A complex disorder, chronic fatigue syndrome isn’t easily diagnosed, and doctors only have theories at present to understand why some people develop this debilitating condition. According to the Mayo Clinic, some theories as to the cause of the condition include viral infections and psychological stress, as well as a combination of factors.
Because of the devastating effect chronic fatigue syndrome has on sufferers, scientists have put significant effort into finding the cause of CFS, but so far no consensus has been found for why some people develop the condition. Other names by which chronic fatigue syndrome is known include myalgic encephalomyelitis and immune dysfunction syndrome.
What is Chronic Fatigue Syndrome?
According to the Centers for Disease Control and Prevention (CDC), people who suffer from the affliction experience profound fatigue that isn’t improved through rest and sleep. After starting to experience chronic fatigue syndrome symptoms, sufferers may be diagnosed with the condition after suffering for at least six consecutive months and finding that symptoms aren’t due to purposeful exertions like excessive exercise.
The symptoms of chronic fatigue syndrome usually impact the memory, joints, and ability to sleep, in addition to a variety of other physical and mental ailments. When deciding whether to diagnose an individual with chronic fatigue syndrome, doctors must find that the person suffers from at least four of the eight classic symptoms of the affliction. Those symptoms include:
- Extensive muscle pain
- Impaired memory and inability to concentrate
- Mysterious joint pain with no visible swelling
- Recurring or frequent sore throat
- Painful lymph nodes in the armpits or neck
- Post-exertion weakness that lasts more than a day
- Un-refreshing sleep
- Unusually harsh headaches
In addition, sufferers must find that their fatigue and symptoms prevent them from performing normal, daily activities like a full-time job, care of the family, and activities that require physical or mental exertion. Importantly, the symptoms associated with the onset of a chronic fatigue syndrome test must have appeared at the same time as the fatigue and not before.
Additional risk factors for CFS include various demographic factors that include age and genetics. The most common sufferers of chronic fatigue syndrome are women aged 30 to 50. Some past illnesses could contribute to the development of the disease, as well as certain environmental factors.
Causes of Chronic Fatigue Syndrome
As the affliction is not yet fully understood by doctors, the best that science has to offer on chronic fatigue syndrome causes are a selection of general infections, deficiencies, and stressors. According to the National Institutes of Health, chronic fatigue syndrome shares symptoms with a variety of other illnesses, so diagnosing the condition is difficult.
Some of the suspected causes of chronic fatigue syndrome include various infections, nutritional deficiencies, and immune system problems. Additionally, scientists have identified extremely low blood pressure or hypotension as a possible cause, as well as significant stress affecting the adrenal glands, pituitary, or hypothalamus.
Diagnosing Chronic Fatigue Syndrome
There’s no easy way to determine whether someone has chronic fatigue syndrome because there’s no standard lab test or biomarker for the disease. Not surprisingly, chronic fatigue is common to CFS, but it’s also a common symptom for a variety of different illnesses. The CDC suggests that these and other challenges lead to a low rate of diagnosis.
When a patient suspects chronic fatigue syndrome or is suffering from the various symptoms of the affliction, a doctor will perform a chronic fatigue syndrome test to rule out other conditions and determine whether a patient has CFS. Like most diagnoses, the doctor will need to take a detailed account of a patient’s health and family history, as well as conduct a full physical and mental status examination.
One of the primary features of a chronic fatigue syndrome test is ruling out other possible causes of symptoms. After determining that a patient has had at least six months of severe fatigue that hasn’t been relieved by traditional rest or sleep, the doctor will ask about other symptoms related to body pain, cognitive issues, and flu-like symptoms.
Depending on the symptoms reported by the patient, a doctor may order a variety of other laboratory screening tests to make sure that another illness isn’t at work. Additionally, the doctor may order extra tests after receiving the results of the initial laboratory work to narrow down a diagnosis.
An alternative diagnosis to chronic fatigue syndrome is idiopathic fatigue. According to the University of Maryland Medical Center, idiopathic fatigue means that a patient doesn’t meet all of the criteria for a diagnosis of CFS and that the cause of the patient’s fatigue is unknown. Doctors sometimes refer to this condition as idiopathic chronic fatigue.
Because of the connection of CFS to fibromyalgia and alternative diagnoses, a doctor may take x-rays, but these chronic fatigue syndrome pictures may come back with normal results. However, sometimes x-rays can help rule out other conditions when they come back without signs of other illnesses or diseases.
CFS Connection to Epstein Barr Virus
The federal government’s National Library of Medicine lists an Epstein Barr virus chronic fatigue syndrome link as one of the causes of the disease. Often known as mononucleosis or glandular fever, Epstein-Barr virus, many people contract EBV and don’t show any symptoms. The CDC suggests most people will become infected with the virus at some point in their lives, and that most people will get the virus in childhood.
