Chronic Fatigue Syndrome
Chronic fatigue syndrome (CFS), known otherwise as myalgic encephalomyelitis (ME) or systemic exertion intolerance disease (SEID), is a health condition that causes extreme tiredness that isn’t explained by any other medical cause and that has been present for more than six months.
The fatigue worsens after physical activity and mental stress and does not improve with rest.
CFS is a chronic, long-term illness that can be disabling. People with CSF report feeling extreme fatigue and yet having trouble sleeping.
Some people with CFS are bedridden. Others experience post-exertion malaise (PEM), meaning they feel worse after being active—even when doing normal daily living activities like cooking, cleaning, and bathing.
Research on Chronic fatigue syndrome
Researchers report that 25% of people diagnosed with CFS become housebound or bedridden for some time during their illness.
A significant number of people with CFS experience gaps in work because of their symptoms.
CFS can affect the quality of life and relationships. It can be difficult to participate in things like hobbies and fun activities.
Most people diagnosed with CFS are between 40 and 60 years old, but CFS can affect people of all ages, including children.
It affects women more than men. However, CFS is often misdiagnosed or not diagnosed at all. In fact, researchers estimate that there may be a many as 2.5 million people in the U.S. alone who have CFS but have never been diagnosed.
Part of the reason CFS may not be diagnosed as often as possible is that, previously, some medical professionals disputed its existence as a distinct illness.
Many medical schools in the U.S. did not include CFS in their teaching curriculum.
Recent research has shown CFS to feature the cohesive picture of a medical disorder, despite the variability of its symptoms.
Diagnosis of Chronic fatigue syndrome
There are currently no laboratory or medical tests to diagnose CFS. When the diagnosis is made, it is based on a careful review of a person’s symptoms and medical history.
It is often a diagnosis of exclusion, made by ruling out any other illnesses or conditions that could explain an individual’s symptoms.
However, recent research from Stanford University has discovered a potential screening test for CFS.
Using an electric current and a blood sample, scientists found they could measure the recovery rate of a stressed blood sample.
In a small study of 80 participants, they distinguished between subjects who had CFS and those who did not.
Research is ongoing and may lead to a diagnostic test and new specific treatments for CFS.
Symptoms of Chronic fatigue syndrome
While people with CFS may not look sick, they may experience many and often diverse symptoms.
The most significant symptom is fatigue, but people with CFS report many other symptoms, and symptoms can vary widely.
One of CFS’s more common and debilitating symptoms is post-exertional malaise (PEM), which is extreme and long-lasting exhaustion after physical activity.
PEM worsens after even minor physical, mental, or emotional exertion. Other things can trigger PEM, like too much light or loud sounds.
PEM can take a few hours, on average 12–48, after the exposure to appear and last for several days or weeks.
Pain is a persistent and difficult symptom of CFS. Many people experience general aches, deep muscle pain, and frequent headaches.
Another common symptom of CFS is sleep problems like feeling tired and unrested even after sleeping for hours.
People with CFS may also have other conditions that interrupt sleep, like restless leg syndrome, vivid dreams, nightmares, and muscle spasms.
Dizziness or lightheadedness, also called orthostatic intolerance, is another common symptom of CFS.
These symptoms seem to occur most often when a person stands or sits upright and may be accompanied by blurred vision and rapid or fluttering heartbeat.
Other CFS symptoms include joint pain, skin that is painful or sensitive to the touch, sore throat, enlarged lymph nodes, migraines, insomnia, and intense stress reactions.
There is no cure for CFS; however, there are treatment options for individual symptoms. For example, treating PEM involves a process called pacing.
Pacing aims to teach an individual how to create a daily balance between activities and rest to avoid CFS symptom flares.
Patients may also be asked to keep journals of symptoms and their daily activities to help understand the triggers and avoid them.
Various medications may be prescribed to help relieve specific symptoms like pain, headaches, depression, anxiety, and stress.
For sleep difficulties associated with CFS, learning and maintaining good sleep hygiene is important. Consulting a sleep specialist may help as well.
The causes of CFS are not clearly understood.
Researchers are investigating several potential factors that may be related to CFS, such as:
- Immune system irregularities—Scientists have found that individuals with CFS have immune systems that are slightly different from people who do not have it. Anyhow, there is not sufficient evidence to confirm that these differences are actually causing CFS.
- Viral infections—Symptoms of CFS have developed after viral infections, and some researchers think these viral infections may trigger CFS. Viral infections that may trigger CFS include Epstein-Barr virus and certain strains of human herpesvirus; however, no specific connection has been identified.
- Hormone imbalances—Individuals with CFS sometimes have abnormal levels of hormones in the pituitary and adrenal glands and the hypothalamus, which produce hormones that help fight stress.
- Physical or emotional trauma—Some people with CFS reported having had a trauma of some kind shortly before their CFS symptoms began.
While some healthcare professionals might still question the existence of CFS, most doctors understand it is a real condition for individuals who experience it.
People with CFS have a wide variety of symptoms. Sadly there is no cure for CFS; there are treatment options for many symptoms.
There is also promising research that may lead to a test for CFS and even better treatment options.
“Chronic fatigue syndrome.” Mayo Clinic. September 24, 2020. https://www.mayoclinic.org/diseases-conditions/chronic-fatigue-syndrome/symptoms-causes/syc-20360490 (accessed April 29, 2021).
“Chronic Fatigue Syndrome.” MedlinePlus. January 26, 2021. https://medlineplus.gov/chronicfatiguesyndrome.html (accessed April 29, 2021).
“Chronic Fatigue Syndrome (CFS).” Health Encyclopedia, University of Rochester Medical Center. https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=85&contentid=P00618 (accessed April 29, 2021).
“Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).” Centers for Disease Control and Prevention. January 28, 2021. https://www.cdc.gov/me-cfs/index.html (accessed April 29, 2021).
American Myalgic Encephalomyelitis and Chronic Fatigue Syndrome Society, P.O. Box 26, Whately, MA, 01093-0026, (954) 434-0290, https://ammes.org/.