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Chronic Fatigue Syndrome: Symptoms and Treatment

Chronic Fatigue Syndrome (CFS)

Chronic fatigue syndrome (CFS) is a debilitating disease that causes significant tiredness and weakness. In some cases it can cause general muscle pain and a multiple number of symptoms. Unfortunately, the exact cause of chronic fatigue syndrome is unknown. Chronic fatigue syndrome most commonly arises from flu like symptoms or from neurological, endocrinological and immunological dysfunction in the body.

Chronic Fatigue Syndrome Symptoms

Chronic fatigue syndrome (CFS) is primary characterized by prolonged fatigue that does not get better with rest. But, chronic fatigue syndrome is often associated with other signs and symptoms. Here are the main chronic fatigue syndrome symptoms:
  • Fatigue – fatigue that is the primary symptom of chronic fatigue syndrome. It has the ability to stop the person from doing normal activities of daily living. It can be so severe that even going to the toilet can be an exhausting exercise. Rest or any other intervention does not improve fatigue. Some medications help fatigue but are usually a temporary relief.
  • Sore Throat – a sore throat is one of the most common chronic fatigue syndrome symptoms. The sore throat is possibly due to dysfunction in the thyroid caused by the chronic fatigue syndrome and immune dysfunction.
  • Myalgia – myalgia is general muscle pain that occurs throughout the body. It is not usually specific in one area. In some sufferers of chronic fatigue, the muscle pain is constant and can be very severe causing a lot of suffering.
  • Headaches – headaches are very common with chronic fatigue. Usually, the headaches are more severe than usual when suffering from chronic fatigue. It is sometimes uncharacteristic of a normal headache and can feel sometimes like a migraine.
  • Memory Loss – People suffering from CFS suffer from short term and long term memory loss. Its possibly due to the lack of sleep, pain and fatigue which contributes to memory issue. Usually the more severe the symptoms of pain and sleep, the more severe the memory loss.
  • Lack of concentration – Sufferers of CFS have trouble focusing on a task and therefore have trouble concentrating.
  • Pain in joints without inflammation – Sufferers will feel pain in their joints which can move from one joint to another. Usually the pain feels like a ache deep inside the joint and there is no redness or swelling in the joint.
  • Enlarged Lymph nodes in the Neck and Axilla – Due to the lack of exercise, movement and immune dysfunction, CFS will have enlarged lymph nodes in the neck and armpits.
  • Disturbed and Unrefreshing Sleep – Disturbed and unrefreshing sleep is common with CFS. Hence CFS people will feel tired, weak and unmotivated in the morning and during the day.
  • Exhaustion and Malaise – extreme exhaustion and malaise that lasts for 24 hours or more with any mental or physical exertion.
  • Nausea – at times, CFS can be severe such that sufferers complain of nausea and vomiting.

Chronic Fatigue Syndrome Diagnosis

Diagnosis of chronic fatigue syndrome is based on exclusion of other diseases and symptoms. Unfortunately, there is no concrete scientific test to diagnose chronic fatigue syndrome hence it is based on elimination of other diseases and conditions.

Nevertheless, there are certain characteristics of people having chronic fatigue syndrome. Here are some steps used by doctors for a chronic fatigue syndrome diagnosis.

The guidelines used by the CDC (Centers for Disease Control) specify certain characteristics for chronic fatigue.

Exclude other conditions and diseases

The first step is rule out any chronic infections particularly to the nervous system such as Mononucleosis, Lyme disease or Tuberculosis. Then another test to exclude autoimmune system diseases (a condition where the body’s own immune system attacks itself) such as lupus or multiple sclerosis. The test involves having blood tests and investigations such as MRI scans to rule out these diseases.

The reason why these tests are done is because chronic fatigue syndrome has similar signs and symptoms to these neurological and infectious conditions and also there is no specific medical test for chronic fatigue.

Unexplained persistent fatigue

The next step for chronic fatigue syndrome diagnosis is unexplained persistent fatigue that is not due to physical stress or exertion which is not relieved by rest. The person experiences fatigue for no particular reason and is not treated by any means. It can appear suddenly and can last for an unidentified amount of time. This results in a decline or difficulty in performing daily activities of living.

Symptoms that are present for more than 6 months

If four of these symptoms are present for more than 6 months or more, then they are categorized in having chronic fatigue syndrome. The symptoms that the person may present are:

Myalgia – or general muscle pain in the body. The person may experience chronic achiness in the body all over and usually cannot be specified in one area.

