Cachexia (Wasting Syndrome)

April 2, 2024

3 min read

Cachexia or wasting syndrome is a condition that causes extreme weight loss and muscle wasting, including loss of body fat in people who are very sick with a chronic disease or illness.

What is Cachexia?

Cachexia is a complex metabolic syndrome that causes you to lose a significant amount of skeletal muscle and body fat. The condition happens when the basal metabolic rate in an individual increases without an increase in calorie or protein intake.

Cachexia can cause unintentional weight loss, loss of appetite, and progressive muscle wasting in people with various chronic conditions like cancer, HIV, multiple sclerosis, and renal failure.

Stages of Cachexia

Cachexia can happen in three stages.

Precachexia: In this stage, you lose 5% of your body weight because of a known disease. The condition can also cause metabolism and inflammation.
Cachexia: In this stage, you lose more than 5% of your body weight in 12 months or less without trying to lose weight. Other symptoms include fatigue, inflammation, loss of muscle strength, and decreased appetite.
Refractory cachexia: People in this stage show a lack of response to cancer treatment and lose muscle, weight, and body functions.

Causes of Cachexia

Cachexia can cause your metabolic rate to speed up, so you need more energy. At the same time, diseases like cancer and their treatment can reduce your appetite, causing you to eat less food than required.

The imbalance can cause extreme weight loss, muscle wasting, and decreased body fat.

Cachexia can happen in the later stages of chronic diseases like:

Cancer
Congestive heart failure
Rheumatoid arthritis
Cystic fibrosis
Chronic kidney disease
Chronic obstructive pulmonary disease

Cancer cachexia can be caused by the following factors:

Cancer symptoms like pain and fatigue can affect your appetite.
Cancer treatments like chemotherapy and radiation can keep your body from absorbing nutrients.
Certain cytokines released by the immune system can cause inflammation, speeding up fat and muscle loss.
Insulin resistance may increase muscle loss.
Increased protein turnover in cancer can cause muscle loss.

Symptoms of Cachexia

The symptoms of cachexia may include:

Involuntary weight loss: Weight loss can happen even after getting enough nutrition or calories.
Anorexia or loss of appetite: Cachexia may cause a loss of desire to eat food, and anorexia.
Swelling or edema: Low protein in blood can cause swelling in tissues because of a fluid build-up.
Reduced functional ability: A person may experience fatigue, low energy levels, and general malaise that affects their quality of life.

Complications of Cachexia

Cachexia may have complications like:

An adverse response to chemotherapy
Side effects from chemotherapy or other cancer treatments
An increased risk of surgery complications
An increased medical risk
Trouble in functioning physically

Diagnosis of Cachexia

Cachexia can be diagnosed based on a variety of criteria. Commonly, a person with cachexia will have two main symptoms.

Losing 5% of their body weight over six to twelve months
Having a BMI of less than 20 in people below 65 years and a BMI of less than 22 in people over 65 years

Cachexia can be evaluated through different measures.

Body mass index(BMI)
Lean muscle mass
Food intake diaries
Blood tests like C-reactive protein, serum albumin, and white blood cell counts

Treatment of Cachexia

Treatment of cachexia can involve:

Making diet changes with calorie-dense foods
Using supplements like Omega-3 fatty acids to improve energy and appetite
Using appetite stimulants like megestrol and dronabinol to boost your appetite
Taking non-steroidal anti-inflammatory drugs like NSAIDs and steroids to fight inflammation
Eating small, frequent meals made of high-calorie ingredients and choosing drinks with nutritional supplements
Undergoing physical therapy
Meditating
Doing Yoga
Exercising
Using support groups
Counseling either alone or with family