Chronic Fatigue Syndrome

Chronic fatigue syndrome (KRAH-nik fuh-TEEG SIN-drome), or CFS, is a condition that makes people feel extremely exhausted and affects their participation in normal activities, such as work or school Although the cause of the syndrome is still not known, researchers are investigating the possibility that an infection might trigger the condition in some cases.

What Is Chronic Fatigue Syndrome?

Chronic fatigue syndrome is a condition that causes almost constant exhaustion. People with CFS cannot just get more sleep to feel better, because their fatigue does not improve with rest. In addition, physical or mental work may make the fatigue worse. Doctors and scientists do not know what causes CFS. In the past, people with CFS often were told their symptoms were psychological, or "all in their heads." It was not until the 1980s that CFS began to be recognized as a medical condition associated with the physical symptoms of severe fatigue and weakness. CFS affects all racial groups, and the condition occurs in teens as well as adults. According to the National Institutes of Health, a woman is at least two to four times more likely than a man to develop CFS. Some studies have estimated that as many as 800,000 people in the United States have the syndrome.

What Are the Symptoms of CFS?

For a diagnosis of CFS, a person must have a sudden onset of exhaustion that continues for 6 months or recurs during that period of time. In addition, the person must have four of the following symptoms, and the symptoms must have started after the fatigue began:

• joint pain in several places in the body (without redness or swelling)
• muscle pain
• sore throat
• tender lymph nodes ^*
• difficulty in concentrating or short-term memory problems
• headaches different from those previously experienced
• general exhaustion that lasts for more than 24 hours after exercise or exertion
• a feeling of tiredness despite having slept

Some people with CFS also experience:

• dizziness
• abdominal pain
• weight loss
• nausea
• night sweats
• chest pain
• continuing cough
• shortness of breath
• anxiety
• depression
• irregular heartbeat
• abnormal skin sensations

People diagnosed with CFS are not just a little sleepy. The fatigue they experience is so great that it significantly interferes with work or school.

What Causes CFS?

Doctors do not know what causes CFS. Because many people first experience the symptoms of CFS after an illness caused by a virus (such as mononucleosis or hepatitis), some scientists think that a viral illness can trigger the condition. Toxins, stress, and physical or emotional injury also have been suggested as possible causes of CFS. Some researchers think that CFS stems from a problem in the immune system, which helps the body fight disease. Because many people with CFS experience depression, other doctors believe that a psychological condition produces the physical symptoms of CFS. In the past, CFS has been blamed on many other conditions, such as allergies, hypoglycemia ^* , infection with Epstein-Barr virus (the virus that causes mononucleosis), candidiasis ^* , neurasthenia ^* , and Lyme disease.

Diagnosis and Treatment of CFS

CFS is diagnosed if a person has the symptoms listed earlier. There are no specific laboratory tests that can confirm the diagnosis of CFS, although a person may have to undergo blood tests and physical examinations to rule out other possible causes of symptoms, such as multiple sclerosis ^* , hypothyroidism ^* , or heart or kidney disease. A diagnosis of CFS often is made when nothing else is found to account for the symptoms.

Because the cause of CFS is unknown, treatment for CFS involves relieving the symptoms. Although there is no specific treatment for CFS, moderate exercise, such as yoga or tai chi; antidepressants (medications that can ease depression); and nonsteroidal anti-inflammatory drugs, such as ibuprofen, can help minimize the severity of many of the symptoms. It is also important for people with CFS to watch their stress levels, because mental, physical, or emotional overexertion can aggravate CFS symptoms. A few patients with CFS may respond to drinking extra fluids and eating extra salt. Some people also find cognitive behavioral therapy ^* and rehabilitative therapy ^* helpful in decreasing or coping with their symptoms. For most patients, the symptoms of CFS are most severe in the beginning, and later they may come and go. Some people recover completely from CFS, although it is not clear why this happens. Most CFS patients recover gradually within 5 years after symptoms begin.