Chronic Fatigue Syndrome

Are you feeling fatigued? Do you have substantial impairment of short-term memory or concentration? Do you have a constant sore throat? Do you often have unrefreshing sleep and fatigue lasting more than 24 hours following exertion? If so, you may want to find out if you have CFS.

CFS, or Chronic Fatigue Syndrome, is recognized by the National Institute of Health (NIH), Centers for Disease Control (CDC), Food and Drug Administration (FDA), and Social Security Administration (SSA) as a serious, often disabling illness. It is marked by unrelenting exhaustion, muscle pain, cognitive disorders that patients call "brain fog", and a myriad of other physical symptoms.

Some patients are bedridden; others consider themselves fortunate if they can work or attend school at least part time, since any exertion typically worsens their symptoms.

Research is being done on many fronts, from cardiology to immunology to endocrinology, but the condition remains a mystery. Even the most promising treatments seem to work only for some patients and improve their lives by only small degrees.

The diagnosis of CSF is based on clinical criteria and it is largely dependent upon ruling out other organic and psychological causes of fatigue. In other words, it is a "diagnosis of exception." The diagnostic criteria published by the Centers for Disease Control may be summarized as follows:

Major Criteria: New onset of severe fatigue for six months or more, causing at least a 50 percent activity reduction. Exclusion of other illnesses causing similar symptoms.

Minor Criteria (eight or more): Mild fever, sore throat, painful or swollen lymph nodes, generalized muscle weakness, muscle discomfort, fatigue worsened by exercise, headaches, neuropsychologic complaints, sleep disturbance, acute onset of symptom complex.

Physical Examination Criteria (two of three): Fever, throat inflammation, palpable or tender lymph nodes. If you think your meet the criteria for CSF:

1. Make an appointment with your regular physician or another doctor, preferably one who is familiar with CFS.
2. Prepare for the appointment by writing down your symptoms and how long you have been experiencing them.
3. Show this list to your doctor, and explain the symptoms and activity limitations that you have been struggling with.
4. The doctor should conduct a complete physical exam and order a variety of laboratory tests to rule out other illnesses.
5. Discuss your concerns with your doctor, and listen to his or her impressions about your condition.
6. Schedule a follow-up appointment to find out the results of your lab tests and discuss your diagnosis.

1. Some doctors aren't familiar with CFS or may try to dismiss your symptoms as 'all in your head'. If you don't feel that your physician is taking you seriously, see another doctor.
2. Keep a record of your symptoms and how they impose limitations on your activity level, so you can share it with your doctor.
3. Don't try to diagnose yourself or treat your symptoms without consulting a medical professional.

Further reading and references:

Concise Encyclopedia of Chronic Fatigue Syndrome by Roberto Patarca-Montero, M.D., PhD., available from Women?s Health America. Inc. for $24.95. To order, call toll free at 1-800-558-7046

The Doctor?s Guide to Chronic Fatigue Syndrome Understanding, Treating, and Living with CFIDS by David S. Bell, M.D., available from Women?s Health America, Inc. for $15.00. To order, call toll free at 1-800-558-7046

CFIDS Association of America at www.cfids.org
1-800-442-3437