Dr. Linette Williamson - Chronic Fatigue in Oceanside
What is CFS (Chronic Fatigue Syndrome)
Chronic fatigue syndrome (CFS) is a condition defined by extreme fatigue or tiredness that does not go away with sleep and can not be explained by an underlying medical condition.
CFS can also be referred to as myalgic encephalomyelitis (ME) or systemic exertion intolerance disease (SEID). The causes of CFS aren't completely understood yet. Some theories include viral infection, psychological stress, or a combination of factors. Since no single cause has been determined, and since numerous other conditions produce similar symptoms, CFS can be hard to diagnose.
There are no tests for CFS. Your physician will need to rule out other reasons for your fatigue when determining a diagnosis. While CFS was previously a controversial diagnosis, it's now widely accepted as a medical disorder. CFS can impact anyone, though it's most frequent among females in their 40s and 50s. There's currently no cure, however treatment can alleviate symptoms.
Here's what you need to know about CFS, including symptoms, treatment options, and outlook.
What Triggers CFS?
The cause of CFS is unknown. Researchers hypothesize that contributing factors may include:
- Viruses
- A weakened immune system
- Stress
- Hormone imbalances
It's even possible that some people are genetically predisposed to develop CFS.
Though CFS can in some cases develop after a viral infection, no single kind of infection has been found to trigger CFS. Some viral infections that have been studied in relation to CFS include those caused by:
- Epstein-Barr virus (EBV)
- Human herpesvirus 6
- Ross River virus (RRV)
- Rubella virus
Infections caused by bacteria, including Coxiella burnetii and Mycoplasma pneumoniae, have also been studied in connection with CFS.
The Centers for Disease Control and Prevention (CDC) has indicated that CFS may be the end stage of several various conditions, instead of one specific condition.
In fact, about 1 in 10 people with EBV, Ross River virus, or Coxiella burnetii infection will develop a condition that fulfills the criteria for a CFS diagnosis.
Additionally, researchers say that those who've had severe symptoms with any of these three infections are at a higher risk for later developing CFS.
People with CFS sometimes have weakened immune systems, but doctors don't know whether this is enough to cause the disorder.
Individuals with CFS can also in some cases have abnormal hormone levels. Physicians haven't yet concluded whether this is significant, either.
What Are the Symptoms of CFS?
Symptoms of CFS differ according to the individual and the severity of the condition.
The most common symptom is fatigue that's serious enough to interfere with your everyday activities.
For CFS to be diagnosed, a dramatically reduced ability to execute your typical daily activities with fatigue has to last for a minimum of 6 months. It must not be treatable with bed rest.
You will also experience extreme fatigue after physical or mental activities, which is referred to as post-exertional malaise (PEM). This can last for more than 24 hours after the task.
CFS can also present sleep problems, such as:
- Feeling unrefreshed after a night's sleep
- Chronic insomnia
- Other sleep disorders
Additionally, you may also experience:
- Loss of memory
- Decreased concentration
- Orthostatic intolerance (going from lying or seated to standing positions makes you light-headed, dizzy, or faint)
Physical symptoms of CFS might include:
- Muscle pain
- Persistent headaches
- Multi-joint pain without redness or swelling
- Frequent sore throat
- Tender and swollen lymph nodes in your neck and armpits
CFS affects some individuals in cycles, with periods of feeling worse and then better.
Symptoms may in some cases even disappear entirely, which is referred to as remission. But, it's still possible for symptoms to return later, which is referred to as a relapse.
This cycle of remission and relapse can make it challenging to manage your symptoms, but it's possible.
How is CFS Diagnosed?
CFS is a very challenging disorder to diagnose.
According to the Institute of Medicine, as of 2015, CFS develops in about 836,000 to 2.5 million Americans. It's estimated, however, that 84 to 91 percent have yet to receive a diagnosis.
There are no medical exams to screen for CFS. Its symptoms are similar to several other conditions. Many people with CFS do not "look sick," so physicians may not realize that they indeed have a health problem.
In order to get a CFS diagnosis, your physician will eliminate other possible causes and discuss your medical history with you.
They'll verify that you at least have the core symptoms previously mentioned. They'll also ask about the duration and severity of your unexplained fatigue.
Eliminating other potential reasons for your fatigue is an essential part of the diagnosis procedure. Some conditions with symptoms that resemble those of CFS include:
- Mononucleosis
- Lyme disease
- Multiple sclerosis
- Lupus (SLE)
- Hypothyroidism
- Fibromyalgia
- Major depressive disorder
- Severe obesity
- Sleep disorders
The side effects of particular drugs, such as antihistamines and alcohol, can resemble symptoms of CFS as well.
Due to the similarities between symptoms of CFS and many other disorders, it's important to not self-diagnose. Talk to your physician regarding your symptoms. They can work with you to get relief.
How Is CFS Treated?
There's presently no specific cure for CFS.
Each individual has different symptoms and therefore might need different types of treatment to manage the disorder and alleviate their symptoms.
Treatments include:
- Cognitive behavioural therapy (CBT)
- A structured exercise program called graded exercise therapy (GET)
- Medicine to manage pain, nausea and sleeping problems
Most individuals with CFS will improve with time, especially with treatment, although some individuals do not make a full recovery.
It's also likely there will be periods when your symptoms improve or worsen.
Kids and young people with CFS/ME are more likely to recover completely.
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