How is Chronic Fatigue Syndrome diagnosed. What are the core symptoms of ME/CFS. Who is at risk for developing Chronic Fatigue Syndrome. What causes CFS/ME. How does CFS impact daily life. What treatments are available for Chronic Fatigue Syndrome. Can CFS be cured or managed long-term.

Understanding Chronic Fatigue Syndrome: An Overview

Chronic Fatigue Syndrome (CFS), also known as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), is a complex and debilitating condition affecting millions of people worldwide. This mysterious illness is characterized by extreme fatigue that doesn’t improve with rest and can significantly impact a person’s quality of life.

Approximately 2.5 million Americans are affected by ME/CFS, yet experts estimate that only about 20% of cases are diagnosed. This underdiagnosis highlights the challenges in identifying and understanding this condition.

The Diagnostic Challenge: Why ME/CFS is Difficult to Identify

Diagnosing ME/CFS presents a unique set of challenges for healthcare professionals. Unlike many other medical conditions, there is no simple blood test or imaging study that can definitively confirm the presence of CFS. This lack of a clear diagnostic marker contributes to the difficulty in identifying and managing the condition.

Many symptoms of ME/CFS overlap with other health issues, further complicating the diagnostic process. Conditions such as mononucleosis, Lyme disease, lupus, multiple sclerosis, fibromyalgia, sleep disorders, and depression can present with similar symptoms, requiring careful evaluation to distinguish ME/CFS from these other potential causes.

Is there a specific test for Chronic Fatigue Syndrome?

Currently, there is no single, definitive test for ME/CFS. Diagnosis is based on a comprehensive evaluation of symptoms, medical history, and the exclusion of other potential causes. Researchers are actively working to develop more accurate diagnostic tools, but for now, the process remains complex and multifaceted.

Core Symptoms and Diagnostic Criteria for ME/CFS

While the absence of a specific test makes diagnosis challenging, healthcare providers rely on a set of core symptoms and diagnostic criteria to identify ME/CFS. Understanding these key indicators is crucial for both patients and medical professionals.

What are the primary symptoms of Chronic Fatigue Syndrome?

The hallmark symptom of ME/CFS is extreme fatigue that persists for six months or longer and is not alleviated by rest. However, this fatigue alone is not sufficient for a diagnosis. Healthcare providers look for a combination of symptoms, including:

• Post-exertional malaise (PEM): Worsening of symptoms after physical or mental exertion
• Unrefreshing sleep: Difficulty falling asleep, staying asleep, or waking up feeling unrestored
• Cognitive impairment: Problems with thinking, memory, and concentration (often referred to as “brain fog”)
• Orthostatic intolerance: Worsening of symptoms when standing or sitting upright, potentially accompanied by dizziness, weakness, or vision changes

In addition to these core symptoms, individuals with ME/CFS may experience a range of other issues, including:

• Muscle and joint pain
• Headaches
• Sore throat
• Tender lymph nodes
• Sensitivity to light
• Low-grade fever
• Mood changes, including depression

The Diagnostic Process: Steps to Identifying ME/CFS

Given the complexity of ME/CFS, healthcare providers must follow a careful and thorough diagnostic process to accurately identify the condition. This process typically involves several key steps:

1. Comprehensive medical history review
2. Physical examination
3. Evaluation of symptoms against diagnostic criteria
4. Exclusion of other potential causes
5. Additional testing as needed

How long does it take to receive a diagnosis of Chronic Fatigue Syndrome?

The time required to reach a diagnosis of ME/CFS can vary significantly from person to person. In some cases, it may take months or even years to receive a definitive diagnosis. This extended timeline is due to the need to rule out other conditions and observe the persistence of symptoms over time. Patients are encouraged to work closely with their healthcare providers throughout this process and to advocate for their health needs.

Risk Factors and Demographic Patterns in ME/CFS

While the exact cause of ME/CFS remains unknown, researchers have identified certain patterns and risk factors associated with the condition. Understanding these factors can help in early identification and management of the illness.

