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Chronic Fatigue Syndrome (CFS)

Last updated March 26, 2017

Chronic Fatigue Syndrome (CFS) is a disorder having an unknown, or as yet unidentified cause that leads to substantial reduction of an individual’s physical and mental exertion levels, for great lengths of time (over six months).

What are the other Names for this Condition? (Also known as/Synonyms)

  • Akureyri Disease
  • Benign Myalgic Encephalomyelitis
  • CFIDS (Chronic Fatigue and Immune Dysfunction Syndrome)

What is Chronic Fatigue Syndrome? (Definition/Background Information)

  • Chronic Fatigue Syndrome (CFS) is a disorder having an unknown, or as yet unidentified cause that leads to substantial reduction of an individual’s physical and mental exertion levels, for great lengths of time (over six months)
  • The main characteristic feature of CFS is an unexplained and stubborn chronic fatigue, which is not diminished/removed by rest, or there is a completely reduced activity level
  • Individuals with such an extreme fatigue are not able to perform their regular (work) activities, or study, or indulge in any personal/social activity
  • Common symptoms apart from severe fatigue/tiredness include a lack of concentration, headaches, sore throat, joint pain, etc.

Who gets Chronic Fatigue Syndrome? (Age and Sex Distribution)

  • Chronic Fatigue Syndrome is commonly seen in women, who are between 30-50 years old
  • Adults are more prone to CFS than children
  • No racial or ethnic predilection is noted

What are the Risk Factors for Chronic Fatigue Syndrome? (Predisposing Factors)

The following risk factors are noted with Chronic Fatigue Syndrome:

  • Women are at an increased risk, than men (by over four times)
  • Adults in the 40-50 year age group
  • Those with a positive family history of Chronic Fatigue Syndrome maybe at a higher risk
  • Individuals with certain viral infections (Epstein-Barr virus, enterovirus, rubella virus), whose immune systems are weakened by immunodeficiency infections (HIV, AIDS), or other such debilitating conditions, may have a higher susceptibility
  • Individuals with an impoverished health status, having low blood pressures, and a high stress, are more prone to be affected

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Chronic Fatigue Syndrome? (Etiology)

  • Chronic Fatigue Syndrome is a complex disorder; the exact cause of this condition is unclear
  • It may be due to viral infections, immunodeficiency disease, or the outcome of other health-related triggers
  • Other CFS causes speculated include, nutritional deficiency, very low blood pressures, and acute stress

What are the Signs and Symptoms of Chronic Fatigue Syndrome?

Most of the signs and symptoms associated with Chronic Fatigue Syndrome are identical to those found with other infections and disorders. Hence, many a times CFS is overlooked. Apart from a severe energy-draining fatigue that does not improve with more than ample rest or sleep, some of the significant factors (that are used to diagnose the disorder), which last up to six months, are:

  • Absolutely reduced physical and mental activity levels; much less than what the individual was previously capable of
  • Extreme exhaustion
  • Lack of concentration, memory problems
  • Nagging pain of the joints, muscles
  • Headache, lack of sleep
  • Sore throat
  • Lymph nodes in the armpits and neck, feel soft and tender

Certain other secondary symptoms are noted in some individuals. These include:

  • Loss of balance, dizziness, feeling faint
  • Bowel problems
  • Mild fever
  • Allergic to medications, foods, odors, even noise
  • Increased sensitivity to light, visual/eye problems
  • Fogginess of the brain
  • Feeling chilly
  • Night sweats
  • Anxiety and depression, irritability

How is Chronic Fatigue Syndrome Diagnosed?

  • Diagnosing a disorder of unknown cause is complicated, especially when the signs and symptoms are similar to those of other illnesses
  • Diagnostic tests that are performed for Chronic Fatigue Syndrome mainly look to exclude other diseases, which cause fatigue and other related symptoms that overlap with those of CFS.CFS is hence, a diagnosis of exclusion
  • No definite test for Chronic Fatigue Syndrome exist; however, the physician studies the medical history of the patient, conducts a physical examination, identifies CFS-related symptoms, checks for long-term extreme fatigue, and signs of periodic waxing and waning of the conditions. These steps help the healthcare provider diagnose the syndrome

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Chronic Fatigue Syndrome?

Complications due to Chronic Fatigue Syndrome include:

  • Social isolation, being cut-off from work and social activities, for long periods
  • Side effects of medications used
  • Depression, anxiety, and mood swings

How is Chronic Fatigue Syndrome Treated?

