Question: Do I Have Chronic Fatigue Syndrome?
I'm tired all the time, and I'm really starting to worry that something is seriously wrong with me. Could I have chronic fatigue syndrome?
That's a difficult question to answer, and it depends on multiple factors.
First, you need to understand that there's a difference between the symptom of chronic fatigue (being tired all the time) and the illness called chronic fatigue syndrome.
The Symptom of Chronic Fatigue
It's important to realize that most people who are tired all the time don't have chronic fatigue syndrome (ME/CFS). Fatigue is one of the top complaints doctors hear because it can be a feature of so many conditions. In addition, fatigue is often caused by lifestyle factors rather than illness.
Lifestyle factors that can lead to a state of chronic fatigue include:
- Poor diet
- High stress
- Too little sleep
A lot of people these days live with one or more of these factors, so it's good to evaluate them when looking for the source of your fatigue. Most of us would probably benefit from eating better, sleeping better and reducing or better managing our stress. The following resources can help you with those issues:
- Six Weeks to a Healthier Diet, by About.com Nutrition Guide Shereen Jegtvig
- How to Lose Weight, also by Shereen Jegtvig
- Is Your Stress Level Unhealthy? by About.com Stress Management Guide Elizabeth Scott
- 10 Ways to Get Better Sleep, by About.com Sleep Guide Brandon Peters, M.D.
Just about any illness - chronic or short-term - can cause fatigue, so it's important for your doctor to consider your full range of symptoms and look for likely causes other than ME/CFS. In fact, ruling out other possible causes is part of the ME/CFS diagnostic process.
Chronic Fatigue Syndrome (ME/CFS)
Don't let the name fool you - ME/CFS is a lot more than just being tired. The fatigue is profound and gets worse after even mild exertion, and it's often accompanied by flu-like symptoms, cognitive dysfunction ("brain fog") and any combination of about 45 other possible symptoms. Many people describe it as coming down with a nasty flu and never getting any better.
So far, there's no medical test for diagnosing ME/CFS. For a doctor to even consider a diagnosis, you have to have been experiencing fatigue for at least six months. Then, any other possible causes of the fatigue (and other symptoms you may be experiencing) need to be ruled out.
That means a set of basic blood tests and, if indicated, further tests to check for chronic infections, such as mononucleosis and tuberculosis; autoimmune diseases, such as lupus or multiple sclerosis; emotional or psychiatric conditions; and the nervous-system disorder fibromyalgia, which is similar to ME/CFS.
Without going through this process, it's impossible to say whether somebody has ME/CFS. However, looking over the federal Centers for Disease Control and Prevention guidelines can help you determine whether it seems to fit your specific case.
Do you have:
Unexplained persistent fatigue that's not caused by ongoing exertion, is not substantially better after rest or sleep, and has resulted in a significant reduction in your activity level?
No? Then you don't have ME/CFS.
Yes? Then do you also have:
Four or more of the following symptoms for the past six months or more?
- Impaired memory or concentration
- Extreme, prolonged exhaustion and feelings of illness after physical or mental activity (post-exertional malaise)
- Unrefreshing sleep
- Muscle aches and pains
- Joint pain with no swelling or redness
- A new type of headache or a change in your headache pattern
- Frequent sore throat
- Tender lymph nodes in your neck and near your breast
Still saying yes? Then ME/CFS may be something to bring up with your doctor. Keep in mind that these criteria are just a starting point - your doctor will still need to do a lot of testing before determining whether you have ME/CFS.
Centers for Disease Control and Prevention. "Diagnosing CFS"