What Procedures And Tests To Diagnose Chronic Fatigue Syndrome
There is no single test to diagnose chronic fatigue syndrome. The disease is a diagnosis of exclusion, which means that all other conditions and illnesses that cause the symptoms are ruled out. CFS may be diagnosed based on the following:
- Certain signs and symptoms must be present.
- Some nonspecific laboratory tests, such as blood tests and tests of the immune system, suggest the diagnosis.
Laboratory tests are used to rule out other fatigue-causing diseases. Also, some laboratory abnormalities are seen in CFS and support the diagnosis.
Your doctor may perform the following tests:
- Tests to exclude other causes of fatigue: Thyroid, adrenal, and liver function tests are useful to rule out disorders that may cause fatigue. In people with CFS, the results of these tests should be normal.
- Blood tests: The most consistent laboratory finding in people with chronic fatigue syndrome is an erythrocyte sedimentation rate at the very low end of normal, indicating a absence of inflammation. If the ESR is elevated or even in the high-normal range, another diagnosis is likely. If any other abnormalities are found on blood tests, your doctor may rule out CFS and begin testing for another condition.
- Antibody tests: Your doctor may order antibody tests to determine whether you have had a prior infection, such as Lyme disease, Chlamydia pneumoniae pneumonia, or Epstein-Barr virus.
Your doctor may perform the following imaging studies:
Signals From Central Nervous System
The central nervous system consists of the brain, spinal cord, and nerves. Its responsible for sending information to different parts of your body. If you have fibromyalgia, your brain may send itch signals to the nerves in your skin. This can cause your skin to become oversensitive, triggering a sensation of itchiness. While this is not proven to occur with fibromyalgia, repeatedly scratching your skin can cause a rash.
Treat The Worst First
Start by listing your worst symptomsthe ones that make it hardest to get through the day. With your doctor, focus first on treating those symptoms. Decide whether a specialist might be helpful for any of them.
The most common ME/CFS symptoms can also be the most treatable.
Symptoms worse after activity
Learning how to manage your activity can help you be as active as possible without causing your symptoms to get worse. This includes:
- Estimating how much energy you have on a given day. This is sometimes called your “energy envelope.” You spend only that much energy, and not more.
- Estimating how much energy an activity takes and how long you can do that activity. You stop when you reach that time, and then take a break.
- Not pushing yourself to get more done on days you feel well.
- Adapting activities to make them easier. One example is sitting down while doing the dishes.
Good sleep habits can help improve the quality of your sleep. If you also try medicine for sleep, it’s best to start on a low dose. Certain antidepressants help with sleep, mood, and chronic pain, so your doctor may suggest trying one.
Feeling dizzy or weak while sitting or standing
Your doctor may have you wear pressure stockings, put your legs up while sitting, or increase your salt intake. Your doctor may also suggest medicines like fludrocortisone or midodrine.
Depression, anxiety, and distress
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How To Manage It
Understanding the cause of a fibromyalgia rash can help you manage and treat this condition. If you believe your rash is caused by medication, let your doctor know. Theyll likely discuss a number of possibilities with you, including changing your medication or lowering the dose.
Here are tips to manage the rash at home:
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Muscle And Joint Pain
Most people with chronic fatigue syndrome experience acute or chronic pain, stiffness and soreness in their muscles and joints. Chronic pain is one of the 10 symptoms of chronic fatigue syndrome . The extent and severity of the pain depends on the pain tolerance of the sufferer. The pain is generally intermittent in nature, starts randomly and subsides on its own in time. It generally lasts for some weeks, but can even persist for months in certain cases.
Find The Perfect Moisturizer
Since so many common skin problems involve dry skin, moisturizer is very important in any CFS skincare routine.
Finding a moisturizer might be a process of trial and error. Everyones skin is different so depending on your skin, you may need a lighter or heavier moisturizer.
It can be frustrating dealing with the symptoms of chronic fatigue syndrome on top of skin irritation. Understanding that common skin problems start within the body can help you find the issue and the solution. Making changes to your diet, getting more sleep, and establishing a solid skincare routine can help clear up your skin!
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Things No One Tells You About Chronic Fatigue Syndrome
Imagine feeling too exhausted to get out of bed, let alone go to work or spend time with your family. Now combine that kind of physical exhaustion with severe stomach pain, aching joints, and brain fog that makes it impossible to read a book or sustain a thought. Finally, imagine telling a doctor how you feel, and having him roll his eyes.
This is reality for many of those who suffer from the disease most know as “chronic fatigue syndrome.” There’s often little help or support available to them from the medical community or from friends and family.
“When you tell people how you feel, they say, ‘Well, I’m tired, too,'” says Carol Head, a recovered CFS sufferer and president of the Solve ME/CFS Initiativea charitable organization that funds medical research in pursuit of a cure for chronic fatigue.