Who is most likely to develop Chronic Fatigue Syndrome?

ME/CFS can affect individuals of any age, gender, or background. However, certain demographic patterns have been observed:

• Gender: Women are up to four times more likely to be diagnosed with ME/CFS than men
• Age: While it can occur at any age, ME/CFS most commonly affects middle-aged individuals
• Stress: High levels of physical or emotional stress may increase the risk of developing ME/CFS
• Genetic predisposition: Some research suggests a possible genetic component to ME/CFS susceptibility

It’s important to note that these patterns do not determine who will or won’t develop ME/CFS, but rather highlight groups that may be at higher risk.

The Impact of ME/CFS on Daily Life

Chronic Fatigue Syndrome can have a profound impact on an individual’s quality of life, affecting various aspects of daily functioning. Understanding these impacts is crucial for patients, caregivers, and healthcare providers in managing the condition effectively.

How does Chronic Fatigue Syndrome affect a person’s ability to work and socialize?

ME/CFS can significantly impair a person’s ability to engage in work, social activities, and even basic daily tasks. The extreme fatigue, cognitive difficulties, and post-exertional malaise associated with the condition can make it challenging to maintain regular employment or sustain social relationships. Many individuals with ME/CFS may need to make substantial lifestyle adjustments to manage their symptoms effectively.

Some common impacts of ME/CFS on daily life include:

• Reduced work capacity or inability to work
• Limitations in physical activities and exercise
• Difficulty maintaining social relationships
• Challenges in completing household chores and personal care tasks
• Increased dependency on family members or caregivers
• Financial strain due to medical expenses and reduced income
• Emotional and psychological stress

Treatment Approaches and Management Strategies for ME/CFS

While there is currently no cure for Chronic Fatigue Syndrome, various treatment approaches and management strategies can help alleviate symptoms and improve quality of life for individuals with ME/CFS.

What are the most effective treatments for managing Chronic Fatigue Syndrome symptoms?

Treatment for ME/CFS is typically tailored to each individual’s specific symptoms and needs. A multidisciplinary approach involving various healthcare professionals is often most effective. Some common treatment strategies include:

1. Pacing and activity management: Learning to balance activity and rest to avoid symptom flare-ups
2. Cognitive Behavioral Therapy (CBT): Helping patients develop coping strategies and manage the psychological impact of the condition
3. Medications: Addressing specific symptoms such as pain, sleep disturbances, or mood issues
4. Sleep hygiene improvements: Implementing strategies to improve sleep quality
5. Nutritional support: Addressing any nutritional deficiencies and optimizing diet
6. Gentle exercise programs: Carefully structured physical activity plans tailored to individual capabilities
7. Complementary therapies: Such as acupuncture, massage, or mindfulness practices, which some patients find helpful

It’s crucial for patients to work closely with their healthcare providers to develop a personalized treatment plan that addresses their specific needs and symptoms.

The Future of ME/CFS Research and Treatment

As understanding of Chronic Fatigue Syndrome continues to evolve, researchers are actively pursuing new avenues for diagnosis, treatment, and potentially even prevention of ME/CFS. These ongoing efforts offer hope for improved outcomes for individuals affected by this challenging condition.

What promising developments are on the horizon for ME/CFS research?

Several areas of research show promise for advancing our understanding and management of ME/CFS:

• Biomarker identification: Efforts to discover reliable biological markers for diagnosis and treatment monitoring
• Neuroimaging studies: Investigations into brain structure and function in ME/CFS patients
• Immunological research: Exploring the role of the immune system in ME/CFS development and progression
• Microbiome studies: Investigating the potential influence of gut bacteria on ME/CFS symptoms
• Genetic research: Identifying potential genetic factors that may contribute to ME/CFS susceptibility
• Novel treatment approaches: Exploring new medications and therapeutic strategies specifically targeting ME/CFS mechanisms

These research efforts hold the potential to significantly improve diagnosis, treatment, and quality of life for individuals with ME/CFS in the coming years.

