How is Chronic Fatigue Syndrome diagnosed. What tests are used to identify ME/CFS. Can blood tests detect Chronic Fatigue Syndrome. What are the core symptoms of ME/CFS. How do doctors rule out other conditions when diagnosing CFS.

Understanding Chronic Fatigue Syndrome (ME/CFS)

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex and debilitating condition affecting millions of people worldwide. Despite its prevalence, diagnosing ME/CFS remains challenging due to the lack of a definitive test and the overlap of symptoms with other conditions.

ME/CFS affects approximately 2.5 million Americans, yet experts estimate that only about 20% of cases are properly diagnosed. This underscores the importance of raising awareness and improving diagnostic methods for this often misunderstood condition.

Core Symptoms and Diagnostic Criteria for ME/CFS

To receive a diagnosis of ME/CFS, patients must exhibit several key symptoms:

• Extreme fatigue lasting for 6 months or longer, unrelieved by rest
• Post-exertional malaise (PEM) – worsening of symptoms after physical or mental exertion
• Unrefreshing sleep
• Cognitive difficulties (often referred to as “brain fog”)
• Orthostatic intolerance – symptoms that worsen when standing or sitting upright

Doctors typically require patients to experience at least three of these core symptoms, along with either cognitive impairment or orthostatic intolerance, to make a diagnosis of ME/CFS.

The Diagnostic Challenge: Ruling Out Other Conditions

Diagnosing ME/CFS is largely a process of exclusion, as many of its symptoms overlap with other medical conditions. Physicians must carefully rule out alternative explanations for a patient’s symptoms before arriving at an ME/CFS diagnosis.

Some conditions that may present similarly to ME/CFS include:

• Mononucleosis
• Lyme disease
• Lupus
• Multiple sclerosis
• Fibromyalgia
• Sleep disorders
• Depression

To differentiate ME/CFS from these conditions, doctors may order a variety of tests and examinations.

Current Diagnostic Approaches for ME/CFS

While there is no single definitive test for ME/CFS, healthcare providers use a combination of methods to assess patients and reach a diagnosis:

Comprehensive Medical History

Doctors will gather detailed information about a patient’s symptoms, their onset, duration, and impact on daily life. This history helps identify patterns consistent with ME/CFS and rule out other potential causes.

Physical Examination

A thorough physical exam can help detect signs of other medical conditions and assess the severity of ME/CFS symptoms.

Blood and Urine Tests

While these tests cannot confirm ME/CFS, they can help rule out other conditions and check for underlying health issues that may be contributing to symptoms.

Specialized Testing

In some cases, doctors may order additional tests such as sleep studies, cognitive assessments, or tilt table tests to evaluate specific aspects of a patient’s condition.

Emerging Biomarkers and Diagnostic Tests for ME/CFS

Recent research has shown promise in developing more objective diagnostic tools for ME/CFS. One such breakthrough comes from Stanford University, where scientists have created a blood-based test that may help identify the condition.

The Stanford Blood Test

This innovative test, still in its pilot phase, measures how a person’s immune cells respond to stress. In a study of 40 participants (20 with ME/CFS and 20 without), the test yielded highly accurate results in distinguishing between the two groups.

How does the Stanford blood test work?

The test involves exposing blood samples to a stressor and then measuring the electrical changes in the cells. Researchers found that the blood cells from ME/CFS patients showed a clear and consistent pattern of response, different from those without the condition.

Potential Impact of the Stanford Test

If further validated, this blood test could revolutionize ME/CFS diagnosis by providing an objective, biological marker for the condition. This would not only help patients receive proper diagnosis and treatment more quickly but also lend credibility to a disease that has often been dismissed or misunderstood.

The Importance of Early Diagnosis and Treatment

Research indicates that early intervention in ME/CFS cases may lead to better outcomes for patients. However, the current diagnostic process can be lengthy and frustrating for those experiencing symptoms.

Why is timely diagnosis crucial for ME/CFS patients?

• Early management strategies can help prevent symptom worsening
• Proper diagnosis allows for targeted treatment approaches
• Validation of symptoms can provide psychological relief and access to support services
• Early identification may improve long-term prognosis and quality of life

Managing ME/CFS: A Multifaceted Approach

While there is no cure for ME/CFS, various strategies can help manage symptoms and improve quality of life:

Pacing and Energy Management

Learning to balance activity and rest is crucial for ME/CFS patients to avoid post-exertional malaise.

