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Chronic Fatigue Syndrome

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D E S C R I P T I O N

Chronic fatigue syndrome (CFS) is characterized by a group of flu-like symptoms that persist or recur frequently for more than six months. Fatigue and weakness usually debilitate patients.

CFS patients may also experience joint and muscle pain, depression, insomnia and an inability to concentrate. Fibromyalgia, a disease with similar symptoms, may be referred to as an extreme type of CFS.

The cause of the disorder is unknown and researchers are studying ways to better treat patients.


R I S K

Pinpointing risk factors is difficult because an exact cause has not been found. Scientists and physicians no longer believe that the Epstein-Barr virus, which also gives rise to fatigue, causes CFS.

In about one-third of cases, CFS develops after a case of infection, such as a cold or hepatitis. Other risk factors include emotional stress, exposure to toxins, hormone imbalance or allergies.

Women account for the majority of cases. Children and adolescent cases of CFS have also been documented.


S Y M P T O M S

Fatigue is a symptom of many medical conditions. Physicians must eliminate other conditions, such as mental disorders or infection, before making a diagnosis of CFS.

Four or more of the following symptoms must be present for more than six months:

1. Short-term memory loss or a severe inability to concentrate.
2. Sore throat.
3. Swollen lymph nodes in the neck or armpits.
4. Muscle pain.
5. Joint pain without redness or swelling.
6. Intense or changing patterns of headaches.
7. Sleep that does not refresh, impairing patients' ability to function normally.
8. Fatigue, after any exertion, that lasts for more than one day.

Symptoms can last for weeks to years, depending upon the individual. Some CFS patients recover enough to resume work while some grow progressively worse.


T R E A T M E N T

While a definitive cure has not been found, medical scientists are trying to find treatments that may lead to better management of the disease. Physicians and patients can choose from a wide range of therapies to find a regimen that works best to alleviate symptoms.

1. Lifestyle management - CFS patients need to pace themselves and know their limits. Patients should keep a manageable daily routine, avoiding unusual physical or emotional stress. Supervised modest exercise is important to avoid deconditioning.

2. Psychotherapy and supportive counseling - Certain psychotherapies help patients to cope and alleviate some of the distress associated with CFS.

3. Medication - Anti-depressant and anti-anxiety drugs may help to relieve some symptoms. Amitriptyline (Elavil) improves sleep and energy levels and relieves mild pain. Common over-the-counter, pain-relief drugs relieve pain and fever. Some CFS patients may benefit from drugs and other therapies that treat low blood pressure.

4. Dietary supplements and herbs - The effectiveness of most dietary supplements has not been scientifically tested. However, some CFS patients seem to benefit from taking a variety of vitamins, coenzymes, minerals and herbal preparations. Examples of these supplements include iron, melatonin, selenium, vitamins B12, C, and A, astralagus, bromelain, echinacea, garlic, Ginkgo biloba, ginseng, quercetin and St. John's Wort.

5. Non-drug therapies - Some CFS patients find relief in acupuncture, aquatic therapy, chiropractic adjustments, massage, self-hypnosis, tai chi, stretching, yoga and therapeutic touch.


P R E V E N T I O N

Since doctors don't know how CFS develops, they canít recommend any effective preventive measures.

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