According to the Centers for Disease Control and Prevention, there are 2.5 million Americans diagnosed with myalgic encephalomyelitis or chronic fatigue syndrome (CFS). For the many that suffer from this illness, there is no cure; treatment begins with addressing the most incapacitating symptoms.
This column will look at the complexity of the condition making CFS difficult to diagnose as many of the symptoms overlap with other illnesses and diseases.
The National Academy of Medicine’s 2015 diagnostic criteria documents the following as the three primary symptoms of CFS. Fatigue, unrefreshing sleep, and post-exertional malaise (PEM) which occurs after physical or mental exertion. PEM is the exacerbation of CFS symptoms. All three of the above must be present and the level of severity must be moderate to severe at least 50% of the time. Additionally, a person must experience one of the following: worsening symptoms after standing or sitting upright, or “brain fog”- difficulty with memory and focus becoming more severe when tired/stressed.
According to the Mayo Clinic, CFS additional symptoms may include headaches, sore throat, enlarged lymph nodes in neck or armpits, unexplained muscle or joint pain, or dizziness when standing.
Extreme fatigue is defined by United States Institute of Medicine as being new, not life-long; severe enough that a person can no longer participate in activities they did prior to onset or illness; not improved by rest, and include post-exertional malaise or PEM (which can take days or weeks to recover from).
There are many medical conditions that can trigger symptoms of CFS including, but not limited to, sleep disorders, anemia, diabetes, cancer, many autoimmune diseases, hormonal imbalances such as an overactive or underactive thyroid, depression and anxiety.
Unfortunately, there is not one test or procedure to diagnose CFS. The causes of CFS can come on suddenly following a viral infection, surgery, injury, or emotional trauma. Following the Coronavirus pandemic, many COVID long-haulers experience CFS symptoms.
If you believe you have symptoms of CFS, it is recommended to schedule an appointment with your primary care physician. Be sure to list all symptoms being as specific as possible as to when they began, the severity, and the impacts it has caused on your quality of life. Also, communicate any updated health and personal information with your physician. Blood work as well as additional diagnostic testing may be needed to rule out other medical conditions. Your physician may refer you to a specialist if there is concern the symptoms are related to a specific medical illness.
If other medical conditions are ruled out, managing the most debilitating symptoms is key to feeling better. This may include over the counter medications to manage pain or prescriptions to treat anxiety and depression. However, counseling, support groups or exercise may also be part of the individual care plan.
Column is written by Laura Falt, director of business development in Connecticut. Laura welcomes the opportunity to be a resource to the community on services for older adults and is often featured in local publications.