Do I Have Chronic Fatigue Syndrome

Diagnosis And Treatment For Me/cfs

Currently, there is no single test to diagnose ME/CFS. Doctors make a diagnosis by excluding all other illnesses that might be causing symptoms and following accepted diagnostic criteria. The persons results from routine medical tests will often be normal, but additional tests may show abnormalities.

Myalgic Encephalomyelitis/chronic Fatigue Syndrome: Essentials Of Diagnosis And Management

• Alison C. BestedAffiliations
• Lily ChuCorrespondenceCorrespondence: Address to Lily Chu, MD, MSHS, Independent Consultant, 16 Lorton Ave, Unit 4, Burlingame, CA 94010.
• Nancy G. KlimasAffiliationsInstitute for Neuro Immune Medicine, Dr Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL
• Jose G. MontoyaAffiliationsDr Jack S. Remington Laboratory for Specialty Diagnostics, Palo Alto Medical Foundation Research Institute, Palo Alto, CA
• Irma R. ReyAffiliationsInstitute for Neuro Immune Medicine, Dr Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL

What We Know Now

As I discussed in a recent article in the journal JAMA, research has documented underlying biological abnormalities involving many organ systems in people with ME/CFS, compared with healthy controls. Heres an overview of what the current science suggests.

The brain. Tests of brain hormones, formal tests of thinking, magnetic resonance imaging , and positron emission tomography scans of the brain are abnormal in a substantial fraction of patients with ME/CFS. Tests of the autonomic nervous system, which controls vital functions including body temperature, blood pressure, heart rate, breathing rate, and movement of the intestines and bladder, also are abnormal. Not all of these abnormalities of the brain are present in every person with ME/CFS, and they appear to come and go.

Energy metabolism. We are alive because the cells of our body are alive. And theyre alive because they can make energy, and use that energy to do their jobs and remain alive. Our cells make energy out of the oxygen in the air we breathe, and out of the sugars, fats, and proteins we eat. In ME/CFS, research has shown that the cells have trouble both making and using energy. That is, people with ME/CFS feel they dont have enough energy because their cells are not making enough, nor using what they make efficiently. The ability of cells to extract oxygen from the blood and use it to make energy appears particularly defective after physical and mental exertion.

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If You Think Its All About How Much You Sleep You Need To Read On

What does it mean to feel energetic?

Watching children play, adults marvel at their energy. Cant we feel energetic as well? The answer is yes, although as we age, it is normal to experience less vigor. This fatigue is not entirely due to the physical process of aging. Stress increases as we agewe may have big mortgages, car payments, increasing responsibility at work, ill parents, medical conditions, or children to raise. And we often play lessthose who are younger are often better at prioritizing socializing, trying new things and having fun, while we can become bogged down in responsibility and forget to do the things that fill us up.

Adults also tend to decrease their activities as they get olderand less activity is associated with greater fatigue. It can mean poorer physical conditioning, too, which means that less activity is needed to produce muscle strain. Fatigue is functional it can help protect us against overexertion. However, our bodies are also sensitive to too little activity. So although fatigue is often associated with not wanting to do anything, paradoxically, sometimes we need to increase activity to shake off the cobwebs.Too often we take the cues of fatigue as a sign that we must do less.

What can we do to feel less fatigued?

Symptoms Of Chronic Fatigue Syndrome

The main feature of ME/CFS is a type of exhaustion known as post-exertional malaise, crash or payback. This means having flu-like symptoms after exercise and not having enough energy for daily activities.

Research shows that people with ME/CFS have a different physiological response to activity or exercise from other people. This includes abnormal exhaustion after any form of exertion, and a worsening of other symptoms. The response may be delayed, perhaps after 24 hours. Depending on the amount and type of exercise, it may result in post-exertional malaise for a few days, or serious relapses lasting weeks, months or even years.

• problems with thinking, concentrating, memory loss, vision, clumsiness, muscle twitching or tingling
• disrupted sleep
• sore throat, tender lymph nodes and a flu-like feeling
• inability to cope with temperature changes.

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What Are The Symptoms/warning Signs Of Chronic Fatigue Syndrome

In order to be diagnosed with CFS a patient must satisfy two criteria. Severe chronic fatigue must have lasted at least six months with other known medical conditions excluded by clinical diagnoses. Also, a person must concurrently have four or more of the following symptoms: substantial impairment in short-term memory or concentration sore throat tender lymph nodes muscle pain multi-joint pain without swelling or redness headaches of a new type, pattern or severity unrefreshing sleep and post-exertional malaise lasting more than 24 hours. The symptoms must have persisted or recurred during six or more consecutive months and must not have predated the fatigue.

Getting Older And Me/cfs

There is very little information on getting older and ME/CFS, however people can develop ME/CFS at any age. Additionally, all of the strategies such as pacing to reduce PEM and managing symptoms still apply. As people age, other problems with their health may also arise, so discussing any new symptoms with their doctor important.

