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.
How Will Me/cfs Affect My Quality Of Life
Not everyone will experience the same symptoms so itâs important not to compare people with ME/CFS. People with ME/CFS can have very different experiences of the condition and how long their symptoms last.
The impact of symptoms can be:
As symptoms change over time so does the impact they have on peopleâs lives.
How Is Chronic Fatigue Syndrome Treated
Treatment is determined by your healthcare provider and based on:
- Your overall health and medical history
- Extent of the condition
- Your tolerance for specific medicines, procedures, or therapies
- Expectations for the course of the condition
- Your opinion or preference
- Medicine, including corticosteroids, antidepressants, and others
- Light-intensity aerobic exercise
- Dietary supplements and herbal preparations
- Psychotherapy and supportive counseling
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What Are The Signs & Symptoms Of Chronic Fatigue Syndrome
There’s a long list of possible symptoms that someone with chronic fatigue syndrome can have. The most common ones include:
- severe fatigue, which can make it hard to get out of bed and do normal daily activities
- sleep problems, such as trouble falling or staying asleep, or not having a refreshing sleep
- symptoms getting worse after physical or mental effort
- symptoms or dizziness that get worse after standing up or sitting upright from a lying down position
- problems with concentration and memory
- headaches and stomachaches
Food Allergies Food Intolerance And Fatigue
Symptoms: Fatigue, sleepiness, continued exhaustion
Although food is supposed to give you energy, medical research suggests that hidden food intolerances — or allergies — can do the opposite. In fact, fatigue may be an early warning sign of food intolerance or food allergy. Celiac disease, which happens when you cant digest gluten, may also cause fatigue.
Ask your doctor about the elimination diet. This is a diet in which you cut out certain foods linked to a variety of symptoms, including sleepiness within 10 to 30 minutes of eating them, for a certain period of time to see if that makes a difference. You can also talk to your doctor about a food allergy test — or invest in a home test such as ALCAT — which may help you identify the offending foods.
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Years Of Research On Fatigue
Today, Omdal works at Stavanger University Hospital and the University of Bergen. But his story begins much earlier.
As a PhD candidate in Tromsø in the 1990s, Omdal studied how the autoimmune disease lupus affected the brain.
The young doctor believed patients struggled most with memory and thinking problems. Soon, however, he found that exhaustion was a much bigger challenge.
Knowledge about the phenomenon was scant. Fatigue was often considered a mental problem.
Omdal nevertheless thought it strange that such pervasive exhaustion would not have biological explanations. This was the start of a 20-year long search for the biomedical mechanisms behind chronic fatigue.
He and his colleagues have found traces both in genes and in chemical processes that are linked to fatigue.
Omdal believes that a picture is beginning to emerge that chronic fatigue is linked to an ancient protection mechanism.
Not An Easy Question To Answer
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?
Verywell / Emily Roberts
It’s difficult to say whether you could have chronic fatigue syndrome. Even for a healthcare provider experienced with it, this is a tough diagnosis to make, and it takes multiple steps.
To answer the question of whether you might have this disease, first, you need to understand that there’s a difference between the symptoms of chronic fatigue and the illness known as chronic fatigue syndrome, which is also called myalgic encephalomyelitis or ME/CFS.
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How Is Cfs Diagnosed
CFS is a very challenging condition to diagnose.
According to the Institute of Medicine, as of 2015, CFS occurs in about 836,000 to 2.5 million Americans. Its estimated, however, that 84 to 91 percent have yet to receive a diagnosis.
There are no medical tests to screen for CFS. Its symptoms are similar to many other conditions. Many people with CFS dont look sick, so doctors may not recognize that they indeed have a health condition.
In order to receive a CFS diagnosis, your doctor will rule out other potential causes and review your medical history with you.
Theyll confirm that you at least have the core symptoms previously mentioned. Theyll also ask about the duration and severity of your unexplained fatigue.
Ruling out other potential causes of your fatigue is a key part of the diagnosis process. Some conditions with symptoms that resemble those of CFS include:
- severe obesity
- sleep disorders
Because of the similarities between symptoms of CFS and many other conditions, its important to not self-diagnose. Talk to your doctor about your symptoms. They can work with you to get relief.
Much Remains To Be Done
Omdal and his colleagues have come a long way towards a new understanding of what lies behind the crippling exhaustion that afflicts so many patients. Nevertheless, a lot of research remains.
It will be especially important to investigate what happens in the bodies of people with long-term fatigue after having Covid-19, Omdal notes.
The researchers face numerous challenges.
At present, says Omdal, we dont have any objective methods for measuring fatigue. Doctors and researchers instead use a number of different questionnaires, and opinions vary on how they should be used and interpreted.
