What is Chronic Fatigue Syndrome?
We all get tired. Many of us at times have felt depressed.
But the mystery known as chronic fatigue syndrome (CFS) is
not like the normal ups and downs we experience in everyday
life. The early sign of this illness is a strong and noticeable
fatigue that comes on suddenly and often comes and goes or
never stops. You feel too tired to do normal activities or
are easily exhausted with no apparent reason. Unlike the mind
fog of a serious hangover, to which researchers have compared
CFS, the profound weakness of CFS does not go away with a
few good nights of sleep. Instead, it slyly steals your energy
and vigor over months and sometimes years.
How CFS Begins and Its Symptoms
For many people, CFS begins after a bout with a cold, bronchitis,
hepatitis, or an intestinal bug. For some, it follows a bout
of infectious mononucleosis, or mono, which temporarily saps
the energy of many teenagers and young adults. Often, people
say that their illnesses started during a period of high stress.
In others, CFS develops more gradually, with no clear illness
or other event starting it.
Unlike flu symptoms, which usually go away in a few days or
weeks, CFS symptoms either hang on or come and go frequently
for more than six months.
CFS symptoms include:
- Headache
- Tender lymph nodes
- Fatigue and weakness
- Muscle and joint aches
- Inability to concentrate
Who Gets CFS?
CFS was once stereotyped as a new "yuppie flu" because those
who sought help for and caused scientific interest in CFS
in the early 1980s were mainly well-educated, well-off women
in their thirties and forties. Similar illnesses, known by
different names, however, date back at least to the late 1800s.
The modern stereotype arose. Since then, doctors have seen
the syndrome in people of all ages, races, and social and
economic classes from several countries around the world.
Still, CFS is diagnosed two to four times more often in women
than in men, possibly because of biological, psychological,
and social influences. For example, CFS may have a gender
difference similar to diseases such as systemic lupus erythematosus
and multiple sclerosis, which affect more women than men.
Women may be more likely than men to talk with their doctors
about CFS-like symptoms.
Some members of the medical community and the public do not
know about or are skeptical of the syndrome. An increasingly
diverse patient group will likely emerge as more doctors see
CFS as a real disorder.
How Many People Have It?
Because there is no specific laboratory test or clinical
sign for CFS, no one knows how many people this illness affects.
CDC estimates, however, that as many as 500,000 people in
the United States have a CFS-like condition.
What Causes CFS?
While no one knows what causes CFS, for more than a century,
doctors have reported seeing illnesses similar to it. In the
l860s, Dr. George Beard named the syndrome neurasthenia because
he thought it was a nervous disorder with weakness and fatigue.
Since then, health experts have suggested other explanations
for this baffling illness:
- Iron-poor blood (anemia)
- Low blood sugar (hypoglycemia)
- Environmental allergy
- A body wide yeast infection (candidiasis)
In the mid-1980s, the illness became labeled "chronic EBV"
when laboratory clues led scientists to wonder whether the
Epstein-Barr virus (EBV) might be causing this group of symptoms.
New evidence soon cast doubt on the theory that EBV could
be the only thing causing CFS. High levels of EBV antibodies
(disease-fighting proteins) have now been found in some healthy
people as well as in some people with CFS. Likewise, some
people who don’t have EBV antibodies, and who thus have
never been infected with the virus, can show CFS symptoms.
How is CFS Diagnosed?
Doctors find it difficult to diagnose CFS because it has the
same symptoms as many other diseases. When talking with and
examining you, your doctor must first rule out diseases that
look similar, such as multiple sclerosis and systemic
lupus erythematosus in which symptoms can take years to
develop. In follow-up visits, you and your doctor need to
be alert to any new cues or symptoms that might show that
the problem is something other than CFS.
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