Chronic Fatigue Syndrome–Diagnosis and Prognosis

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How Is It Diagnosed?

According to the CDC (Centers for Disease Control) as of 2013, more than 1 million people in the United States have chronic fatigue syndrome, 0.35% of the population at that time. An obvious question is, for a disorder that occurs only 12% as often as fibromyalgia, what possible ways to diagnose it could there be? In short, none. There are currently no diagnostic tests that can confirm the presence of CFS in a patient. Nevertheless, there are criteria based on the commonly observed symptoms. A doctor must perform blood and urine tests that can exclude or confirm other illnesses as the cause and still weigh your range of symptoms against the other difficultly (yes, that is a word!) diagnosed conditions like fibromyalgia in case you have one of those instead. He or she should also rule out mental disorders, existing or previously experienced illnesses, and medication side effects.

The CDC and most doctors currently use a case definition produced by a group of CFS experts in 1994 to diagnose the condition:

  • “The individual has severe chronic fatigue for 6 or more consecutive months that is not due to ongoing exertion or other medical conditions associated with fatigue (these other conditions need to be ruled out by a doctor after diagnostic tests have been conducted)
  • The fatigue significantly interferes with daily activities and work
  • The individual concurrently has four or more of the following symptoms:
    • post-exertion malaise lasting more than 24 hours
    • unrefreshing sleep
    • significant impairment of short-term memory or concentration
    • muscle pain
    • pain in the joints without swelling or redness
    • headaches of a new type, pattern, or severity
    • tender lymph nodes in the neck or armpit
    • a sore throat that is frequent or recurring

These symptoms persisted or recurred during 6 or more consecutive months of illness and they cannot have first appeared before the fatigue.” (http://www.cdc.gov/cfs/case-definition/index.html)

Any other common symptoms associated with CFS should not be used in its diagnosis, though they likely confirm its presence afterwards.

What’s the Prognosis?

As with fibromyalgia, there is no cure, but unlike FMS, neither are there any FDA-approved medications to treat it as a specific disorder. The frequent changes that occur in the nature of a patient’s CFS and cycles of remission and relapse also make it a difficult disorder to treat. But, as with any incurable illness, the symptoms can be managed with some success, depending on the patient and the severity and variability of his or her symptoms.

Medications can be prescribed to treat sleep problems and lack of energy, pain, depression, and gastrointestinal problems while regulating sleep patterns, managing and reducing stress, physical therapy and exercise, and therapy for emotional problems can also help. CFS sufferers have also found that alternative therapies such as massage therapy, acupuncture, hydrotherapy, and yoga seem to help relieve symptoms as well. All in all, there is not much difference in treatment between chronic fatigue syndrome and fibromyalgia syndrome.

 

Chronic Fatigue Syndrome–Definition and Symptoms

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What Is It?

Chronic fatigue syndrome (CFS)–aka chronic fatigue and immune dysfunction syndrome (CFIDS) aka myalgic encephalomyelitis (ME)–is an illness characterized by intense, deep, and persistent fatigue and exhaustion. Definite immune system abnormalities have been found in the majority of CFS patients, hence the alternate names (“myalgic” = of or relating to myalgia, which is muscle pain; “encephalomyelitis = inflammation of the brain and spinal cord, usually due to viral infection).

About 1 million, less than 1%, of Americans have CFS, and among them, more women are affected than men. The cause is unknown–though current thoughts trend toward infection, immune disorder, or neurological disorder–and there is no cure. CFS produces some similar symptoms to fibromyalgia syndrome (FMS) and the two often occur together, but there are differences.

What Are the Symptoms?

A syndrome is a set of symptoms that occur together, indicating the existence of a particular disease. Therefore, chronic fatigue syndrome most commonly presents the following set of symptoms:

  • as stated above, overwhelming, persistent fatigue
  • post-exertional malaise–disproportionate exhaustion lasting at least a day after mental or physical exercise
  • pain–muscle pain; joint pain without swelling or redness; headaches
  • unrefreshing sleep; sleep difficulties
  • impaired memory and concentration; brain fog, cognitive difficulties
  • frequent or recurring sore throats
  • tender and/or enlarged lymph nodes in the neck and armpits
  • other flu-like symptoms

Additional symptoms (and disorders) that often occur along with these are:

  • gastrointestinal problems
  • allergies and sensitivities to foods, odors, chemicals, medications
  • depression, mood swings, irritability
  • visual disturbances (blurry sight, light sensitivity, eye pain)
  • dizziness, balance problems, fainting; difficulty maintaining an upright posture
  • chills, night sweats
  • gynecological problems, including PMS
  • chronic inflammation of the bladder wall (interstitial cystitis), chronic pelvic pain
  • temporomandibular joint disorder (TMJ)

I think what really sets CFS apart from FMS are the flu-like symptoms that often precipitate and accompany the illness. If not for a lack of these flu-like symptoms, I would believe that I have chronic fatigue syndrome rather than fibro. But who knows. I could even have both, which is called comorbidity–the simultaneous presence of 2 (or more) chronic medical conditions in 1 person. Many fibro and CFS sufferers can attest to having comorbidity.

Are you a CFS sufferer? Do you experience comorbidity? How do you cope?