Not all professionals are even aware of how big a problem fatigue is. This can have major consequences for patients.
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How To Prove To Your Doctor You’ve Got Chronic Fatigue Syndrome Me/cfs And Are Not Just Depressed
Wrong diagnoses hurt. They lead doctors to prescribe treatments that dont work and may even be harmful and they keep doctors from prescribing treatments that do work. They waste patients money and, given the fact that the earlier a person is diagnosed with ME/CFS the better chance they have of improving their health, they contribute to poor health.
Many people with ME/CFS and FM are mistakenly diagnosed with depression first
The fact that only from 15-20% of people in the U.S. with Chronic Fatigue Syndrome have been diagnosed with it suggests wrong diagnoses run rampant in this disorder. Of all the wrong diagnoses, being diagnosed with depression is surely the most common.
Who has not been diagnosed with depression at some point? I was diagnosed with depression by my primary care provider only to have the psychologist I was sent to tell me, I know what depression is and youre not depressed.
I was lucky.
Fortunately, Dr. Lenny Jason has come up with a way to convince your doctor that youre not simply depressed. But first, a little history.
Chroniuc Fatigue Cause No : Undiagnosed Heart Disease
If you find yourself becoming exhausted after activity that used to be easy, it may be time to talk to your doctor about the possibility of heart disease.
According to Nieca Goldberg, MD, director of the NYU Medical Center Women’s Heart Program and associate professor at the NYU School of Medicine, when overwhelming fatigue sets in after ordinary tasks — such as vacuuming the house, doing yard work, or commuting from work each day — your heart may be sending out an SOS that it needs medical attention.
“This doesn’t mean that you should panic every time you yawn,” says Goldberg. “Most of the time, fatigue is not the first sign of heart disease, and it’s usually linked to something far less serious.”
At the same time, Goldberg points out that heart disease is the leading cause of death in women. “If fatigue following activity is significant, and no other possible reason comes to mind, see your doctor for a checkup,” she advises. If your fatigue is related to your heart, medication or treatment procedures can usually help correct the problem, reduce the fatigue, and restore your energy.
Harris H. McIlwain, MD, rheumatologist, adjunct professor, Universityof South Florida, Tampa author, TheFibromyalgia Handbook, 3rdEdition.
Ronald R. Fieve, MD, psychopharmacologist, professor of clinical psychiatry,Columbia Presbyterian Medical Center, New York City author, Bipolar II.
W. Stephen Pray, PhD, RPh, Southwestern Oklahoma State University,Weatherford, Okla.
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How Does It Happen
Doctors donât know the cause of chronic fatigue syndrome, but
they have identified different underlying abnormalities in people with the condition.
Immune system problems: Several different parts of the immune system are different in people with chronic fatigue syndrome, and some research indicates that these abnormalities may cause the symptoms of the illness. However, fortunately, people with chronic fatigue syndrome do not have a defective immune system, in the way that people with HIV/AIDS do.
Energy production: In people with chronic fatigue syndrome, the cells in the body have trouble making enough energy.
Brain abnormalities: Abnormalities are seen in pictures of the brain , in levels of brain hormones, and in the electrical system of the brain . These abnormalities can come and go, and are not necessarily permanent.
Blood pressure and pulse issues: On standing, people can have a drop in blood pressure and an increase in how fast the heart beats. Sometimes people feel like fainting or actually faint, if the blood pressure drops too low.
Genes: Some studies have found abnormalities in the structure of certain genes. Other studies have found abnormalities in how some genes are turned on and off, inside cells. Studies of identical and non-identical twins indicate that some people inherit a genetic susceptibility to getting the illness.
Inflammation Disappeared But Not The Exhaustion
The researchers first examined a group of patients with active disease symptoms. Then they ran new tests after three months of treatment for ulcerative colitis. By then, some of the patients guts had recovered.
However, the patients had not become any less exhausted. Nor was there any difference in fatigue between patients whose intestines had benefited from treatment and those who still had active inflammation.
Why didnt the fatigue diminish when the inflammation subsided?
Are the patients immune systems still active? Or are other mechanisms contributing to the fatigue? For example, researchers find good reason to believe that leakage of bacteria-produced substances from the intestine could play a role.
Omdal points out that it is also well known that a number of other conditions or factors, like depression or psychosocial conditions, can affect the experience of fatigue.
He says that there is a clear connection between exhaustion and depression. This fits well with the hypothesis that fatigue is due to the brain activating illness behaviour, which is also linked to depression.