Cognitive Behavioral Therapy (CBT)

CBT can help patients develop coping strategies and manage the psychological impact of living with a chronic illness.

Medications

While no drugs are specifically approved for ME/CFS, certain medications may help manage individual symptoms such as pain, sleep disturbances, or orthostatic intolerance.

Lifestyle Modifications

Dietary changes, gentle exercise (when appropriate), and stress reduction techniques may help some patients manage their symptoms.

The Future of ME/CFS Research and Diagnosis

As our understanding of ME/CFS grows, so does the potential for more effective diagnostic tools and treatments. Ongoing research is exploring various aspects of the condition, including:

• Genetic factors that may predispose individuals to ME/CFS
• The role of the immune system in the development and progression of the disease
• Potential infectious triggers or environmental factors
• Advanced neuroimaging techniques to identify brain changes associated with ME/CFS

What advancements can we expect in ME/CFS diagnosis and treatment?

As research progresses, we may see:

1. More sensitive and specific biomarker tests
2. Personalized treatment approaches based on individual patient profiles
3. Improved understanding of the underlying mechanisms of ME/CFS
4. Development of targeted therapies to address the root causes of the condition

Supporting ME/CFS Patients: Beyond Diagnosis

While improving diagnostic methods is crucial, it’s equally important to address the broader needs of ME/CFS patients:

Education and Awareness

Increasing public and medical community awareness about ME/CFS can help reduce stigma and improve support for patients.

Research Funding

Continued investment in ME/CFS research is essential for developing better diagnostic tools and treatments.

Patient Advocacy

Supporting patient advocacy groups can help drive policy changes and improve access to care for those with ME/CFS.

Interdisciplinary Care

Encouraging collaboration between different medical specialties can lead to more comprehensive care for ME/CFS patients.

Chronic Fatigue Syndrome remains a challenging condition to diagnose and treat. However, recent advancements in research, such as the Stanford blood test, offer hope for more accurate and timely diagnosis in the future. As our understanding of ME/CFS grows, so does the potential for improved patient care and quality of life for those affected by this debilitating condition.

The journey towards better ME/CFS diagnosis and treatment is ongoing, requiring continued effort from researchers, healthcare providers, and patient advocates. By raising awareness, supporting research, and developing more effective diagnostic tools, we can work towards a future where ME/CFS is better understood, recognized, and managed.

For those experiencing symptoms of ME/CFS, it’s crucial to seek medical attention and advocate for comprehensive evaluation. While the diagnostic process may be complex, early intervention and proper management can make a significant difference in long-term outcomes. As research progresses, patients and healthcare providers alike can look forward to more precise diagnostic methods and targeted treatment options, bringing hope to millions affected by this challenging condition.

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.

Top Picks

Biomarker for chronic fatigue syndrome identified | News Center

Stanford scientists devised a blood-based test that accurately identified people with chronic fatigue syndrome, a new study reports.

April 29, 2019
– By Hanae Armitage

People suffering from a debilitating and often discounted disease known as chronic fatigue syndrome may soon have something they’ve been seeking for decades: scientific proof of their ailment.

Researchers at the Stanford University School of Medicine have created a blood test that can flag the disease, which currently lacks a standard, reliable diagnostic test.

“Too often, this disease is categorized as imaginary,” said Ron Davis, PhD, professor of biochemistry and of genetics. When individuals with chronic fatigue syndrome seek help from a doctor, they may undergo a series of tests that check liver, kidney and heart function, as well as blood and immune cell counts, Davis said. “All these different tests would normally guide the doctor toward one illness or another, but for chronic fatigue syndrome patients, the results all come back normal,” he said.

The problem, he said, is that they’re not looking deep enough. Now, Davis; Rahim Esfandyarpour, PhD, a former Stanford research associate; and their colleagues have devised a blood-based test that successfully identified participants in a study with chronic fatigue syndrome. The test, which is still in a pilot phase, is based on how a person’s immune cells respond to stress. With blood samples from 40 people — 20 with chronic fatigue syndrome and 20 without — the test yielded precise results, accurately flagging all chronic fatigue syndrome patients and none of the healthy individuals. 

The diagnostic platform could even help identify possible drugs to treat chronic fatigue syndrome. By exposing the participants’ blood samples to drug candidates and rerunning the diagnostic test, the scientists could potentially see whether the drug improved the immune cells’ response. Already, the team is using the platform to screen for potential drugs they hope can help people with chronic fatigue syndrome down the line. 

