Also known as myalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS), the condition involves persistent incapacitating weakness or fatigue, accompanied by nonspecific symptoms.
The fatigue and symptoms last at least 6 months, they are not attributable to any known cause, and they do not improve with bed rest.
CFS syndrome is more than just feeling tired often. The condition interferes with everyday life and can make it hard to function.
Literature on the condition dates back to the 1700s. Through the centuries, it's been falsely attributed to various causes and is only now beginning to be better understood.
- People with CFS find it hard to function at home and at work. They may need to spend a lot of time resting in bed or at home.
- Some of the symptoms are similar to those of common viral infections, including muscle aches, headache, and fatigue.
- CFS occurs most often in people aged 30-50 years, more often in women than men, and sometimes in children and adolescents.
CFS symptoms are similar to flu and include headaches.
People with CFS experience extreme fatigue and a wide range of other symptoms, including flu-like symptoms and chronic pain.
Patients and patient advocates often prefer to call the condition chronic fatigue and immune dysfunction syndrome (CFIDS), to convey the complexity of the illness.
Symptoms appear within a few hours or days and last for 6 months or more.
They can include:
- tender lymph nodes
- sore throat
- muscle pain
- joint pain
- feeling tired
- feeling discomfort after physical exertion for more than 24 hours
These symptoms either stay with a person or come and go for more than 6 months. They often resemble those of other health conditions.
Effect on quality of life
Many people with CFS find it difficult to carry out everyday tasks, including work. Employment rates vary. Over half of those with CFS feel too unwell to work, and nearly two-thirds are limited in their work because of their illness.
- significant reductions in levels of physical activity
- a level of impairment similar to other fatiguing medical conditions, such as Sjögren's syndrome, lupus, rheumatoid arthritis, chronic obstructive pulmonary disease (COPD), and the effects of chemotherapy
Some people lead relatively normal lives, but others are unable to get out of bed or to care for themselves.
Cognitive behavioral therapy is a common treatment for CFS.
The main goal of treatment is symptom relief.
Treatment options include:
- Stress management: A person with CFS should avoid overexertion, physical, and emotional stress. Moderate exercise that is monitored by a doctor or physical therapist may improve symptoms. Light exercise and stretching 4 hours before bedtime may help with sleep.
- Cognitive behavioral therapy (CBT): Activity pacing can help moderate activity and spread it evenly throughout the day, without overexertion.
- Medications: Antidepressants can help improve sleep and relieve depression. Anti-anxiety drugs can treat panic disorders. Acetaminophen (Tylenol), aspirin (Bayer), and nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen can treat pain and fever.
Stimulants may help, but strong stimulants may trigger a cycle where increases in energy and activity eventually lead to increased tiredness and relapse.
There are no guidelines for preventing CFS, because the cause is unknown.
The Institute of Medicine (IOM) estimates that 836,000 to 2.5 million Americans have CFS, but around 84 to 91 percent of them do not yet have a diagnosis, so the exact number is not known.
CFS is difficult to diagnose because no lab tests can confirm it and symptoms resemble those of other conditions.
According to The BMJ, diagnostic factors include:
- persistent and disabling fatigue with unrefreshing sleep
- fatigue, exhaustion, and a general feeling of being unwell after exertion
- problems with short-term memory
- difficulty concentrating
- sore throat
- dizziness and lightheadedness that improve when a person lies down
Other factors that may help confirm a diagnosis include:
- Age: CFS often starts during adolescence or between the ages of 30 and 50 years
- Flu-like symptoms: These include general pain and a feeling of being unwell, and a fever
- Previous illness: The person has often had an infection or virus that they cannot seem to recover from
- Mental health issues: The person is more likely to have depression, an anxiety disorder, or an affective disorder
At least 1 in 4 people are bed-bound or housebound at some point in their lives.
It is most likely to affect females with an autoimmune disorder, and those who have family members with the same condition.
The cause of CFS is unknown. To discover possible triggers, researchers are studying the relationship between stress, the immune system, toxins, the central nervous system, and activation of a latent virus. Some researchers suspect a virus may cause it; however, no specific virus has been identified.
Studies suggest that CFS may be caused by inflammation of the nervous system, and that this inflammation may be some immune response or process. Other factors such as age, prior illness, stress, environment, or genetics may also play a role.
According to the British Dietetic Association (BDA), people with CFS may experience digestive problems, such as:
- gas and bloating
- abdominal pain
- diarrhea and constipation
- intolerance or sensitivity to alcohol, caffeine, some foods, and some drugs
They recommend following a balanced, healthful diet and suggest the following tips:
- Avoid large meals and eat little and often, for example, every 3 to 4 hours.
- Include a portion of starchy food, and especially slow-release starchy food, such as oats, with every meal, as these can help maintain steady energy levels.
- Consume at least five portions of fruit and vegetables every day.
- Include protein foods in at least two meals, such as meat, fish, nuts, soya, or lentils.
- Consume milk and dairy products or alternatives, such as soy milk.
- Avoid high-sugar and high GI foods, such as sodas and candies, as these can lead to energy and blood sugar spikes.
- Have fruit ready as a snack in case you have a craving for comfort food.
It is important to maintain a healthy weight. This includes not eating too much when you are too tired to exercise, and also keeping up a healthful intake if your appetite is low.
There is no evidence that an anti-candida diet or any other restrictive diet will help with CFS. Anyone who thinks they may have a food intolerance should speak to their doctor before cutting out any food group.
Any supplements should first be discussed with a health care provider, too. These can be expensive, and some have adverse effects.
Mystery continues to surround CFS, but biological evidence of the disease is slowly emerging, and there is hope that treatments may emerge in the future.
For now, managing symptoms through treatment can help some people achieve a better quality of life.