McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
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What is chronic fatigue syndrome?

Chronic fatigue syndrome (CFS) is a complex of possibly related symptoms that may have several causes. The syndrome is not well understood. The main symptom is overwhelming fatigue that lasts for at least 6 months and interferes with daily living.

Most people with CFS are middle-class, 20- to 40-year-old adults. The syndrome seems to especially affect young, well-educated women. However, men and women of all ages can have CFS.

How does it occur?

The cause of chronic fatigue syndrome is not known. We do know that the following conditions may cause some of the symptoms:

• depression
• anxiety
• stress
• allergies
• infections such as Epstein-Barr virus, infectious mononucleosis, Lyme disease, and AIDS
• problems with the body's immune system
• tumors
• rheumatic diseases
• certain disorders of the nervous system
• anemia
• hormone problems, such as with the thyroid and pituitary glands and with diabetes

Medications, such as drugs used to treat anxiety, depression, and hypertension (high blood pressure), may cause symptoms of chronic fatigue.

What are the symptoms?

Physical symptoms of CFS may include:

• overwhelming exhaustion, fatigue, or weakness that lasts longer than 6 months
• mild fever
• sore throat
• chills and night sweats
• swollen or tender lymph nodes
• muscle weakness, aches, and pain
• headache
• joint aches and pain
• allergic reactions
• weight gain or loss
• skin rash
• difficulty being physically active
• dizziness or lightheadedness.

Psychological symptoms of CFS may include:

• confusion
• memory loss
• sleep disturbances
• anxiety
• irritability
• difficulty concentrating
• apathy and depression
• personality changes
• mood swings
• reduced sex drive.

How is it diagnosed?

Many illnesses cause symptoms similar to those of CFS. Your health care provider will try to rule out other illnesses and possible causes of your fatigue by asking about your symptoms and giving you a complete physical exam. If you have been having fevers but don't have one when you see your provider, you may be asked to record your temperature at home several times a day.

You may have a number of tests, such as urine and blood tests, to check for infections, immune or metabolic diseases, hormone problems, anemia, and tumors.

If your provider cannot find a cause for your fatigue, you may be diagnosed with chronic fatigue syndrome.

How is it treated?

If your health care provider diagnoses an illness or other cause for your fatigue, treatment of the problem will relieve the fatigue. If you have chronic fatigue syndrome, there is currently no known cure. However, two types of treatment can be helpful:

• a special exercise program
• behavior therapy.

The exercise program starts slowly and easily. You increase the amount of exercise very gradually with the goals of increasing your muscle strength and energy. Behavior therapy should focus on the positive (what you are able to do) and help you feel more optimistic as your muscle strength and energy improve.

Your health care provider may prescribe medicine for symptoms such as headache and muscle pain. Antidepressant medicines may help lessen your fatigue and improve your ability to function. Treatment for depression often helps relieve painful symptoms.

How long will the effects last?

Chronic fatigue syndrome is not well understood or easily treated. You may continue to have the symptoms for months or years. Usually, the symptoms are most severe during the first year. Most people with CFS feel much better within 2 years.

How can I take care of myself?

• Rest as much as possible while you and your health care provider try to treat the illness.
• Follow the treatment prescribed by your health care provider.
• Follow your health care provider's recommendations for exercise.
• Stop smoking.
• Eat balanced, nutritious meals.
• Drink 6 to 8 glasses of water daily.
• Drink less coffee.
• Drink less alcohol.
• Learn to pace yourself to avoid fatigue. Prioritize your activities each day. Do the most important ones in the morning when your energy level may be higher. It doesn't matter if everything doesn't get done in 1 day. Ask for help at home and at work when the load is too great to handle. Take frequent rest breaks during the day to relax or walk around.
• Engage in recreational activities at least once or twice a week.
• Join local support groups. Talking with others who have similar problems can really help.

If nothing helps, you may wish to get a second medical opinion.

What can be done to help prevent fatigue?

See your health care provider if you have any unusual or persistent body changes or symptoms. This will allow your provider to identify and treat any underlying health problems early and help prevent your fatigue from becoming worse.

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.