CFS continued ... The problem is that in many cases, fatigue is nothing more than a shirker’s ruse to get out of work and take a ‘sickie’. And yet there do appear to be many genuine cases. After reading the report, I wonder if you consider you have the disease? The symptoms match many other conditions as well.

The report is reprinted below:

# The Centers for Disease Control and other top health officials are kicking off an awareness campaign about the controversial disease that has some doctors skeptical.

# Chronic fatigue syndrome (CFS) affects more than one million people in the United States. There are tens of millions of people with similar fatiguing illnesses who do not fully meet the strict research definition of CFS.

Risk Factors for CFS

# People of every age, gender, ethnicity and socioeconomic group can have CFS.

# CFS affects women at four times the rate of men.

# CFS is most common in people in their 40s and 50s.

# Children can develop the illness, particularly during the teen years.

Defining CFS Symptoms

# CFS is marked by extreme fatigue that has lasted at least six months; is not the result of ongoing effort; is not substantially relieved by rest; and causes a substantial reduction in daily activities.

In addition to fatigue, CFS includes eight characteristic symptoms:

# postexertional malaise (relapse of symptoms after physical or mental exertion);

# unrefreshing sleep;

# substantial impairment in memory/concentration; muscle pain;

# pain in multiple joints;

# headaches of a new type, pattern or severity;

# sore throat;

# tender neck or armpit lymph nodes.

Symptoms and their consequences can be severe. CFS can be as disabling as multiple sclerosis, lupus, rheumatoid arthritis, congestive heart failure and similar chronic conditions. Symptom severity varies from patient to patient and may vary over time for an individual patient.

Diagnosis of CFS

# There are no physical signs that identify CFS

# There are no diagnostic laboratory tests for CFS. People who suffer the symptoms of CFS must be carefully evaluated by a physician because many treatable medical and psychiatric conditions are hard to distinguish from CFS.

# Common conditions that should be ruled out through a careful medical history and appropriate testing include mononucleosis, Lyme disease, thyroid conditions, diabetes, multiple sclerosis, various cancers, depression and bipolar disorder.

# Research conducted by the Centers for Disease Control and Prevention (CDC) indicates that less than 20% of CFS patients in this country have been diagnosed.

Treatment of CFS

# Since there is no known cure for CFS, treatment is aimed at symptom relief and improved function. A combination of drug and nondrug therapies is usually recommended.

# No single therapy exists that helps all CFS patients. Lifestyle changes, including prevention of overexertion, reduced stress, dietary restrictions, gentle stretching and nutritional supplementation, are frequently recommended in addition to drug therapies used to treat sleep, pain and other specific symptoms.

Carefully supervised physical therapy may also be part of treatment for CFS. However, symptoms can be exacerbated by overly ambitious physical activity. A very moderate approach to exercise and activity management is recommended to avoid overactivity and to prevent deconditioning.

# Although health care professionals may hesitate to give patients a diagnosis of CFS for various reasons, it's important to receive an appropriate and accurate diagnosis to guide treatment and further evaluation.

# Delays in diagnosis and treatment are thought to be associated with poorer long-term outcomes. For example, CDC's research has shown that those who have CFS for two years or less were more likely to improve. It's not known if early intervention is responsible for this more favorable outcome; however, the longer a person is ill before diagnosis, the more complicated the course of the illness appears to be.

Recovery from CFS

# CFS affects each individual differently. Some people with CFS remain homebound and others improve to the point that they can resume work and other activities, even though they continue to experience symptoms.

# Recovery rates for CFS are unclear. Improvement rates varied from 8% to 63% in a 2005 review of published studies, with a median of 40% of patients improving during follow-up. However, full recovery from CFS may be rare, with an average of only 5% to 10% sustaining total remission.

Possible Causes of CFS

# Despite an intensive, nearly 20-year search, the cause of CFS remains unknown. Many different infectious agents and physiologic and psychological causes have been considered, and the search continues.

# Much of the ongoing research into a cause has centered on the roles of the immune, endocrine and nervous systems may play in CFS. More recently, interactions among these factors are under evaluation.

# Genetic and environmental factors may play a role in developing and/or prolonging the illness, although more research is needed to confirm this. CDC is applying cutting-edge genomic and proteomic tools to understand the origins and pathogenesis of CFS.

# CFS is not caused by depression, although the two illnesses often coexist, and many patients with CFS have no psychiatric disorder.