Like chronic fatigue syndrome, EBV isn’t fully understood by scientists, and it’s still under active study by doctors. Scientists drew a connection between CFS and EBV because the symptoms of CFS have an immunological component, and Epstein-Barr virus affects the immune system. Scientists postulate that other viruses like EBV could also cause someone to develop CFS, and that’s why a chronic fatigue syndrome Epstein Barr connection is a popular theory.
Relationship of CFS to Other Afflictions
The Solve ME/CFS Initiative (formerly the CFIDS Association of America) suggests that the symptoms of chronic fatigue immune dysfunction syndrome match a variety of other conditions. They also say that many patients actually suffer from more than one type of disease affecting the immune system.
For example, a chronic fatigue syndrome fibromyalgia connection is common, as well as multiple diagnoses of irritable bowel syndrome, interstitial cystitis, and temporomandibular joint disorder. All of these disorders carry similar symptoms, and many patients will receive different diagnoses from different doctors because of the similarity of symptoms.
It’s essential that patients do not self-diagnosis CFS because of the chance that symptoms are due to another disease that may require a different treatment or which might have a medicinal treatment or cure associated with it. CFS can only be diagnosed when all other potential illnesses have been excluded.
The severity of CFS tends to vary greatly in different patients, and many of the symptoms aren’t physically visible, so friends and family might not understand why a person received a chronic fatigue syndrome diagnosis. Additional symptoms reported by some people diagnosed with CFS include:
- Allergies to foods, smells, and chemicals
- Blurred vision and eye sensitivity
- Cognitive problems or brain fog
- Depression and irritability
- Dizziness and lack of balance
- Gastrointestinal problems
- Gynecological problems and severe PMS
- Inability to sit upright
- Night sweats or chills
- Tendency to faint
Chronic Fatigue Syndrome Treatment
Early diagnosis of chronic fatigue syndrome can greatly improve the likelihood of improvement from the debilitating symptoms. After receiving a diagnosis of CFS, a healthcare professional will help a patient develop a treatment for chronic fatigue syndrome based upon the patient’s individual circumstances. One of the most important ways a person with CFS can treat the disease is through proper management of exercise and daily activities.
Common daily chores like cleaning and errands become difficult when someone suffers from CFS, and intense activity often causes symptoms to get much worse for a day or two after the exertion. It’s important to design an activity program that doesn’t lead to an endless cycle of crashes and recoveries between bouts of extreme exercise or activities.
An important way to reduce symptom flare-ups and severe fatigue is through a balanced program of rest, activity, and work. This program will prevent a person from experiencing muscle loss and reconditioning while also reducing the likelihood of fatigue. A balanced routine of activities may help a patient manage pain, as well as improve sleep and reduce the severity of symptoms associated with CFS.
Graded Exercise Therapy to Treat CFS
The concept of exercise for someone who has chronic fatigue syndrome may seem absurd, but doctors may recommend an exercise routine under the idea of graded exercise therapy. This type of exercise routine features activities that are very low intensity and are gradually increased over time. Starting with low-intensity exercises helps reduce the likelihood of the “push-crash” cycle occurring after strenuous exercise.
Graded exercise therapy may start with exercises like walking and lifting light weights. Some routines may feature body weight exercises and movements that progress to lifting weights or performing exercises like wall push-ups and toe raises. For patients suffering from debilitating symptoms that have led to a housebound existence, the simple act of lifting small objects and walking around the house may help.
Nutritional Choices for Chronic Fatigue Syndrome
Purposeful choices regarding a chronic fatigue syndrome diet may help reduce the severity of symptoms. An independent educational charity in the UK called the Institute for Optimum Nutrition recommends that patients consider an anti-Candida diet as part of a treatment regimen. An overgrowth of Candida may impact the immune system, and a person suffering from CFS has an underperforming immune system.
The diet will include reducing consumption of table sugar (sucrose), avoiding lactose in milk, and reducing consumption of fructose from fruit. In addition, an anti-Candida diet will require a patient to avoid eating products with yeast like bread, as well as fermented items like alcohol and vinegar. A reduction of cheese and stimulants like coffee is also part of the diet.
Helpful foods on the anti-Candida diet include:
- Whole grains
- Yogurt (low sugar or natural)
A person with chronic fatigue syndrome may also need to confront issues of low blood sugar as hypoglycemia often coincides with a diagnosis of CFS. Strategies to keep blood sugar at a healthy level include a diet that features complex carbohydrates with each meal, as well as protein. Helpful snacks at bedtime to maintain blood sugar overnight include natural yogurt or hard-boiled eggs.
Some vitamin supplements may also help maintain nutrient levels in persons suffering from chronic fatigue syndrome. Helpful vitamins may include a comprehensive mineral, Vitamin C for its value to the immune system, and probiotics that promote healthy intestinal bacteria. A doctor is an invaluable ally in developing a unique nutritional program to deal with the symptoms and biochemical irregularities present in the body.
Estimates from the Solve ME/CFS Initiative suggest that at least one million people in the United States have the condition and that millions of additional people suffer from CFS around the world. Women are four times as likely to suffer from chronic fatigue syndrome; however, the disease can strike any person of any demographic group.