Chronic fatigue syndrome

What is chronic fatigue syndrome?

Chronic fatigue syndrome (CFS) also known as ME (Myalgic Encephalomyelitis) is a condition that causes fatigue, which is severe enough that it interferes with a person's ability to participate in normal work, recreation or social activities. The condition has been classified by the World Health Organisation (WHO) as a disease of the nervous system.

There is an estimated 150,000 people in the UK who are affected by CFS.

What causes chronic fatigue syndrome?

No one really knows what causes chronic fatigue syndrome and no specific cause has been found.

The symptoms may be caused by an immune system that isn't working well or by some kind of viral infection like the herpes virus, glandular fever or the flu. You may also be more susceptible if you suffer with depression. Chronic fatigue syndrome affects 3 times more women than men and the illness strikes most commonly in the 20-40 age group though children can also be affected.

What are the symptoms of chronic fatigue syndrome?

The most common symptom of CFS is severe fatigue or exhaustion, unlike any other tiredness experienced before and it is not relieved by rest. This fatigue can come on gradually or suddenly and last for several months or longer. Others symptoms can be present but these can vary with each person, they may include:

• Frequent sore throats
• Muscle aches and pains, without swelling or redness
• Poor concentration and memory
• Abdominal pain
• Sweating, shivering or feeling cold
• Headaches
• Mood swings or depression
• Tender or painful lymph nodes in the neck or armpits
• Trouble sleeping or disturbed sleep patterns.

How is chronic fatigue syndrome diagnosed?

There is no actual test for CFS and so confirmation of the illness may take some time and it is important that a diagnosis is only made after other well known and recognised illnesses have been excluded, such as anaemia or thyroid problems. To exclude other illnesses your doctor may carry out a physical examination and carry out some urine and blood tests. Your doctor may also suggest you have some x-rays and a brain scan.

How is chronic fatigue syndrome treated?

There is no actual cure for CFS though some of the symptoms such as muscle aches, sleep problems and depression can be treated with medicine. Your doctor may prescribe a low dose anti-depressant, which has been known to help some people with CFS. Symptoms may also be eased by relaxation therapies, such as yoga. Doctors also recommend that you eat a well balanced diet, rich in fruit and vegetables.

There is also good evidence that a form of rehabilitation called cognitive behavioural therapy (CBT) helps people with CFS manage better on a day to day basis. The therapy is aimed at changing negative attitudes and teaching you to think more constructively.

What treatment works well for one patient might be ineffective for others or even make them feel worse. Your doctor will help you decide what treatments are best for you.

Living with chronic fatigue syndrome

The symptoms you experience with CFS can change from day to day and certain factors can aggravate the illness. For example, too much physical or mental effort can make things worse.

You need to be flexible and adjust your lifestyle to help you to live with the condition. At the onset of CFS a period of bed rest may be necessary though you should try to get out of bed at least once a day even if it is just to sit in a chair. You should then gradually increase your activity level, see how much you can manage without causing a relapse. Try to pace your activities so that you can rest in between. You should also avoid the urge to try and complete tasks in one go.

The long term outlook for people with CFS varies and is unpredictable, some people will improve and recover gradually between 6 months and a year, while others experience a long-term pattern of recovery and relapse.