Most everyone feels “worn out” now and then from stress, lack of sleep, or just the pace of daily living. That’s normal. But when fatigue becomes prolonged or overwhelming, it could be a sign of serious illness.
You may have read or heard about chronic fatigue syndrome, called CFS for short. CFS typically starts as a sudden, flu-like condition. But instead of getting better, a person may develop a host of lingering symptoms including incapacitating fatigue, mild fever, swollen glands, sore throat, muscle weakness, headaches, dizziness or lightheadedness, difficulty in concentrating, confusion and depression. These symptoms may come and go, vary from mild to incapacitating and last for months or years.
CFS isn’t well understood. In fact, it was only first officially described by the Centers for Disease Control and Prevention, a branch of the federal government, in 1988. (CFS has gone by several names over the years, including chronic fatigue immune dysfunction syndrome, chronic Epstein-Barr virus syndrome, chronic mononucleosis, myalgic encephalomyelitis and “yuppie flu.”) Theories about what causes it and how to treat it abound, but there are no clear-cut answers.
Further complicating matters is the fact that there is no conclusive laboratory test for CFS. That means doctors can arrive at a diagnosis of CFS only by ruling out a long list of other conditions that have similar symptoms.
To help doctors diagnose CFS, scientists associated with the Centers for Disease Control and Prevention have developed a detailed definition of the illness.
The major criteria are:
- Onset of persistent fatigue that doesn’t get better with bed rest and reduces daily activity by 50 percent for at least six months
- Fatigue not explained by another medical or psychiatric illness.
- Four or more of the following symptoms concurrently: substantial impairment in short-term memory or concentration; sore throat; tender lymph nodes; muscle pain; multi-joint pain without swelling or redness; headaches of a new type, pattern or severity; unrefreshing sleep; and postexertion malaise lasting more than 24 hours.
The symptoms must have persisted or recurred during six or more consecutive months of illness and must not have predated the fatigue.
How is CFS treated? Most doctors recommend that patients improve their general health and physical condition by eating a balanced diet, getting enough rest, gradually increasing regular exercise without overdoing it (strenuous activity can cause setbacks), cutting back on caffeine and alcohol, stopping smoking and avoiding stressful situations.
Taking medication for CFS has met with mixed results. Recent tests of antiviral drugs that boost the immune system have been inconclusive, working no better than placebos in some studies. Low doses of certain antidepressants, on the other hand, appear to be helpful.
If you feel tired all the time, don’t ignore it. The feeling could be a sign of CFS—or another serious illness.