Chronic Fatigue Syndrome

At this time, there is no accepted conclusive test or series of tests of chronic fatigue syndrome. Chronic Fatigue Syndrome is therefore difficult to diagnose. If a doctor suspects a patient may have Chronic Fatigue Syndrome, they often begin the diagnostic process by eliminating other potential causes of the patient's symptoms. It is important to note that "Chronic fatigue" can be caused by a wide variety of conditions which should be investigated, although treatment of the patient's symptoms can begin before a complete diagnosis is made. A lack of information and awareness has led to many patients being stigmatized as hypochondriac or lazy. The Centers for Disease Control & Prevention (CDC) have now recognized Chronic Fatigue Syndrome as a serious illness and have recently launched a campaign to raise public and medical awareness about it.

It is not known whether any patients truly “recover” from Chronic Fatigue Syndrome, or merely recuperate enough to regain previous levels of activity.

Symptoms of Chronic Fatigue Syndrome (CFS)

Patients with Chronic Fatigue Syndrome may exhibit many symptoms – other than fatigue, including: pain, muscle weakness, loss of brain function, hypersensitivity, orthostatic intolerance, digestive disturbances, depression, immune system weakness, and cardiac and respiratory problems. Recently, genetics and stress have been found to be factors in the development of Chronic Fatigue Syndrome.

A great deal of debate has surrounded the issue of how best to define Chronic Fatigue Syndrome.  Generally, the following consensus was reached: in order to receive a diagnosis of chronic fatigue syndrome, a patient must satisfy two criteria:

1. Have severe chronic fatigue of six months or longer duration with other known medical conditions excluded by clinical diagnosis; and
2. Concurrently have four or more of the following symptoms: substantial impairment in short-term memory or concentration; sore throat; tender lymph nodes; muscle pain; multi-joint pain without swelling or redness; headaches of a new type, pattern or severity; unrefreshing sleep; and post-exertional malaise lasting more than 24 hours.

The symptoms must have persisted or recurred during six or more consecutive months of illness and must not have predated the fatigue.

Managing chronic fatigue syndrome can be as complex as the illness itself. There is no cure yet, no prescription drugs have been developed specifically for Chronic Fatigue Syndrome, and symptoms vary considerably over time. These factors complicate the treatment picture and require you and your health care team to constantly monitor and frequently revise treatment strategies.

It may take some time to find a combination of traditional and alternative therapies that works for you, but it’s important not to delay symptom management. For instance, untreated sleep problems can actually make other symptoms—like pain and memory problems—worse.

One key to managing Chronic Fatigue Syndrome is working with your doctor and other health care practitioners to create an individualized treatment program for you. This program should be based on a combination of therapies that address coping techniques, symptoms and activity management.

A multidisciplinary team of health care professionals working together to develop this individualized care plan is ideal. This team might include physicians and other primary care professionals, mental health professionals, rehabilitation specialists and physical or exercise therapists. Other professionals, like a sleep therapist or dietician, can be added as needed, and you may only need one or two consultations with such specialists.

However, it should be noted, there remains considerable skepticism amongst some medical professionals about the existence of Chronic Fatigue Syndrome as a 'real' — i.e. medical as opposed to behavioral — condition, possibly due to the extreme uncertainty of its etiology, and the lack of testing for biomedical signs. Many people are inclined to believe that a condition with few or no specific biomedical markers may be psychological in origin. This had led to a frustration in many patients, who feel that their disability is not psychological, but biological.

Alternative Therapies

Deep breathing and muscle relaxation techniques, massage and healing touch, and movement therapies like stretching, yoga and tai chi can be beneficial for some Chronic Fatigue Syndrome patients in reducing anxiety and promoting a sense of well-being. Other CFS patients try healthy/natural supplements with energy and wellness enhancing ingredients.

Be sure to discuss all potential alternative therapies with your health care professional.