Chronic Fatigue

Chronic Fatigue Syndrome (CFS), now often called Myalgic Encephalitis Chronic Fatigue Syndrome (ME/CFS), and also known as Chronic Fatigue Immune Dysfunction Syndrome (CFIDS) is a medical condition characterized by post-exertional fatigue, more fatigue than you would normally expect after routine exercise. Fatigue that stops you in your tracks can last for hours and even weeks. It can even occur following a short walk.

This fatigue can be measured through a Cardiopulmonary Exercise Test (CPET) monitoring your anaerobic threshold and your oxygen consumption. The test will merely confirm what you experience every day. Normal activity wipes you out.

The IACFS (International Association of Chronic Fatigue Syndrome), a well-respected and large group of health care providers who have dedicated much of their practices and much of their lives to helping people with MECFS, issued a 2012 Primer to aid doctors in evaluating and treating people with MECFS. This primer summarizes the current state of knowledge with respect to ME/CFS, including diagnosis, treatment, biomarkers, and symptoms. Most importantly, the Primer recognizes that, like Fibromyalgia, there is a genetic basis for susceptibility to CFS, and known triggers include infections and physical trauma.

In 2010, attorney Steve Krafchick was appointed by the U.S. Secretary of the Department of Health and Human Services to serve a 4-year term on the national Chronic Fatigue Syndrome Advisory Committee (CFSAC).

Should you wish to view the 2012 primer, Click here.

In addition to problems with post exertional fatigue or malaise, Chronic Fatigue Syndrome patients also experience other symptoms. These symptoms include orthostatic intolerance (getting light headed or dizzy when changing positions—this can be measured with a tilt table test), cognitive problems (especially memory and concentration), and waking up and feeling unrefreshed after a typical night’s sleep. CFS patients also can experience gastrointestinal problems, urological problems, and gynecologic problems. Often CFS patients suffer from emotional distress because of the consequences of the fatigue and other symptoms on their ability to work, enjoy family, enjoy other activities. The fatigue can vary as a considerable annoyance to a condition that requires someone to remain in bed most of the day.

ME/CFS remains a diagnosis of exclusion. This means other explanations for the symptoms that are considered part of CFS need to be ruled out. If the symptoms persist after adequate treatment of the medical condition being ruled out, then this supports the ME/CFS diagnosis. The presence of post exertional fatigue or malaise is often what helps establish the diagnosis if it cannot be explained by any other medical condition you have.