What is Chronic Fatigue Syndrome

There are different names for this illness that affects an estimated 2-million people in the U.S. and millions more around the world. The two most often used are:

  1. Chronic Fatigue Syndrome or "CFS" which is often used in the United States.
  2. Myalgic Encephalopathy or "ME" (a term that the ME Association feels is more appropriate than the original, Myalgic Encephalomyelitis). ME is used in other countries.

The acronym ME/CFS is currently used by researchers to reflect the difference in classification. Even though definitions of the two illnesses do not match, chronic fatigue syndrome specialists in the U.S. acknowledge that the diseases are basically the same.

ME/CFS is a multiple-symptom disorder that affects people of all socioeconomic, ethnic and racial groups as well as people of all ages. However, women report symptoms more frequently than men and more people report symptoms in their 40s and 50s.

The way people suffer from CFS is not described completely by a simple list of symptoms. David Tuller, coordinator at the University of California, Berkeley writes:

"In an interview with The New York Times, best-selling author Laura Hillenbrand ('Seabiscuit'), who has lived with CFS for decades, called the name of the illness 'condescending' and 'so grossly misleading.'  She added: 'The average person who has this disease, before they got it, we were not lazy people; it's very typical that people were Type A and hard, hard workers …

Fatigue is what we experience, but it is what a match is to an atomic bomb. This disease leaves people bedridden. I've gone through phases where I couldn't roll over in bed. I couldn't speak. To have it called 'fatigue' is a gross misnomer.'"

People with ME/CFS show abnormalities in the immune system, the nervous system, and endocrine system. Because cells of all three systems share the same receptors, any illness that affects one of these systems will affect all three.


What Causes Chronic Fatigue Syndrome?

Researchers have not found a specific cause of ME/CFS. A significant obstacle is the fact that like fibromyalgia, symptoms can vary widely from one person to the next. However, the most common symptom is one of overwhelming exhaustion that gets worse with activity, and does not get better with additional rest. Interestingly, a person with ME/CFS may not experience the full extent of the exhaustion until up to 48 hours later.

Chronic Fatigue Syndrome symptoms often resemble a post-viral state and therefore recurring or chronic viruses are believed to contribute to the illness in many patients. Viruses that have been associated with the condition include:

  • Epstein-Barr virus (EBV, which causes infectious mononucleosis)
  • Human herpes virus 6 (HHV-6)
  • Cytomegalovirus (CMV)
  • Coxsackie viruses B1 and B4

Once you have had a pathogenic virus it can be reactivated when your immunity is low, or by adverse environmental conditions, and trigger or perpetrate ME/CFS. Infections that precede ME/CFS may also cause the illness.


Getting a Diagnosis

There is no single test to confirm that you have CFS, and experts so far have mostly only alluded to a cause with many believing it's brought on by a combination of factors.

An August 2016 article posted by Science Daily explains that researchers "using a variety of techniques to identify and assess targeted metabolites in blood plasma" have identified a unique chemical signature for the disorder.

Another report in Science Daily in June 2016 explains that researchers at Cornell University have identified "biological markers" that relate to gut bacteria and "inflammatory microbial agents in the blood."

These researchers claim to have correctly diagnosed CFS in 83 percent of patients through stool samples and blood work, "offering a noninvasive diagnosis and a step toward understanding the cause of the disease."

Depending on symptoms, the physician may rule out arthritis and other autoimmune diseases, lupus, Lyme disease, rheumatoid parasitic infections, neurological disorders such as multiple sclerosis, and endocrine disorders such as hypothyroidism, systemic infections, inflammatory conditions and even heart disease.


CFS Symptoms

Each person with ME/CFS has their own unique set of symptoms, and the intensity of symptoms varies from person to person. Fatigue, however, must be severe.

Many ME/CFS symptoms are reflective of an autonomic nervous system disorder; others are indicative of a persistent viral infection.

In order to meet the diagnostic criteria of ME/CFS, a patient must have unexplained, persistent fatigue for at least six months, along with the following:

  •  Post-exertional malaise for more than 24 hours after mental or physical exertion.
  • Unrefreshing sleep. You wake up tired, even if you have ample sleep.
  • Cognitive problems or dizziness upon standing due to blood pressure irregularities

Other common symptoms include muscle and joint pain, headaches, sore throat, enlarged lymph nodes in the neck or armpits, heart palpitations, digestive issues or food intolerance, difficulty concentrating or finding words, sensitivity to light, noise, and odor and a feeling sick all over.




Treatment Options

A typical treatment regimen can include prescription and over-the-counter medications to help with specific symptoms, supplements, complementary or alternative therapies, and emotional support.

Some doctors recommend cognitive behavioral therapy and gradually increasing exercise, but many people with ME/CFS cannot tolerate exercise due to post-exertional malaise.

Complementary medical professionals recommend dietary changes, yoga and acupuncture to complement other treatments.

Because ME/CFS can be made worse by stress, many patients benefit from counseling, support group meetings and stress-reduction techniques.


Self-help Techniques

While there is no known cure for ME/CFS, there are methods of supporting your body to alleviate symptoms, including the foods you choose and the decisions you make throughout each day. These choices may not only help reduce your symptoms, but may also help improve your overall health.

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NOTE: These statements are meant for educational purposes only and should not be interpreted as a substitute for appropriate medical advice or treatment. FCI offers support as an adjunct to, not a substitute for, professional health care. Any attempt to diagnose or treat illness should come under the direction of a healthcare professional.