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Del Mar, CA

Chronic Fatigue in Rancho Santa Fe, CA

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Definition of CFS (Chronic Fatigue Syndrome)

Chronic fatigue syndrome (CFS) is a condition defined by extreme fatigue or tiredness that does not go away with sleep and can't be explained by an underlying medical condition. CFS can also be described as myalgic encephalomyelitis (ME) or systemic exertion intolerance disease (SEID).

The causes of CFS aren't completely understood yet. Some theories include viral infection, psychological stress, or a combination of factors. Since no single cause has been identified, and since many other conditions produce similar symptoms, CFS can be hard to diagnose.

There are no tests for CFS. Your physician will have to eliminate other reasons for your fatigue when determining a diagnosis. While CFS was previously a controversial diagnosis, it's currently widely accepted as a medical condition.

CFS can affect anyone, though it's most frequent amongst females in their 40s and 50s. There's currently no cure, however, treatment can alleviate symptoms. Here's what you need to know about CFS, including symptoms, treatment options, and outlook.

What triggers CFS?

The source of CFS is not known. Researchers speculate that contributing factors might include:

  • viruses
  • a weakened immune system
  • stress
  • hormonal imbalances

It's even possible that some people are genetically predisposed to develop CFS.

Though CFS can sometimes develop after a viral infection, no specific type of infection has been found to cause CFS. Some viral infections that have been studied in connection with CFS include those caused by:

  • Epstein-Barr virus (EBV)
  • human herpesvirus 6
  • Ross River virus (RRV)
  • rubella virus

Infections caused by bacteria, including Coxiella burnetii and Mycoplasma pneumonia, have also been researched in connection with CFS.

The Centers for Disease Control and Prevention (CDC) has suggested that CFS might be the end stage of multiple different conditions, instead of one specific condition. In fact, approximately 1 in 10 individuals with EBV, Ross River virus, or Coxiella burnetii infection will develop a condition that meets the requirements for a CFS diagnosis.

Furthermore, researchers say that those who've had severe symptoms with any of these three infections are at a greater risk for later developing CFS.

People with CFS in some cases have weakened immune systems, but physicians don't know whether this is enough to cause the disorder. Individuals with CFS can also occasionally have unusual hormone levels. Doctors have not yet concluded whether this is significant, either.

What are the symptoms of CFS?

Symptoms of CFS vary according to the individual and the severity of the condition. The most common symptom is fatigue that's serious enough to interfere with your everyday activities.

For CFS to be diagnosed, a dramatically reduced ability to perform your typical daily activities with fatigue must last for a minimum of 6 months. It must not be curable with bed rest. You will also experience extreme fatigue after physical or mental activities, which is referred to as post-exertional malaise (PEM). This can last for more than 24 hours after the task.

CFS can also introduce sleep problems, such as:

  • feeling unrefreshed after a night's sleep
  • chronic insomnia
  • other sleep disorders

Additionally, you may also experience:

  • loss of memory
  • reduced concentration
  • orthostatic intolerance (going from lying or seated to standing positions makes you light-headed, dizzy, or faint)

Physical symptoms of CFS might consist of:

  • muscle pain
  • persistent headaches
  • multi-joint pain without redness or swelling
  • frequent sore throat
  • tender and swollen lymph nodes in your neck and armpits

CFS affects some people in cycles, with periods of feeling worse and then better. Symptoms might sometimes even disappear completely, which is referred to as remission. However, it's still possible for symptoms to return later on, which is referred to as a relapse. This cycle of remission and relapse can make it difficult to manage your symptoms, but it's possible.

How is CFS diagnosed?

CFS is a very difficult condition to diagnose. According to the Institute of Medicine, as of 2015, CFS develops in approximately 836,000 to 2.5 million Americans. It's estimated, however, that 84 to 91 percent have yet to receive a diagnosis.

There are no medical exams to screen for CFS. Its symptoms resemble many other disorders. Many people with CFS don't "look sick," so physicians may not realize that they actually have a health problem.

In order to get a CFS diagnosis, your physician will eliminate other potential causes and discuss your medical history with you. They'll verify that you at least have the core symptoms previously mentioned. They'll also ask about the duration and extent of your unexplained fatigue.

Eliminating other potential reasons for your fatigue is a crucial part of the diagnosis procedure. Some disorders with symptoms that are similar to those of CFS include:

  • mononucleosis
  • Lyme disease
  • multiple sclerosis
  • lupus (SLE)
  • hypothyroidism
  • fibromyalgia
  • major depressive disorder
  • severe obesity
  • sleep disorders

The side effects of particular drugs, such as antihistamines and alcohol, can resemble symptoms of CFS as well. Because of the similarities between symptoms of CFS and several other disorders, it's important to not self-diagnose. Talk to your doctor about your symptoms. They can work with you to get relief.

How is CFS treated?

There's currently no specific cure for CFS. Everyone has various symptoms and thus might need different types of treatment to manage the condition and alleviate their symptoms.

Treatments consist of:

  • cognitive behavioral therapy (CBT)
  • a structured exercise program called graded exercise therapy (GET)
  • medication to manage pain, nausea, and sleeping problems

Most individuals with CFS will improve over time, especially with treatment, although some individuals do not make a complete recovery. It's also likely there will be periods when your symptoms improve or worsen. Kids and young people with CFS/ME are more likely to recover completely.

For further information about Dr. Stengler’s practice and his clinic in Rancho Santa Fe, California, please visit our website at or give us a call at (760) 274-2377

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