Chronic fatigue syndrome (CFS) is one of several names given to a poorly understood, variably debilitating disorder of uncertain cause/causes. It is a complicated disorder characterized by extreme fatigue that doesn't improve with bed rest and may worsen with physical or mental activity. Chronic fatigue syndrome may occur after an infection, such as a cold or viral illness. The onset can be during or shortly after a time of great stress, or chronic fatigue syndrome come on gradually without a clear starting point or obvious cause. Women are diagnosed with chronic fatigue syndrome far more often than men are. However, it's unclear whether chronic fatigue syndrome affects women more frequently or if women report it more often than men do. Treatment for chronic fatigue syndrome focuses on a combination of approaches to relieve signs and symptoms.
Causes:
Of all chronic illnesses, chronic fatigue syndrome is one of the most mysterious. Unlike definite infections, it has no clear cause. Several possible causes have been proposed, including:
* Depression.
* Iron deficiency anemia.
* Low blood sugar (hypoglycemia).
* History of allergies.
* Virus infection, such as Epstein-Barr virus or human herpesvirus 6.
* Dysfunction in the immune system.
* Changes in the levels of hormones produced in the hypothalamus, pituitary glands or adrenal glands.
* Mild, chronic low blood pressure (hypotension).
The cause of chronic fatigue syndrome may be an inflammation of the pathways of the nervous system as a response to an autoimmune process, but with nothing measurable in the blood as in other autoimmune diseases, such as rheumatoid arthritis and lupus. Chronic fatigue syndrome may also occur when a viral illness is complicated by a dysfunctional immune system.
Symptoms:
Chronic fatigue syndrome is a flu-like condition that can drain your energy and, sometimes, last for years. People previously healthy and full of energy may experience a variety of signs and symptoms.
Primary- Loss of memory or concentration, Sore throat, Painful and mildly enlarged lymph nodes in your neck or armpits, Unexplained muscle soreness, Pain that moves from one joint to another without swelling or redness, Headache of a new type, pattern or severity, Sleep disturbance, Extreme exhaustion lasting more than 24 hours after physical or mental exercise, etc.
Additional signs and symptoms-Abdominal pain, Allergies or sensitivities to foods, alcohol, odors, chemicals, medications or noise, Bloating, Chest pain, Chronic cough, Diarrhea, Dizziness, balance problems or fainting, Dry mouth, Earache, Irregular heartbeat, Jaw pain, Morning stiffness, Nausea, Chills and night sweats, Psychological problems, such as depression, irritability, anxiety disorders and panic attacks, Shortness of breath, Tingling sensations, Visual disturbances, such as blurring, sensitivity to light, eye pain and dry eyes, Weight loss or gain, etc.
Diagnosis:
A diagnosis of chronic fatigue syndrome is based on exclusion. This means that before arriving at a diagnosis, a doctor has ruled out any other disease or condition that may be causing your fatigue and related symptoms.
In general, doctors find it difficult to diagnose chronic fatigue syndrome because it has some of the same signs and symptoms as many other diseases. There's no diagnostic or laboratory procedure to confirm the presence of chronic fatigue syndrome.
Doctors exclude certain conditions before considering a diagnosis of chronic fatigue syndrome. These include:
* Having an active, identifiable medical condition that often results in fatigue, such as low levels of thyroid hormones (hypothyroidism) or sleep apnea.
* Using medicines that may cause fatigue.
* Having a relapse of a previously treated illness that can result in fatigue, such as cancer.
* Having had a past or current diagnosis of a major depressive disorder or other psychiatric illness, such as schizophrenia or an eating disorder.
* Abusing alcohol or another substance.
* Being severely obese, as defined by a body mass index (BMI) of 45 or greater.
Over time, be alert to any new cues that might indicate that the problem is caused by something other than chronic fatigue syndrome. When other diseases or conditions are excluded, your doctor may then determine if your illness meets the CFS-specific criteria.
Treatment:
There's no specific chronic fatigue syndrome treatment. In general, doctors aim to relieve signs and symptoms by using a combination of treatments, which may include:
Moderating daily activity- Your doctor may encourage you to slow down and to avoid excessive physical and psychological stress. However, too much rest can make you weaker, worsening your long-term symptoms. Your goal should be to maintain a moderate level of daily activity and gently increase your stamina over time.
Cognitive behavior therapy- This treatment, often used in combination with graduated exercise, also has been found to improve the symptoms of chronic fatigue syndrome. In cognitive behavior therapy, you work with a mental health professional to identify negative beliefs and behaviors that might be delaying your recovery and replace them with healthy, positive ones.
Treatment of depression- If you're depressed, medications, such as tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs), may help. Antidepressants may also help improve sleep and relieve pain. Tricyclic antidepressants include amitriptyline (Limbitrol, a multi-ingredient drug that contains amitriptyline), desipramine (Norpramin) and nortriptyline (Aventyl, Pamelor). SSRIs include fluoxetine (Prozac, Sarafem), paroxetine (Paxil), sertraline (Zoloft) and bupropion (Wellbutrin).
Treatment of existing pain- Acetaminophen (Tylenol, others) and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen (Advil, Motrin, others), may be helpful to reduce pain and fever.
Treatment of allergy-like symptoms- Antihistamines, such as fexofenadine (Allegra) and cetirizine (Zyrtec), and decongestants that contain pseudoephedrine (Sudafed) may relieve allergy-like symptoms such as runny nose.
Treatment of low blood pressure (hypotension)- The drugs fludrocortisone (Florinef), atenolol (Tenormin) and midodrine (ProAmatine, Orvaten) may be useful for certain people with chronic fatigue syndrome.