  • Individualized treatment strategies are evolved by the healthcare team to manage Chronic Fatigue Syndrome due to its complex nature, and considering the fact that there is no specific cure for CFS
  • Rehabilitation of health, professional mental support, physical therapy, in addition to administering drugs that treat specific symptoms, is the regimen adopted
  • Physical and mental exertions worsen the condition; light exercising and bed rests are recommended

How can Chronic Fatigue Syndrome be Prevented?

  • Chronic Fatigue Disorder is an illness of unknown cause, with no standard treatment methods available
  • Staying healthy, being aware of the risk factors, and understanding the associated symptoms, would help in preventing the disorder, or in seeking timely treatment

What is the Prognosis of Chronic Fatigue Syndrome? (Outcomes/Resolutions)

  • The intensity of Chronic Fatigue Syndrome differs from person to person. Some can maintain a regular active life with certain limitations; in others, it considerably restricts their daily activities for great lengths of time
  • The disabling condition and weakness caused by CFS can parallel those seen with similar chronic disorders, like multiple sclerosis, heart disease, chronic obstructive pulmonary disorder, etc.
  • CFS has a cyclical nature most times, with periods of worsening symptoms, and periods of relatively good health. Such a pattern of decline and rise makes it hard on the patient to manage themselves. A complete recovery has been observed in some patients, after six months or more
  • Proper treatment of the symptoms and a good quality healthcare is beneficial for a speedy recovery

Additional and Relevant Useful Information for Chronic Fatigue Syndrome:

Chronic Fatigue Syndrome may involve making drastic changes to one’s lifestyle and daily routine, by adapting to the changed conditions and limitations.

Following are certain facts that help understand, the differences between Chronic Fatigue Syndrome and Fibromyalgia:

  • Fibromyalgia and Chronic Fatigue Syndrome can have similar symptoms
  • Both may co-exist, which makes the diagnosis of either fibromyalgia, or CFS very challenging, in such individuals
  • Generally, in fibromyalgia the primary symptom is generalized pain, whereas CFS main symptom is chronic fatigue, which does not get better even with rest
  • It is estimated that 3 in 4 individuals with fibromyalgia may have Chronic Fatigue Syndrome and vice versa
  • In fibromyalgia, a chemical in the brain, called substance P is increased in levels. But in CFS, there is no increase in the substance. Substance P is responsible for pain perception
  • A protein called RNasel is increased in cells with CFS, but such increase is not seen in fibromyalgia
  • Generally, fibromyalgia symptoms are initiated by physical stresses to the body (such as a major surgery, or an injury to the body due to an accident). On the other hand, Chronic Fatigue Syndrome often starts after an individual has suffered a flu-like illness

What are some Useful Resources for Additional Information?

Centers for Disease Control and Prevention (CDC)
1600 Clifton Rd. Atlanta, GA 30333, USA
Phone: (404) 639-3534
Toll-Free: 800-CDC-INFO (800-232-4636)
TTY: (888) 232-6348
Email: cdcinfo@cdc.gov
Website: http://www.cdc.gov

The CFIDS Association of America
PO Box 220398 Charlotte, NC 28222-0398
Phone: (704) 365-2343
Email: CFIDS@CFIDS.org
Website: http://solvecfs.org

References and Information Sources used for the Article:

http://www.cdc.gov/cfs/index.html (accessed on 9/4/12)

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002224/ (accessed on 9/4/12)

Helpful Peer-Reviewed Medical Articles:

Asberg, M., Nygren, A., & Nager, A. (2013). [Distinguishing between depression and chronic fatigue syndrome]. Lakartidningen, 110(9-10), 484-486.

Christley, Y., Duffy, T., Everall, I. P., & Martin, C. R. (2013). The neuropsychiatric and neuropsychological features of chronic fatigue syndrome: revisiting the enigma. Curr Psychiatry Rep, 15(4), 353. doi: 10.1007/s11920-013-0353-8

Henningsen, P., & Martin, A. (2013). [Chronic fatigue syndrome]. Dtsch Med Wochenschr, 138(1-2), 33-38. doi: 10.1055/s-0032-1327358

Katz, B. Z., & Jason, L. A. (2013). Chronic fatigue syndrome following infections in adolescents. Curr Opin Pediatr, 25(1), 95-102. doi: 10.1097/MOP.0b013e32835c1108

Moss-Morris, R., Deary, V., & Castell, B. (2013). Chronic fatigue syndrome. Handb Clin Neurol, 110, 303-314. doi: 10.1016/B978-0-444-52901-5.00025-3

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Sept. 21, 2013
Last updated: March 26, 2017

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