Chronic Fatigue Syndrome

Chronic Fatigue Syndrome (CFS) is not the normal ups and downs experienced in everyday life. The early sign of this illness is a strong and noticeable fatigue that comes on suddenly and often comes and goes or never stops. It is not improved by bed rest and may be worsened by physical or mental activity. Persons with CFS most often function at a substantially lower level of activity than they were capable of before the onset of the illness. CFS is diagnosed two to four times more often in women than in men possibly because of biological, psychological and social influences.

In order to be diagnosed with CFS a patient must satisfy two criteria. Severe chronic fatigue must have lasted at least six months with other known medical conditions excluded by clinical diagnoses. Also, a person must 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 and must not have predated the fatigue.

Despite a vigorous search, the cause(s) for CFS remain unknown. One possibility may be that CFS represents an endpoint of disease resulting from multiple precipitating causes. Some conditions that have been proposed to trigger the development of CFS include viral infections or other transient traumatic conditions, stress and toxins.

Research indicates that CFS is most common in people in their 40s and 50s and women are more likely than men to be affected.

There is currently no cure for CFS. The therapies for this disorder are directed at symptom relief. It is important to maintain good health by eating a balanced diet and getting adequate rest, exercising regularly without causing more fatigue, and pacing oneself because too much stress can aggravate the symptoms of CFS. Working with a physician to develop a program that provides the greatest benefits also will help in reducing frustration with the illness.

Non-pharmacological therapies include acupuncture, aquatic therapy, chiropractic, cranial-sacral, light exercise, massage, self-hypnosis, stretching, tai chi, therapeutic touch and yoga. Certain psychotherapies such as cognitive behavioral therapy also have shown promise for facilitating patient coping and for alleviating some of the distress associated with CFS.

In pharmacological therapy there is a variety of medications that can relieve specific symptoms. It is important to begin with low doses and to escalate the dosage gradually as necessary.

Some CFS patients may also find it therapeutic to meet with other people who have this illness, and this can be accomplished by joining a local CFS support group. Support groups are not appropriate for everyone, and may actually add to their stress rather than relieving it.

The clinical course of CFS varies considerably among persons who have the disorder. The actual percentage of patients who recover is unknown, and even the definition of what should be considered recovery is subject to debate. Some patients recover to the point where they can resume work and other activities, but continue to experience various or periodic CFS symptoms. Some patients recover completely with time, and some grow progressively worse. CFS follows a cyclical course, alternating between periods of illness and relative well being.

MEDLINEplus 
800-338-7657 
http://www.nlm.nih.gov/medlineplus/chronicfatiguesyndrome.html

National Institute of Allergy and Infectious Diseases
http://www.niaid.nih.gov/factsheets/cfs.htm

U.S. Centers for Disease Control and Prevention National Center for Infectious Diseases 
888-232-3228 
www.cdc.gov /cfs