What are the Causes?
The cause of CFS is not clearly understood at this time. Current research is evaluating a number of potential causes, including: infection, immunological factors, hormonal factors, neurological problems, and nutritional deficiencies.
How is it Diagnosed?
No diagnostic tests are available at this time. It is important to rule out other potential causes of profound fatigue prior to accepting CFS as the diagnosis. Therefore, one must not self-diagnose CFS as other potentially dangerous conditions may be the true cause.
One must be evaluated by a knowledgeable health care provider who takes a careful history, conducts a physical examination, and orders the necessary laboratory tests to rule out other potential causes of your symptoms.
There are two diagnostic criteria:
- Have severe chronic fatigue for six months or longer with other potential medical conditions excluded.
- Must concurrently have four or more of the diagnostic symptoms described above. These symptoms must have persisted or recurred during six or more consecutive months of illness and must not have predated the fatigue.
What are Similar Medical Conditions that Must Be Excluded?
CFS can resemble many other disorders with similar symptoms. It is common for people to mistakenly assume they have CFS when they have another illness that needs to be treated. The following conditions should be excluded before a diagnosis of CFS is given:
- Alcohol or substance abuse
- Autoimmune disease
- Bipolar affective disorder
- Cancer
- Chronic hepatitis
- Chronic mononucleosis
- Diabetes
- Eating disorder
- Fibromyalgia syndrome
- Hormonal disorder
- Hypothyroidism
- Lupus
- Lyme disease
- Major depression
- Multiple chemical sensitivities
- Multiple sclerosis
- Myalgic encephalomyelitis
- Narcolepsy
- Neurasthenia
- Obesity
- Reactions to prescribed medications
- Schizophrenia
- Sleep apnea
- Subacute infections
The Importance of Persistence
As there is no specific test for CFS and fatigue is a symptom common to many illnesses, it is sometimes frustratingly difficult to obtain the accurate diagnosis. It is an invisible illness and patients may not look sick. Additionally, it often has a pattern of remission and relapse, and symptoms may vary greatly from one affected person to the next.
It is estimated that of the four million Americans with CFS, less than 20% have been appropriately diagnosed. Therefore, it is important to be educated about this potential condition, and persistent about pursuing appropriate evaluation and treatment. Research suggests that early recognition of this disease can increase the likelihood of improvement.
Source:
Chronic Fatigue Syndrome. Centers for Disease Control and Prevention, Department of Health and Human Services.
