Hope at last if you feel TATT (that’s Tired All The Time): unique NHS service launched to combat long-term fatigue | Mail on Sunday | 1 November 2015

November 1, 2015

From The Mail on Sunday, 1 November 2015 (Story by Roger Dobson).

* New research shows one Briton in eight is affected by long-term fatigue
* Symptoms manifested by conditions including arthritis and sleep apnoea
* A new fatigue clinic in Newcastle will treat patients and carry out research

The first NHS service for patients who complain of being tired all the time – or TATT – has been launched. The move comes as new research shows that one Briton in eight is affected by long-term fatigue, which is separate from the condition chronic fatigue syndrome (CFS), also known as ME or myalgic encephalopathy.

The symptoms often begin in a person’s 30s, according to new research, and are manifested in a range of conditions from rheumatoid arthritis to sleep apnoea.

In some cases, tiny changes in the autonomic nervous system, leading to a drop in blood supplies getting to the brain, heart and muscles, may be responsible, according to experts at the fatigue clinic which is part of the Clinics for Research and Service in Themed Assessments (CRESTA) in Newcastle.

Fatigue is an umbrella term for a range of problems, including tiredness, reduced energy levels, muscle weakness, memory problems, anxiety, dizziness, and palpitations. The symptoms that patients have are not helped by sleep or rest.

Although fatigue is commonly associated with CFS/ME, which is believed by many experts to be a neurological condition similar to MS or Parkinson’s and affects about 250,000 people in the UK, work at the Newcastle clinic and other centres shows that it is far more common as a symptom of other conditions, and that in some cases, there may be no identifiable cause.

Up to 70 per cent of patients with rheumatological diseases suffer with fatigue, and it has also been linked to lupus, Sjögren’s syndrome, chronic infections, thyroid and liver conditions and restless leg syndrome.

The scale of the problem is shown in a new study in the journal Sleep And Biological Rhythms, based on a sample of 1,200 people.

It found that overall, 13.6 per cent of people, including 20.9 per cent of women, had suffered with fatigue for at least one month.

‘Fatigue, whether it is a side effect of a chronic disease or chronic fatigue syndrome, is increasingly being recognised in the UK,’ says Katie Hackett, Arthritis Research UK research fellow at Newcastle University and a member of the CRESTA team.

The fatigue clinic is part of the Clinics for Research and Service in Themed Assessments (CRESTA) in Newcastle (above)

‘Research suggests patients believe there is a lack of medical interest in fatigue, and while there are many CFS services across the NHS, there was, until now, no service aimed at those who suffer with other causes of fatigue.’

Gill Turner, 51, from Newcastle, has been treated at the clinic for fatigue associated with Sjögren’s syndrome, an auto-immune disease characterised by excessively dry eyes and mouth, plus muscle and joint pain and profound fatigue.

She says: ‘Fatigue became a big problem about two years ago. I felt utterly exhausted all of the time, even after plenty of sleep, and I had muscle ache and my body felt very floppy and immobile.

‘The problem is that all the treatments in the UK are geared up to people with a clear diagnosis of chronic fatigue syndrome, which I do not have.

‘I have had physiotherapy and occupational therapy as well as having various specific tests. One of those tests finally showed a genetic illness which helped to explain some of my symptoms.

‘I have also been given advice about managing my problems and day-to-day coping with the fatigue. There is also a network of others attending the clinic, called the CRESTA Champions, who are in all in similar situations. The group is encouraging and reassuring.

‘The clinic has made a real difference to my life. They recognise that fatigue is a real problem that needs to be treated.

‘The clinic has not only shown me that I am not alone – but previous symptoms which had never been really acknowledged were finally explained.’

It is hoped that a TATT service can eventually be rolled out nationwide across the NHS.

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