Chronic Fatigue Syndrome? You deserve to know what’s going on

You’re devastatingly fatigued. And you’re experiencing concentration and memory issues, lousy sleep, lightheadedness, and joint pain. “What the heck is going on? I mean, could I have chronic fatigue syndrome?” You deserve to know…

We’ve been living in fatiguing times, so it’s understandable that many of us feel absolutely wiped-out. But if the fatigue won’t resolve, and a variety of other symptoms hit, we may be dealing with chronic fatigue syndrome. 

Just like our frustrated, worn-out, and angry friend above, we deserve to know what’s going on.

Let’s see what we can figure-out…

What is chronic fatigue syndrome?

What has been traditionally known as chronic fatigue syndrome is now medically recognized as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). In some circles it’s referred to as systemic exertion intolerance disease (SEID).

Though acceptance of ME/CFS in the medical world has greatly increased, and it’s garnering more research attention, it remains a mysterious load of misery.

ME/CFS is characterized by extreme fatigue that’s often exacerbated by physical, emotional, and mental activity. And the thing is, the fatigue doesn’t resolve with rest. A variety of unpleasant symptoms, which vary by case, are also involved. 

Symptoms of ME/CFS may peak and stabilize early in its presentation, and may come and go over time. Complete recovery is a possibility; however, not to be counted upon.

Okay, the symptoms of ME/CFS can be all over the board and there isn’t a detectable pattern. Here are the biggies…

• Fatigue that interferes with daily activities and doesn’t resolve with bed rest
• Extreme fatigue lasting for more than 24 hours after physical, emotional, or mental exercise (post-exertional malaise – PEM)
• Sleep problems: unrefreshing, insomnia, others
• Concentration and memory problems
• Frequent sore throat
• Mildly enlarged and tender lymph nodes in the neck and armpits
• Muscle and/or joint pain
• Lightheadedness that worsens with moving from lying down or sitting to standing (orthostatic hypotension)
• Pain that moves from one joint to another with no swelling or redness
• Headaches

Keep in mind, ME/CFS symptoms may present in cycles. They may even disappear, only to come back down the road. Of course, with the exception of fatigue issues, one doesn’t have to have all of the symptoms to qualify for a diagnosis.

Some 2.5 million Americans are believed to have ME/CFS. And I’m betting there are a significant number of undiagnosed cases.

ME/CFS can present at any age; however, it’s more likely to strike those in their 40s and 50s.

Although gender isn’t a proven risk factor for ME/CFS, the record shows that women are two to four times more likely to be diagnosed. A lot of that may have to do with the fact that women are typically more inclined to report symptoms and seek treatment.

What causes chronic fatigue syndrome?

As I said, ME/CFS research has ramped-up. Still, its cause remains a mystery. As we discuss cause, it’s really important to keep in mind that ME/CFS may well be an end-stage phenomenon of any number of conditions.

Here are the most widely recognized – suspected or researched – causes…

• Genetic predisposition
• Physical or emotional trauma
• Viral infection (e.g., Epstein-Barr virus, human herpesvirus 6, Ross River virus, rubella virus)
• Bacterial infection (e.g., Coxiella burnetii, mycoplasma pneumoniae)
• Immune system dysfunction
• Stress
• Hormonal imbalances
• Allergies
• Environmental factors

Again, ME/CFS may be an end-stage phenomenon of a variety of conditions, especially viral and bacterial infections.

Is there a test for chronic fatigue syndrome?

There was a time when testing for ME/CFS was out of the question. However, these days, testing research is in the works.

The first bit of good news came in 2019 when Stanford University scientists identified a biomarker for ME/CFS. My understanding is they developed a blood-based test that accurately identified individuals with ME/CFS. 

And just last year, researchers at CHU Sainte-Justine and Université de Montréal devised a unique two-step testing method.

Routine testing for ME/CFS isn’t available yet, but given recent developments, I wouldn’t be surprised if good news was announced sooner rather than later.

In the meantime, we’re going to have to continue to rely upon signs, symptoms, and rule-outs. Speaking of which, the most significant rule-outs are mononucleosis, Lyme disease, multiple sclerosis, systemic lupus erythematosus, hypothyroidism, fibromyalgia, major depressive disorder, sleep disorders, severe obesity, and drug and alcohol side effects.

How is chronic fatigue syndrome treated?

Most important in the treatment of ME/CFS is seeing a physician as soon as possible if you suspect you have it. Early diagnosis is the key to management and possible remission. 

That said, there’s no specific treatment for CFS. Certainly no cure. So that means physicians and counselors typically recommend a combination of strategies and techniques to manage symptoms based upon individual presentation.

Given the significant role post-exertional malaise (PEM) plays in ME/CFS, pacing (activity management) is a significant treatment strategy. It helps to balance activity and rest in an effort to avoid ME/CFS flare-ups. In pacing, the individual determines their limits (“energy envelope”), plans activities, and rests to stay within those limits. A diary is kept. 

Other common interventions…

• Moderating physical, mental, and emotional stress
• Counseling
• The gradual onset of an exercise program or adjustments to a current regimen. Vigorous exercise could be a problem.
• Maintaining healthy lifestyle habits
• Limiting caffeine to help with sleep, as well as nicotine and alcohol
• Establishing a sleep routine, while limiting napping
• Treating associated symptoms (e.g., depression, physical pain, lightheadedness)
• Acupuncture, massage, stretching, yoga, meditation, tai chi, breathing and relaxation exercises

Incidentally, there are no prescription drugs approved for the treatment of ME/CFS. However, they may be used to manage troubling symptoms.

It’s a wrap

Absolutely, we’ve been living in fatiguing times. And if the fatigue, and accompanying symptoms, match what we’ve discussed we may be dealing with ME/CFS. 

“What the heck is going on? I mean, could I have chronic fatigue syndrome?” You deserve to know.

Don’t think twice about seeing your doc. It’s that important.

Speaking of fatigue, you may find Chipur article, Fatigue: Why Are You So Worn-Out?, interesting and helpful.

And as long as you’re at it, why not peruse all of the Chipur titles.

Thanks to healthline for a portion of our reference material.