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Chronic Fatigue Syndrome Diagnosis.pdf

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Chronic Fatigue Syndrome Diagnosis

FIBROMYALGIA AND CHRONIC FATIGUE SYNDROME

Chronic Fatigue: Symptom vs.

Disease
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By Adrienne Dellwo
Updated July 05, 2016

The terms "chronic fatigue" and "chronic fatigue syndrome" often are used
interchangeably, but they're actually two very different things:
1. Chronic fatigue is a symptom of just about every illness and a consequence of
lifestyle choices and factors, such as not getting adequate rest or being
extremely busy. It just means that you're tired all the time.
2. Chronic fatigue syndrome is a disease with specific diagnostic criteria and a
lengthy symptoms list that includes fatigue that's not relieved by rest, exercise
intolerance (post-exertional malaise), flu-like symptoms, and cognitive
dysfunction.
When you're trying to learn about your illness and find treatments for it, it pays
to make sure you're looking at information about the disease and not the
symptom.

Understanding Fatigue
Fatigue is one of the most common complaints doctors hear. Much of the time it's
caused by stress, lack of sleep, overexertion, or minor illness, such as a cold.
Typically, fatigue goes away when you get rest or recover from being sick.
In both chronic fatigue and ME/CFS, fatigue is extreme and constant. It makes it
difficult or impossible for you to function at even the most basic level. Think of

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the way you felt the last time you were seriously ill, severely sleep deprived, or
coming out from under anesthesia that's the kind of fatigue we're talking
about.

What Is Chronic Fatigue (the Symptom)?

If you simply have chronic fatigue, it means that you have exhaustion or lack of
energy for six months or longer.
Chronic fatigue is generally a symptom of something else, such as:
Infection
Immune or autoimmune disorders (such as lupus or rheumatoid arthritis)
Muscle or nerve diseases (such as multiple sclerosis)
Endocrine diseases (such as hypothyroidism)
Depression

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Organ disease
Fibromyalgia
Sleep disorders or ongoing lack of sleep
High stress levels
Nutritional deficiency
Some causes of chronic fatigue (such as lack of sleep, nutritional deficiency, or
short-term infection) have an obvious solution and are somewhat easy to correct.
When caused by a chronic illness, chronic fatigue can be treated but not cured.
In some cases, doctors can't figure out the cause of chronic fatigue, but the

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person doesn't meet the diagnostic criteria for ME/CFS. Those cases are diagnosed
as idopathic chronic fatigue. (Idiopathic means without known cause.)

Chronic Fatigue Syndrome

To get a diagnosis of chronic fatigue syndrome, you need more than extreme,
persistent fatigue that lasts longer than six months. You've also got to have at
least four of the following, also for longer than six months but starting after the
fatigue:
Impaired memory or concentration
Post-exertional malaise
Unrefreshing sleep
Muscle pain
Joint pain without swelling or redness
Headaches of a new type or severity

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Sore throat that's frequent or recurring

Tender cervical or axillary lymph nodes
In addition to these diagnostic criteria, ME/CFS has about 50 recognized
symptoms, including dizziness and balance problems, allergies and chemical
sensitivities, anxiety, stiffness, numbness, and irregular heart beat. While not
required for a diagnosis, these other symptoms can help your doctor identify
what's going on in your body.

Why Does it Matter?

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It's in your best interest to pay attention to whether websites and other
information sources are talking about the symptom or the disease. It might seem
like they're just using a shorter form of a long name and are really talking about
the same thing.
Sometimes, that may be true. However, other times, it may be used to deceive

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you. Say a website claims that a certain product is proven to "relieve chronic
fatigue." Which one are they really talking about? If they're talking about the
symptom, that product is unlikely to be much help for ME/CFS. The language
might be used intentionally to make you think it could work for you.
People who are educated about ME/CFS know to use the proper abbreviations,
whether that's CFS, ME/CFS, CFS/ME, CFIDS, or SEID. Dropping the "syndrome"
out of the name is frowned on in the patient/advocate/research community
because it's inaccurate. When it comes to your health, you can't afford to fall for
deception or listen to inaccurate sources.
Sources:

