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How To Diagnose Chronic Fatigue

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What Complications Are Associated With Myalgic Encephalomyelitis/chronic Fatigue Syndrome

Chronic Fatigue Syndrome and ME Simplified – How to Diagnose and Treat CFS | A Psychiatrist Explains

For some people, the fatigue associated with ME/CFS makes activities of daily living very difficult or even impossible. Research shows that only half of all people diagnosed with ME/CFS work full-time or part-time jobs.

ME/CFS causes significant depression in many people living with the condition. If you experience depression, talk with your doctor â effective treatments are available.

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.

When Should I Call The Doctor About Chronic Fatigue Syndrome

People seek medical care when the fatigue and cognitive difficulties of chronic fatigue syndrome affect their quality of life. People who have questions about a particular treatment should contact a qualified health-care provider, local medical society, or university medical school for additional information.

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What Are Common Symptoms Of Chronic Fatigue Syndrome

CFS, also sometimes called myalgic encephalomyelitis , is a serious chronic illness that can cause extreme tiredness. Individuals suffering from CFS may feel so tired that they cant do simple everyday tasks. The fatigue associated with CFS can grow to become only worse with mental health conditions or physical struggles. At the same time, it is not known to improve with rest.

In addition to weakness fatigue, individuals who suffer from CFS often have other symptoms, such as cognitive impairments, sleep problems, headaches, and joint pain. Some people also experience problems with memory and concentration.

Symptoms Of Chronic Fatigue Syndrome

Treating the Problem of Chronic Fatigue with Good Chiropractor and ...

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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Severe Or Very Severe Cfs/me

If you have severe or very severe CFS/ME, you will need more frequent reviews and increased support and care. You should also be referred:

  • To a physiotherapist or occupational therapist working in an CFS specialist team for support on developing energy management plans.
  • To a dietician with a special interest in CFS.

The process and pace of any CBT should be adjusted to meet your needs. This might include shorter, less frequent sessions and longer-term goals.

How Is Chronic Fatigue Syndrome Diagnosed

Before diagnosing chronic fatigue syndrome, a doctor examines a person and rules out other possible causes of their symptoms.

There is no specific test that conclusively proves the existence of chronic fatigue syndrome. Instead, testing may involve physical tests of blood, urine, thyroid function, muscle enzymes, gluten tolerance, and other analyses depending on the persons symptom profile.

The doctor also asks questions and may administer questionnaires, such as the Centers for Disease Control Symptom Inventory or the DePaul Symptom Questionnaire, for a better picture of the symptoms.

Symptoms of chronic fatigue syndrome can come and go, and they vary from person to person. This variability can make it difficult for diagnostic measures to capture how a person is affected by the disease, even if the effects are real and noticeable. Some experts argue that chronic fatigue syndrome should be further divided into different subtypes based on groups of symptoms.

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What Is Myalgic Encephalomyelitis/chronic Fatigue Syndrome

Myalgic encephalomyelitis/chronic fatigue syndrome is persistent and crippling fatigue lasting 6 months or longer. People living with ME/CFS often experience other symptoms, like unrefreshing sleep and muscle aches. The condition is also sometimes called chronic fatigue syndrome.

Doctors do not know what causes ME/CFS, and there is no cure. You may be able to manage symptoms with cognitive-behavioral therapy, exercise, and medications, like antidepressants and sleep aids. The goal of treatment is to make symptoms as manageable as possible to increase your quality of life.

How Chronic Fatigue Syndrome Is Diagnosed

Diagnosing Fibromyalgia and Chronic Fatigue Syndrome

The path to a diagnosis of chronic fatigue syndrome can be frustrating. The condition is characterized by its symptoms and there is no single test that can confirm it. Complicating the issue even further is the fact that many CFS symptoms mirror those of other illnesses, including heart, lung, thyroid, and even psychiatric disorders.

As a disease, chronic fatigue syndrome is diagnosed when other possible explanations for how you are feeling have been explored and excluded.

The condition is also called myalgic encephalomyelitis or systemic exertion intolerance disease .

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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.

What Else Could It Be

Many people who have ME/CFS have other conditions, too. If you get treated for those, it might also improve your chronic fatigue.

ME/CFS can look a lot like âmonoâ , Lyme disease, lupus, multiple sclerosis, fibromyalgia, sleep disorders, or depression. It affects about 2.5 million Americans, but experts believe only about 20% are diagnosed.

