Chronic Fatigue Syndrome (CFS) is a type of fatigue that does not improve with rest and does not appear to be caused by an underlying medical condition. CFS is also known as myalgic encephalomyelitis (ME) or systemic exertion intolerance disease (SEID).
There is still no complete understanding of the causes of CFS. Some theories include technical difficulties, viral infection or psychological stress. CFS is difficult to diagnose because there is no single cause, and many other illnesses produce similar symptoms.
It is not possible to test for CFS. If you have fatigue, there are probably other causes that have to be ruled out by your doctor. Until recently, CFS was considered a medical condition, but now it’s widely recognized.
People of all ages can suffer from CFS, but most commonly it strikes women in their thirties and forties. Treatment can alleviate symptoms, but there is no cure for CFS.
This article will provide information regarding CFS, including symptoms, treatment options and prognosis.
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What are the effects of ME/CFS on people?
There is no universal cure for ME/CFS, as some people are affected more severely than others. A person with ME/CFS can suffer from four levels of severity, which indicate the level of disability they can experience:
- Mild: Pre-illness activity reduced by 50%.
- Moderate: mostly housebound.
- Severe: mostly bedridden.
- Very severe: The patient is bedridden and requires assistance with nutritional and hydration needs
There is a wide range of severity when it comes to ME/CFS. The severity of ME/CFS in a patient can vary from one level to another over time, and the condition could improve or worsen. It is possible for a patient’s disease to worsen dramatically without a known cause for some patients. There are some patients who have a “fluctuating illness” which causes them to have extended periods of better and worse health. The cause of this is unknown.
The majority of people who suffer from ME/CFS have the disease for the rest of their lives. Fewer than 10% of patients recover fully (return to pre-illness function). The ability to do more will improve as time passes, but it will be a gradual and slow process for some people with ME/CFS. Nevertheless, not everyone has this experience. The condition of some people can worsen over time while the condition of others may remain somewhat stable. When people are supported and paced, they are often able to improve their quality of life.
CFS in children
It is a disabling disease that is characterized by complex symptoms. A cure or approved treatment for the illness has not yet been discovered, and scientists are not sure what causes the disease. It’s common to think of ME/CFS as a problem that affects adults. However, it can also affect children (both adolescents and their younger siblings).
- There have been few studies in children about ME/CFS, so little is known
- The prevalence of ME/CFS in children is estimated to be up to 2 per 1,000
- The prevalence of ME/CFS is higher among adolescents than among young children
What is the cause of CFS?
CFS has an unknown cause. Scientists speculate the following factors might contribute:
- Weakened immunity
- Hormonal imbalances
There may be genetic predispositions to CFS as well.
The cause of CFS has not been determined, but it can sometimes develop following a viral infection. There are several viral infections that have been linked with CFS, including:
- Epstein-Barr virus (EBV)
- Human herpesvirus 6
- Ross River virus (RRV)
- Rubella virus
There has also been researching on bacterial infections, such as Coxiella burnetii and Mycoplasma pneumoniae, which are related to CFS.
CFS may be the end stage of multiple diseases rather than one specific disease. The Centers for Disease Control and Prevention (CDC) have suggested this.
About one out of every 10 people with EBV, Ross River virus, or Coxiella burnetii infection develops CFS.
Researchers also suggest that those who have had severe symptoms during any of these three infections are more likely to develop CFS later on.
CFS patients may have impaired immune systems, although doctors aren’t certain that this is enough to lead to the disorder.
CFS patients sometimes experience abnormal hormone levels as well. Medical professionals aren’t sure whether this has any significance.
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Risk factors for CFS
Many people with chronic fatigue syndrome are in their 40s and 50s.
CFS is also affected significantly by gender, with women being twice as likely to be diagnosed as men with the condition.
Risk factors that may be associated with CFS include:
- Genetic predisposition
- Environmental factors
What are the symptoms of CFS?
There is no single set of symptoms associated with CFS; symptoms vary with the severity of the condition and the individual.
Fatigue that interferes with daily activities is the most common symptom of chronic fatigue syndrome.
Symptoms of chronic fatigue syndrome must persist for at least 6 months for you to be diagnosed with it. Rest isn’t a cure for chronic fatigue syndrome.
The term post-exertional malaise (PEM) is used to refer to extreme fatigue after physical or mental exertion. It typically lasts for at least 24 hours following the exercise.
Sleep problems can also develop as a result of CFS, for example:
- Not feeling refreshed after sleeping
- Chronic insomnia
- Other sleep disorders
Other symptoms of chronic insomnia may include:
- Loss of memory
- Reduced concentration
- Intolerant to orthostatic changes in position (feels light-headed, dizzy, or faint when you rise from lying or seated to standing positions)
There are several physical symptoms of CFS, including:
- Muscle pain
- Frequent headaches
- Multi-joint pain that does not involve swelling or redness
- Frequent sore throat
- Your neck and armpits are swollen and tender
Some people with chronic fatigue syndrome feel ill in cycles, often with periods of worsening and then improvement.
Remission occurs when symptoms disappear completely. However, a relapse is possible later on, when symptoms return.
There is a chance that you can manage your symptoms even in the face of this cycle of remission and relapse.
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What is the diagnosis for CFS?
