Is It Fatigue or Chronic Fatigue Syndrome?

Joseph Couri, MD
Methodist Medical Group Rheumatology
Fatigue is an ongoing part of life for many individuals today. Lack of sleep for parents and others trying to squeeze all their “To-Do” list into 24 hours has become somewhat accepted in today’s busy lifestyle.

But for the thousands of people who suffer from Chronic Fatigue Syndrome (CFS), the causes for their fatigue remains a mystery. Chronic Fatigue Syndrome is a debilitating and complex disorder characterized by profound fatigue that is not improved by bed rest and that may worsen with physical or mental activity.

Symptoms may include headaches, sore throat, tender or painful areas in the neck and back, unexplained muscle soreness, pain that moves from joint to joint without swelling or redness, loss of memory or concentration, trouble sleeping and extreme tiredness that lasts more than 24 hours after exercising.

The media originally termed the illness yuppie flu and in the late ’80s it appeared that the only people who suffered from “yuppie flu” were the young, upwardly mobile urban professionals who, because of their lifestyle, were always tired.

Today, we know that Chronic Fatigue Syndrome can be an early warning sign that something is wrong with some of the body’s systems. Diseases and disorders like depression, diabetes, hypothyroidism and even certain cancers count fatigue as a primary symptom.

Unlike chronic fatigue, Chronic Fatigue Syndrome is the illness, not merely a symptom. It’s estimated that more than one million Americans suffer from CFS. It strikes more people in this country than multiple sclerosis, lupus, lung cancer or ovarian cancer.

Because the symptoms of Chronic Fatigue Syndrome are non-specific, medical professionals have difficulty diagnosing the illness. Even more confusing, some medical professionals still don’t recognize CFS as a valid illness, but rather see it as a psychosomatic disorder.

Researchers continue to explore possible causes and risk factors for CFS, but there are some characteristics that may help indicate people most at risk:

• CFS occurs four times more frequently in women than in men, although people of either gender are able to develop the disease.
• Most often the patient is in their 40s and 50s, but people of all ages can be affected.
• CFS is less common in children than adults.
• CFS occurs in all ethic and racial groups and is not limited to any one area of the world.
• People of all income levels can be affected.
• CFS sometimes is seen in members of the same family, however there is no evidence it’s contagious.

Doctors don’t know the cause of Chronic Fatigue Syndrome. However, several possible causes have been proposed, including:

• Iron deficiency (anemia)
• Low blood sugar (hypoglycemia)
• History of allergies
• Virus infection, such as Epstein-Barr virus or human herpes virus 6
• Dysfunction in the immune system
• Changes in the levels of hormones produced in the hypothalamus, pituitary glands or adrenal glands
• Mild, chronic low blood pressure
• Association with fibromyalgia

There’s no specific treatment for CFS. Doctors aim to relieve symptoms by using a combination of treatments that may include lifestyle changes, exercise, treatment for psychiatric problems, pain relief, allergy symptoms, low blood pressure and treatments for problems of the nervous system.

Learning how to manage fatigue can help patients improve the level of functioning and quality of life despite the symptoms. These can include a focused effort to reduce stress, to get enough sleep, regular exercise and to maintain a healthy lifestyle.

Today’s medicine can only treat symptoms. CFS is a chronic illness and requires on-going attention. tpw

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