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Chronic fatigue, a feeling of being tired all the time, but is unrelated to physical activity, is a symptom of various diseases. Some examples of medical conditions that are marked with chronic fatigue include hypothyroidism (under-active thyroid gland), autoimmune diseases, obesity, chronic infection, diseases of the heart, liver or adrenal gland, depression, sleep apnea, and cancer. Persistent fatigue may also be related to malingering, alcoholism and drug abuse. In many of these cases, the cause may be identified through clinical evaluation and laboratory examinations.

In some people, however, these clinical examinations turn out negative for any disease, suggesting that bodily functions are essentially normal. So why do patients continue to feel persistently tired, unable to sleep well, and experiencing muscle aches?

In 1994, an international group of experts defined a condition known today as Chronic Fatigue Syndrome (CFS), which is a condition that is diagnosed by exclusion of other possible diseases. It is, however, diagnosed in patients who fulfill two essential criteria:

  1. They have experienced severe chronic fatigue for at least six months, and

  2. They are experiencing at least four symptoms from this list of 8 symptoms:

  • significantly impaired short-term memory or ability to concentrate

  • sore throat

  • enlarged, tender lymph nodes in the neck or armpit

  • muscle pain not related to injury or overexertion

  • joint pains not associated with swelling and redness

  • new type of headache

  • sleep non-refreshing

  • malaise or exhaustion after physical or mental activity, lasting more than 24 hours

There is no specific laboratory test that can diagnose CFS, and it is often identified after excluding all possible conditions and only after considering the two established criteria.

What Causes Chronic Fatigue Syndrome?

No exact cause has been identified for this disease, but there are certain risk factors associated with it. Some research suggests that infection with viruses such as Epstein-Barr, herpesvirus, coxsackievirus B, or mouse leukemia virus may trigger chronic fatigue that leads to CFS. Impairment of the immune system has also been linked to CFS, since many patients have a history of repeated infections, as well as stress and exposure to toxic substances. Others also suggest that hormonal imbalance may be involved. Women are more likely to report their symptoms, and are therefore more likely to be diagnosed with the condition. It is also more common in people aged 40 to 50.

Stress, inactivity and obesity are also linked to development of CFS.

Treatment of Chronic Fatigue

If you have been experiencing severe tiredness that is not related to physical activity, and which has lasted more than a few weeks, consult your doctor for proper diagnosis and treatment. Your doctor will conduct a thorough evaluation, which may include various laboratory tests to find any abnormalities in function related to chronic fatigue. If no abnormalities are found, other conditions may be considered, including CFS.

There is no specific treatment or cure for CFS. However, supportive therapy may help relieve your symptoms. Muscle aches, joint pains and headache may be relieved by taking over-the-counter pain relievers. Many patients experience depression due to their condition, and antidepressants such as sertraline (Zoloft) or bupropion (Wellbutrin) may help them sleep better and improve their moods.

Lifestyle changes play an important role in treating the symptoms of CFS. A healthy diet, regular exercise and psychological counseling are essential to maintaining physical and mental well-being. Some also suggest taking diet supplements, undergoing acupuncture, or trying holistic treatments, but more studies have to be done to establish their benefits on CFS.

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