The diagnosis of CFS is not an easy task.
About 836,000 to 2.5 million Americans suffer from CFS, according to the Institute of Medicine. A diagnosis, however, is still elusive for 84 to 91 percent of patients.
It is not possible to screen for CFS with medical tests. It shares many symptoms with other illnesses. Doctors may not recognize the fact that CFS sufferers are ill because they do not “look sick.”
CFS needs to be excluded as a cause and your medical history must be reviewed with your doctor.
A medical professional must get confirmation that you exhibit the symptoms previously listed. Additionally, your fatigue will be assessed based on its severity and duration.
An essential part of diagnosing your fatigue is ruling out other potential causes. Here are a few conditions with similar symptoms:
- Lyme disease
- Multiple sclerosis
- Lupus (SLE)
- Major depressive disorder
- Severe obesity
- Sleep disorders
Antihistamines and alcohol can also have side effects that mimic symptoms of CFS.
The symptoms of CFS are similar to those of various other illnesses, so making a self-diagnosis is not advisable. Visit a physician for diagnosis. The doctor will help find relief.
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Chronic fatigue syndrome treatment
Unfortunately, CFS has no specific cure at this time.
The symptoms of each individual may need to be treated differently to manage the disorder and alleviate symptoms.
Creating the right treatment plan for you will require collaboration between you and your healthcare team. You can discuss whether the treatments have benefits or side effects with them.
Addressing post-exertional malaise (PEM) symptoms
The symptoms of CFS can become worse even with minimal physical, mental or emotional exertion.
It is typical for symptoms to worsen between 12 and 48 hours after activity and persist for days or even weeks.
PEM flare-ups can be prevented with active management, also called pacing. In order to stay within your personal limits, you need to determine what your limits are for physical and mental activity, plan them and then rest.
Keeping a diary of your activities can help you find your own personal limits. Some doctors refer to staying within this envelope as your “energy envelope.”
People with CFS may not tolerate vigorous aerobic exercise routines because they do not tolerate such an exercise routine for most chronic conditions.
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Home remedies and lifestyle changes
If you are having trouble managing your symptoms, you may want to try making some lifestyle changes.
Insomnia can be relieved and your sleep improved by reducing or eliminating caffeine consumption. Cigarettes and alcohol should also be limited or avoided.
If you can’t sleep at night because of naps during the day, avoid taking them.
Create a schedule for sleeping. Every morning, aim to get up around the same time and to go to bed at the same time each night.
You can’t treat your symptoms with one medication. The medication you take may also need to change as your symptoms change over time.
It’s not uncommon for CFS to be caused or triggered by depression. The physician may prescribe low-dose antidepressants or refer you to a mental health provider.
Sleep aids may be suggested by your doctor if lifestyle changes won’t help you sleep. You can also take pain-reducers to manage the aches and pains you experience due to CFS.
Your medication therapy will be tailored to your specific needs if medication is necessary. Consult with your physician. CFS can’t be treated with a one-size-fits-all approach.
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The pain associated with CFS may be reduced with acupuncture, tai chi, yoga and massage. It is always best to consult your physician before starting any treatment.
Housebound or bedbound with ME/CFS
The number of ME/CFS patients who are housebound or bedridden is approximately 25%. It is possible for housebound people to perform some basic daily tasks themselves, such as brushing their teeth, cooking, and using a computer for a short period of time, but they must pace their activities and often rely on aids (such as a chair to sit on while cooking in the kitchen). There is not enough energy available for them to leave the house, so they are unable to leave the house. They often need wheelchairs or mobility scooters, or other assistance (such as driving) when leaving the house. It can take days or even weeks to recover from leaving the house.
It is not uncommon for people to be bedridden for part of their lives due to severe illnesses. It is possible for the very ill to be incapable of performing even the simplest tasks on their own, such as eating or going to the bathroom. Getting enough nutrition and fluids can be a challenge, and they may require additional medical devices, such as feeding tubes.
Facts about chronic fatigue syndrome
- ME/CFS affects an estimated 2.5 million Americans
- Children and teens can get it as well
- Most women who suffer from it are in their 40s and 50s
- Men are less likely to develop it than women
- Mild or moderate cases are the most common
- Approximately 1 in 4 people with this condition suffer from severe symptoms
ME/CFS sufferers can probably manage their condition on their own if their illness is mild. You may find it difficult to move around when you have moderate symptoms. The afternoon may be the best time to sleep, for example.
If you suffer from severe symptoms, you are just as susceptible to heart disease, rheumatoid arthritis, and lupus.
Chronic fatigue syndrome has the potential to cause the following complications:
- Lifestyle restrictions
- Increased work absences
- Social isolation
What are the long-term prospects?
The exact cause and cure of CFS remain unknown despite increased research efforts. Approximately 5% of people with CFS recover. This can make managing it difficult.
If you suffer from chronic fatigue, you will likely need to change your lifestyle. You may be depressed, anxious, or feeling socially isolated as a result. Making decisions and transitions can be made easier if you join a support group.
It’s critical to work with your doctor to develop a treatment plan tailored to your needs as CFS progresses differently for every person.
Most people find it helpful to work with a team of healthcare providers. Typically, this involves doctors, therapists and rehabilitation specialists.