Diagnosis of Chronic Fatigue Syndrome
In order to arrive at a diagnosis of CFS, it is necessary to follow the systematic procedure, recommended by a panel of CFS experts.
- The first step, is obtaining a detailed medical history, followed by a complete physical examination.
- The next is assessment of the mental status of the patient. This can be achieved by a short oral test or a brief discussion.
- This would be followed by a battery of lab tests (blood and urine tests) to identify alternative causes of fatigue, if any.
- If the test results raise suspicion of any other disorder, additional tests may have to be done to confirm the diagnosis, based on which further treatment can be instituted.
- If no other cause for the fatigue is obtained from the multidisciplinary approach, a diagnosis of CFS would be made, provided the symptoms correlate with the CFS definition.
A diagnosis of CFS can be arrived at, only if the following two criteria are satisfied.
- Extreme fatigue that results in a substantial reduction in the functionality of an individual, which cannot be attributed to exertion, and not relieved by rest.
- The presence of sore throat, impaired memory or ability to concentrate, tender lymph nodes (cervical/axillary), muscle pain, joint pain, new type of headaches, unrefreshing sleep, depression or malaise following exertion. Here again, 4 or more of the above mentioned symptoms should be present for a period of 4 months or more, to confirm the CFS diagnosis.
If the patient's symptoms are less severe, or if the criteria for CFS diagnosis are not satisfied, the patient is said to have idiopathic (of an unexplained cause) chronic fatigue.
References:
- Chronic Fatigue Syndrome - (http://www.nlm.nih.gov/medlineplus/chronicfatiguesyndrome.html)
- Myalgic Encephalomyelitis/Chronic Fatigue Syndrome - (http://www.cdc.gov/ncidod/diseases/cfs/)
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I have all these symptoms of ME/CFS for over a year and had presented to my GP with symptoms but at time they seem unrelated. Recently when I told her I believed I had it, her comments were "You don't have it by what I know although you are definitely stressed, and definitely fatigued". When I responded that I had sore throat/tender glands in my neck and that if I do more than normal activity I am wrecked afterwards and sometimes have flu like illness without being the bug, she did not reply. It left me angry she did not take me seriously although my counsellor whom is also a registered doctor agreed with my diagnosis. It is unfortunate no lab. tests exist to prove this. What I think confuses my doctor is the fact I am 51 and have chronic pain treated with prescribed narcotics but she cannot explain sudden weight gain [12kg] in a year as well as all the other chronic fatigue like signs! Thanks, Jem
As described CFS is a set of symptoms and not a disease by itself. the underlying causes are still unknown to medical science but due to some medical conditions also you can get these kind of symptoms [Syndrome]. I just read in another article about 'andropause'. a situation described similar (although not) to menapause in women. Here the level of Testestorone (male hormone) gets depleted. This can be tested in blood test. Also other conditions include vit B12 deficiency, clinical depression, anxiety disorders, etc. You can rule out some of them as there are tests available. As you have described, you were on pain management medicines that may also have such side effects. Also, acceptance / non-acceptance by your doctor should not mean anything to you. Its the right treatment is required for the same. So, first thrash out the possibilities where tests are available (Vit B12, TSH, testestorone level, etc) and then you'll be sure about this yourself. All the best!
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