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Uncovering The Mystery Of Cfs

Some people may be genetically predisposed to the CFS, plus viruses and stress appear to play a role. A weakened or compromised immune system and hormonal imbalances have been found in conjunction with CFS diagnoses, so they may have a part in its development too.

Because CFS has been linked to several viral infections in the past, it is thought that it could be more of an end-stage symptom than a unique condition of its own. Individuals with severe infections seem to be at greater risk for developing CFS than others. However, there are also cases of CFS reported in which no viral infection has ever been identified, so it continues to be a mystery.

What doctors and scientists have been able to identify are risk factors. Along with viral infections, there seem to be certain factors that up your chances of getting CFS.

It most commonly develops later in life between the ages of 40 and 50.

Women are more likely to be diagnosed than men.

Allergies, stress, and environmental factors also seem to increase your risk.

What Are The Symptoms Of Chronic Fatigue

Among the symptoms are severe fatigue that comes from work, physical activity, shopping or something as simple as showering. Other symptoms include sleep problems and muscle pain and aches.

Fatigue is a vague symptom. It could be coming from a lot of different things, Dr. Zaidi said. We have to properly investigate how long its been occurring, and rule out secondary causes. Could it be sleep apnea, depression, a thyroid problem, could it be anemic? Those are to name a few.

Dr. Zaidi recommends talking to your doctor about your symptoms and have the appropriate bloodwork done to eliminate other causes.

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Autonomic Nervous System Abnormalities

Researchers are investigating links between autonomic system dysfunction and CFS. The autonomic nervous system controls involuntary actions, including regulating blood pressure.

Some people who have CFS also have symptoms of a condition known as neurally mediated hypotension . NMH causes a dramatic drop in blood pressure when a person stands up, for even as few as 10 minutes. Its immediate effects can be light-headedness, nausea, and fainting.

A related condition experienced by some people with CFS is called postural orthostatic tachycardia syndrome . POTS causes a rapid increase in blood pressure when changing from a lying down to a standing up position.

The Chronic Fatigue Syndrome Also Presents Problems In Definition And Measurement Is Associated With Even More Morbidity Than Chronic Fatigue Itself And Is Often

For years, many professionals within the medical community did not recognize cfs as a true condition, nor was there agreement on its prevalence. Describes the symptoms, diagnosis, and treatment of nephrotic syndrome in children for parents and a physical exam may help diagnose childhood nephrotic syndrome. For the clinical picture of chronic pancreatitis , the following main syndromes are characteristic: Progressive synosteosis in aperts syndrome , with a description of roentgenographic. There are different theories about what causes chronic fatigue syndrome and few certainties. in almost all cases, the etiology is unknown different kinds of leukemia are believed to have different. The first step is to see if there is any other explainable cause for your fatigue. Acute hf develops within a few hours and requires immediate hospitalization in the hospital. Causes abnormalities of chromosomes have been found in. The role of schauerte e. Diagnostic criteria for chronic fatigue syndrome6. Fatigue can be defined as a pervasive sense of tiredness b: The exact cause of chronic fatigue syndrome is unknown, but it is believed that a combination of genetic predisposition and environmental factors.

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What Can I Do To Cope With Me/cfs

Talking about your feelings with a friend or family member can help. Sometimes it also helps to talk with people who are going through the same thing. Consider joining an ME/CFS support group. See the “ME/CFS Organizations” section at the end of this fact sheet for a list of organizations that offer additional information on ME/CFS and can help you find ME/CFS support groups.

Who Gets Chronic Fatigue Syndrome

Chronic fatigue syndrome can affect people of all ethnicities and ages, but is most common in people in their forties or fifties. Its very rare in kids. A few teens do get CFS, and it affects more girls than guys.

Sometimes different people in the same family get CFS. This may be because the tendency to develop CFS is genetic.

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Articles On Chronic Fatigue Syndrome

• Tips for Living With CFS

Thereâs no simple blood test or X-ray to diagnose chronic fatigue syndrome â also known as myalgic encephalomyelitis/chronic fatigue syndrome . And many of the symptoms of the illness — deep tiredness, unrelieved by rest or sleep, feeling worse after physical or mental exertion, trouble concentrating, feeling worse after standing and remaining on oneâs feet and other symptoms– are also seen in other conditions, too, making the diagnosis of ME/CFS more difficult.

The Multiple Sclerosis / Chronic Fatigue Syndrome Study

Theyre mumbling that HIV/AIDS is quite treatable? I think they would agree that multiple sclerosis is not. Wouldnt they, like anyone, quail at the idea of having MS?

Hit them with a study showing that multiple sclerosis patients were twice as functional, experienced considerably less pain and had greatly increased vitality compared to people with ME/CFS All this in a disease known for the high rates of fatigue it produces.

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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.

Treatment Of Chronic Fatigue Syndrome

• Cognitive-behavioral therapy

• Graded exercise

• Drugs for depression, sleep, or pain if indicated

In most cases, symptoms of chronic fatigue syndrome lessen over time. However, it often takes years for symptoms to subside, and not all symptoms disappear. People may recover more fully if they focus more on what function they can recover than on how much function they have lost.

