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Chronic Fatigue Syndrome

(CFS; Chronic Fatigue and Immune Dysfunction Syndrome)

Definition

Chronic fatigue syndrome (CFS) is a condition that causes chronic, debilitating fatigue. It continues for at least 6 months. The fatigue is not relieved by bed rest. People who have CFS perform at a significantly lower level compared to their activity prior to the onset of the illness.

Causes

The cause of CFS is unknown. Some believe there may be a link between CFS and stress, the immune system, toxins, the central nervous system, or activation of latent virus.
Central Nervous System and Organs Including Endocrine Glands
CNS and Endocrine
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Risk Factors

Women are more likely to have CFS than men. It is also more common in people between 25-55 years of age.

Symptoms

Symptoms vary from person to person. They include:

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. There are no specific diagnostic tests for CFS. Your doctor may do several other tests to rule out other conditions that can have similar symptoms.
The doctor will look for the following signs to determine if you have CFS:

Treatment

The main goal of CFS treatment is to achieve symptom relief.
Treatments for CFS include:

Physical Activity

If you have CFS, avoid overexertion and physical and emotional stress. Balancing your activities throughout the day may help you to not overexert yourself. Moderate exercise that is monitored by a doctor or physical therapist may improve symptoms. Slowly increase the duration and intensity of exercise. Light exercise and stretching 4 hours before bedtime may help with sleep.
In addition, your doctor may have you work with a physical therapist. Some therapies that might be helpful for you include:

Diet and Nutrition

A well-balanced diet can help prevent nutritional deficiencies and weight fluctuations. Nutritional supplements cannot make up for an inadequate diet. Avoid foods to which you may be sensitive.

Counseling

CFS can be mentally and physically debilitating. Depression is common among people with CFS. In fact, as many as half develop depression as a consequence of CFS. Psychotherapy and supportive counseling often help those with CFS cope with the disorder. Learning relaxation training and stress management techniques , as well as changing your sleep routine, may also help.
Talk with your therapist about whether cognitive behavioral therapy is right for you to reduce fatigue symptoms.

Medications

Medications used to treat specific symptoms of CFS include:
  • Antidepressants
  • Anti-anxiety drugs
  • Over-the-counter medications like acetaminophen, aspirin, and ibuprofen to treat pain and fever
  • Stimulants—mild ones may be helpful
  • Sedatives—to help with insomnia

Experimental Treatments

The following experimental treatments are sometimes used for CFS but have not been proven to be effective. Talk to your doctor before trying any experimental treatments.

Prevention

There are no current guidelines for preventing CFS because the cause is unknown.

RESOURCES

Centers for Disease Control and Prevention http://www.cdc.gov

Chronic Fatigue and Immune Dysfunction Syndrome Association of America http://www.cfids.org

CANADIAN RESOURCES

Health Canada http://www.hc-sc.gc.ca

Women's Health Matters http://www.womenshealthmatters.ca

References

Chronic fatigue syndrome. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/chronic-fatigue-syndrome.html. Updated November 2010. Accessed December 28, 2012.

Chronic fatigue syndrome. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/cfs/index.html. Updated May 16, 2012. Accessed December 28, 2012.

Chronic fatigue syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 10, 2012. Accessed December 28, 2012.

Craig T, Kakumanu S. Chronic fatigue syndrome: evaluation and treatment. Am Fam Physician. 2002;65(6):1083-1090.

Darbishire L, Ridsdale L, et al. Distinguishing patients with chronic fatigue from those with chronic fatigue syndrome: a diagnostic study in UK primary care. Br J Gen Pract. 2003;53(491):441-445.

Prins JB, Bleijenberg G, et al. Cognitive behaviour therapy for chronic fatigue syndrome: a multicertre randomized controlled trial. Lancet. 2001;357(9259):841-847.

Reeves WC, Wagner D, et al. Chronic fatigue syndrome: A clinically empirical approach to its definition and study. BMC Medicine. 2005;3:19.

Reid S, Chalder T, et al. Chronic fatigue syndrome. Clin Evid. 2004;(12):1578-1593.

Rimes KA, Chalder T. Treatments for chronic fatigue syndrome. Occup Med. 2005;55:32-39.

3/3/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: White P, Goldsmith K, et al. Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): a randomised trial. Lancet. 2011;377(9768):823-826.

10/1/2013 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Patterson E, Wan YW, et al. Nonpharmacological nursing interventions for the management of patient fatigue: a literature review. J Clin Nurs. 2013;22(19-20):2668-2678.

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