CONDITIONS

What Is Chronic Fatigue Syndrome

Chronic fatigue syndrome (CFS) is a disorder that causes severe and potentially debilitating fatigue. Patients with chronic fatigue syndrome can also experience muscle weakness, changes in mental capacity/memory, insomnia, and joint/muscle pain.

An estimated 800,000 adults in the US suffer from chronic fatigue syndrome, though only 20% receive proper diagnosis and treatment.

What Causes Chronic Fatigue Syndrome

Scientists and medical experts are unsure of the exact cause of chronic fatigue syndrome (CFS). The following are the leading theories on the causes of CFS:


Viral infection. Some studies suggest a link between CFS and certain viral infections including Epstein-Barr (virus responsible for mononucleosis among other health conditions), coxsackie B, xenotropic murine leukemia virus-related virus (XMRV).


Genes. CFS has been found to be associated with certain genes that control the body’s response to trauma and immune system function among other things.


Certain health conditions. Some believe that the following health conditions may contribute to the development of CFS in affected individuals, as they often occur along with the condition:

  •  Fibromyalgia
  • Depression and other mental disorders
  • Eating disorders
  • Chronic headaches
  • ADHD
  • Allergies
  • Irritable bowel syndrome and other digestive disorders

Hormone/Neurochemical abnormalities. Some studies have shown CFS to be associated with imbalances in neurotransmitters (the brain’s communication chemicals) as well as abnormalities in the section of the brain responsible for regulating sleep patterns and deficiencies in stress hormones such as cortisol

Risk Factors For Chronic Fatigue Syndrome

The following factors can influence your risk of developing CFS:

Previous exposure to viruses. Individuals who have previously been infected with any of  the following viruses are more likely to develop CFS:

  • Epstein-Barr
  • Coxsackie B
  • Xenotropic murine leukemia virus-related virus (XMRV)
  • Human T cell lymphotropic virus (HTLV)
  • Measles
  • Cytomegalovirus
  • Parovirus

Sex. Women are more often affected than men. As many as 4 out of 5 CFS patients are women.

Age. CFS most often develops in individuals from the ages of 40-60.

Genetics. CFS has been linked to several genes relating to immune function and trauma response, though it is not known to what degree the condition is hereditary.

Existing health conditions. Certain health conditions increase an individual’s risk of developing CFS. These include:

  • Fibromyalgia
  • Depression and other mental disorders
  • Eating disorders
  • Chronic headaches
  • ADHD
  • Allergies
  • Irritable bowel syndrome and other digestive disorders

Diagnosing Chronic Fatigue Syndrome

Because little is known about chronic fatigue syndrome and its category of symptoms are so broad, CFS can be a very difficult to diagnosis. The CDC recommends the following procedure for diagnosing CFS:

Medical history and physical examination. This will help your doctor better understand your risk of developing the disease as well as identify other possible causes of your symptoms.

Mental health assessment. Since CFS is often related to and shares symptoms with mental illnesses, your doctor will briefly assess the state of your mental health.

Assessment of patient’s condition in relation to CFS diagnostic criteria. A patient is said to have CFS if he/she meets the following criteria:

  • Severe or chronic fatigue for 6 or more consecutive months that is not due to ongoing exertion or other medical conditions
  • Fatigue interferes with daily activities/work.
  • Experiences 4 or more of the following symptoms at the same time:
    • Post-exertion fatigue lasting more than 24 hours
    • Unrefreshing sleep
    • Significant impairment of short-term memory/concentration
    • Muscle pain
    • Multi-join pain (without swelling or redness)
    • Chronic headaches
    • Tender cervical or axillary lymph nodes
    • A frequent sore throat

Symptoms of Chronic Fatigue Syndrome

The following symptoms may be signs of chronic fatigue syndrome:

  • Post-exertion fatigue lasting more than 24 hours
  • Unrefreshing sleep
  • Significant impairment of short-term memory/concentration
  • Muscle pain
  • Multi-join pain (without swelling or redness)
  • Chronic headaches
  • Tender cervical or axillary lymph nodes
  • A frequent sore throat

Prognosis

The prognosis for chronic fatigue syndrome depends on the patient and the severity of the symptoms. Some patients find that their symptoms improve simply with physical therapies and behavioral counseling, while others find that they improve with medications or a combination of medication and therapies/counseling. Unfortunately for some, neither medication nor therapy helps with CFS symptoms.

Living With Chronic Fatigue Syndrome

The following tips can help make living with CFS more manageable:

  • Know your limitations. It can take time to adjust to your body’s new limits. Include resting time in all of your plans, and be careful not to overwhelm your body with an especially busy schedule.
  • Be flexible. Know that your energy levels may fluctuate not according to plan.
  • Consider all treatment optionsincluding alternative therapies. Speak with your doctor and other health professionals to best determine which course of treatment is best for you.
  • Educate yourself and others. Knowing about your disorder can help you better understand the symptoms you experience. Talking to others about your condition can help them understand the changes in your behavior that are caused by disorder.
  • Build a support system.Talk to trusted loved ones or join a support group. Visit the website for CFIDS & Fibromyalgia self-help for more information.

