This document provides an overview of chronic fatigue syndrome (CFS), including its symptoms, diagnosis, and living with the condition. CFS is a complex illness characterized by severe fatigue and other symptoms like muscle pain and cognitive impairment that are worsened by physical or mental activity. While the cause is unknown, diagnosis involves ruling out other conditions and having specific symptoms for at least 6 months. Managing CFS requires an individualized treatment plan and coping strategies, as living with a fluctuating condition can be difficult both physically and emotionally.
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Health Topics
Chronic Fatigue Synrome
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2. Overview
Chronic fatigue syndrome, or CFS, is a devastating
and complex disorder. People with CFS have
overwhelming fatigue and a host of other
symptoms that are not improved by bed rest and
that can get worse after physical activity or mental
exertion. They often function at a substantially
lower level of activity than they were capable of
before they became ill.
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3. Overview
Besides severe fatigue, other symptoms include
muscle pain, impaired memory or mental
concentration, insomnia, and post-exertion
malaise lasting more than 24 hours. In some
cases, CFS can persist for years.
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4. Overview
Researchers have not yet identified what causes
CFS, and there are no tests to diagnose CFS.
Moreover, because many illnesses have fatigue as
a symptom, doctors need to take care to rule out
other conditions, which may be treatable.
CDC
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5. Symptoms
Chronic fatigue syndrome can be misdiagnosed or
overlooked because its symptoms are similar to so
many other illnesses. Fatigue, for instance, can be
a symptom for hundreds of illnesses. Looking
closer at the nature of the symptoms though, can
help a doctor distinguish CFS from other illnesses.
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6. Symptoms
Primary SymptomsAs the name chronic fatigue
syndrome suggests, fatigue is one part of this
illness. With CFS, however, the fatigue is
accompanied by other symptoms. In addition, the
fatigue is not the kind you might feel after a
particularly busy day or week, after a sleepless
night, or after a single stressful event. It's a
severe, incapacitating fatigue that isn't improved
by bed rest and that is often worsened by physical
activity or mental exertion. It's an all-
encompassing fatigue that can
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7. Symptoms
People with CFS function at a significantly lower
level of activity than they were capable of before
they became ill. The illness results in a substantial
reduction in work-related, personal, social, and
educational activities.
The fatigue of CFS is accompanied by characteristic
illness symptoms lasting at least 6 months. These
symptoms include:
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8. Symptoms
increased malaise (extreme exhaustion and
sickness) following physical activity or mental
exertion
problems with sleep
difficulties with memory and concentration
persistent muscle pain
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9. Symptoms
joint pain (without redness or swelling)
headache
tender lymph nodes in the neck or armpit
sore throat
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10. Symptoms
Other SymptomsThe symptoms listed above are
the symptoms used to diagnose CFS. However,
many CFS patients and patients in general may
experience other symptoms, including:
brain fog (feeling like you're in a mental fog)
difficulty maintaining an upright position,
dizziness, balance problems or fainting
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11. Symptoms
allergies or sensitivities to foods, odors, chemicals,
medications, or noise
irritable bowel
chills and night sweats
visual disturbances (sensitivity to light, blurring,
eye pain)
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12. Symptoms
depression or mood problems (irritability, mood
swings, anxiety, panic attacks)
It's important to tell your health care professional
if you're experiencing any of these symptoms. You
might have CFS, or you might have another
treatable disorder. Only a health care professional
can diagnose CFS.
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13. Symptoms
What's the Clinical Course of CFS?The severity of
CFS varies from patient to patient. Some people
can maintain fairly active lives. For most
patients, however, CFS significantly limits their
work, school, and family activities for periods of
time.
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14. Symptoms
While symptoms vary from person to person in
number, type, and severity, all CFS patients are
limited in what they can do to some degree. CDC
studies show that CFS can be as disabling as
multiple sclerosis, lupus, rheumatoid arthritis,
heart disease, end-stage renal disease, chronic
obstructive pulmonary disease (COPD), and similar
chronic conditions.
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15. Symptoms
CFS often affects patients in cycles: Patients will
have periods of illness followed by periods of
relative well-being. For some patients, symptoms
may diminish or even go into complete remission;
however, they often recur at a later point in time.
This pattern of remission and relapse makes CFS
especially hard for patients to manage. Patients
who are in remission may be tempted to overdo
activities when they're feeling better, but this
overexertion may actually contribute to a relapse.