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Who Is At Risk For Chronic Fatigue Syndrome

Because the cause of CFS is not known, its hard to know what might put someone at risk for getting the condition. However, certain factors are seen more often in people with CFS. These factors include:

  • Gender. CFS happens up to 4 times more often in women than in men.
  • Age. CFS commonly affects middle-aged people, but people of any age can get it.

I Don’t Have Insurance How Can The Affordable Care Act Help Me

How Chronic Fatigue Syndrome Is Treated

If you’re uninsured or have been denied coverage in the past for ME/CFS, the Health Insurance Marketplace may be able to provide you with access to affordable coverage. With health insurance plans in the Marketplace, you can no longer be refused coverage just because you have a pre-existing health condition. Medicaid and the Children’s Health Insurance Program also can’t refuse to cover you or charge you more because of a health condition. They also can’t charge women more than men. Learn more about the Affordable Care Act and the Health Insurance Marketplace at Healthcare.gov.

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Impact And Prognosis Of Me/cfs

  • Nacul L.
  • Lacerda E.M.

Pharmacoecon Open.

  • Campion P.
  • et al.

BMC Public Health.J Chronic Fatigue Syndr.

  • Cox D.L.
  • Findley L.J.

Br J Occup Ther.

  • Mild: mobile and self-caring may continue working but will have reduced other activities
  • Moderate: reduced mobility, restricted in instrumental activities of daily living, needs frequent periods of rest usually not working
  • Severe: mostly housebound limited to minimal activities of daily living severe cognitive difficulties may be wheelchair dependent
  • Very severe: mostly bedridden unable to independently carry out most activities of daily living often experience extreme sensitivity to light, sound, and other sensory input
  • Tian H.
  • et al.

Am J Epidemiol.Chronic Illn.

Qual Life Res.Disabil Rehabil.Occup Med .

Rehabil Psychol.Front Pediatr.Fatigue.

Treating Chronic Fatigue Syndrome And Fibromyalgia

Theres no standard treatment for ME/CFS or fibromyalgia. Most people end up with multiple types of treatment. It can take a lot of trial and error to come up with a good treatment regimen.

Types of treatment include:

Topical pain relievers like BioFreeze and Tiger Balm are commonly used, as well.

Therapies

Therapy for ME/CFS aims to help you adjust to a life with chronic illness and the limitations it imposes. Types include:

  • Cognitive behavioral therapy : A type of talk therapy that addresses negative thoughts and habits and how to replace them with healthier behaviors.
  • Graded exercise therapy: Controlled exercise that attempts to build exercise tolerance.
  • Emotional support and counseling: May involve a therapist to help with lifestyle changes and possibly a support group.

CAM Treatments

CAM treatments are common in ME/CFS because drug therapies are rarely effective enough on their own. They include:

Most of these have very little research to back them up.

Supplements

Supplements are also poorly researched but popular in people with ME/CFS. Many are in common use, including:

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Guidelines For Diagnosing Me/cfs

Guidelines from the National Institute for Health and Care Excellence say doctors should consider diagnosing ME/CFS if a patient has extreme tiredness that cannot be explained by other causes and the tiredness:

  • started recently, has lasted a long time, or keeps coming back
  • means you cannot do the things you used to do
  • gets worse after activity or gentle exercise, such as a short walk

You must also have some of these symptoms:

  • problems sleeping, such as insomnia
  • muscle or joint pain
  • fast or irregular heartbeats
  • doing exercise or concentrating makes your symptoms worse

The GP should consult a specialist if they’re unsure about the diagnosis or if you have severe symptoms.

If a child or young person under 18 has symptoms of possible ME/CFS, they may be referred to a paediatrician.

As the symptoms of ME/CFS are similar to those of many common illnesses that usually get better on their own, a diagnosis of ME/CFS may be considered if you do not get better as quickly as expected.

The diagnosis should be confirmed by a doctor after other conditions have been ruled out, and if your symptoms have lasted at least 3 months.

Page last reviewed: 29 October 2021 Next review due: 29 October 2024

How To Overcome Fatigue

Chronic Fatigue Syndrome | Triggers, Symptoms, Diagnosis, Treatment

A patient named Josie recently came to Parsley Health with a long-standing history of fatigue. She had symptoms since graduating from college 7 years ago and clearly qualified for the diagnosis of chronic fatigue syndrome/systemic exertion intolerance disease.

In conventional medicine, the treatments that are recommended for chronic fatigue consist of cognitive behavioral therapy, anti-depressant pharmaceutical medications, graded exercise therapy, sleep hygiene, discouraging over-sleeping, and referrals to support groups. Unfortunately, none of these treatments effectively address the root cause of what the fatigue is. Its no wonder that more than half of patients with chronic fatigue dont improve after a year of therapy.