Living with ME/CFS: Coping Strategies and Support Systems

Coping with Chronic Fatigue Syndrome can be challenging, but developing effective strategies and accessing support can greatly improve quality of life for those affected by the condition.

How can individuals with ME/CFS best manage their condition day-to-day?

Effective day-to-day management of ME/CFS often involves a combination of practical strategies and emotional support:

• Develop a consistent daily routine that balances activity and rest
• Practice energy conservation techniques, prioritizing essential tasks
• Maintain a symptom diary to identify triggers and patterns
• Communicate openly with family, friends, and employers about limitations and needs
• Join support groups or online communities to connect with others who understand the challenges of ME/CFS
• Explore stress-reduction techniques such as meditation, gentle yoga, or deep breathing exercises
• Work with a mental health professional to develop coping strategies and address emotional challenges
• Stay informed about current research and treatment options

By implementing these strategies and building a strong support network, individuals with ME/CFS can better navigate the challenges of living with this chronic condition and maintain the best possible quality of life.

What resources are available for individuals with ME/CFS and their caregivers?

Numerous resources exist to support those affected by Chronic Fatigue Syndrome:

• Patient advocacy organizations: Provide education, support, and resources for ME/CFS patients and their families
• Online forums and support groups: Offer opportunities to connect with others facing similar challenges
• Educational materials: Books, websites, and pamphlets providing information on managing ME/CFS
• Specialized clinics: Some medical centers offer multidisciplinary care specifically for ME/CFS patients
• Disability resources: Information on navigating work accommodations and disability benefits
• Caregiver support services: Resources and support groups specifically for those caring for individuals with ME/CFS

Accessing these resources can provide valuable support, information, and community for those navigating life with ME/CFS.

Chronic Fatigue Syndrome (CFS) – Exams, Tests, Diagnosis, Related Conditions

Written by WebMD Editorial Contributors

• See Your Doctor
• What Else Could It Be?
• Checking the Symptoms

There’s no simple blood test or X-ray to diagnose chronic fatigue syndrome – also known as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). And many of the symptoms of the illness — deep tiredness, unrelieved by rest or sleep, feeling worse after physical or mental exertion, trouble concentrating, feeling worse after standing and remaining on one’s feet and other symptoms– are also seen in other conditions, too, making the diagnosis of ME/CFS more difficult.

If you think you might have ME/CFS, make an appointment to see your doctor. Research shows that getting treatment sooner might bring better results.

Your doctor will ask for a lot of information about your health. Unfortunately, there is not yet a diagnostic test that is sufficiently accurate to be useful. Your doctor will need to rule out other conditions or causes before they can diagnose ME/CFS.

They might order other tests like blood and urine tests and scans. They will need the names of all the prescription and over-the-counter medicine you take, in case one of them is causing your symptoms. Also, tell your doctor if you take any supplements. Even so-called “natural” or “herbal” remedies can have side effects, and they might cause problems if used with other medications you’re taking.

Your doctor will give you a complete physical exam and ask you questions about your emotions. This will give them a better idea of what your needs are. It’s important to make sure you don’t have another disorder, which could be serious and could get better with treatment.

Many people who have ME/CFS have other conditions, too. If you get treated for those, it might also improve your chronic fatigue.

 ME/CFS can look a lot like “mono” (mononucleosis), Lyme disease, lupus, multiple sclerosis, fibromyalgia, sleep disorders, or depression. It affects about 2.5 million Americans, but experts believe only about 20% are diagnosed. 

Your doctor will review your medical history and test results. They will check to see if you have several key symptoms, beginning with extreme tiredness, or fatigue, that doesn’t improve with bed rest for 6 months or longer.

Then, your doctor will check to see if you have three of these “core” symptoms of CFS:

• Reduced ability to do usual activities for six months or more because of fatigue
• Worsening of symptoms (difficulty thinking, problems sleeping, sore throat, headaches, feeling dizzy, or severe tiredness). after physical or mental exertion
• Trouble falling asleep or staying asleep, and awakening unrested

Along with the three symptoms, you must have one of these for a diagnosis of ME/CFS:

• Problems with thinking and memory
• Worsening of symptoms while standing or sitting upright; you might feel lightheaded, dizzy or weak, and you may have blurred vision or see spots.

