causing painful swelling. Over long periods of time, the inflammation associated with rheumatoid arthritis can cause bone erosion and joint deformity.

While there's no cure for rheumatoid arthritis, Exercise Therapy and medication can help slow the disease's progression.

MULTIPLE SCLEROSIS (MS)

MS is a disease in which the immune system eats away at the protective covering of nerves.

In MS, resulting nerve damage disrupts communication between the brain and the body.

MS causes many different symptoms, including vision loss, pain, fatigue and impaired coordination. The symptoms, severity and duration can vary from person to person. Some people may be symptom free for most of their lives, while others can have severe, chronic symptoms that never go away.

Causes of Cancer Fatigue

Cancer fatigue may be caused by many factors, and the factors that contribute to your cancer fatigue may be completely different from those of someone else. However, possible contributing factors include:

Your cancer. Your cancer can cause changes to your body that can lead to fatigue. For instance, some cancers release proteins called cytokines, which are thought to cause fatigue.

Other cancers can increase your body's need for energy, weaken your muscles, cause damage to certain organs (such as liver, kidney, heart or lungs) or alter your body's hormones, all of which may contribute to fatigue.

Cancer treatment. Chemotherapy, radiation therapy, surgery, bone marrow transplantation and immunotherapy may all cause fatigue. You may experience fatigue if cancer treatment damages healthy cells in addition to the cancer cells. Or fatigue might happen as your body works to repair damage caused by treatment.

Some treatment side effects — such as anemia, nausea, vomiting, pain, insomnia and changes in mood — also may cause fatigue.

Anemia. You might develop anemia if your treatment destroys too many healthy red blood cells. You can also develop anemia if the cancer has spread to your bone marrow and interferes with blood cell production or causes you to lose blood.

Pain. If you experience chronic pain, you may be less active, eat less, sleep less and become depressed, all of which may add to your fatigue.

Emotions. Anxiety, stress or depression associated with your cancer diagnosis also may lead to fatigue.

Lack of sleep. If you're sleeping less at night or if your sleep is frequently interrupted, you may experience fatigue.

Poor nutrition. In order to work efficiently, your body needs the energy that a healthy diet provides. When you have cancer, your body may need more nutrients than usual. But it can be hard to take in enough nutrients if treatment side effects, such as nausea and vomiting, make it difficult to eat.

Medications. Certain medications, such as pain relievers, can cause fatigue.

Lack of exercise. If you're used to being on the go, slowing down can make you feel fatigued.

Hormonal changes. Hormone therapy is a common cancer treatment that causes changes in the body's hormone levels that can lead to significant fatigue. Hormonal changes may also occur as side effects of other cancer treatments.

Not everyone who has cancer experiences fatigue. And if you do, the level of cancer fatigue you experience can vary — you may feel a mild lack of energy, or you may feel completely wiped out.

A safe and tailored exercise program can help you improve your energy, regain fitness, improve mental function, elevate mood, and make a return to self-managed exercise.

Most Mast Cell Disorder patients have fatigue, and approximately half have cognitive dysfunction, and many symptoms of ME/CFS are also found; this may result in other a misdiagnosis of chronic fatigue syndrome or be the result of having both illnesses. The rate of post-exertional malaise, which is now considered the hallmark of ME/CFS, is unknown in MCAS patients.

Research on the relationship between mast cells and ME is in its infancy. One study found that individuals diagnosed with moderate to severe ME have been noted to have higher amounts of dysfunctional mast cells in circulation.

Post-viral fatigue is when the fatigue that started with a viral infection continues for a longer period of time after the infection has gone.

Post COVID Fatigue exhibit the following symptoms:

Mental and Physical Fatigue
Sleep disturbance
Breathing discomfort
Headaches
Sore throats
Pain
Light and Sound Senstivities