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June 2003 National Institutes of Health. "Chronic Fatigue Research: Challenges and
Opportunities."
2007 University of Maryland Medical Center (UMMC). All rights reserved. "Chronic
Fatigue Syndrome"
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FIBROMYALGIA AND CHRONIC FATIGUE SYNDROME

Do I Have Chronic Fatigue

Syndrome?
Identifying Chronic Fatigue Syndrome
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Credit: Cavan Images/The Image Bank/Getty Images

By Adrienne Dellwo - Reviewed by a board-certified physician.

Updated May 10, 2016

Do you feel like you're tired all the time, to the point that you are starting to
worry that something is seriously wrong? Have you begun to wonder if you could
have chronic fatigue syndrome?
Chronic fatigue syndrome and diagnosing whether you are suffering from it is
difficult, and it depends on multiple factors.
First, you need to understand that there's a difference between the symptoms of
chronic fatigue (being tired all the time) and the illness known as chronic fatigue

syndrome.

The Symptoms of Chronic Fatigue

It's important to realize that most people who are tired all the time don't have
myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Fatigue is one of
the top complaints doctors hear because it can be a feature of so many conditions.
In addition, fatigue is often caused by lifestyle factors rather than illness.
Lifestyle factors that can lead to a state of chronic fatigue include:
Poor diet
Obesity
High stress

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Too little sleep

A lot of people these days live with one or more of these factors, so it's good to
evaluate them when looking for the source of your fatigue. Most of us would
probably benefit from eating healthier, getting more and better quality sleep and
reducing or better managing our stress. The following resources can help you
with those issues:
How to Lose Weight
Is Your Stress Level Unhealthy?
10 Ways to Get Better Sleep
Just about any illness, whether chronic or short-term, can cause fatigue, so it's
important for your doctor to consider your full range of symptoms and look for
likely causes other than ME/CFS.
In fact, ruling out other possible causes is part of the ME/CFS diagnostic process.

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Chronic Fatigue Syndrome (ME/CFS)

Don't let the name fool you: ME/CFS is a lot more than just being tired. The
fatigue is profound and gets worse after even mild exertion, and it's often
accompanied by flu-like symptoms, cognitive dysfunction ("brain fog") and any
combination of about 45 other possible symptoms.
Many people describe it as coming down with a nasty flu and never getting any
better.
So far, there's no medical test for diagnosing ME/CFS. For a doctor to even
consider a diagnosis, you have to have been experiencing fatigue for at least six

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months. Then, any other possible causes of the fatigue (and other symptoms you
may be experiencing) need to be ruled out.
That means a set of basic blood tests and, if indicated, further tests to check for
chronic infections, such as mononucleosis and tuberculosis; autoimmune
diseases, such as lupus or multiple sclerosis; emotional or psychiatric conditions;
and the nervous-system disorder fibromyalgia, which is similar to ME/CFS.
Without going through this process, it's impossible to say whether somebody has
ME/CFS. However, looking over the Centers for Disease Control and Prevention
(CDC) guidelines can help you determine whether it seems to fit your specific
case.

Identifying ME/CFS
Do you have:

Unexplained persistent fatigue that's not caused by ongoing exertion, is not

substantially better after rest or sleep, and has resulted in a significant
reduction in your activity level?

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No? Then you don't have ME/CFS.