Not only did Josie suffer from fatigue, she was also suffering from chronic digestive issues, irritable bowel syndrome, autoimmune thyroiditis and hypothyroidism , insomnia, body aches, cystic acne, weight gain, PMS, anxiety, and depression. In a standard conventional model, she probably would have been referred to a rheumatologist, sleep specialist, psychiatrist and dermatologist, in addition to her endocrinologist.

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How Is Chronic Fatigue Syndrome Diagnosed Unfortunately The Only Way To Diagnose Cfs Is To Rule Out All Other Possible Causes Of Your Fatigue

Fatigue is one of the most poorly managed and confusing conditions in all of medicine. And part of the reason why is that no one has decided what fatigue really is.

For example, your doctor may have diagnosed you with:

  • chronic fatigue syndrome ,
  • systemic exertional intolerance disorder

Even the names for your fatigue are confusing!

Diagnosis Of Chronic Fatigue Syndrome

  • Clinical criteria

  • Laboratory evaluation to exclude non-CFS disorders

The diagnosis of CFS is made by the characteristic history combined with a normal physical examination and normal laboratory test results. Any abnormal physical findings or laboratory tests must be evaluated and alternative diagnoses that cause those findings and/or the patient’s symptoms excluded before the diagnosis of CFS can be made. The case definition is often useful but should be considered an epidemiologic and research tool and in some circumstances should not be strictly applied to individual patients.

In February 2015, the Institute of Medicine published an extensive review of this disease called Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness. In this review, they proposed a new name, systemic exertion intolerance disease , and new diagnostic criteria that simplified the diagnosis and emphasized the most consistent features. In addition, the review clearly emphasized the validity of this debilitating disease.

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Me/cfs Is Not A Somatization Disorder

Somatization disorders occur when a person misidentifies psychiatric symptoms for physical ones. The high levels of mood disorders present in ME/CFS and its many symptoms have sparked efforts by psychiatrists to label the disease as a somatization disorder.

A 2019 study which assessed the effects of having a comorbid disorder such as fibromyalgia or a mood disorder on the symptoms associated with ME/CFS attempted to clear up that issue. Since mood disorders have a multiplier effect on somatization disorders the researchers determined if the presence of mood disorders (or comorbid disorders such as exacerbated the symptoms associated with ME/CFS.

Because mood disorders did not exacerbate the symptoms associated with ME/CFS but have a comorbid disease did, the researchers determined that ME/CFS is not somatization disorder and is not closely allied with mood disorder but that it is closely allied with diseases like FM and irritable bowel syndrome . The increased rate of mood disorders in ME/CFS is most likely simply the result of having a difficult, chronic illness.

Where Do Most Veterans Get Cfs

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Gulf War veterans are significantly more likely than the general population to develop chronic fatigue syndrome. While the exact cause of CFS is unknown, it is believed to be associated with Gulf War-related exposures, such as chemicals and hazardous materials. Treatment for CFS typically focuses on managing symptoms and improving quality of life.

According to a study posted in NCBI, Gulf War veterans are also more likely to suffer from post-traumatic stress disorder , which has been linked to the development of CFS. As a result, Gulf War veterans should be aware of the risks associated with CFS and seek medical help.

If you are a Gulf War veteran who is experiencing fatigue or other unexplained symptoms, it is important to talk to your doctor about the possibility of CFS.

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Etiology Of Chronic Fatigue Syndrome

Etiology of CFS is unknown. No infectious, hormonal, immunologic, or psychiatric cause has been established. Among the many proposed infectious causes, Epstein-Barr virus, Lyme disease, candidiasis, and cytomegalovirus have been proven not to cause CFS. Similarly, there are no allergic markers and no immunosuppression.

Some people who have recovered from COVID-19 infection COVID-19 COVID-19 is an acute, sometimes severe, respiratory illness caused by a novel coronavirus SARS-CoV-2. COVID-19 was first reported in late 2019 in Wuhan, China and has since spread extensively… read more have become “long-haulers” with persistent symptoms. Some of these symptoms result from organ damage from the infection and/or treatment, and others may be from posttraumatic stress disorder Posttraumatic Stress Disorder Posttraumatic stress disorder is recurring, intrusive recollections of an overwhelming traumatic event recollections last > 1 month and begin within 6 months of the event. The pathophysiology… read more . In addition, in some patients COVID-19 seems to trigger typical CFS, but further study is needed to confirm this association and determine causality.

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:

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