CFS can begin in different ways. Aside from fatigue, people with CFS experience a variety of other symptoms such as difficulty concentrating, sore throat, and muscle aches that either persist or come and go for more than six months. CFS often begins after you have had a cold, an intestinal virus, or bronchitis. Teenagers and young adults sometimes get it after a bout of mononucleosis. Other people find that CFS starts during a period of high stress. But for some people it comes on slowly, and there is no distinct, triggering event. You feel too tired to carry out your normal daily routine, and may be easily exhausted by any activity.
Early in the illness, the most common symptoms are sore throat, fever, muscle pain, and muscle weakness. At this point you may sleep a great deal, but as time passes you may instead have difficulty falling asleep, or may wake up too soon.
To receive a diagnosis of CFS, you must have severe fatigue that has lasted at least six months without any other explanation, and must have at least four of the following symptoms: poor short-term memory or difficulty concentrating; a sore throat; tender lymph nodes; muscle and joint aches; a new type of headache that you never had before; sleep that does not make you feel rested; and fatigue after exercise that lasts more than 24 hours Table 01. Among the many other symptoms patients experience are sensitivity to noise, light, food, medicines, and chemicals; difficulty sleeping; pain in the abdomen and digestive problems; mood swings; psychological problems such as anxiety, depression, and irritability; chronic cough; diarrhea; dizziness; dry eyes or mouth; earaches; irregular heartbeat; inability to tolerate alcohol; jaw pain; morning stiffness; nausea; night sweats; shortness of breath; weight loss; odd tingling sensations in the skin; and decreased interest in sex. It is important to remember that having any or even a combination of several of these disorders does not necessarily mean that you have CFS.
Table 1. Diagnosis and Symptoms of CFS
You must meet both of the following criteria to be diagnosed with CFS 1. You have severe fatigue that has lasted at least 6 months, and you have not been diagnosed with any other illness that could explain your symptoms. 2. You have had at least 4 of the following symptoms for 6 months, and these symptoms did not begin before the fatigue: ???Poor concentration or short-term memory ???Sore throat ???Tender lymph nodes ???Muscle and joint aches ???Headaches of a type you haven?t had before ???Unrestful sleep ???Fatigue that lasts over 24 hours after exercise Other common symptoms of CFS Sensitivity to noise, light, food, medicines, and chemicals Sleep problems Abdominal pain Digestive distress Mood swings, anxiety, depression, and irritability Chronic cough Diarrhea Dizziness Dry eyes or mouth Earaches Irregular heartbeat Intolerance to alcohol Jaw pain Morning stiffness Nausea Night sweats Shortness of breath Weight loss Odd tingling sensations in the skin Decreased interest in sex
The course of CFS varies from one patient to another. The symptoms of CFS can vary in an individual and from person to person. The illness involves many ups and downs. Many people reach a point early in their illness where the symptoms stop getting worse. After that, periods of feeling worse alternate with periods of feeling better.
Several illnesses have symptoms similar to those of CFS. A number of other illnesses involve symptoms similar to those of CFS; especially the profound fatigue. A diagnosis of one of these conditions rules out a diagnosis of CFS:
- fibromyalgia syndrome
- neurasthenia (chronic mental and physical weakness and fatigue)
- multiple chemical sensitivities (a syndrome of fluctuating symptoms that affects more than one body system and is provoked by exposure to low levels of chemicals, foods, or other agents in the environment)
- chronic mononucleosis
- sleep disorders such as narcolepsy
- major depression
- bipolar affective disorder
- eating disorders
- autoimmune disease such as lupus or multiple sclerosis
- some hormonal disorders
- certain infections
- chronic mononucleosis
- low thyroid function
- alcohol or drug abuse
- reactions to prescription medication.
Although anyone can get CFS, it is more common in women. CFS is two to four times more common in women than in men, and scientists do not know why. Adolescents can have CFS, but they get it less often than adults do. CFS has been reported in children under the age of 12.
No one knows for sure whether CFS is contagious. There is no scientific evidence showing that CFS can be given from one person to another. Most people who come in contact with people who have the illness do not develop it. Studies of groups of cases in the same locations did not reveal any infectious organism that could be transmitted from person to person.
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