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16. Symptoms
The percentage of CFS patients who recover is
unknown, but there is some evidence to indicate
that patients benefit when accompanying
conditions are identified and treated and when
symptoms are managed. High-quality health care is
important.
CDC
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17. Diagnosis
For doctors, diagnosing chronic fatigue
syndrome (CFS) can be complicated by a number
of factors:
-- There's no lab test or biomarker for
CFS.
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18. Diagnosis
-- Fatigue and other symptoms of CFS are
common to many illnesses.
-- For some CFS patients, it may not be
obvious to doctors that they are ill.
-- The illness has a pattern of remission
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19. Diagnosis
and relapse.
-- Symptoms vary from person to person in
type, number, and severity.
These factors have contributed to a low
diagnosis rate. Of the one to four million
Americans who have CFS,
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20. Diagnosis
less than 20% have been diagnosed.
Exams and Screening Tests for CFS
Because there is no blood test, brain
scan, or other lab test to diagnose CFS, the doctor
should first rule
out other possible causes.
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21. Diagnosis
If a patient has had 6 or more
consecutive months of severe fatigue that is
reported to be
unrelieved by sufficient bed rest and that is
accompanied by
nonspecific symptoms, including flu-like
symptoms, generalized pain,
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22. Diagnosis
and memory problems, the doctor should consider
the possibility that
the patient may have CFS. Further exams and tests
are needed before a
diagnosis can be made:
A detailed medical history will be
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23. Diagnosis
needed and should include a review of
medications that could be
causing the fatigue and symptoms
A thorough physical and mental status
examination will also be needed
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24. Diagnosis
A battery of laboratory screening tests
will be needed to help identify or rule out other
possible causes of
the symptoms that could be treated
The doctor may also order additional
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25. Diagnosis
tests to follow up on results of the initial screening
tests
A CFS diagnosis requires that the
patient has been fatigued for 6 months or
more and has 4 of
the 8 symptoms for CFS for 6 months or more.
If, however, the patient
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26. Diagnosis
has been fatigued for 6 months or more but does
not have four of the
eight symptoms, the diagnosis may be idiopathic
fatigue.
CDC
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27. Living and Coping
Managing chronic fatigue syndrome can be as
complex as the illness itself. There is no cure, no
prescription drugs have been developed
specifically for CFS, and symptoms can vary a lot
over time. Thus, people with CFS should closely
monitor their health and let their doctor know of
any changes; and doctors should regularly monitor
their patients' conditions and change treatment
strategies as needed.
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28. Living and Coping
A team approach that involves doctors and
patients is one key to successfully managing CFS.
Patients and their doctors can work together to
create an individualized treatment program that
best meets the needs of the patient with CFS. This
program should be based on a combination of
therapies that address symptoms, coping
techniques, and managing normal daily activities.
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29. Living and Coping
CFS affects patients in different ways, and the
treatment plan should be tailored to address
symptoms that are most disruptive or disabling for
each patient. Helping the patient get relief from
symptoms is the main goal of treatment.
However, expecting a patient to return to usual
activities should not be the immediate goal
because the physical and mental exertion needed
to try to reach that goal may aggravate the illness.
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30. Living and Coping
Because CFS is a complicated illness, its
management may require input from a variety of
medical professionals. Primary care providers can
develop effective treatment plans based on their
experience in treating other illnesses. Patients
benefit when they can work in collaboration with a
team of doctors and other health care
professionals, who might also include
rehabilitation specialists, mental health
professionals, and physical or exercise therapists.
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31. Living and Coping
Difficulties of Living with CFSLiving with chronic
fatigue syndrome can be difficult. Like other
debilitating chronic illnesses, CFS can have a
devastating impact on patients' daily lives and
require them to make major lifestyle changes to
adapt to many new limitations.
Common difficulties for CFS patients include
problems coping with:
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32. Living and Coping
the changing and unpredictable symptoms
a decrease in stamina that interferes with activities
of daily life
memory and concentration problems that
seriously hurt work or school performance
loss of independence, livelihood, and economic
security
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33. Living and Coping
alterations in relationships with partners, family
members, and friends
worries about raising children
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34. Living and Coping
Feelings of anger, guilt, anxiety, isolation and
abandonment are common in CFS patients. While
it's OK to have such feelings, unresolved emotions
and stress can make symptoms worse, interfere
with prescription drug therapies, and make
recovery harder.
CDC
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