Chronic Fatigue Syndrome

Chronic fatigue syndrome, commonly referred to as CFS, is a condition of unknown origin whose main symptom is unremitting and disabling exhaustion. In some cases, the syndrome follows an infectious illness. In others, the symptoms appear during a time of unusual stress, or they may start gradually, with no apparent cause, at any time from adolescence through middle age. At least two-thirds of sufferers are white middle-class women.

Although the cause of chronic fatigue syndrome is unknown, under investigation as possible causes are hormone deficiencies, allergies, the reactivation of a dormant virus, and neurological damage sustained in a previous illness.

Recent studies have discounted a number of earlier suspects, including infection with the Epstein-Barr virus, cytomegalovirus, herpes virus, and viruses similar to HIV, the organism that causes AIDS.

Experts disagree on what role, if any, psychological factors play. About half the individuals diagnosed as having CFS seem to have had a pre-existing psychiatric disorder. Other patients develop depression and anxiety only after the syndrome has taken hold.

Diagnostic Studies and Procedure

There is no specific test for chronic fatigue syndrome; instead, the government's Centers for Disease Control and Prevention (CDC) has compiled the following list of conditions that must be present to make a diagnosis:

• Debilitating fatigue lasting for at least six months.
• The exclusion, by examination and testing, of other disorders that may cause fatigue.
• A combination of eight or more symptoms that develop over the course of a few days and persist for six months or more. These include:
  • Mild fever
  • Sore throat
  • Painful lymph nodes
  • Generalized muscle weakness
  • Muscle aches
  • Headache
  • Joint pains
• Prolonged fatigue after exercise
• Inability to concentrate and other nervous system complaints
• Altered sleep habits

Medical Treatments

Because there is no single treatment for the syndrome, symptoms are treated as they present themselves. Aspirin and other non-steroidal anti-inflammatory medications are helpful in alleviating fever, headaches, and muscle and joint pains. Antidepressants or other psychotropic drugs may be prescribed for depression and anxiety.

Alternative Therapies

A number of the drugs prescribed for chronic fatigue syndrome can cause side effects that add to the debilitating nature of the disorder, thus many patients turn to alternative therapies before traditional medicine.

Herbal Medicine. Among the herbs that are commonly recommended are: purple coneflower, or echinacea, extract or capsules, which is said lo stimulate the immune system; licorice root capsules and dried or fresh shitake mushrooms, which are used in Chinese medicine to increase resistance to disease; and suma, a South American herb similar to ginseng that is taken as capsules or tablets or as a tonic to fight fatigue. Also suggested are teas, extracts, or tablets of rosemary, ginseng root (both American and Siberian), peppermint, and rose hips.

Naturopathy. Practitioners recommend several dietary supplements intended to strengthen the immune system: a multivitamin and mineral supplement with a high content of all the B vitamins; also, beta carotene (precursor to vitamin A), extra vitamin C, and zinc. (If megadoses are advised, consult your doctor.)

T'ai Chi. These gentle exercises are said to refresh the fatigued body. Although they require relatively little physical energy, the exercises do help to tone muscles. Doing them in a group can also boost morale.

Self-Treatment

To cope with chronic fatigue syndrome, follow a regimen of good nutrition, adequate rest, and moderate exercise. Keep your life balanced; avoid stressful circumstances and overexertion. Join a support group, which can provide comfort and understanding as well as referrals and treatment suggestions.

Other Causes of Chronic Fatigue

Among the many diseases that should be ruled out when diagnosing chronic fatigue syndrome are depression, lupus, leukemia and other cancers, hepatitis, AIDS, anemia, and heart, lung, liver, and kidney diseases. Also, side effects of certain drugs produce symptoms of chronic fatigue syndrome.