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Chronic Fatigue Syndrome
(Chronic Fatigue and Immune Dysfunction Syndrome)

Definition:
Chronic fatigue syndrome (CFS) is a chronic, debilitating disorder that affects the brain and multiple parts of the body. It causes a sudden onset of extreme fatigue that is not relieved with bed rest and is often made worse by physical or mental activity. Symptoms last at least six months and are severe enough to impair or interfere with daily activities.

Causes:
The cause of CFS is unknown. Researchers are studying the relationship between stress, the immune system, activation of latent virus which could trigger a neuroendocrine response.

Risk Factors:
A risk factor is something that increases your chance of getting a disease or condition. Data has shown that the following factors seem to be associated with the development of CFS.
  • Sex: female
  • Age: 20-50 years old
  • Stress
Symptoms:
Symptoms vary from person to person. They include:
  • Chronic fatigue that is not relieved with bed rest and often worsens with physical or mental activity
  • General weakness
  • Muscle aches over six months
  • Joint pain without swelling or redness over six months
  • Headaches over six months
  • Trouble with short-term memory or concentration
  • Forgetfulness or confusion
  • Irritability, anxiety, mood swings, or depression
  • Sore throat over six months
  • Tender lymph nodes over six months
  • Trouble sleeping or not feeling refreshed after sleep over six months
  • Prolonged fatigue lasting 24 hours or more after exercise
  • Eyes sensitive to light
  • Reduced activities (social, job-related, educational, and personal)
  • Low blood pressure
  • School absenteeism
  • Dizziness
Diagnosis:
The doctor will ask about your symptoms and medical history, and perform a physical exam. There are no specific diagnostic tests for CFS, but the doctor will perform several tests to rule out other conditions that can have similar symptoms.

The doctor will look for the following signs to determine if you have CFS:

  • Severe, chronic fatigue for at least six months that is not due to another illness or medical cause, AND
  • At least four of the following symptoms according to the International Chronic Fatigue Syndrome Study Group Criteria:
    • Impairment of short-term memory or concentration
    • Sore throat
    • Tender lymph nodes
    • Muscle pain
    • Joint pain without swelling or redness
    • Headaches of a new type, severity or pattern
    • Unrefreshing sleep
    • Prolonged fatigue lasting 24 hours or more after exercise
Treatment:
The main goals of CFS treatment is to achieve symptom relief.

Treatments for CFS include:

Physical Activity
CFS patients should avoid overexertion and physical and emotional stress. Moderate exercise that is monitored by a physician or physical therapist may improve symptoms.

Physical Therapies
  • Massage
  • Stretching
  • Tai chi
  • Yoga
Counseling
CFS can be mentally and physically debilitating. Psychotherapy and supportive counseling often helps CFS patients cope with the disorder. Relaxation training and stress management
may also help.

Medications
Medications used to treat specific symptoms of CFS include:
  • Antidepressants–to help improve sleep and relieve depression
  • Anti-anxiety drugs–to treat panic disorders suffered by some CFS patients
  • Nonsteroidal anti-inflammatory drugs–to treat pain and fever
  • Sedatives–to help with insomnia
  • Immunotherapy–to help boost the immune system
Experimental Treatments
The following experimental treatments are sometimes used for CFS, but have not been proven to be effective. Talk to your doctor before trying any experimental treatments.
  • Experimental drugs
  • Dietary and vitamin supplements (eg, magnesium)
  • Herbal remedies (eg, evening primrose oil)
  • Acupuncture
  • Aquatic therapy
  • Chiropractic therapy
  • Self-hypnosis
Prevention:
There are no guidelines for preventing CFS because the cause is not known.
 
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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