It could take a while to get your diagnosis. It’s OK to ask how you can relieve your symptoms while you wait. Your doctor or health professional will schedule follow-up appointments to see how your treatment is working.

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Chronic Fatigue Syndrome | Johns Hopkins Medicine

What is chronic fatigue syndrome?

Chronic fatigue syndrome (CFS) is characterized by profound tiredness, regardless of bed rest. Its symptoms may worsen with physical or mental activity. CFS can happen suddenly and last for years. The condition affects more females than males.

What causes chronic fatigue syndrome?

The cause of CFS is not known.

Who is at risk for chronic fatigue syndrome?

Because the cause of CFS is not known, it’s hard to know what might put someone at risk for getting the condition. However, certain factors are seen more often in people with CFS. These factors include:

• Gender. CFS happens up to 4 times more often in women than in men.
• Age. CFS commonly affects middle-aged people, but people of any age can get it.

What are the symptoms of chronic fatigue syndrome?

Symptoms of CFS often mimic the flu. The following are the most common symptoms of CFS. However, each person may experience symptoms differently. Symptoms may include:

• Sensitivity to light
• Headache
• Tender lymph nodes
• Fatigue and weakness
• Muscle and joint pain
• Inability to concentrate
• Insomnia
• Forgetfulness
• Mood swings
• Confusion
• Low-grade fever
• Depression

The symptoms of CFS may look like other medical conditions. Always talk with your healthcare provider for a diagnosis.

How is chronic fatigue syndrome diagnosed?

CFS diagnosis depends on two criteria:

1. Severity and duration. The severe and chronic tiredness lasts for more than 6 months and other medical conditions have been ruled out.
2. Number of symptoms.  Four or more symptoms of CFS are present.

A specific treatment for CFS has yet to be proven effective. Vitamin supplements and medicines have some benefit. Many treatments just relieve the symptoms of CFS.

How is chronic fatigue syndrome treated?

Treatment is determined by your healthcare provider and based on:

• Your overall health and medical history
• Extent of the condition
• Your tolerance for specific medicines, procedures, or therapies
• Expectations for the course of the condition
• Your opinion or preference

Treatment may include:

• Medicine, including corticosteroids, antidepressants, and others
• Light-intensity aerobic exercise (but avoid moderate to vigorously intense physical activity) 
• Dietary supplements and herbal preparations
• Psychotherapy and supportive counseling

Living with chronic fatigue syndrome

There is currently no cure for chronic fatigue syndrome. Dealing with the severe fatigue can be very challenging. It is important that you work with your healthcare provider to find treatments that help you. Some people find counseling or support groups helpful.

When should I call my healthcare provider?

If your symptoms get worse or you have new symptoms, let your healthcare provider know.

Key points about chronic fatigue syndrome

• Chronic fatigue syndrome is characterized by profound tiredness.
• Symptoms often worsen with physical or mental activity.
• In addition to severe fatigue, symptoms include light sensitivity, headache, muscle and joint pain, difficulty concentrating, mood swings, and depression.
• Treatments may include medicines, exercise, supplements, and counseling.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.

5.1. Diagnosis and treatment of varicothrombophlebitisPhlebological Center “Antireflux”

• ← Chapter 4 THROMBOPHILIA. ETIOLOGY AND PATHOGENESIS. MARKERS FOR THROMBOPHILIC CONDITIONS
• Contents
• → 5. 2. Clinical picture and diagnosis of deep vein thrombosis

The term “thrombophlebitis” refers to thrombotic lesions of the saphenous veins with clinical signs of inflammation. Most often, thrombophlebitis is a complication of varicose transformation of the saphenous veins – varicothrombophlebitis.

Diagnosis

Clinical manifestations of varicothrombophlebitis are pain, hyperemia in the projection of the affected vein, local fever, hyperesthesia of the skin, and the presence of a cord-like, dense cord on palpation (Fig. 5.1). Patients with suspected varicothrombophlebitis should purposefully find out the presence of symptoms indicating deep vein thrombosis and pulmonary embolism.