Yes? Then do you also have:

Four or more of the following symptoms for the past six months or more?
1. Impaired memory or concentration
2. Extreme, prolonged exhaustion and feelings of illness after physical or mental
activity (post-exertional malaise)
3. Unrefreshing sleep
4. Muscle aches and pains
5. Joint pain with no swelling or redness
6. A new type of headache or a change in your headache pattern
7. Frequent sore throat
8. Tender lymph nodes in your neck and near your breast
Still saying yes? Then ME/CFS may be something to bring up with your doctor.
Keep in mind that these criteria are just a starting point. Your doctor will still
need to do a lot of testing before determining whether you have ME/CFS.
Sources

Chronic Fatigue Syndrome: Diagnostic Tests to Exclude Other Causes. Centers for
Disease Control and Prevention.
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Diagnosing Chronic
Fatigue Syndrome

New Name, Criteria for

Chronic Fatigue
Syndrome

Understanding ME/CFS

Chronic Fatigue Versus

Chronic Fatigue
Syndrome

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FIBROMYALGIA AND CHRONIC FATIGUE SYNDROME

Chronic Fatigue Syndrome Diagnosis

Expect Lots of Testing
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Hero Images/Getty Images

By Adrienne Dellwo
Updated May 19, 2016

Getting a Chronic Fatigue Syndrome Diagnosis

So far, no medical test is proven to provide an accurate chronic fatigue syndrome
diagnosis, but some doctors and researchers claim they do have tests that can
identify certain subgroups of chronic fatigue syndrome patients. However, these
tests have yet to garner the support of the overall medical community.
Chronic fatigue syndrome is a diagnosis of exclusion.
That means the first step is for doctors to rule out conditions with similar
symptoms, including chronic infections such as tuberculosis, mononucleosis or
Lyme disease; nervous system disorders such as fibromyalgia; autoimmune
diseases such as multiple sclerosis and lupus; or psychiatric/emotional conditions.
(A diagnosis of depression does not exclude the possibility of chronic fatigue
syndrome.)

A 2015 report from the Institute of Medicine put forth new diagnostic criteria
(along with a new name, SEID) based on their review of more than 9,000
scientific studies. These criteria are similar to the Canadian Consensus Criteria,
which advocacy groups have long called for in the U.S.
The new criteria include:
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Six months of profound, unexplained fatigue;

AND post-exertional malaise (extreme symptoms following exertion);
AND unrefreshing sleep;
PLUS cognitive problems OR orthostatic intolerance (dizziness upon standing.)

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The previous criteria included fatigue plus four or more symptoms from a list that
included all of the above except orthostatic intolerance as well as several other
symptoms, including sore throat, joint pain, headaches, and tender lymph nodes.
However, it was possible under the old criteria to diagnose chronic fatigue
syndrome without any of the symptoms (save fatigue) required by the new
criteria.
Learn more about the report: New Name, Criteria for Chronic Fatigue Syndrome

Tracking Your Symptoms

While they're not required for a diagnosis of chronic fatigue syndrome, a

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complete list of your symptoms can help your doctor diagnose you. It's helpful if
you first become familiar with the full range of chronic fatigue syndrome
symptoms and then start keeping a symptom journal.

To date, no medical specialty has "claimed" this condition. It's up to you to find a
doctor who's knowledgeable about it.
Source:
Centers for Disease Control and Prevention, May 3 2006. "Diagnosing CFS"
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in Chonic Fatigue
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New Name, Criteria for

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FIBROMYALGIA AND CHRONIC FATIGUE SYNDROME

Quick Facts About Chronic Fatigue

Syndrome
Just the Basics!
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By Adrienne Dellwo
Updated April 08, 2016

Chronic Fatigue Syndrome Basics

Chronic fatigue syndrome's defining
characteristic is a persistent deep fatigue,
similar to what other people feel when they're
seriously ill or sleep deprived. In people with
chronic fatigue syndrome, however, sleep
Darren Hopes/Getty Images

doesn't relieve fatigue as it does in healthy

people.