Part of the problem, Head says, is that non-sufferers hear “fatigue” and think they understand what a CFS sufferer is going through. But they really don’t. “People who have endured both chemotherapy and ME/CFS say ME/CFS is even more debilitating, so ‘fatigue’ is not a good word for it,” she says.
The “ME” in ME/CFS stands for myalgic encephalomyelitisan alternate name Head and other sufferers prefer to chronic fatigue syndrome. “CFS is such a lightweight name,” she says. “The term ‘myalgic encephalomyelitis’ has actually been around longer, and it has the advantage of sounding like the serious, real disease that this is.”
It’s often debilitating.
It goes beyond chronic fatigue.
British Columbia Specific Information
Many Canadians are affected by complex chronic diseases . CCDs are illnesses that last a long time, require treatment and management, and often do not get better on their own. Fibromyalgia , Myalgic Encephalomyelitis , which is also called Chronic Fatigue Syndrome , and Chronic Lyme Disease are examples of complex chronic diseases.
To learn more about fibromyalgia, myalgic encephalomyelitis or chronic Lyme-like disease, visit HealthLinkBCs Complex Chronic Diseases health feature.
What Home Remedies Treat Chronic Fatigue Syndrome
Physical activity performed at a comfortable pace is important for everyone to maintain good health, including people with chronic fatigue syndrome. People with CFS need to learn how much activity is helpful and when to stop, so they do not increase their level of fatigue.
In general, people with CFS should pace themselves carefully and avoid excessive physical or emotional stress. Remember, the goal is to avoid increasing fatigue or pain. Maintain a regular and manageable daily routine to avoid a relapse or increase of symptoms. Exercise should be supervised by a knowledgeable health-care provider or physical therapist.Total rest should also be avoided as it may make your fatigue worse. You should maintain physical activity at a comfortable pace. If you increase your level of physical activity, do so gradually.Decreased consumption of alcohol and caffeine at night may help you sleep.Try to minimize social isolation.
Always ask your doctor about any new treatment, including herbal supplements.
Causes Of Chronic Fatigue Syndrome
Despite considerable research, the cause of chronic fatigue syndrome remains unknown. Controversy exists as to whether there is a single cause or many causes and whether the cause is physical or mental, but either way the symptoms are very real to the person.
Some researchers believe the syndrome ultimately will prove to have several causes, including genetic predisposition and exposure to microbes, toxins, and other physical and emotional factors.
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What To Think About
Along with the treatment you get from your doctor, you might find that other treatments help too. Some people may try different diets or natural health products to help manage their symptoms. If you try a new diet or natural health product pay attention to how your body and symptoms respond to it. It may help to work closely with your doctor to figure out what works best for you.
Your mind and body are connected and affect each other. Physical illnesses can be made worseor betterby your feelings and attitudes, and vice versa. Learn as much as you can about ME/CFS. Then work with your doctor to learn ways to cope with your symptoms. Get emotional support from your health professionals as well as from your family and friends.
Suggestive Physical Signs And Symptoms
The following signs are suggestive of ME/CFS but are not specific for it. Physical signs are more prominent at the beginning of the illness before patients have had a chance to learn how to accommodate their life to the illness and stay within their energy envelope. Patients look tired. They have drooped postures and slouch with rounded shoulders when sitting in a chair. Some patients need to lie down on the examination table while they wait to be seen. Others come in wheelchairs. The totally bedridden patients cannot come for office visits and need to be seen at their home. Some patients have periorbital shiners indicating allergies and puffy eyes indicating fatigue or edema. They may have a sore throat and examination of their throat shows crimson or red crescents. These are seen during a crash and viral vesicles can also sometimes be seen indicating viral reactivation. This may be accompanied by tender lymphadenopathy in the cervical, axillary and inguinal areas. Examination of the pupils may show oscillation of the pupils or diminished pupillary accommodation. The imbalance of the central sympathetic and parasympathetic nervous system in may be the underlying mechanism .
Some patients also have Fibromyalgia in addition to ME/CFS and have positive tender points on examination.
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Demographics And Comorbidities According To Psoriasis Status
Our study included 2616 patients with psoriasis and 10,464 participants without psoriasis. The comparison between demographics and comorbidities of the psoriasis and non-psoriasis groups are presented in Table . The mean age of patients with psoriasis was 45.2 years, with a mild predominance in men . In addition, patients with psoriasis suffered from more comorbidities such as diabetes, depression, anxiety, sleep disorder, and renal disease than did the participants without psoriasis.
Table 1 Demographic factors and comorbidities of study participants according to psoriasis status
What Are The Signs And Symptoms Of Cfs
Symptoms of CFS may change from day to day and can range from mild to severe. CFS can start suddenly, or the symptoms may come on slowly. The symptoms may come and go, or last for months to years. You may have any of the following:
- Problems remembering or concentrating
- Fatigue that does not go away after you rest
- Fatigue that lasts longer than 24 hours after exercise or strenuous activity
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What Is Chronic Fatigue Syndrome
Chronic fatigue syndrome , also referred to as myalgic encephalomyelitis , is a condition that causes marked long-term tiredness and other symptoms which are not caused by any other known medical condition.
