Our pilot studies (PS) show that chronic fatigue (CF) is a problem in the general population associated with higher adrenergic neurovascular tone (ANVT). ANVT is measured by systolic time intervals (STI = PEP/LVET × 100%). Baseline (low stress level) ANVT is predicted by temperance analysis testing (r = .98, p < .01). ANVT can be increased by pain, stress, certain foods, and sympathomimetic drugs, which were avoided during the study. In our prospective studies, as with PS, a random sample of the general population was acquired using patients with a normal distribution of STI values (25-56%). Patients were 3/1 women/men, age range 30-65 years. Exclusions were patients with elevated C-reactive protein, HgA1C > 6.0, depression, fibromyalgia, and smokers. PS criteria of STI at 25-36% was used to identify CF patients with significantly (sig) higher symptom levels (SL) (1-100 scale of fatigue scored by patient) versus normal age-matched controls (C). Blind correlations were made with systolic blood pressure (SBP), SL, cardiac output (CO), and systemic vascular resistance (SVR) by 2D echo. This was done by blind matrix at baseline (without stress) = time (T)1 and during treatment (Rx) = T2. Patients were grouped by STI ranges (Group [G]1 25-30%, G2 31-36%, C50-56%) using PS guidelines. Rx of CF patients consisted of amitriptyline (10-50 mg/day) and diltiazem CD (240-360 mg/day). Prospective results: group means are shown.
Where *sig. different from C at p < .01 by T test. G1 and 2 (28% of general population) had sig lower STI and CO with sig higher SL at T1 versus C. Rx sig reduced SL and SVR and increased STI and CO. In parallel studies pain, stress, certain foods, and sympathomimetic drugs that reduce STI (p < .01 by T test) also increased SL and produced higher degrees of fatigue and/or fibromyalgia. CF occurs in the general population due to higher ANVT without inflammatory disorders. Thus, reduction in ANVT can significantly reduce symptom levels in chronic fatigue.
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