Screening

Chronic fatigue syndrome is not screened for. If you believe you are experiencing any of the symptoms of Chronic fatigue syndrome, schedule an appointment with your doctor.

Medication And Treatment

The treatment methods for CFS vary greatly depending on the doctor’s assessment of the patient and the severity of the symptoms. Many treatment plans combine medications, behavioral and physical therapy, and diet/lifestyle changes.

The following medications are available to help control CFS symptoms:


Nonsteroidal anti-inflammatory drugs(NSAIDs), which can help manage pain. These include:

  • Aspirin
  • Ibuprofen
  • Naproxen

Anti-depressants, including:

  • Amitriptyline
  • Doxepin
  • Desipramine
  • Notriptyline

Selective serotonin-reuptake inhibitors (SSRIs), which serve as a mood regulator. These include:

  • Fluoxetine
  • Sertraline
  • Paroxetine
  • Duloxetine

COX-2 Inhibitors, which serve an anti-inflammatory purpose in the body. The most common of COX-2 inhibitors is Celecoxib (Celebrex).

  • Stimulants, which can help with CFS symptoms related to ability to focus and short term memory loss. These include:
    • Dexamphetamine
    • Adderall
    • Methylphenidate

In addition to medication, a range of therapies may also be useful in managing CFS symptoms. These include:

  • Cognitive-behavioral therapy (CBT), which can assist patients in managing the stress of symptoms and reorganizing their lives around their new limitations. CBT typically spans a few months and can involve building management skills, maintaining a positive psyche, and learning how to confront and resolve CFS-related conflicts.
  • Graded exercise. Some patients report success with programs that gradually increase their level of physical activity until overall energy levels increase.
  • Dietary therapy.Healthcare professionals will most likely recommend maintaining a healthy, balanced diet with plenty of vegetables, fiber-rich foods, and lean proteins. This can help the body maintain overall good health.

Complementary and Alternative Treatment

The following alternative treatments may be helpful in reducing CFS symptoms:

Mind/body techniques such as:

  • Yoga
  • Guided mediation
  • Tai Chi
  • Hypnosis
  • Massage

Dietary supplements, including:

  • Coenzyme Q10
  • Vitamin b12
  • Vitamin C
  • Magnesium
  • DHEA
  • Ginseng

Herbal supplements. The following herbs have been found to be mood and energy regulators:

  • St. John’s Wort
  • Gingko
  • Comfrey
  • Ma Huang

*Check with your doctor before beginning any sort of alternative treatment regimen. Many alternative supplements may interact with prescribed medications, causing potentially serious side effects.

Care Guide

The following tips can help you better care for your loved one with chronic fatigue syndrome:

  • Be accepting of your loved one’s new limitations. Remember that they are adjusting just as much as you are during the first months of diagnosis.
  • Assist in planning and time management. When making plans with your loved one, make sure to include ample time for rest and recovery.
  • Encourage healthy eating. If you are cooking for your loved one, do the best to provide healthy, balanced meals rich in vegetables and lean proteins.
  • Listen to your loved ones thoughts and concerns. Be as open as possible to his or her perspectives, as you may serve as a critical source of support for him or her.

When To Contact A Doctor

If you experience many of the following symptoms over a course of several months, contact your doctor. This may be a sign of chronic fatigue syndrome:

  • Post-exertion fatigue lasting more than 24 hours
  • Unrefreshing sleep
  • Significant impairment of short-term memory/concentration
  • Muscle pain
  • Multi-join pain (without swelling or redness)
  • Chronic headaches
  • Tender cervical or axillary lymph nodes
  • A frequent sore throat

If you are undergoing treatment for CFS, contact your doctor if you experience any of the following:

  • Skin rashes/itchiness
  • Irreguler heartbeat
  • Sudden change in sleep patterns
  • Persistent nausea/diarrhea
  • Depression
  • Thoughts of suicide (If you are experiencing thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255)

These may be a sign of a severe reaction to your medications

Questions For Your Doctor

To find a doctor who specializes in CFS, visit FM/CFS/ME Resources.

Questions For A Doctor

You may want to ask your doctor the following questions upon your CFS diagnosis:

  • What is my condition caused by?
  • What is my chance of a full recovery?
  • What treatment methods are available?
  • What are the side effects?
  • What can I do to lessen my symptoms?
  • What changes should I make to my diet?
  • Does my condition affect my physical limitations?
  • Is this condition hereditary?

Resources

For more information on CFS, visit:

For more information on finding CFS doctors as well as tips on living with CFS, visit FM/CFS/ME Resources.

For more information about the prevalence of CFS, visit New Study Finds High Prevalence of Chronic Fatigue Syndrome.

For more information on CFS support groups, visit CFIDS & FIBROMYALGIA Self-Help.