Specific symptoms such as pain, depression, and poor sleep are treated. Cognitive behavioral therapy and gradual graded exercise, which have helped some people, may be worth trying.

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What Is Chronic Fatigue Syndrome

Chronic fatigue syndrome is a complicated disease for doctors to diagnose and even fully understand.

CFS is a chronic condition that makes people feel very tired and weak. They can also have headaches, dizziness, or other physical symptoms. Sometimes they have emotional symptoms too, like anger or sadness.

Different people with CFS can have different symptoms. Many CFS symptoms are similar to those of other health conditions, like mono, Lyme disease, or depression. And the symptoms can vary over time, even in the same person.

This makes treating the illness complicated. No single medicine or treatment can address all the possible symptoms.

CFS is sometimes called myalgic encephalomyelitis . Myalgic means muscle aches. Encephalomyelitis means that there may be inflammation in the brain or spinal cord.

Deterrence And Patient Education

Living with chronic fatigue syndrome can be stressful, as the symptoms can affect the quality of life. Most people are generally healthy and active before developing CFS, making it particularly distressing. The most crucial factor for patients to successfully cope with CFS is establishing a strong relationship with an experienced health care provider. Having a provider that patients can trust, who listens to them and understands that their symptoms are real, can be validating and helpful. While it is discouraging to know that there is no quick cure for CFS, an experienced provider can work with the patient to find ways to manage their symptoms and maximize their quality of life.

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If I Dont Have Any Of These Disorders Do I Have Chronic Fatigue Syndrome

Its possible. First, though, go over the list at the top to see if youve been sleeping poorly recently, been under a lot of stress, if youve been very inactive lately, , if your diet has worsened, or if youve recently been put on a new medication

The fatigue, it should be noted, in ME/CFS is often immense, and is always accompanied by something called post-exertional malaise or PEM. PEM refers to a dramatic worsening of symptoms after exertion that sometimes takes a day or two to appear.

Only a physician can diagnose you with ME/CFS. In the meantime learn more about the symptoms found in ME/CFS, and check out the CDCs page on ME/CFS.

Children Young People And Me/cfs

ME/CFS can affect people of all ages, including the very young. Young people with ME/CFS, especially children under the age of ten, might have trouble knowing or articulating that something is wrong. They may not realise that their loss of stamina, or other symptoms they are experiencing, are not normal. Alternatively, they may not have the words to describe what they are feeling.

For both younger children and teenagers, schooling can be affected but ME/CFS is not school refusal. While school refusal can often be accompanied by physical complaints , and these complaints may tend to disappear when the young person stays home, the pattern is different with ME/CFS. In a young person with ME/CFS, some symptoms never ease and symptom exacerbation is triggered by activity. In ME/CFS, symptoms are likely to be worse after school attendance, and can reduce with pacing and rest, which includes time away from school or during holidays.

Some young people with ME/CFS can continue to attend school, and others may be too unwell for regular classroom attendance. Parents, healthcare providers, schools and the child or teenager need to work together to come up with a plan for the young persons continued education. This plan needs to take into account the energy limits of ME/CFS. Being creative and flexible is key and might include things like fewer subjects or school from home.

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Va Disability Rating Criteria For Chronic Fatigue Syndrome

According to 38 CFR, Part 4, theSchedule for Rating Disabilities, paragraph §4.88a the diagnosis of ChronicFatigue Syndrome for VA rating purposes requires the following:

#1. New onset of debilitating fatigue severe enough to reduce daily activity to less than 50 percent of the usual level for at least six months AND

#2. The exclusion, by history, physical examination, and laboratory tests, of all other clinical conditions that may produce similar symptoms AND

#3. Six or more of the following:

• Acute onset of Chronic Fatigue Syndrome ,
• Low grade fever,

Viral And Other Infections

Post-viral fatigue syndrome or post-viral syndrome describes a type of chronic fatigue syndrome that occurs following a viral infection. A recent review found EpsteinâBarr virus antibody activity to be higher in patients with CFS, and that a subset of patients with CFS were likely to have increased EBV activity compared to controls. Viral infection is a significant risk factor for CFS, with one study finding 22% of people with EBV experience fatigue six months later, and 9% having strictly defined CFS. A systematic review found that fatigue severity was the main predictor of prognosis in CFS, and did not identify psychological factors linked to prognosis.

Another review found that risk factors for developing CFS after mononucleosis, dengue fever, or Q-fever included longer bed-rest during the illness, poorer pre-illness physical fitness, attributing symptoms to physical illness, belief that a long recovery time is needed, as well as pre-infection distress and fatigue. The same review found biological factors such as CD4 and CD8 activation and liver inflammation are predictors of sub-acute fatigue but not CFS.

A study comparing diagnostic labels found that people labelled with ME had the worst prognosis, while those with PVFS had the best. Whether this is due to those with more severe or longer-lasting symptoms results in a label with the description of ME, or if being labelled with ME adversely causes a more severe or prolonged illness is unclear.

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