Chronic Fatigue Syndrome: Is it for Real?

Do you feel sluggish and extremely lethargic and have headaches, fever and sore muscles all the time despite eating and sleeping well? Perhaps you could be suffering from chronic fatigue syndrome (CFS).

Although CFS has been around since the 1700s and was profoundly noted in the 1980s, it is considered by many people, including health professionals and the general public, as an excuse to be lazy or unproductive, hence earning itself the epithet of Yuppie Disease. Others consider it to be a psychological ailment.

Until today, it still remains a mysterious and controversial malady. The question remains- is it real or imagined?


Continuing research confirms that CFS is indeed a physical illness — just one that is yet to be fully understood by the medical fraternity. One million people in the United States are said to have CFS, and tens of millions more have a CFS-like condition, according to the US Centers for Disease Control and Prevention (CDC).

The Merck Manual (Edition for Healthcare Professionals) defines CFS as long-standing, severe, disabling fatigue without demonstrable muscle weakness. According to the manual, there are no underlying disorders that could explain the fatigue, incuding depression, anxiety and other psychological manifestations.


It is almost impossible to put a finger on the exact prevalence of the condition as it is usually estimated to be between seven to 38 people per 100,000.

Prevalence estimates may tend to vary in a given population, due to differences in diagnostic evaluation, physician-patient attitudes and social acceptability. Prevalence of CFS from office-based studies is seen to be higher among whites although community surveys indicate a higher prevalence among blacks, Hispanics and American Indians – and least common among Asians.

Gender-based studies  point to a higher occurence of CFS among women. The average age of disease onset for both males and females is their 30s.


CFS usually happens suddenly. Among the first symptom is a flu-like condition with painful, swollen lymph nodes, extreme fatigue, fever and upper respiratory tract infections. The most significant symptom is extreme exhaustion – a persistent and debilitating fatigue which prevents patient from undertaking simple daily activities like getting out of bed, getting dressed and going to work.


There is no definitive diagnostic test for CFS. Diagnosis is usually made by clinical examination. If a patient has experienced a continued episode of fatigue that is not relieved by bed rest for six consecutive months and has flu-like symptoms of generalised pain and memory impairment, the physician will further investigate the possibility that the patient may be afflicted with CFS.

It is not known what causes or even triggers CFS. While research is on-going to establish the  cause, medical science is exploring the possibility that people afflicted by CFS may have a dysfunction of the immune and central nervous system.

Researchers are also looking at other potential reasons for CFS such as metabolic abnomalities and risk factors such as genetic predisposition, age and gender, prior illness as well as environment and stress.

Earlier research suggests that the Epstein Barr virus is a possible culprit but this is yet to be conclusively established. Researchers strongly feel that a virus could be the reason for the disease as symptoms mimic a typical case of a viral infection.


Non-sedating antidepressants are commonly prescribed, although the effects are unsatisfying. Patients are encouraged to make positive lifestyle adaptations which offer a good foundation for other treatment plans.

Recommended lifestyle changes include following a regular, manageable daily routine as well as reducing physical and emotional stress. While patients are advised to get more rest, prolonged bed rest must be avoided as it can de-condition muscles and increase fatigue.

Some CFS patients have found relief after consuming more organic food and avoiding alcoholic beverages as well as coffee, sugar and food additives. Engaging in mild to moderate exercise regularly such as stretching and simple water exercise can help alleviate symptoms.

Cognitive behaviour therapy, combined with exercise, is also recommended to relieve symptoms. In cognitive behavior therapy, patients work with their psychologist to identify negative beliefs and behaviours that might be delaying their recovery and replace them with healthy and positive ones.

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