A paper describing the research findings was published online April 29 in the Proceedings of the National Academy of Sciences. Davis is the senior author. Esfandyarpour, who is now on the faculty of the University of California-Irvine, is the lead author. 

Providing the proof

The diagnosis of chronic fatigue syndrome, when it actually is diagnosed, is based on symptoms — exhaustion, sensitivity to light and unexplained pain, among other things — and it comes only after other disease possibilities have been eliminated. It is also known as myalgic encephalomyelitis and designated by the acronym ME/CFS. It’s estimated that 2 million people in the United States have chronic fatigue syndrome, but that’s a rough guess, Davis said, and it’s likely much higher.

For Davis, the quest to find scientific evidence of the malady is personal. It comes from a desire to help his son, who has suffered from ME/CFS for about a decade. In fact, it was a biological clue that Davis first spotted in his son that led him and Esfandyarpour to develop the new diagnostic tool.

We clearly see a difference in the way healthy and chronic fatigue syndrome immune cells process stress.

The approach, of which Esfandyarpour led the development, employs a “nanoelectronic assay,” which is a test that measures changes in miniscule amounts of energy as a proxy for the health of immune cells and blood plasma. The diagnostic technology contains thousands of electrodes that create an electrical current, as well as chambers to hold simplified blood samples composed of immune cells and plasma. Inside the chambers, the immune cells and plasma interfere with the current, changing its flow from one end to another. The change in electrical activity is directly correlated with the health of the sample. 

The idea is to stress the samples from both healthy and ill patients using salt, and then compare how each sample affects the flow of the electrical current. Changes in the current indicate changes in the cell: the bigger the change in current, the bigger the change on a cellular level. A big change is not a good thing; it’s a sign that the cells and plasma are flailing under stress and incapable of processing it properly. All of the blood samples from ME/CFS patients created a clear spike in the test, whereas those from healthy controls returned data that was on a relatively even keel.

“We don’t know exactly why the cells and plasma are acting this way, or even what they’re doing,” Davis said. “But there is scientific evidence that this disease is not a fabrication of a patient’s mind. We clearly see a difference in the way healthy and chronic fatigue syndrome immune cells process stress.” Now, Esfandyarpour and Davis are expanding their work to confirm the findings in a larger cohort of participants. Recruitment for the larger project, which aims to further confirm the success of the diagnostic test, is being done on a rolling basis. Those who are interested in participating should contact clinical research coordinator Anna Okumu.

Doubling up

In addition to diagnosing ME/CFS, the researchers are also harnessing the platform to screen for drug-based treatments, since currently the options are slim. “Using the nanoelectronics assay, we can add controlled doses of many different potentially therapeutic drugs to the patient’s blood samples and run the diagnostic test again,” Esfandyarpour said.

If the blood samples taken from those with ME/CFS still respond poorly to stress and generate a spike in electrical current, then the drug likely didn’t work. If, however, a drug seems to mitigate the jump in electrical activity, that could mean it is helping the immune cells and plasma better process stress. So far, the team has already found a candidate drug that seems to restore healthy function to immune cells and plasma when tested in the assay. The drug, while successful in the assay, is not currently being used in people with ME/CFS, but Davis and Esfandyarpour are hopeful that they can test their finding in a clinical trial in the future.

All of the drugs being tested are either already approved by the Food and Drug Administration or will soon be broadly accessible to the public, which is key to fast access and dissemination should any of these compounds pan out.

Davis is a member of Stanford Bio-X, the Stanford Cancer Institute and the Stanford Maternal & Child Health Research Institute.

Other Stanford authors of the study are research scientists Mohsen Nemat-Gorgani and Julie Wilhelmy and research assistant, Alex Kashi.

The study was funded by the Open Medicine Foundation. Davis is the director of the foundation’s scientific advisory board.

Stanford’s departments of Genetics and of Biochemistry also supported the work.

Media Contacts

About Stanford Medicine

Stanford Medicine is an integrated academic health system comprising the Stanford School of Medicine and adult and pediatric health care delivery systems. Together, they harness the full potential of biomedicine through collaborative research, education and clinical care for patients. For more information, please visit med.stanford.edu.

Coming soon a blood test to detect chronic fatigue syndrome

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June 18

Chronic Fatigue Syndrome is a debilitating condition that raises more questions than it answers. The causes of this syndrome are poorly understood, the disease is difficult to diagnose, and at the moment there is no generally accepted effective method for its treatment.