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People with chronic fatigue syndrome also have other symptoms, including severe
pain, cognitive problems such as memory loss and confusion, and post-exertional
malaise.
Post-exertional malaise causes intense fatigue, pain and muscle weakness for up
to 48 hours following exercise or other forms of exertion.
Things like injury, illness and stress (emotional or physical) can make symptoms
worse. Some people have specific triggers (things that increase symptoms), such
as foods or chemicals.
People with chronic fatigue syndrome also frequently have coexisting conditions,
including fibromyalgia, irritable bowel syndrome, myofascial pain syndrome and
multiple chemical sensitivity.
People from every culture and socioeconomic level get chronic fatigue syndrome.
It's most common in women, but men and children can come down with it as
well.
Chronic fatigue syndrome, by different names, dates back to the 1700s.
Throughout the centuries, it's been falsely attributed to various causes and is only
now beginning to be understood by medical science.
More than 1 million people in the U.S. are known to have chronic fatigue
syndrome, but some experts and advocates estimate that many people are
undiagnosed and that the number is actually much higher.
Many people with chronic fatigue syndrome are too disabled to work.
The Social Security Administration does recognize chronic fatigue syndrome as a
potentially disabling condition. However, having a disability claim approved is a
long and difficult process that can be complicated by the ambiguous nature of
chronic fatigue syndrome symptoms and the lack of a diagnostic test.
Chronic fatigue syndrome goes by several names, including chronic fatigue and
immune dysfunction syndrome (CFIDS), myalgic encephalomyelitis (ME),
ME/CFS, and systemic exertion intolerance disease (SEID).

Diagnosing Chronic Fatigue Syndrome

So far, no test can accurately diagnose chronic fatigue syndrome. Doctors do need
to rule out numerous conditions with similar symptoms before diagnosing it.
Diagnostic criteria include unexplained, persistent fatigue that's lasted for at least
6 months, and at least four of several other symptoms, including impaired
memory or concentration, post-exertional malaise, unrefreshing sleep, muscle
pain and others.
Learn more: Diagnosing Chronic Fatigue Syndrome

Treating Chronic Fatigue Syndrome

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The FDA has yet to approve any drugs for chronic fatigue syndrome.
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No medical specialty has "claimed" this disease, which can make it difficult to
find a doctor knowledgeable about diagnosing and treating it.
People with chronic fatigue syndrome sometimes see massage therapists,
chiropractors, physical therapists and other complementary and alternativemedicine practitioners.
They may also see a psychiatrist or psychologist to deal with the difficulties of a
debilitating condition and possibly for depression.
Depression is common in people with chronic fatigue syndrome, as it is in
debilitating pain conditions overall. Chronic fatigue syndrome, however, is not a
psychiatric condition.
Learn more: Treating Chronic Fatigue Syndrome

What Causes Chronic Fatigue Syndrome?

Researchers don't yet know the exact cause of chronic fatigue syndrome, but
many experts now believe it's triggered by genetic mutations combined with

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exposure to certain viruses or toxins.

Even though it has "syndrome" in its most commonly used name, a 2015 report
by the U.S. Institute of Medicine elevated it to an official disease when it
suggested the name SEID.
Some researchers believe that there have been outbreaks of chronic fatigue
syndrome, but other say we have insufficient evidence to prove any such
outbreaks.
Sources:
Centers for Disease Control and Prevention, May 3 2006 "Diagnosing CFS" and
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"Possible Causes"
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Chronic Fatigue
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Fibromyalgia What's
the Dierence?

Why Does Chronic

Fatigue Syndrome Have
So Many Names?

SEID - Systemic
Exertion Intolerance
Disease

Chronic Fatigue
Syndrome, ME, SEID &
Other Names: Why I
Use What I Use

CONTINUE READING

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Chronic Fatigue Syndrome, ME,

SEID & Other Names: Why I Use
What I Use

Why Does Chronic Fatigue

Syndrome Have So Many Names?

How to Tell if You're 'Just Tired' or

You Have ME/CFS

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Understanding ME/CFS

New Name, Criteria for Chronic

Fatigue Syndrome

The Many Symptoms of ME/CFS

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Diagnosing Fibromyalgia &

Chronic Fatigue Syndrome: Why
It's So Hard

Can Yoga Help with Chronic

Fatigue Syndrome?

How Exercise Testing Could Help

Treat Chronic Fatigue Syndrome

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Sleep Basics for Fibromyalgia &

Chronic Fatigue Syndrome

How Can I Explain Chronic Fatigue

Syndrome?

Exercise Without the Crash

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