Chronic Fatigue Syndrome Diagnosis
Information for Physicians on Diagosing Chronic Fatigue Syndrome
The Centers for Disease Control (CDC) has established certain criteria for diagnosing Chronic Fatigue Syndrome:
1. Fatigue that is persistent, relapsing or debilitating; does not improve with bed rest; and reduces or impairs average daily activity level by more than 50 percent for a period of at least 6 months. Patient has no previous history of fatigue.
2. The patient has 4 or more of the following symptoms, which must have persisted or recurred during 6 or more consecutive months and predated the fatigue:
- Short-term memory or concentration problems
- Sore throat
- Multi-joint pain without joint swelling or redness
- Muscle pain
- Headaches of a new type, pattern or severity
- Non-refreshing sleep
- Post-exertional malaise lasting more than 24 hours
In addition, a number of minor symptoms may also appear:
- Poor sleep
- Achiness
- Brain fog
- Increased thirst
- Bowel disorders
- Recurrent infections
- Exhausting after minimal exertion
The CDC criteria should not be thought of as final guidelines in diagnosing Chronic Fatigue Syndrome. Research has shown the people with disabling fatigue who fit the Chronic Fatigue Syndrome criteria have the same immunologic changes and responses to treatment as those who don't fit the criteria.
According to Edward J. Conley, D.O, author of America Exhausted, "At least 50 percent of the patients we see for Chronic Fatigue Syndrome do not have symptoms severe enough to be classified as Chronic Fatigue Syndrome, but that does not mean these people are healthy. They just don't fit a committee's definition for Chronic Fatigue Syndrome."
"My experience also suggests that the underlying causes and the response to treatment are not affected by whether patients strictly meet CDC guides," says Jacob Teitelbaum, M.D. "I prefer to use the term Severe Chronic Fatigue States (SCFS) for these conditions."
In his book, From Fatigued to Fantastic, Dr. Teitelbaum states that it is important to look for and treat all of the factors simultaneously. Chronic fatigue states are unusual in that each problem can trigger other problems. Because of this, it is rare to find only one single underlying problem by the time the patient seeks medical help. The process that occurs is analogous to an automobile with no battery and no starter. If you fix only the battery or the starter, the car won't run. If both the battery and the starter are fixed at the same time, the care would be fine. In the same way, if we treat all of a patient's problems simultaneously, the person feels well.
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