CHRONIC FATIGUE SYNDROME What is Chronic Fatigue Syndrome (CFS)?

A person with chronic fatigue syndrome (CFS) feels completely worn-out and overtired. This extreme tiredness makes it hard to do the daily tasks that most of us do without thinking — like dressing, bathing, or eating. Sleep or rest does not make the tiredness go away. It can be made worse by moving, exercising, or even thinking.

CFS can happen over time or come on suddenly. People who get CFS over time get more and more tired over weeks or months. People who get CFS suddenly feel fine one day and then feel extremely tired the next. A person with CFS may have muscle pain, trouble focusing, or insomnia (not being able to sleep). The extreme tiredness may come and go. In some cases the extreme tiredness never goes away. The extreme tiredness must go on for at least 6 months before a diagnosis of CFS can be made.

No one knows for sure what causes CFS. Many people with CFS say it started after an infection, such as a cold or stomach bug. It also can follow a bout of infectious mononucleosis (mono), the “kissing disease” that drains your energy. Some people with CFS say it started after a time of great stress, such as the loss of a loved one or major surgery.

It can be hard to figure out if a person has CFS because extreme tiredness is a common symptom of many illnesses. Also, some medical treatments, such as chemotherapy, can cause extreme tiredness.

The signs of CFS can come and go or they can stay with a person. At first, you may feel like you have the flu. As well as extreme tiredness and weakness, CFS symptoms include:

• forgetting things or having a hard time focusing
• feeling tired even after sleeping
• muscle pain or aches
• pain or aches in joints without swelling or redness
• feeling discomfort or "out-of-sorts" for more than 24 hours after being active
• headaches of a new type, pattern, or strength
• tender lymph nodes in the neck or under the arm
• sore throat

Many people with CFS report other symptoms too, ranging from a constant cough to feelings of depression. If you think you may have chronic fatigue syndrome, talk to your doctor.

Experts think as many as half a million Americans have a CFS-like condition. The exact number of people with chronic fatigue syndrome is not known. CFS can affect people of all ages, racial/ethnic backgrounds, and economic statuses.

More women than men are diagnosed with CFS. But, it is not known for sure that this illness affects more women than men. It may be that women talk to their doctors more often about things like tiredness and pain.

It can be hard for your doctor to diagnose chronic fatigue syndrome because there is no lab test for it. And many signs of CFS are also signs of other illnesses or medical treatments.

If you think you may have CFS, see your doctor. Your doctor will:

• ask you about your physical and mental health
• do a physical exam
• order urine and blood tests, which will tell your doctor if something other than CFS might be causing your symptoms
• order more tests, if your urine and blood tests do not show a cause for your symptoms
• classify you as having CFS if:

1. you have been extremely tired for 6 months or more and tests do not show a cause for your symptoms
   
   AND
   
2. you have 4 or more of the symptoms listed in the section “What are the signs of CFS?” in this article.

This process can take a long time (even years), so try to be patient with your doctor. While these tests are being done, talk to your doctor about ways to help ease your symptoms.

Right now, there is no cure for chronic fatigue syndrome. But there are things you can do to feel better. Talk to your doctor about ways to ease your symptoms and deal with your tiredness. You might also try these:

Lifestyle changes:

• Try to stop or do less of the things that seem to trigger your tiredness. For a week or two, write down what you do each day and note when you feel really tired. Then, look over this list to find out which activities tend to tire you out. An occupational therapist can help you by looking at your daily habits and suggesting changes to help you save energy. Your doctor can help you find an occupational therapist near where you live.
• Regular exercise can lessen body aches and joint and muscle pain and increase your energy level. Be sure to talk to your doctor before starting an exercise plan. Your doctor can help you create a plan that is right for you. Don't exercise too much. Too much exercise can cause more tiredness.

Medications:

• Over-the-counter pain relievers such as Advil, Motrin, or Aleve can help with body aches, headaches, and muscle and joint pain.
• Nondrowsy antihistamines can help with allergy symptoms, such as runny nose and itchy eyes.
• Antidepressants can help improve sleep and ease pain.

Some people say their chronic fatigue syndrome symptoms get better with complementary or alternative treatments, such as massage, acupuncture, chiropractic care, yoga, stretching, or self-hypnosis. Keep in mind that many alternative treatments, dietary supplements, and herbal remedies claim to cure CFS, but they might do more harm than good. Talk to your doctor before seeing someone else for treatment or before trying alternative therapies.

Also, keep in mind that your doctor may need to learn more about CFS to better help you. If you feel your doctor doesn’t know a lot about CFS or has doubts about it being a “real” illness, see another doctor for a second opinion. Contact a local university medical school or research center for help finding a doctor who treats people with chronic fatigue syndrome.