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Chronic Fatigue Syndrome; Diagnosis.

Chronic fatigue syndrome (CFS) is often misdiagnosed because its symptoms are shared by other disorders, including:


sleep apnea


alcohol or substance abuse

severe obesity


multiple sclerosis



anorexia nervosa

bulimia nervosa


bipolar disorder


Thus, the diagnosis of CFS is one of exclusion, i.e., excluding other possible causes of the symptom complex. Some diseases eliminate a diagnosis of CFS, such as multiple sclerosis, lupus or a severe psychiatric disorder such as schizophrenia. It would not provide any benefits in these cases to have a second diagnosis.

The current diagnostic criteria for CFS specifies debilitating fatigue for at least six months that doesn't improve with rest and gets worse with physical or mental exertion that was previously well tolerated. It also requires the presence of four of the following symptoms:

unrefreshing sleep

impairment in short-term memory or concentration

post-exertional malaise occurring within 12 to 24 hours of exertion and lasting 24 hours or more

joint pain without joint swelling or redness

muscle discomfort or pain

headaches of a new type or severity

recurrent sore throat

tender lymph nodes in the neck and underarms

Multiple subjective symptoms are also reported, and although these are not included in the current diagnostic criteria, they are reported with relative frequency. These include:

Irritable bowel syndrome and other gastrointestinal complaints

Allergy-like symptoms

Skin rashes

Visual disturbances


Numbness and tingling in arms and legs

Sensitivities to various chemicals

Dry eyes


Night sweats

Alcohol and medication intolerances

Some CFS patients also report mild to moderate symptoms of anxiety or depression. However, many people with CFS don't have depression or any other psychiatric illness. Depression may be a secondary effect of CFS, not necessarily a primary condition, as people attempt to cope with the changes in lifestyle that living with a chronic illness dictates.

Whether anxiety or depression occurs before or during the illness is not the significant factor; getting help for these distressing conditions is what is essential.

Some also find allergies are significantly more common in CFS patients than in the general population. Many CFS patients have a history of allergies years before the onset of the syndrome. Sometimes patients report a worsening of allergic symptoms or the onset of new allergies after becoming ill with CFS. Because allergies are so common in people with CFS, it is important to identify symptoms caused by allergies so they can be treated independently.

Your health care professional should take a thorough medical history, and conduct extensive physical and mental status examinations, including laboratory tests.


"Chronic Fatigue Syndrome." Fact Sheet. National Institute of Allergy and Infectious Diseases. National Institutes of Health. Accessed Oct. 2001.

"Chronic Fatigue Syndrome." Centers for Disease Control and Prevention. National Center for Infectious Diseases. Accessed Oct. 2001.

"Introduction to CFIDS and CFS" and "Medical Issues." The CFIDS Association of America, Inc. Accessed Oct. 2001.

Natelson, Benjamin, H., Facing and Fighting Fatigue, (Yale University Press, 1998)

"About CFS: Demographics." The Centers for Disease Control. May 2005. Accessed May 2006.

"About CFS: Diagnosis." The Centers for Disease Control. May 2005. Accessed May 2006. "Genetics a factor in chronic fatigue." Molecular Biology and Bioinformatics News. April 30, 2006. Accessed June 2006."Basic Facts (on CFS)." The Centers for Disease Control. May 2006. Accessed June 2006.

Keywords: chronic fatigue syndrome, cfs, symptoms, test for chronic fatigue syndrome, multiple sclerosis, lupus
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Publication:NWHRC Health Center - Chronic Fatigue Syndrome
Article Type:Disease/Disorder overview
Date:Aug 9, 2006
Previous Article:Chronic Fatigue Syndrome; Overview.
Next Article:Chronic Fatigue Syndrome; Treatment.

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