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Fatigue: Don’t Assume It’s Depression
Fatigue is a part of a wide spectrum of diagnoses ranging from being a symptom in depression, anxiety, seasonal affective disorder, and multiple other diagnoses to being a full syndromal disorder in CFS, yet CFS goes undiagnosed in 80% of cases and is often misdiagnosed as depression. The Diagnostic and Statistical Manual of Mental Disorders doesn’t list CFS as a diagnosis although the International Classification of Diseases, 10th Revision, does. In clinical practice, CFS presentations range from complicated cases associated with a psychotic state resulting in multiple murders in one case report to noncomplicated presentations with multiple psychiatric disorders, primarily depression. It is very important to understand the distinctive features between chronic fatigue and depressive disorder when evaluating a patient with a main complaint of fatigue. A full detailed history accompanied by questionnaire forms can be very helpful to differentiate CFS from major depressive disorder. There is still no specific test that can confidently differentiate between them. Multiple studies have tried to find distinctive factors and they are listed in .
Viral Or Bacterial Infection And Fatigue
Symptoms: Fatigue, fever, head or body aches.
Fatigue can be a symptom of infections ranging from the flu to HIV. If you have an infection, you’ll probably have other symptoms like fever, head or body aches, shortness of breath, or appetite loss.
Infections that may cause fatigue include:
Fibromyalgia is one of the more common causes of chronic fatigue and musculoskeletal pain, especially in women. Fibromyalgia and chronic fatigue syndrome are considered separate but related disorders. They share a common symptom: severe fatigue that greatly interferes with people’s lives.
With fibromyalgia, you may feel that no matter how long you sleep, it’s never restful. And you may feel as if you are always fatigued during daytime hours. Your sleep may be interrupted by frequent waking. Yet, you may not remember any sleep disruptions the next day. Some people with fibromyalgia live in a constant fibro fog — a hazy feeling that makes it hard to concentrate.
Constant daytime fatigue with fibromyalgia often results in people not getting enough exercise. That causes a decline in physical fitness. It can also lead to mood-related problems. The best way to offset these effects is to try to exercise more. Exercise has tremendous benefits for sleep, mood, and fatigue.
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Celiac Disease And Intestinal Problems
Another doctor who is very familiar with the phenomenon is Professor Knut Lundin at the University of Oslo. He has been treating and researching patients with celiac disease for several years.
We believe fatigue is a significant problem for patients with celiac disease, he says.
Lundin explains that celiac disease can be difficult to detect because the symptoms are so varied. Not everyone experiences abdominal pain and digestive problems, but three signs should always make a doctor suspect celiac disease:
Iron deficiency, stomach rumbling and constant tiredness.
Lundin says that fatigue is also very common in other intestinal disorders like inflammatory bowel disease and irritable bowel syndrome .
We know surprisingly little about what causes this exhaustion, despite the fact that so many people struggle with it.
Lundin summarized the research done on celiac disease and fatigue in 2018 and found large gaps in the knowledge base. The studies were few in number and had several weaknesses.
Why do we know so little about this condition?
What Happens If I Miss A Dose
Take the missed dose as soon as you remember, but avoid taking the medication if you do not plan to be awake for several hours. If it is close to your normal bedtime hour, you may need to skip the missed dose and wait until the next day to take the medicine again.
Talk with your doctor about what to do if you miss a dose of armodafinil. Do not take extra medicine to make up the missed dose.
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Viral And Other Infections
The term post-viral fatigue syndrome is used to describe CFS-like symptoms that occur after a viral infection. A recent review found Epstein-Barr 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. One review found risk factors for developing CFS after mononucleosis, dengue fever or the bacterial infection Q-fever include 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, however these findings are not generally accepted due to the use of the Oxford criteria in selecting patients. The CDC does not recognize attribution of symptoms as a risk factor.
What Questions Should I Ask My Doctor
- Take along a list of all the symptoms you are experiencing in case you forget some of them during your talk with the doctor or nurse.
- Talk about how much you can do at work or school and around the house.
- Ask if there are any financial supports or services you could apply for.
- Ask for help with pain, sleep and remaining active if these are problems for you.
- Ask about what you should be eating.
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Pots: A Little Known Cause Of Extreme Fatigue
Everyone knows what being tired feels like at the end of a long day. But some people experience fatigue so severe and so seemingly random that its hard to describe. If that sounds familiar, there could be more going on than daily stress.
While there are many causes of fatigue, one of them is frequently missed and misdiagnosed: postural orthostatic tachycardia syndrome . Physical medicine and neuromuscular specialist Tae Chung, M.D., answers questions about POTS and extreme fatigue as one of its symptoms.