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Chronic Fatigue Syndrome

What Is Chronic Fatigue Syndrome?

Chronic Fatigue Syndrome (CFS) is a medical problem that causes many people to become so fatigued and tired that they are not able to adequately function or perform normal daily tasks. This is called chronic fatigue. The main criteria for making the diagnosis of CFS are chronic fatigue that causes at least a 50% reduction in activity and ability to function, lasting for 6 or more months. Typical of CFS is that physical or mental activity often makes the symptoms worse, and rest usually doesn't improve symptoms.

CFS is unfortunately a complicated and difficult to diagnose. Some people have a hard time accepting CFS as a disease. It's important to remember that this fatigue is real and that they can work with their doctor to improve their symptoms.

What Other Symptoms Occur With CFS?

Not only do people with CFS experience fatigue that lasts for long periods of time, but they often experience a number of other symptoms such as headaches, sore throat, tender or pain involving their neck or armpits, unexplained muscle soreness, pain that moves from joint to joint without swelling or redness, loss of memory or concentration, trouble sleeping and extreme tiredness after exercising often lasting more than 24 hours. These and other symptoms often either come and go or won't go away. They often last for 6 months or more.

CFS may occur after an illness such as a cold or it can start during or shortly after a period of high stress. It often comes on slowly without any clear starting point or any obvious cause. In some cases, CFS may last for years then suddenly go away.

Making the Diagnosis of CFS

Making a diagnosis of CFS requires finding the Major Criteria (below) and the presence of at least 8 of the 11 Minor Criteria symptoms listed below or 6 of the 11 symptoms and 2 of the 3 signs:

Major Criteria:

  • New on set of fatigue causing 50% reduction in activity for at least 6 months
  • Exclusion of other illnesses that can cause fatigue

Minor Criteria Symptoms:

  • Mild fever
  • Recurrent sore throat
  • Painful lymph nodes
  • Muscle weakness
  • Muscle pain
  • Prolonged fatigue after exercise
  • Recurrent headache
  • Migratory joint pain
  • Neurologic or psychologic complaints
    • Sensitivity to bright light
    • Forgetfulness
    • Confusion
    • Inability to concentrate
    • Excessive irritability
    • Depression
  • Sleep disturbance (hypersomnia or insomnia)
  • Sudden onset of symptom complex

Minor Criteria Signs:

  • Low-grade fever
  • Nonexudative pharyngitis (non-infected sore throat)
  • Palpable tender lymph nodes

What Causes Chronic Fatigue Syndrome?

We do not know what causes CFS. CFS may be caused by an immune system that isn't working well, it may be caused by a yet unknown virus. Researchers are still looking for the cause of CFS.

How Is Chronic Fatigue Syndrome Treated?

The first step is to see if there is any other explainable cause for the fatigue. Your physician will likely want to review your symptoms and medical history, and perform a comprehensive physical examination. Diagnostic tests will generally be done to rule in or out conditions which might be indicated by your symptoms, however, generally lab testing is not very helpful when the diagnosis is CFS.

Some of the symptoms, such as muscle aches, sleep problems, anxiety and depression, can be treated with medications. These medications usually only help to relieve the symptoms and allow you to be more active, they do not however, cure the fatigue. To date there is no single medicine that cures the entire syndrome. Fortunately, most symptoms improve with time.

What Can I Do To Help Myself?

  • You can keep a daily diary to identify the times and conditions when your energy returns. Plan your activities around these times.
  • You can keep up some level of activity and exercise, within your abilities. You can work with your doctor to help you plan an exercise program to maintain your strength at whatever level is possible. Exercise can help your body and mind. Becoming sedimentary and allowing your muscles to atrophy will not help you at all.
  • Give yourself all the permission you need to recognize and express your feelings, especially any sadness, anger or frustration you are experiencing. You may need to grieve for the energy you have lost.
  • Ask for support from your family and friends. Look for support groups or counseling in your community. Ask your doctor for help in finding resources. Emotional support is important for coping with a chronic health problem.
  • If your memory and concentration are affected by chronic fatigue, keep lists and make notes to remind yourself of important things. Also, give yourself more time for activities that take concentration. Medicine may also help you sleep better, which might improve your memory and concentration.

How Can Your Doctor Help?

We work with patients to provide symptom relief and to help you find ways of coping with the life changes caused by their CFS.

An Alternative Medical Approach to CFS

Chronic fatigue affects people physically, mentally, emotionally, socially, and spiritually. Resolution of symptoms often requires that you address all of these factors in order to have the best chance of 1) adjusting to your illness and feeling more satisfied with your life and 2) eliminating or curing it.

There are a number of alternative medical treatments involving nutrition, nutritional supplements, herbs, visualization therapy, goal setting, affirmations, empowerment, positive thinking, even counseling and cognitive behavior therapy that have proven efficacy in helping treat and heal CFS.

If you have CFS, a good long-term relationship with competent and caring physician can greatly help you. For more information, call 805-435-1200 and make an appointment for help.


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