- CFS stands for chronic fatigue syndrome. Chronic means persistent or long-term.
- MEstands formyalgic encephalomyelitis. Myalgic means muscle aches or pains. Encephalomyelitis means inflammation of the brain and spinal cord.
Chronic fatigue syndrome is a fluctuating condition in which your symptoms can change unpredictably in nature and severity over a day, week or longer. The impacts are variable in severity, but can involve flare-ups and relapses even if symptoms are well managed.
There is no test to diagnose the condition. The diagnosis is made in people who have a certain set of symptoms .
Severity Of Chronic Fatigue Syndrome Symptoms
Symptoms vary widely in severity and people may have some symptoms more severely than others. However, the following definitions are provided by NICE to provide a guide to the level of impact of symptoms on everyday functioning:
Features of mild chronic fatigue syndromeThese include:
- You are able to care for yourself and do some light domestic tasks but may have difficulties with mobility.
- You are usually still able to work or attend education, but to do this you have probably stopped all leisure and social pursuits.
- You often have reduced hours, take days off and use the weekend to cope with the rest of the week.
Features of moderate chronic fatigue syndromeThese include:
- You have reduced mobility and are restricted in all activities of daily living.
- However you may have peaks and troughs in your level of symptoms and ability to do activities.
- You have usually stopped work or education, and need rest periods, often resting in the afternoon for one or two hours.
- Your sleep at night is generally of poor quality and disturbed.
Features of severe chronic fatigue syndromeThese include:
- You are unable to do any activity for yourself, or you can carry out minimal daily tasks only .
- You have severe cognitive difficulties and may depend on a wheelchair for mobility.
- You are often unable to leave the house or you have a severe and prolonged after-effect if you do so.
- You may also spend most of your time in bed and are often extremely sensitive to light and sound.
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Etiology And Pathophysiology Of Me/cfs
A specific cause of ME/CFS has not been found and there is no clinically available diagnostic test. Prior to having ME/CFS, most patients were healthy, fully functional and had active social lives. 50%80% of patients with ME/CFS started suddenly with a flu-like illness, from which the patient never recovered. ME/CFS is commonly found after an infection by a virus, bacteria or parasite.
The pathophysiological consequences of ME/CFS are multi-systemic. Below is a brief overview of the information available to date. See the 2015 IOM report for a more extensive summary .
When To See A Healthcare Provider
You should see your healthcare provider if any of your symptoms are incapacitating or severe. The symptoms of ME/CFS are shared with many other conditions, some of which may require monitoring or immediate treatment.
If your symptoms are generally mild and fluctuating, you may question your need for an evaluation. Even if your symptoms are severe, you may have friends or family members who think you are exaggerating and don’t understand what you are experiencing. But chronic fatigue syndrome is more than just being tiredit’s feeling sick.
Chronic Fatigue Syndrome Doctor Discussion Guide
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
When your symptoms last for more than two weeks, continue to get worse, or if you have a pattern of recurrences , it’s time to make an appointment.
While the diagnosis of ME/CFS won’t be made until you have the symptoms for more than six months, you shouldn’t delay seeking care and assessment. ME/CFS is diagnosed by symptoms and excluding other conditions. You may discover your symptoms are due to a condition that has an effective treatment available.
Keep a record of your symptoms, noting dates they began or worsened and what may have triggered them. Some of them may resolve if they are due to an overlapping condition that is being treated, but some symptoms may remain and need to be addressed.
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An Alternative To Traditional Medication
Chronic fatigue syndrome is a long-term illness characterised by extreme tiredness. CFS is also known as ME, which stands for myalgic encephalomyelitis. CFS/ME can affect anyone of any age but itâs more common in women, and tends to develop between 20 and 40 years of age.
In addition to fatigue, people with CFS/ME may have other symptoms, including:
- Sleep problems
The severity of symptoms can vary from day to day, or even within a day.
The symptoms of CFS/ME are similar to the symptoms of some other illnesses, so diagnosis is often a process of ruling out all the other possible causes of fatigue.
CFS/ME is a multifactorial disease with lots of different underlying causes. Conventional treatment usually focuses on managing the symptoms, but success is limited and many people suffer with the condition long term.
- Cognitive behavioural therapy â this is a talking therapy that can help CFS/ME sufferers to learn to modify their thoughts and behaviours to facilitate recovery
- A structured exercise programme called graded exercise therapy â appropriate exercise can actually speed recovery from CFS/ME
- Medications to control pain, nausea, sleeping problems and depression
How can Functional Medicine help with Chronic Fatigue Syndrome?
Functional medicine looks at CFS/ME differently to conventional medicine. The aim is to uncover imbalances or environmental factors that may be contributing to the chronic fatigue.