What is 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 referred to 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.
Because no single cause has been identified, and because many other conditions generate similar symptoms, CFS can be hard to diagnose. There are no tests for CFS. Your doctor will need to rule out other reasons for your fatigue when determining a diagnosis. While CFS was previously a controversial diagnosis, it’s now widely accepted as a medical condition.
CFS can impact anyone, though it’s most typical amongst women in their 40s and 50s. There’s currently no cure, but treatment can relieve symptoms. Here’s what you need to know about CFS, including symptoms, treatment options, and outlook.
What causes CFS?
The source of CFS is unknown. Researchers hypothesize that contributing factors might include:
- a weakened immune system
- hormonal imbalances
It’s even possible that some people are genetically predisposed to develop CFS.
Though CFS can in some cases develop after a viral infection, no specific kind 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 pneumoniae, have also been studied in relation to CFS.
The Centers for Disease Control and Prevention (CDC) has suggested that CFS may be the end stage of several different conditions, instead of one specific disorder.
In fact, about 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.
Additionally, researchers say that those who’ve had severe symptoms with any of these three infections are at a greater risk for later developing CFS.
Individuals with CFS sometimes have weakened immune systems, but physicians do not know whether this is enough to cause the disorder.
Individuals with CFS can also sometimes have abnormal hormone levels. Physicians have not yet concluded whether this is significant, either.
What are the symptoms of CFS?
Symptoms of CFS vary based on the individual and the extent of the condition.
The most prevalent symptom is fatigue that’s severe enough to disrupt your daily activities.
For CFS to be diagnosed, a significantly reduced ability to perform your typical daily activities with fatigue has to last for a minimum of 6 months. It must not be curable with bed rest.
You will also experience severe fatigue after physical or mental tasks, which is called post-exertional malaise (PEM). This can last for more than 24 hours after the activity.
CFS can also introduce sleep problems, such as:
- feeling unrefreshed after a night’s sleep
- chronic insomnia
- other sleep disorders
In addition, you might 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 may consist of:
- muscle pain
- frequent 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 may sometimes even vanish 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 challenging to manage your symptoms, but it’s possible.
How is CFS diagnosed?
CFS is a very challenging condition to diagnose.
According to the Institute of Medicine, as of 2015, CFS occurs 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 doctors might not recognize that they indeed have a health condition.
In order to receive a CFS diagnosis, your doctor will rule out other possible causes and review 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 possible causes of your fatigue is a crucial part of the diagnosis procedure. Some conditions with symptoms that are similar to those of CFS include:
- Lyme disease
- multiple sclerosis
- lupus (SLE)
- major depressive disorder
- extreme obesity
- sleep disorders
The side effects of certain drugs, such as antihistamines and alcohol, can mimic symptoms of CFS as well.
Due to the similarities between symptoms of CFS and several other disorders, it’s important to not self-diagnose. Consult with your physician about your symptoms. They can work with you to get relief.
How is CFS treated?
There’s currently no specific cure for CFS.
Each person has different symptoms and thus might require different kinds of treatment to manage the condition and alleviate their symptoms.
- cognitive-behavioral therapy (CBT)
- a structured exercise program called graded exercise therapy (GET)
- medicine to manage pain, nausea and sleeping problems
Most people with CFS will improve with time, particularly with treatment, although some individuals do not make a full recovery. It’s also likely there will be periods when your symptoms get better or worsen. Children and young people with CFS/ME are more likely to recover completely.