The main method for diagnosing varicothrombophlebitis is duplex scanning of veins with compression tests. Ultrasound examination allows to determine the localization of thrombotic masses, the nature of the thrombus (occlusive, parietal, floating), its distal and proximal boundaries (Fig. 5.2). Ultrasonic angioscanning also makes it possible to assess the patency of deep and perforating veins, and provides indicative information about the duration of the process. The ultrasound protocol must necessarily include an examination of the saphenous and deep veins of not only the affected, but also the contralateral limb.

Fig. 5.1. Thrombophlebitis of the tributaries of the great saphenous vein on the leg

5.2. Thrombosis of the GSV with thrombus spread through the SPS

Treatment

Treatment depends on the cause and localization of thrombophlebitis. The main goals of the treatment of varicothrombophlebitis are to reduce the effects of acute inflammation and prevent potentially dangerous complications, such as deep vein thrombosis and PE. Conservative treatment of varicothrombophlebitis includes an active regimen, elastic compression of the lower extremities, local and systemic pharmacotherapy. Anticoagulants in therapeutic doses are indicated for patients who have had a thrombus transfer to the deep venous system. With severe pain, it is advisable to use non-steroidal anti-inflammatory drugs (NSAIDs) orally for 5-7 days. Local treatment includes cold, preparations containing heparin, compresses with NSAIDs. Indications for surgical treatment are the localization of thrombophlebitis in the proximal saphenous veins, the spread of thrombosis from the distal to the proximal segment, despite ongoing therapy (ascending thrombophlebitis), the spread of thrombosis through fistulas or perforating veins to the deep venous system. The main type of surgical treatment is crossectomy and, if necessary, thrombectomy from the main veins. Some authors with the development of thrombosis of the saphenous veins against the background of varicose disease recommend the simultaneous implementation of radical phlebectomy.

Table 5.1. Therapeutic tactics for thrombosis of the saphenous veins of the lower extremities (according to the Russian clinical guidelines for the diagnosis, treatment and prevention of venous thromboembolic complications, approved by the council of experts in 2009)

• ← Chapter 4 THROMBOPHILIA. ETIOLOGY AND PATHOGENESIS. MARKERS FOR THROMBOPHILIC CONDITIONS
• Contents
• → 5.2. Clinical picture and diagnosis of deep vein thrombosis

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Using System File Checker to Repair Missing or Corrupted System Files

If some Windows features don’t work or Windows shuts down, use System File Checker to scan Windows and repair files.

Although the steps below may seem complicated at first, just follow them in order and we will try to help you.

Run System File Checker (SFC.exe)

by doing the following.

1. org/ListItem”>

   Open an elevated command prompt. To do this, follow the steps below, depending on the operating system version:

2. Windows 10, Windows 8.1, or Windows 8 users must run Deployment Image Servicing and Management (DISM) before running System File Checker. (If your computer is running Windows 7 or Windows Vista, skip to step 3.)

Type the following command, and then press ENTER. The command may take several minutes to complete.

DISM.exe /Online /Cleanup-image /Restorehealth

Important! When you run this command, DISM contacts Windows Update to obtain files to repair corruption. However, if the Windows Update client is corrupted, use a running instance of Windows as a recovery source, or a parallel Windows folder from a network location or removable media such as a Windows DVD as a source of files. To do this, enter the following command at the command line:

DISM.exe /Online /Cleanup-Image /RestoreHealth /Source: C:\RepairSource\Windows /LimitAccess

Note. Replace the placeholder C:\RepairSource\Windows with the location of your repair source. For more information about using the DISM tool to repair Windows, see Repair a Windows Image.

1. Type the following command at the command prompt, and then press ENTER:

sfc /scannow

The sfc /scannow command will scan all protected system files and replace corrupted files with their cached copy located in a compressed folder at %WinDir% \System32\dllcache.
The %WinDir% placeholder is a Windows operating system folder. For example, C:\Windows.

