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Chronic fatigue syndrome -

CFS goes by a few different names. In addition to the better-known “chronic fatigue syndrome,” it’s also sometimes called myalgic encephalomyelitis (ME) or systemic exertion intolerance disease (SEID).

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An insidious condition -

There is no test to diagnose CFS. This fact, along with the lack of knowledge about its cause, made it a controversial diagnosis in the past. Whether or not it existed was questioned, but, thankfully, it’s now widely accepted as a bona fide medical condition.

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It can be managed -

So, CFS has no known cause and no test for diagnosis. It’s not surprising to learn then that there is currently no cure for this mysterious condition. However, there are plenty of ways to alleviate the symptoms and improve your quality of life.

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The symptoms -

Let’s take a look at the main symptoms associated with CFS. The first, of course, is persistent tiredness that’s severe enough to interfere with your daily life.

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Persistent exhaustion -

For CFS to be diagnosed, this tiredness must be ongoing for at least six months. It doesn’t go away after resting or sleeping, and it impacts your ability to carry out your normal daily tasks and manage your basic responsibilities.

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The severity can vary -

While persistent exhaustion is a universal symptom of CFS, some people may have particularly severe bouts where they cannot get out of bed or need a wheelchair to do so.

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Post-exertional malaise - The fatigue usually gets much worse after performing physical or mental activities. This is known as post-exertional malaise (PEM) and can last for more than 24 hours.

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Sleep problems -

Sleep problems are also common with CFS. You may feel unrefreshed after sleeping, suffer from chronic insomnia, or develop a sleep disorder.

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Mental symptoms -

Mental symptoms that often come with CFS include a sense of brain fog, loss of memory, and reduced ability to concentrate. You might also become dizzy when going from a lying down or seated position to standing up.

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Physical symptoms -

More physical symptoms include muscle pain, joint pain, frequent headaches, frequent sore throats, and sensitive or swollen lymph nodes in the neck and underarms.

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Increased sensitivity -

Some people with CFS also find that they become more sensitive to things like light, sound, and smell.

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Cyclical CFS -

CFS can present itself differently in different people. Some will experience it consistently, while others will go through cycles of feeling better and then worse.

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Remission and relapse -

When the symptoms disappear for a long time, this is called remission. However, they can return again, which is called a relapse. This cycle can make it difficult to manage the symptoms, but it is possible.

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Risk factors -

CFS is most commonly diagnosed in people in their forties and fifties, but can affect any age. Women are somewhere between two and four times more likely to suffer from CFS than men. However, this may simply be because women are more likely to report their symptoms to a doctor.

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Linked to other illnesses - If you have a history of other complex illnesses like fibromyalgia and postural orthostatic tachycardia syndrome, you may be more likely to develop CFS.

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Other factors - There’s also research to suggest that genetic predisposition may be a factor in increasing your risk. Allergies, stress, and environmental factors have also been recognized.

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Possible causes -

As mentioned earlier, we don’t know the cause of CFS yet, but there are several theories. Genetic factors may be one, so if it runs in your family you may be more likely to develop it.

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It may follow an infection -

It’s also theorized that CFS can follow a viral or bacterial infection, although no particular kind of infection has been identified as a cause.

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Is it a unique illness? - The CDC has proposed that CFS is the end stage of multiple illnesses rather than a separate illness in itself. They studied several infections and found that one in 10 patients who suffered from Epstein-Barr virus (EBV), Ross River virus (RRV), or Coxiella burnetii bacterial infection went on to develop symptoms that met the criteria for chronic fatigue syndrome.

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Weakened immune system -

A weak immune system has also been identified as a factor in CFS, but it’s not clear that this is enough to cause the condition by itself.

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Diagnosis -

There are no tests to identify CFS and the symptoms crossover with countless other illnesses. This makes it very difficult to diagnose. In the past, many CFS patients suffered stigma from both doctors and peers because they “don’t look sick.”

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Widely undiagnosed -

The Institute of Medicine estimates that between 800,000 and 2.5 million people in the US have chronic fatigue syndrome, but only 10-20% have received a diagnosis.

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Much to rule out -

In order to receive a CFS diagnosis, the doctor will need to verify that the core symptoms exist for a long period, and rule out other potential causes such as mononucleosis, Lyme disease, fibromyalgia, multiple sclerosis, or severe depression.

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Treatment - There is no cure for chronic fatigue syndrome, so each patient receives different treatment depending on which symptoms they experience.

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PEM flare-ups -

Managing post-exertional malaise (PEM) is a common challenge. PEM flare-ups occur when physical, mental, or emotional exertion makes CFS symptoms much worse. This can last for days.

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Pacing -

A common tactic to avoid PEM is "pacing." This means finding out your unique threshold for activity and making sure you alternate activity with rest to avoid triggering PEM. Keeping a diary can help you work out your personal limits.

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Lifestyle changes - Certain lifestyle changes like cutting caffeine and alcohol are often recommended. For those who struggle with insomnia at night, avoiding napping during the day may be helpful.

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Medication -

No single medication treats all of the symptoms of CFS, but several can help. This syndrome is often linked to depression, so antidepressants may be recommended. Medications to help with insomnia and joint pain are also often prescribed.

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Outlook -

A full recovery, as in a return to full pre-illness functioning, is quite rare for those with chronic fatigue syndrome. Many patients will experience periods of remission and relapse for years, while some will remain in remission after a couple of years of illness. Luckily, new research is showing links between CFS and inflammation, which may soon provide a better understanding of the cause and inform new treatment options.

See also: Inflammation could be the source of all your problems

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