Chronic Fatigue Syndrome

Chronic fatigue syndrome (CFS) is a complicated disorder characterized by extreme fatigue that can't be explained by any underlying medical condition. The fatigue may worsen with physical or mental activity, but doesn't improve with rest.

This condition is also known as systemic exertion intolerance disease (SEID) or myalgic encephalomyelitis (ME). Sometimes it's abbreviated as ME/CFS.

The cause of chronic fatigue syndrome is unknown, although there are many theories — ranging from viral infections to psychological stress. Some experts believe chronic fatigue syndrome might be triggered by a combination of factors.

There's no single test to confirm a diagnosis of chronic fatigue syndrome. You may need a variety of medical tests to rule out other health problems that have similar symptoms. Treatment for chronic fatigue syndrome focuses on symptom relief.

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People who have chronic fatigue syndrome appear to be hypersensitive to even normal amounts of exercise and activity.

Why this occurs in some people and not others is still unknown. Some people may be born with a predisposition for the disorder, which is then triggered by a combination of factors. Potential triggers include:

  • Viral infections. Because some people develop chronic fatigue syndrome after having a viral infection, researchers question whether some viruses might trigger the disorder. Suspicious viruses include Epstein-Barr virus, 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 glands or adrenal glands. But the significance of these abnormalities is still unknown.

Factors that may increase your risk of chronic fatigue syndrome include:

  • Age. Chronic fatigue syndrome can occur at any age, but it most commonly affects people in their 40s and 50s.
  • Sex. Women are diagnosed with chronic fatigue syndrome much more often than men, but it may be that women are simply more likely to report their symptoms to a doctor.
  • Stress. Difficulty managing stress may contribute to the development of chronic fatigue syndrome.
The symptoms of CFS vary based on the individual affected and the severity of the condition. The most common symptom is fatigue that’s severe enough to interfere with your daily activities. For CFS to be diagnosed, fatigue must last for at least six months and must not be curable with bed rest. Additionally, you must have at least four other symptoms.

Other symptoms of CFS may include:

  • loss of memory or concentration
  • feeling unrefreshed after a night’s sleep
  • chronic insomnia (and other sleep disorders)
  • muscle pain
  • frequent headaches
  • multi-joint pain without redness or swelling
  • frequent sore throat
  • tender and swollen lymph nodes in your neck and armpits

You may also experience extreme fatigue after physical or mental activities. This can last for more than 24 hours after the activity.

People are sometimes affected by CFS in cycles, with periods of feeling worse and then better again. Symptoms may sometimes even disappear completely, which is referred to as remission. However, it’s still possible for them to come back again later, in a relapse. The cycle of remission and relapse can make it difficult to manage your symptoms.

CFS is a very challenging condition to diagnose. According to the Institute of Medicine, as of 2015, CFS occurs in about 836,000 to 2.5 million Americans. It’s estimated, however, that 84 to 91 percent are yet to be diagnosed.

There are no lab tests to screen for CFS, and its symptoms are similar to many other illnesses. Many people with CFS don’t “look” sick, so doctors may not recognize that they’re ill.

In order to be diagnosed with CFS, your doctor will rule out other potential causes and review your medical history with you. They’ll make sure that you have at least four of the above symptoms. They’ll also ask about the duration and severity of your unexplained fatigue.

Ruling out other potential causes of your fatigue is a key part of the diagnosis process. Some conditions whose symptoms resemble those of CFS include:

  • mononucleosis
  • Lyme disease
  • multiple sclerosis
  • lupus (SLE)
  • hypothyroidism
  • fibromyalgia
  • major depressive disorder

You may also experience symptoms of CFS if you’re severely obese or have depression or sleep disorders. The side effects of certain drugs, such as antihistamines and alcohol, can mimic CFS as well.

Because the symptoms of CFS resemble those of other conditions, it’s important not to self-diagnose and to talk to your doctor.

There’s currently no specific cure for CFS. Each person has different symptoms and may therefore benefit from different types of treatment, aimed at managing the disease and relieving their symptoms.

Home remedies and lifestyle changes

Making some changes to your lifestyle can help reduce your symptoms. Limiting or eliminating your caffeine intake will help you sleep better and ease your insomnia. You should limit your nicotine and alcohol intake, too.

Try to avoid napping during the day if it’s hurting your ability to sleep at night. Create a sleep routine: You should go to bed at the same time every night and aim to wake up around the same time every morning.

It’s also important to pace yourself during activities. Overexertion can make your symptoms worse and bring on an episode of fatigue. Avoid emotional and physical stress. Find the best ways for you to cope. Take time each day to relax or participate in activities you enjoy.

Medications

Typically, no one medication can treat all of your symptoms. Also, your symptoms may change over time, so your medications may have to, too.

In many cases, CFS can trigger or be a part of depression, and you may need an antidepressant to combat it. If lifestyle changes don’t give you a restful night’s sleep, your doctor may suggest a sleep aid. Pain-reducing medication can also help you cope with aches and joint pain caused by CFS.

Alternative medicine

Acupuncture, tai chi, yoga, and massage may help relieve the pain associated with CFS. Always talk to your doctor before beginning any alternative or complementary treatments.

Chronic Fatigue Syndrome cannot be prevented but it can be managed and the symptoms can be treated.

The best option is to eat a balanced diet, exercise regularly and meditate or do a fun activity to keep stress levels low.

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