Condition in
Family Medicine

Chronic Fatigue

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Overview

Chronic fatigue is a condition that causes extreme tiredness that doesn't go away with rest. It can make everyday activities like getting dressed or walking feel exhausting. The cause isn't always clear, and it can be linked to other conditions or triggered by infections. Some people also experience symptoms like headaches, joint pain, and trouble concentrating.

Our approach

Chronic Fatigue Syndrome (CFS), also known as Myalgic Encephalomyelitis (ME), is a complex and debilitating disorder characterized by extreme fatigue that doesn't improve with rest and may worsen with physical or mental activity. The exact cause is unknown, and it affects multiple systems in the body, including the immune, neurological, and hormonal systems.

Symptoms

Symptoms of Chronic Fatigue Syndrome can vary but commonly include:

  • Persistent Fatigue: Severe exhaustion lasting six months or more, not relieved by rest.
  • Post-Exertional Malaise (PEM): Worsening of symptoms after physical or mental activity.
  • Sleep Problems: Unrefreshing sleep or insomnia.
  • Cognitive Difficulties: Problems with memory, concentration, and information processing (often referred to as "brain fog").
  • Muscle or Joint Pain: Without signs of inflammation.
  • Headaches: Of a new type, pattern, or severity.
  • Sore Throat: Frequent or recurring without infection.
  • Enlarged Lymph Nodes: Tender lymph nodes in the neck or armpits.
  • Dizziness or Lightheadedness: Especially when moving from lying down or sitting to standing.
  • Flu-like Symptoms: General feeling of being unwell.

Diagnosis

Healthcare professionals diagnose Chronic Fatigue Syndrome through a careful evaluation, as there is no specific test for it:

  • Medical History and Symptom Assessment: Discussing the duration, severity, and impact of symptoms on daily life.
  • Physical Examination: Checking for signs that might indicate other conditions.
  • Exclusion of Other Conditions: Conducting blood tests, urine tests, and imaging studies to rule out diseases like anemia, thyroid disorders, diabetes, or infections.
  • Diagnostic Criteria: Using guidelines such as those from the Institute of Medicine (now the National Academy of Medicine) which require:
    • Significant impairment in the ability to engage in pre-illness levels of activity.
    • Post-exertional malaise.
    • Unrefreshing sleep.
    • At least one of the following: cognitive impairment or orthostatic intolerance.
  • Referral to Specialists: May involve neurologists, rheumatologists, or infectious disease experts for further evaluation.