A difficult to diagnose disease discernible by extreme exhaustion, Chronic Fatigue Syndrome can often become debilitating to its sufferers. Sometimes known as Chronic Fatigue Immune Dysfunction Syndrome, this chronic condition is frequently misdiagnosed or not taken seriously by some doctors, even though it can leave a person functioning well below normal capacity for months at a time.
Chronic Fatigue Syndrome is most frequently reported by women, but all demographics may be affected. The cause of the disease is not known, and therefore there is no cure. Chronic Fatigue Syndrome is not simply feeling tired. It is severe fatigue, lack of stamina, an inability to concentrate, and an overall feeling of being unable to cope or function normally. It is often accompanied by discomfort and depression.
The symptoms of Chronic Fatigue Syndrome include but are not limited to headaches, sore throat, flu like symptoms, swollen lymph nodes, muscle pain, joint pain, inability to concentrate, light-headedness, prolonged malaise after even light exertion, and continuous fatigue. This serious form of fatigue keeps a patient from feeling refreshed, even after having plenty of sleep or rest.
If a person suffers from persistent fatigue and experiences four or more of the above-mentioned symptoms for at least six months, she may suffer from Chronic Fatigue Syndrome. If the symptoms are not related to another illness, testing is indicated to determine whether or not Chronic Fatigue is the culprit. Since there is no proven cause for Chronic Fatigue Syndrome, a battery of lab tests is conducted, as a way of ruling out other illnesses. The physician will arrive at a diagnosis of Chronic Fatigue Syndrome by eliminating other possible conditions.
As of Sept. 2011, no defined cause of CFS is known, even after about two decades of research on patients that fit the CFS criteria. Although many diseases coexist with CFS in patients, there are no proven links to any known disease (physical or mental) or pathogen that is responsible for CFS development.
The Centers for Disease Control (CDC) indicates that researchers are still trying to identify the cause(s) of CFS and offer some speculation about the ongoing research. For example, they suggest the possibility that CFS represents an endpoint of multiple diseases or conditions such as viral infections, stress, and toxin exposure. However, the CDC states that "CFS is not caused exclusively by any single recognized infectious disease agent." This includes Epstein-Barr virus, Lyme disease bacteria (Borrelia burgdorferi), human retroviruses, bornaviruses, fungi, Mycoplasma spp, and many others. However, if a person has been infected with several (at least three) different pathogens, the chances of getting CFS goes up. In addition, some researchers have suggested that a new virus found in some CFS patients (termed XMRV or xenotropic murine leukemia virus-related virus) may be a candidate for cause, but it has not been proven to date. In addition, although the CDC says no autoimmune changes like lupus or other diseases are found in CFS, many CFS patients have high levels of immune complexes and anti-self antibodies in their blood that may be a clue to help solve the answer to what causes CFS. The CDC mentions other findings (allergies, T cell activation, and cytokines), but none have any direct link to causing CFS.
The main symptom of chronic fatigue syndrome (CFS) is a devastating tiredness or exhaustion that has lasted at least 6 months and does not improve much with rest. This fatigue also is so severe that it interferes with your work, your play, and your social activities. The fatigue and other symptoms described below may begin suddenly or they may develop gradually over weeks or months.
Other long-term symptoms include:
Forgetfulness, memory loss, confusion, or difficulty concentrating.
Sore throat.
A fever.
Tender lymph nodes in the neck or armpits.
Muscle pain.
Joint pain without redness or swelling.
Headaches that are different from other headaches you have had in the past.
Unrefreshing sleep (waking up feeling tired or not rested).
Feeling unwell after exercise or other physical activities.
Because CFS is not easily diagnosed, health experts have established some rules to help them recognize the disease. To be diagnosed with CFS, you must have fatigue and at least four of the symptoms listed above. At least four of your symptoms must have started at the same time as or after your fatigue began, and they must have lasted for at least 6 months.
But if you have symptoms of CFS, such as often feeling very tired for no clear reason, you may still get treatment even if you don’t quite meet these criteria. For instance, your doctor may decide you need treatment even if you have had symptoms for less than 6 months.
Some people with CFS develop a condition in which their heart rate increases and their blood pressure drops when they stand or sit up from a reclining position. This is often described as feeling "lightheaded" or feeling faint or dizzy. This condition is called orthostatic hypotension.
Depression is common and can make your other symptoms worse. Antidepressant medicines can help you feel better.
CFS causes symptoms that are the same as many other diseases, especially early on. For this reason, it can be diagnosed only after a thorough evaluation has ruled out other conditions with similar symptoms.
There is no cure for chronic fatigue syndrome (CFS) but treatments can help relieve the symptoms.
The effectiveness of treatments depends on how CFS affects you. Early diagnosis, balancing rest with activity, medication to control certain symptoms and self-help measures can all help (see below).
Simply diagnosing CFS and receiving specialist advice about how to deal with it can help.
CFS may last for years. However, many people recover or at least adjust their lifestyle to improve their symptoms.
The National Institute for Health and Clinical Excellence (NICE) advises that an individual programme of treatment should be offered to you with the aims of:
maintaining and if possible extending your emotional and physical abilities
managing the physical and emotional effects of your symptoms
You may be offered the treatments explained below, but remember: what works for one person may not work for you.
The benefits and risks of each treatment should be explained to you, as some treatments could make your symptoms worse. Both you and the healthcare professional treating you will decide on your treatment programme.
If your symptoms continue to get worse for several days after trying a certain treatment, or if your symptoms are particularly severe, contact the healthcare professional who is treating you. It may be necessary to amend your treatment programme.
Activity management is another aspect of your treatment programme that involves setting individual goals and gradually increasing your activity levels. You may be asked to keep a diary of your current activity and rest periods to establish your baseline. Activities can then be gradually increased in a way that you find manageable.
Your treatment may also involve taking medication, although this will depend on your symptoms. For information about your medication, see the patient information leaflet that comes with it.
Over-the-counter painkillers can help to ease any muscle and joint pain and headaches you may have. Stronger painkillers can also be prescribed by your GP, although they should only be used on a short-term basis.
If you have chronic (long-term) pain, you may be referred to a pain management clinic. There are about 300 of these across the UK, mostly located in hospitals.
Antidepressants can be useful for people with CFS who are in pain or having trouble sleeping. Amitriptyline is a low-dose tricyclic antidepressant that may be prescribed. Amitriptyline is not suitable for everyone – for example, it may not be suitable if you have a history of heart problems. It can also cause side effects such as:
a dry mouth
blurred vision
dizziness
drowsiness
As well as these treatments you may find the lifestyle advice below helpful.
Pacing is an important way of controlling CFS symptoms. It involves balancing periods of activity with periods of rest.
Pacing means not overdoing it or pushing yourself beyond your limits. If you do, it could slow down your progress in the long-term. Over time, you can gradually increase your periods of activity, while making sure they are balanced with periods of rest.
Learning how to make the most of your energy helps increase the amount that you can do. However, you may need to arrange your daily and weekly activities around when you can be active and when you will need to rest.
If you pace your activities at a level that is right for you, rather than rushing to do as much as possible in a short space of time, you may be able to make steady progress.
The following recommendations may also help:
Avoid stressful situations.
Avoid alcohol, caffeine, sugar and sweeteners.
Avoid other food and drink that you are sensitive to.
Eat small, regular meals.
Spend time relaxing, such as reading the Bible for example.