Interrupted or unrefreshing sleep – The person may experience interrupted or unrefreshing sleep in which they wake up in the morning feeling tired, weak or unmotivated.

Sore throat – The person experiences frequent sore throats or intermittently experiences sore throats very often in the past 6 months or more.

Post-exertional Mailase – The person experiences prolonged exhaustion and sickness following any mental or physical activity.

Short/ Long term memory loss and impaired Concentration – With chronic fatigue syndrome, the person will usually feel that that have a short or long term memory loss. It is also associated with the inability to sustain a task for a certain period of time.

Tender Axillary or Cervical Lymph nodes – If you feel tender underneath your armpits or around your neck.

Headaches – With chronic fatigue, headaches tend to be more severe than usual.

Joint pain without inflammation – If you feel pain in the joints without swelling or redness.

Your doctor should go through this procedure for a chronic fatigue syndrome diagnosis.

Chronic Fatigue Syndrome Treatment

As there are many causes for CFS, there are several types of chronic fatigue syndrome treatment. Here are the main chronic fatigue syndrome treatment.

Steroid injections

Steroid injections using hydrocortisone has been found to be useful for chronic fatigue syndrome treatment. Steroid or cortisone treatment is useful to treat CFS because it helps to increase the body’s metabolic system and help reduce any inflammatory disorder that is affecting the body system.


Antidepressants are used to treat CFS as it helps to stop mood swings and stress. It also allows the person with CFS to sleep better so people can get more refreshing sleep during the night. This allows the person to have more energy during the day and will fatigue less.

Anti-viral treatment

As some CFS is caused by viruses, antiviral treatments have been shown to be effective in treating CFS. Some antiviral treatments that are effective in treating CFS is Valacyclovir, Ampligen, Interferon and IGG. Out of all the antiviral treatments, Interferon has been shown to be the most effective way in treating chronic fatigue syndrome in random control studies.

Depression Treatment for Chronic Fatigue Syndrome

One of the most common conditions often associated with chronic fatigue syndrome is depression. Due to fatigue, lack of energy and weakness people will tend to become depressed because the lack or inability to perform activities of daily living and physical exercise. Depression with chronic fatigue syndrome is a deadly mix which can spiral down to suicidal tendencies and physical health related issues. Hence, it is very important that treatment for depression is managed straight away to minimize further depression and a faster recovery.

Depression Treatment

There are three effective main ways for depression treatment. They are: psychotherapy, medication and exercise. People with chronic fatigue syndrome have variable results with each treatment.


Psychotherapy treat depression by non-pharmaceutical ways primarily by counselling (but psychotherapy can be combined with pharmaceutical therapy to assist with treatment). Psychotherapy treatment is divided into three parts. First is to provide support and acknowledgement of having depression which helps to minimize existing pain. The second part of the therapy uses cognitive behavioral therapy techniques such as hypnosis or strategies to make the person feel positive about them. The third part is to identify the stressors or keys that make them feel depressed by managing, eliminating or coping with the stressors or triggers of depression.


Medication is often used along side psychotherapy. The most common group of medication for the treatment of depression is antidepressants.

Antidepressants help to alleviate depression symptoms like anxiety, stress and mood changes. Antidepressants work by changing the chemicals or neurotransmitters in the brain which will trigger depression. There are many types of antidepressants. The most common type of antidepressants are:

Tricyclic Antidepressants (TCA) – Work by increasing Serotonin and norepinephrine (which includes drugs such as: Aventyl, Pamelor, Sinequan, Vivactil).
Monoamine Oxidase Inhibitors (MAOI) – increase norepinephrine and serotonin. Drugs found in this class are: Nardil, Marplan and Parnate.
Selective Serotonin Reuptake Inhibitors (SSRI) – increase serotonin and uptake of serotonin in the brain. Zoloft, Prozac, Paxil, Celexa
Welbutrin – increases norepinephrine and dopamine in the brain.
Effexor – increase serotonin and norepinephrine in the brain as above.
Trazodone – this drugs blocks certain neurotransmitters in the brain that triggers depression

All these medication have side effects and must be prescribed by a psychiatrist or doctor for the correct dosage.


Exercise is often effective for the management of depression. When people exercise, they increase the natural neurotransmitter called endorphins which is a natural pain killer. It also helps to block neurotransmitters that trigger depression. With chronic fatigue syndrome, graded exercises tend to be the most effective with the treatment of depression. This is best prescribed by a health professional such as a physical therapist.

Patients are often also advised to slow down, cut down physical exertion and try to avoid mental stress as it may cause a decrease in your immune system.


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