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The Chronic Fatigue Syndrome Diagnosis

Expect Lots of Testing


Updated June 21, 2014

The Chronic Fatigue Syndrome Diagnosis

So far, no medical test is proven to provide an accurate chronic fatigue syndrome diagnosis, but some doctors and researchers claim they do have tests that can identify certain subgroups of chronic fatigue syndrome patients. However, these tests have yet to garner the support of the overall medical community.

Chronic fatigue syndrome is a diagnosis of exclusion. That means the first step is for doctors to rule out conditions with similar symptoms, including chronic infections such as tuberculosis, mononucleosis or Lyme disease; nervous system disorders such as fibromyalgia; autoimmune diseases such as multiple sclerosis and lupus; or psychiatric/emotional conditions. (A diagnosis of depression does not exclude the possibility of chronic fatigue syndrome.)

Second, doctors evaluate the patient following guidelines set by the CDC:

  1. Unexplained persistent fatigue that's not due to ongoing exertion, isn't substantially relieved by rest, is of new onset and results in a significant reduction in previous levels of activitiy.
  2. Four or more of the following symptoms are present for six months or more:
    • Impaired memory or concentration (brain fog)
    • Post-exertional mailaise (extreme, prolonged exhaustion and sickness following physical or mental activity)
    • Unrefreshing sleep
    • Muscle pain (myalgia)
    • Joint pain without swelling or redness
    • Headaches of a new type or severity
    • Sore throat that's frequent or recurring
    • Tender cervical or axillary lymph nodes

These symptoms must have been constant or recurring during at least six months of illness and must not have started before the fatigue.

While they're not required for a diagnosis of chronic fatigue syndrome, a complete list of your symptoms can help your doctor diagnose you. It's helpful if you first become familiar with the full range of chronic fatigue syndrome symptoms and then start keeping a symptom journal.

Some researchers, advocates and chronic fatigue syndrome patients believe the CDC criteria are inadequate. A coalition is calling for the U.S. to adopt Canadian diagnostic criteria for chronic fatigue syndrome.

To date, no medical specialty has "claimed" this condition. It's up to you to find a doctor who's knowledgable about it.

A lot of questions and problems can come up along the road to diagnosis. This article can help you navigate some of the common ones:


Centers for Disease Control and Prevention, May 3 2006. "Diagnosing CFS"

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