Treatment for problems of the nervous system- Symptoms such as dizziness and extreme skin tenderness can sometimes be relieved by clonazepam (Klonopin). Your doctor may prescribe medications such as lorazepam (Ativan) and alprazolam (Xanax) to relieve symptoms of anxiety.
Causes:
Of all chronic illnesses, chronic fatigue syndrome is one of the most mysterious. Unlike definite infections, it has no clear cause. Several possible causes have been proposed, including:
* Depression.
* Iron deficiency anemia.
* Low blood sugar (hypoglycemia).
* History of allergies.
* Virus infection, such as Epstein-Barr virus or human herpesvirus 6.
* Dysfunction in the immune system.
* Changes in the levels of hormones produced in the hypothalamus, pituitary glands or adrenal glands.
* Mild, chronic low blood pressure (hypotension).
The cause of chronic fatigue syndrome may be an inflammation of the pathways of the nervous system as a response to an autoimmune process, but with nothing measurable in the blood as in other autoimmune diseases, such as rheumatoid arthritis and lupus. Chronic fatigue syndrome may also occur when a viral illness is complicated by a dysfunctional immune system.
Symptoms:
Chronic fatigue syndrome is a flu-like condition that can drain your energy and, sometimes, last for years. People previously healthy and full of energy may experience a variety of signs and symptoms.
Primary- Loss of memory or concentration, Sore throat, Painful and mildly enlarged lymph nodes in your neck or armpits, Unexplained muscle soreness, Pain that moves from one joint to another without swelling or redness, Headache of a new type, pattern or severity, Sleep disturbance, Extreme exhaustion lasting more than 24 hours after physical or mental exercise, etc.
Additional signs and symptoms-Abdominal pain, Allergies or sensitivities to foods, alcohol, odors, chemicals, medications or noise, Bloating, Chest pain, Chronic cough, Diarrhea, Dizziness, balance problems or fainting, Dry mouth, Earache, Irregular heartbeat, Jaw pain, Morning stiffness, Nausea, Chills and night sweats, Psychological problems, such as depression, irritability, anxiety disorders and panic attacks, Shortness of breath, Tingling sensations, Visual disturbances, such as blurring, sensitivity to light, eye pain and dry eyes, Weight loss or gain, etc.
Diagnosis:
A diagnosis of chronic fatigue syndrome is based on exclusion. This means that before arriving at a diagnosis, a doctor has ruled out any other disease or condition that may be causing your fatigue and related symptoms.
In general, doctors find it difficult to diagnose chronic fatigue syndrome because it has some of the same signs and symptoms as many other diseases. There's no diagnostic or laboratory procedure to confirm the presence of chronic fatigue syndrome.
Doctors exclude certain conditions before considering a diagnosis of chronic fatigue syndrome. These include:
* Having an active, identifiable medical condition that often results in fatigue, such as low levels of thyroid hormones (hypothyroidism) or sleep apnea.
* Using medicines that may cause fatigue.
* Having a relapse of a previously treated illness that can result in fatigue, such as cancer.
* Having had a past or current diagnosis of a major depressive disorder or other psychiatric illness, such as schizophrenia or an eating disorder.
* Abusing alcohol or another substance.
* Being severely obese, as defined by a body mass index (BMI) of 45 or greater.
Over time, be alert to any new cues that might indicate that the problem is caused by something other than chronic fatigue syndrome. When other diseases or conditions are excluded, your doctor may then determine if your illness meets the CFS-specific criteria.
Treatment:
There's no specific chronic fatigue syndrome treatment. In general, doctors aim to relieve signs and symptoms by using a combination of treatments, which may include:
Moderating daily activity- Your doctor may encourage you to slow down and to avoid excessive physical and psychological stress. However, too much rest can make you weaker, worsening your long-term symptoms. Your goal should be to maintain a moderate level of daily activity and gently increase your stamina over time.
Cognitive behavior therapy- This treatment, often used in combination with graduated exercise, also has been found to improve the symptoms of chronic fatigue syndrome. In cognitive behavior therapy, you work with a mental health professional to identify negative beliefs and behaviors that might be delaying your recovery and replace them with healthy, positive ones.
Treatment of depression- If you're depressed, medications, such as tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs), may help. Antidepressants may also help improve sleep and relieve pain. Tricyclic antidepressants include amitriptyline (Limbitrol, a multi-ingredient drug that contains amitriptyline), desipramine (Norpramin) and nortriptyline (Aventyl, Pamelor). SSRIs include fluoxetine (Prozac, Sarafem), paroxetine (Paxil), sertraline (Zoloft) and bupropion (Wellbutrin).
Treatment of existing pain- Acetaminophen (Tylenol, others) and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen (Advil, Motrin, others), may be helpful to reduce pain and fever.
Treatment of allergy-like symptoms- Antihistamines, such as fexofenadine (Allegra) and cetirizine (Zyrtec), and decongestants that contain pseudoephedrine (Sudafed) may relieve allergy-like symptoms such as runny nose.
Treatment of low blood pressure (hypotension)- The drugs fludrocortisone (Florinef), atenolol (Tenormin) and midodrine (ProAmatine, Orvaten) may be useful for certain people with chronic fatigue syndrome.
Treatment for problems of the nervous system- Symptoms such as dizziness and extreme skin tenderness can sometimes be relieved by clonazepam (Klonopin). Your doctor may prescribe medications such as lorazepam (Ativan) and alprazolam (Xanax) to relieve symptoms of anxiety.
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