Chronic fatigue syndrome

Chronic fatigue syndrome (CFS) is a disorder characterized by the sudden or gradual appearance of incapacitating fatigue.


Causes/associated factors
The cause of chronic fatigue syndrome remains unknown. Symptoms sometimes appear after an infectious disease, but no known pathogen has been linked to CFS. Researchers haven't found any evidence that CFS is contagious.
Other possible causes have been proposed, such as nutritional deficiencies, abnormalities in the endocrine, nervous or immune systems, and physical and emotional stress. Some experts think a combination of factors may be at play.

Chronic fatigue syndrome is most commonly diagnosed in younger adults, and it's two to four times more prevalent in females. Some veterans of the first Gulf War -- primarily men -- seem to be at greater risk for the condition.

Symptoms may appear suddenly or develop slowly. The disease may last from six months to many years, with the most intense symptoms typically noticed during the first two years (if the disease lasts that long). Depending on the person, the symptoms may become progressively worse, improve, come and go, or entirely disappear.


Signs/symptoms
In addition to severe fatigue that doesn't improve with sufficient rest, symptoms of chronic fatigue syndrome include four or more of the following:
sore throat
swollen, tender lymph nodes in the neck or armpit
headaches that are new or different
impaired concentration or short-term memory loss
muscle pain or soreness
pain in multiple joints without swelling or redness
unrefreshing sleep
tiredness that lasts more than 24 hours after exertion or exercise
In addition, some people experience other symptoms, such as chest pain, cough, shortness of breath, earache, dry eyes or mouth, dizziness, abdominal pain or bloating, nausea, diarrhea, night sweats, morning stiffness or jaw pain. As the illness progresses, anxiety or depression may occur.


Diagnosis
The doctor will ask questions about your medical history and symptoms and do a physical exam. To be diagnosed with chronic fatigue syndrome, you must experience extreme fatigue for six months or longer and have four or more other characteristic symptoms (listed above) persistently or recurrently during the six months.
Because there's no single test to confirm CFS, the diagnosis is made after other illnesses are ruled out.


Treatment
Although there's no cure for chronic fatigue syndrome, treatment can minimize symptoms. Get adequate rest. Eat a diet low in fat and high in fiber, including plenty of fruits and vegetables. Regular exercise can also help decrease symptoms. Be sure to get your doctor's OK first, however. He or she may ask a physical therapist to help you plan an appropriate exercise program.
In some cases, medications are prescribed to combat various symptoms. For example, low-dose antidepressants may decrease pain and improve your quality of sleep. Nonsteroidal anti-inflammatory medications (NSAIDs), such as ibuprofen or naproxen, may also help decrease pain.

Cognitive behavioral therapy, which helps you identify and correct beliefs and practices that can block your recovery, has been shown to be helpful. Support groups can also play a major role in treatment.

Research on various medical and alternative treatments for CFS continues.


Complications
Chronic fatigue syndrome is a chronic condition that may lead to anxiety, depression, social isolation, lifestyle changes and time missed from work. Remember, anxiety and depression can be treated.

Pregnancy-specific information
Pregnancy is not a risk factor for chronic fatigue syndrome. It's important to let your doctor know about any fatigue, especially if it lasts past the first three months of pregnancy.

Senior-specific information
Although chronic fatigue syndrome is most common in younger adults, it can develop at any age. Be sure to report any symptoms of unusual fatigue to your doctor.

Prevention
Currently, chronic fatigue syndrome isn't preventable.