Note. Do not close this command line window until the verification is 100% complete. The results of the verification will be shown after the completion of this process.

1. After the verification process is completed, one of the following messages may appear on the screen:

   • Windows Resource Protection found no integrity violations.

     
     This means that missing and corrupted system files are not found.

   • Windows Resource Protection could not perform the requested operation.

     
     To resolve this issue, scan with the System File Checker in Safe Mode, verify that the PendingDeletes and PendingRenames folders are in folder %WinDir% \WinSxS\Temp.

   • Windows Resource Protection found corrupted files and successfully repaired them. See CBS.Log %WinDir% \Logs\CBS\CBS.log for details.

     
     To view detailed information about scanning and restoring system files, go to How to view detailed information about the System File Checker process.

   • Windows Resource Protection found corrupted files but was unable to repair some of them. See CBS.Log %WinDir% \Logs\CBS\CBS. log for details.

     
     To manually repair corrupted files, review the details of the System File Checker process to find the corrupted file, and then manually replace the corrupted file with a guaranteed working copy.

Swipe in from the right edge of the screen to the center and tap Search . Or, if you are using a mouse, move the pointer to the lower right corner of the screen and click the Search button. Type Command Prompt in the Search field, right-click Command Prompt , then select Run as administrator . If the system asks for an administrator password or confirmation, enter the password or click the Allow button.

To do this, click the Start button , type Command Prompt or cmd in the Search field, right-click Command Prompt , and then select Run as Administrator . If you are prompted for an administrator password or confirmation, enter the password or press the Allow .

Additional information

View detailed information about the operation of the System File Checker.

To see the details included in the CBS.Log file, you can copy the details to the Sfcdetails.txt file using the Findstr command and then view them in that file. To do this, follow the steps below.

1. Open an elevated command prompt as described in step 1.

2. At the command prompt, type the following command, and then press ENTER:

   findstr /c:"[SR]" %windir%\Logs\CBS\CBS. log >"%userprofile%\Desktop\sfcdetails.txt" 

   Note. The Sfcdetails.txt file contains information about each run of System File Checker on the computer. It also contains information about files that were not fixed by the System File Checker. Check the date and time of the entries to determine the problematic files found the last time you ran System File Checker.

3. Open the Sfcdetails.txt file on your desktop.

4. The Sfcdetails.txt file uses the following format:

   SFC date and time information
   The following log file example contains an entry for one file that could not be repaired:

   2007-01-12 12:10:42, Info CSI 00000008 [SR] Cannot
   repair member file [l:34{17}]”Accessibility. dll” of Accessibility, Version =
   6.0.6000.16386, pA = PROCESSOR_ARCHITECTURE_MSIL(8), Culture neutral,
   VersionScope neutral, PublicKeyToken = {l:8 b:b03f5f7f11d50a3a}, Type
   neutral, TypeName neutral, PublicKey neutral in the store, file is missing

How to manually replace a damaged system file with a guaranteed working copy of the file.

After determining which system file is corrupted and cannot be repaired using the details in the Sfcdetails.txt file, locate the corrupted file, then manually replace the corrupted file with a guaranteed working copy. To do this, follow the steps below.

Note. A guaranteed working copy of the system file can be taken from another computer that has the same version of Windows installed as your computer. To make sure that a system file that you plan to copy to another computer is working, you can run the verification process with the System File Checker.

1. Proprietorize the corrupted system file to administrator ownership. To do this, copy and then paste (or type) the following command into an elevated command prompt, then press ENTER:

   takeown /f Path_and_file_name
   Note. Placeholder Path_and_file_name is the path and filename for the corrupted file. For example, type takeown /f C:\windows\system32\jscript.dll.

2. Give administrators full access to a corrupted system file. To do this, copy and paste (or type) the following command and press Enter:

   icacls Path_and_file_name /GRANT ADMINISTRATORS:F
   Note. Placeholder Path_and_file_name is the path and filename for the corrupted file.