Chronic Fatigue Syndrome

Fatigue is probably the most common complaint my patients present with and discovering why patients are tired has always been an area of great interest to me. For one person it might be just not having quite the level of energy they wish they had, while at the other end of the spectrum is the chronically exhausted patient who becomes practically bedridden after only minor activity.

After treating chronic fatigue conditions for over 40 years it appears that most fatigue conditions are complex and multifactorial. There is no "magic bullet" or universal treatment for fatigue. My basic approach is to discover and eliminate the cause and/or tree to deficiency. The majority of the time the cause or causes of fatigue can be discovered and treated.

Chronic fatigue conditions can involve multiple organ systems:

Assessment and Treatment of Fatigue Disorders

Testing and treatment for CFS patience varies with the individual, but these are some common approaches:

Allergy evaluation is an important part of our diagnostic evaluation of patients with fatigue, even though many of these patients have no suspicion that allergy could be causing their problems. This would mostly involve food allergy, but also include inhalants such as dust, dust mites, mold, pollen, etc.

Chronic Fatigue Syndrome—CDC Criteria

The symptoms of chronic fatigue cannot be objectively measured. That is the reason why the CDC developed criteria to establish the diagnosis of Chronic Fatigue Syndrome, a systemic disorder comprising a complex set of symptoms, which vary in duration, incidence and severity. The most common characteristic is prolonged fatigue lasting 6 months or more resulting in substantial reduction in the patient's previous ability to participate in occupational, educational, social, and personal activities.

According to the CDC guidelines on CFS, the major characteristics are that the fatigue:

The current CDC definition also requires at least four or more of the following symptoms: