In addition to these key defining characteristics, those who have CFS also report various nonspecific symptoms, including weakness, muscle pain, impaired memory and/or mental concentration, insomnia, and post-exertional fatigue which can last for more than 24 hours. In some cases, CFS can persist for years.
Causes of CFS
The primary cause or causes of CFS have not yet been identified and there are no specific diagnostic tests available at this time. Furthermore, since many illnesses have incapacitating fatigue as a symptom, proper care and caution must be taken to exclude other known and often treatable conditions before a diagnosis of CFS should be made. As the cause or causes of CFS still remains a mystery, despite a diligent search, a single cause for CFS may yet be identified at some point. There is another possibility which is that CFS represents a common endpoint of disease resulting from multiple sudden causes. Some of the possible causes of CFS might be due to infectious agents, immunological dysfunction, stress activating the hypothalamic-pituitary adrenal (HPA) axis, neurally mediated hypotension, and/or nutritional deficiencies. Other conditions that have been proposed to trigger the development of CFS include virus infection or other traumatic conditions, stress, and toxins.
As of this writing, there are no known causes, and there are no specific diagnostic tests available, as we previously mentioned. This makes a harder diagnostic process, and thus, a case definition has been created. In order to be diagnosed accurately with CFS, patients must satisfy two separate criteria.
Diagnosing chronic fatigue syndrome (CFS) can be complicated by a number of factors:
1. There’s no diagnostic laboratory test or biomarker for CFS.
2. Fatigue and other symptoms of CFS are common to many illnesses.
3. CFS is an invisible illness and many patients don’t look sick.
4. The illness has a pattern of remission and relapse.
5. Symptoms vary from person to person in type, number and severity.
These factors have contributed to an alarmingly low diagnosis rate. Of the four million Americans who have CFS, less than 20% have been diagnosed.
Criteria for Diagnosis
Your clinician should consider a diagnosis of CFS if any of these two criteria are met:
1. Unexplained, persistent fatigue that’s not due to ongoing exertion, isn’t substantially relieved by rest, is of new onset (not lifelong) and results in a significant reduction in previous levels of activity.
2. Four or more of the following symptoms are present for six months or more:
* Impaired memory or concentration
* Postexertional malaise (extreme, prolonged exhaustion and sickness following physical or mental activity)
* Unrefreshing sleep
* Muscle pain
* Multijoint pain without swelling or redness
* Headaches of a new type or severity
* Sore throat that’s frequent or recurring
* Tender cervical or axillary lymph nodes
The fatigue and impaired memory or concentration must have impaired the patients normal daily activities, along with other symptoms that must have persisted or recurred during 6 or more consecutive months of illness and must not have predated the fatigue.
Other Commonly Observed Symptoms in CFS
* abdominal pain
* alcohol intolerance
* chest pain
* chronic cough
* dry eyes or mouth
* irregular heartbeat
* jaw pain
* morning stiffness
* night sweats
* psychological problems (depression, irritability, anxiety, panic attacks)
* shortness of breath
* skin sensations, such as tingling
* weight loss
These symptoms do not contribute in any way in the diagnosis of CFS.
Chronic fatigue syndrome can resemble many other illnesses, including mononucleosis, Lyme disease, lupus, multiple sclerosis, fibromyalgia, primary sleep disorders, severe obesity and major depressive disorders. Medications can also cause side effects that mimic the symptoms of CFS.
Because CFS can resemble many other disorders, it’s important not to self-diagnose CFS. It’s not uncommon for people to mistakenly assume they have CFS when they have another illness that needs to be treated. If you have CFS symptoms, consult a health care professional to determine if any other conditions are responsible for your symptoms. A CFS diagnosis can be made only after other conditions have been excluded.
It’s also important not to delay seeking a diagnosis and medical care. CDC research suggests that early diagnosis and treatment of CFS can increase the likelihood of improvement.
Getting Tested for Chronic Fatigue Syndrome
Because there are no blood tests, brain scans or other various lab testing procedures to successfully diagnose CFS, it’s all comes down to a diagnosis by exclusion. 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, and memory problems, the physician should further investigate the possibility that the patient may have CFS. Your health care professional will first take a detailed patient history, including a review of medications that could be causing your fatigue. A thorough physical and mental status examination will also be performed. Next, a battery of laboratory screening tests will be ordered to help identify or rule out other possible causes of your symptoms. Your professional may also order additional tests to follow up on results of the initial screening tests. A diagnosis of insufficient fatigue could be made if a patient has been fatigued for 6 months or more, but does not meet the symptom criteria for CFS.
For the complete process for diagnosing CFS please click the following link: CFS Patient Diagnosing Examination Complete Process
It can be quite difficult to talk to your physician or other health care professional about the possibility that you may have CFS, especially since it is not very easily identified and diagnosed, even by professionals. There are a variety of health care professionals, including physicians, nurse practitioners and physician assistants who can successfully diagnose CFS and help develop an individualized treatment plan designed just for you.
You can access additional information for diagnostic tests for healthcare professionals by clicking on the following link: Healthcare Professionals Diagnostic Testing For Chronic Fatigue Syndrome.