What is Chronic Fatigue Syndrome (CFS)?
Chronic fatigue syndrome, or CFS, is a complex disorder. People with CFS have overwhelming fatigue and a host of other symptoms that are not improved by bed rest and that can get worse after physical activity or mental exertion. They often function at a substantially lower level of activity than they were capable of before they became ill.
Besides severe fatigue, other symptoms include muscle pain, impaired memory or mental concentration, insomnia, and post-exertion malaise lasting more than 24 hours. In some cases, CFS can persist for years.
Researchers have not yet identified what causes CFS, and there are no tests to diagnose CFS. Moreover, because many illnesses have fatigue as a symptom, doctors need to take care to rule out other conditions, which may be treatable.
Symptoms of CFS
There are several case definitions for CFS and all require fatigue as one of the symptoms. CDC uses the 1994 CFS case definition, which requires meeting three criteria:
- The individual has had unexplained, severe fatigue for 6 or more consecutive months
- The individual concurrently has 4 or more of the following 8 symptoms:
- post-exertion malaise lasting more than 24 hours
- unrefreshing sleep
- significant impairment of short-term memory or concentration
- muscle pain
- pain in the joints without swelling or redness
- headaches of a new type, pattern, or severity
- tender lymph nodes in the neck or armpit
- a sore throat that is frequent or recurring
- These symptoms should have persisted or recurred during 6 or more consecutive months of illness, and they cannot have first appeared before the fatigue.
The symptoms listed above are the symptoms used to diagnose this illness. However, many CFS patients may experience other symptoms, including irritable bowel, depression or other psychological problems, chills and night sweats, visual disturbances, brain fog, difficulty maintaining upright position, dizziness, balance problems, fainting, and allergies or sensitivities to foods, odors, chemicals, medications, or noise.
Causes of CFS
Despite a vigorous search, scientists have not yet identified what causes CFS. While a single cause for CFS may yet be identified, another possibility is that CFS has multiple triggers. Some of the possible causes of CFS might be:
- Viral infections. Because some people develop chronic fatigue syndrome after having a viral infection, researchers have wondered if some viruses might trigger the disorder. Suspicious viruses have included Epstein-Barr, human herpes virus 6 and mouse leukemia viruses. No conclusive link has yet been found.
- Immune system problems. The immune systems of people who have chronic fatigue syndrome appear to be impaired slightly, but it’s unclear if this impairment is enough to actually cause the disorder.
- Hormonal imbalances. People who have chronic fatigue syndrome also sometimes experience abnormal blood levels of hormones produced in the hypothalamus, pituitary gland or adrenal glands. But the significance of these abnormalities is still unknown.
Diagnosis of CFS
There’s no single test to confirm a diagnosis of chronic fatigue syndrome. Because the symptoms of chronic fatigue syndrome can mimic so many other health problems, you may need patience while waiting for a diagnosis. Your doctor must rule out a number of other illnesses before diagnosing chronic fatigue syndrome. These may include:
- Sleep disorders. Chronic fatigue can be caused by sleep disorders. A sleep study can determine if your rest is being disturbed by disorders such as obstructive sleep apnea, restless leg syndrome or insomnia.
- Medical problems. Fatigue is a common symptom in several medical conditions, such as anemia, diabetes and underactive thyroid (hypothyroidism). Lab tests can check your blood for evidence of some of the top suspects.
- Mental health issues. Fatigue is also a symptom of a variety of mental health problems, such as depression, anxiety, bipolar disorder and schizophrenia. A counselor can help determine if one of these problems is causing your fatigue.
Treatment for CFS
Treatment for chronic fatigue syndrome focuses on symptom relief.
- Antidepressants. Many people who have chronic fatigue syndrome are also depressed. Treating your depression can make it easier for you to cope with the problems associated with chronic fatigue syndrome. And low doses of some antidepressants also can help improve sleep and relieve pain.
- Sleeping pills. If home measures, such as avoiding caffeine, don’t help you get better rest at night, your doctor might suggest trying prescription sleep aids.
The most effective treatment for chronic fatigue syndrome appears to be a two-pronged approach that combines psychological counseling with a gentle exercise program.
- Graded exercise. A physical therapist can help determine what types of exercise are best for you. Inactive people often begin with range-of-motion and stretching exercises for just a few minutes a day. If you’re exhausted the next day, you’re doing too much. Your strength and endurance will improve as you gradually increase the intensity of your exercise over time.
- Psychological counseling. Talking with a counselor can help you figure out options to work around some of the limitations that chronic fatigue syndrome imposes on you. Feeling more in control of your life can improve your outlook dramatically.
- Lifestyle and home remedies
These self-care steps may be helpful:
- Reduce stress. Develop a plan to avoid or limit overexertion and emotional stress. Allow yourself time each day to relax. That may mean learning how to say no without guilt.
- Improve sleep habits. Go to bed and get up at the same time each day. Limit daytime napping and avoid caffeine, alcohol and nicotine.
- Pace yourself. Keep your activity on an even level. If you do too much on your good days, you may have more bad days.