What is Chronic Fatigue Syndrome?

Posted on 15 January 2013

Chronic Fatigue Syndrome is complex and frustrating. Fortunately these days the medical profession is taking it more and more seriously.

How do I know if I’ve got it?
Chronic Fatigue Syndrome (CFS) is a complex condition and a diagnosis is not always simple. A battery of exclusion tests has to be done to rule out other conditions because many of the symptoms are shared. According to Professor Helmuth Reuter, physician and rheumatologist at the Winelands Medical Research Centre and Mediclinic Stellenbosch: ‘The most important step in establishing the diagnosis is a thorough clinical evaluation, including the exclusion of depression.’

He also recommends a renal function test, liver function test, full blood cell count (to exclude anaemia), a glucose level test for diabetes mellitus, a thyroid function test to exclude hypothyroidism and a C-reactive protein test to exclude ?an inflammatory condition. Depending on the history, an HIV test and chest X-ray to exclude tuberculosis r lung cancer may be included.

‘Depending on the chronic nature and severity of the symptoms, most GPs would probably start with simple steps and follow up,’ says Professor Reuter. Don’t be surprised if you are initially advised to eat fruit and veggies and be given a Vitamin B shot to help you on your way.

What are the symptoms of CFS or myalgic encephalitis (ME)?
The bottom line of CSF or ME is, as the name states, extreme fatigue. Unlike with depression, it may worsen with mental or physical activity. And, frustratingly, it won’t improve with rest. The eight official symptoms include:
•     Fatigue
•     Loss of memory or concentration
•     Sore throat
•     Painful and slightly enlarged lymph nodes in your neck or armpits
•     Unexplained muscle pain
•     Pain that relocates from one joint to another with no swelling or redness
•     Headache of a new type, pattern or severity
•     Feeling unrefreshed after sleep
•     Extreme exhaustion lasting more than 24 hours after physical or mental exercise

How do I know it’s not just a burnout?
This is a common mistake because the symptoms are the same – almost. The critical difference, however, is that burnout usually occurs in a person who works extremely hard or under stressful circumstances, whereas CFS could affect anyone, even a couch potato.

Is this depression?
CFS was previously linked to depression because the two conditions have similar symptoms. However, recent research shows levels of the hormone cortisol are not elevated in CFS patients as they are in those with depression.  Also, CFS patients tend to overestimate their abilities, retain a strong interest in life and struggle to exercise. However, depression can be a ‘side effect’ of CFS because of the negative impact of chronic fatigue on their lives.

How is it treated?
Treatment is usually wide ranging and includes medication, nutrition and exercise. The experts recommend:
• Treatment for nervous-system problems
• Treatment of low blood pressure
• Treatment of allergy-like symptoms
• Treatment of sleep problems
• Moderate daily activity
• Gradual but steady exercise
• Cognitive behavioural therapy
• Treatment of depression
• Treatment of existing pain

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Published in Neurology

In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.

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