Chronic Fatigue Syndrome

What is chronic fatigue syndrome?

Chronic fatigue syndrome (CFS) is a condition of severe tiredness that lasts for at least 6 months and is not caused by other medical conditions. In addition to the tiredness, there are usually other symptoms that are also hard to find a cause for, such as joint pain, headaches or swollen lymph nodes.

Most people who have CFS start having symptoms when they are young or middle-aged adults. The syndrome affects women more often than men. However, men and women of all ages can have CFS.

How does it occur?

Researchers have not yet been able to find the cause of chronic fatigue syndrome.

What are the symptoms?

Symptoms of CFS are:

• overwhelming tiredness or weakness that lasts longer than 6 months
• feeling exhausted for more than 24 hours after you have exercised or exerted yourself in some other way
• feeling tired even after getting several hours of sleep
• problems with short-term memory or concentration
• muscle pain
• pain in several joints (without swelling or redness)
• headaches that are different from what you are used to
• sore throat
• tender lymph nodes in the neck or armpits

How is it diagnosed?

It is difficult to diagnose CFS because many illnesses cause symptoms similar to those of CFS. Your healthcare provider will try to rule out other illnesses and possible causes of your fatigue.

Your provider will ask about your medical history and symptoms. You will have a complete physical exam. If you have been having fevers but don't have one when you see your provider, you may be asked to record your temperature at home several times a day.

You may have a number of tests, such as urine and blood tests, to check for infections, immune or metabolic diseases, hormone problems, anemia, and tumors.

If your history, exam and tests do not find a specific cause for your fatigue, you may be diagnosed with chronic fatigue syndrome.

How is it treated?

There is currently no known cure for CFS. However, in addition to medicine to relieve some of the symptoms, other treatments that can be helpful are:

• an exercise program designed specifically for you
• lifestyle changes, such as avoiding overexertion, reducing stress, avoiding some foods, and taking dietary supplements.
• cognitive behavioral therapy, which is a form of counseling that helps you have more positive attitudes and behaviors, both of which can decrease your symptoms.

The exercise program starts slowly and easily. You increase the amount of exercise very gradually with the goals of increasing your muscle strength and energy. Exercise and lifestyle changes can help reduce symptoms of CFS, such as headaches and trouble concentrating.

Your healthcare provider may recommend or prescribe medicine for symptoms such as headache and muscle pain. You may choose to try acetaminophen or anti-inflammatory medicine such as ibuprofen or naproxen for mild pain. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days for any reason.

Antidepressant medicines may help you sleep better and feel less tired. Taking antidepressants regularly can also lessen chronic or recurrent pain.

How long will the effects last?

Chronic fatigue syndrome is not well understood or easily treated. It affects every person differently. Some people with CFS remain homebound. Others get better and can get back to work and other activities, even though they keep having symptoms. You may keep having symptoms for months or years.

How can I take care of myself?

• Follow the treatment prescribed by your healthcare provider.
• Rest according to your healthcare provider's recommendation. It is OK to lie down and rest for awhile, but don't stop your activities altogether. Try to avoid staying in bed any longer than necessary. Too much rest can cause weak muscles and a loss of bone strength. It may also cause you to feel lightheaded when you have to get up and move around.
• Follow your healthcare provider's recommendations for exercise and lifestyle changes. Irregular sleep patterns, stress, depression, and a lack of exercise can worsen pain and tiredness. Practice good sleep habits. Work to establish a regular, night-time sleep pattern. Make sure you get enough sleep every night.
• Heat may be comforting. This can be done with warm baths, showers, hot tub, an electric heating pad on a low setting for 20 to 30 minutes, or a hot water bottle wrapped in a towel.
• Ice can also help, especially if you have any redness or swelling. Try putting an ice pack, or a bag of frozen peas or corn, wrapped in a towel on the painful area for 20 minutes, 1 to 4 times a day.
• Don’t smoke.
• Eat healthy meals (lean protein, lots of fruits and vegetables, whole grains, and nuts). Healthy foods will give you energy, help you feel better, and help you avoid other health problems.
• Learn to pace yourself to avoid fatigue. Prioritize your activities each day. Do the most important ones in the morning when your energy level may be higher. It doesn't matter if everything doesn't get done in 1 day. Ask for help at home and at work when the load is too great to handle. Take frequent rest breaks during the day to relax or walk.
• Engage in recreational activities at least once or twice a week.
• Keep your follow-up appointments. It is helpful to you and your provider to document how your symptoms change over time and whether your treatments are helping your symptoms. It is also a chance to learn if there are new treatments.
• Join local support groups. Talking with others who have similar problems can really help.

If nothing seems to help, you may wish to get a second medical opinion.

For more information, contact:

• The Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS) Association of America
  Phone: (800) 442-3437
  Web site: http://www.cfids.org
• Centers for Disease Control and Prevention
  Phone: (800) 311-3435
  Web site: http://www.cdc.gov/cfs

How can I help prevent worsening fatigue?

See your healthcare provider if you have any unusual or persistent body changes or symptoms. This will allow your provider to identify and treat any new or underlying health problems early and help keep your fatigue from getting worse.