Chronic Fatigue Syndrome (CFS) also known as chronic fatigue and immune dysfunction syndrome (CFIDS), is a debilitating illness that has long been misunderstood by the public and by health care professionals. The illness has proven to be both complex and mysterious, and there is still no known cause or cure.
Researchers have uncovered biologic abnormalities in CFS patients, producing a “critical mass” of scientific evidence that CFS is a real biologic illness, not a psychiatric condition. Abnormalities have been found in the immune system, the brain, the hypothalamic-pituitary-adrenal (HPA) axis, the cardiovascular system, the autonomic nervous system, and the endocrine system of CFS patients. Although the cause of CFS isn’t yet understood, there is a growing body of research showing that physiologic, environmental and behavioral events experienced over the lifespan—combined with a genetic predisposition—may lead to CFS.
What Are the Symptoms of CFS?
As the name chronic fatigue syndrome suggests, this illness is accompanied by fatigue. However, it’s not the kind of fatigue we experience after a particularly busy day or week, a sleepless night, or stressful events. It’s a severe, incapacitating fatigue that isn’t improved by bed rest and that may be worsened by physical or mental activity.
Although its name trivializes the illness as little more than tiredness, CFS brings with it a constellation of debilitating symptoms. The fatigue of CFS is accompanied by characteristic symptoms lasting at least six months. These symptoms include sleep difficulties, problems with concentration and short-term memory, flu-like symptoms, pain in the joints and muscles, tender lymph nodes, sore throat, and headache. A hallmark of the illness is postexertional malaise, a worsening of symptoms following physical or mental exertion that can require an extended recovery time.
The severity of CFS varies greatly from patient to patient, with some people able to maintain fairly active lives. For others, CFS has a profound impact on work, school and family life. About 25 percent of CFS patients are disabled by the illness. There’s often a pattern of relapse and remission, and patients may cycle between different levels of function. Most symptoms are invisible to others, which makes it difficult for friends, family members, and the public to understand the challenges a person with CFS faces.
What are Common Comorbid Conditions?
In addition to the “diagnostic symptoms” of CFS listed above, it’s not uncommon for CFS patients to have symptoms of other illnesses. These may include visual disturbances (blurring, sensitivity to light, eye pain); psychological problems (irritability, mood swings, anxiety, panic attacks); chills and night sweats; irritable bowel (abdominal pain, diarrhea, constipation, intestinal gas); allergies and sensitivities to foods, odors, chemicals, medications; brain fog and cognitive impairment; difficulty retaining upright posture, dizziness, balance problems, and fainting; gynecological problems including PMS and endometriosis; and many other health problems.
Because these symptoms are shared with many other illnesses—and because many of these conditions lack a diagnostic test or biomarker—unraveling which illnesses are present can be difficult. Some patients actually receive diagnoses for multiple conditions. Common comorbid conditions include fibromyalgia, irritable bowel syndrome, interstitial cystitis, temporomandibular joint disorder, chronic pelvic pain ,and multiple chemical sensitivity.
Because CFS can resemble other comorbid conditions—as well as medical disorders like mononucleosis, multiple sclerosis, chronic Lyme disease, and lupus—it’s frequently misdiagnosed. For more information, call the Association’s resource line at 704-365-2343.