However, scientists say they have taken an important step in developing a laboratory test to diagnose this convoluted and complex disorder, whose symptoms vary widely: exhaustion, chronic pain, confusion and more.

In a new study published in Proceedings of the National Academy of Sciences , scientists say they have created a blood test that can accurately diagnose chronic fatigue syndrome. Not only does the test help determine the biological basis for this mysterious condition, but it may also prove useful in developing effective treatments.

Cellular stress

During the study, the scientists took blood samples from 40 people, half of whom suffered from chronic fatigue syndrome. The researchers say they were able to identify patients with the disease simply by observing how their blood cells behave under stress.

The study is based on so-called “nanoelectronic analysis”, an approach that measures the electrical response of a cell to a chemical stimulus.

As a result of chemical stress, the blood cells of people with chronic fatigue showed large jumps in electrical activity, while the blood cells of healthy people remained stable. These changes in electrical activity indicate the difficulty of coping with cellular stressors.

It is not yet known why the cells in people with chronic fatigue syndrome react this way to a stress test (in this case, a salt bath), but the results of the study bring scientists one step closer to understanding this painful condition, which only affects in the United States of America about two million people.

Unraveling the mystery

In recent years, several theories of chronic fatigue syndrome have emerged, ranging from overactive B cells to viral infections. There is no cure yet, but the researchers say the new test should help identify effective treatments by monitoring how blood cells respond to stress when given therapies. The next step is blood testing on a much larger population sample.

Source: The Discover Mag, 04/30/2019

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes over time, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

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Fatigue Test Chronic Fatigue Syndrome symptoms, treatment online

Do you feel unrested even after sleeping, or do you have insomnia, headaches, depressed mood, apathy and irritability? Perhaps you have chronic fatigue syndrome, the symptoms of which are on the face.

Take the fatigue test online and free of charge and find out if you have a psychological disorder chronic fatigue syndrome – treatment is needed then – or if you are just tired and need to relax and unwind.

The causes of chronic fatigue syndrome can be different: from the herpes virus to emotional and mental burnout from work, lack of sleep and rest, neuropsychic exhaustion, poor nutrition, unhealthy lifestyle and lack of vitamins and antioxidants in the body, oxygen starvation of muscles and brain.

Also, the cause of chronic fatigue, as a neurotic reaction of the body, may be mental disorders, personality disorders, frequent emotional experiences.

In most cases, chronic fatigue syndrome occurs due to the disproportion of intellectual, mental, psychological activity and physical activity and movements.

Chronic fatigue symptom test

Answer the questions on the fatigue test truthfully and calmly reflect on the question.

After testing, you will understand – you have a vegetative, neurotic disorder – chronic fatigue syndrome that needs to be treated, or you are just very tired and you just need a good rest and restore vital energy.

Take the chronic fatigue test online and free

1. Do headaches happen without obvious causes?

Constantly

Sometimes

Rarely

No

2. Is there any virus (herpes, for example)?

Yes

No

Don’t know

3. Do you ever feel like you haven’t rested after a night’s sleep?

Constantly

Periodically

Rarely

No

4. Do you observe increased daytime sleepiness?

Constantly

Periodically

Rarely

No

5. Is there irritation without obvious motives?

Often

Sometimes

Rarely

No

6. Is it difficult to fall asleep in the evening?

Constantly

Often

Rarely

No

7. Depressed, bad mood for no particular reason?

Constantly

Periodically

Rarely

No

8. Do you often have any infectious diseases?

Often

Sometimes

Rarely

No

9. Are there any allergic reactions?

Constantly

Sometimes

Rarely

No

Constantly

Sometimes

Rarely

No

11. Do you feel memory loss?

Yes, noticeable

A little, like

Maybe just a little, sometimes

No

12. Do you notice a decrease in concentration?

Constantly

Periodically

Rarely

No

13. Do you have inflammation in the throat (pharyngitis, inflammation of the tonsils, “tonsillitis”…)?

Yes

Something like there

Don’t know

No

Yes, noticeably

Seemingly yes

Seemingly no

No

15. Do you devote much time to work?

“25” hours a day

most of the time

Half a day

As expected, 8 hours

Less than required

When as, irregular time

16. Do you spend a lot of time on rest?

I constantly rest, even at work

most of the time

Whenever

little

I almost never rest – I never. ..

17. Do you get enough sleep at night?

As “doctor prescribed” – 7-8 hours

Less than seven hours

I sleep little

I sleep a lot, but I often wake up or have nightmares but not I get enough sleep

When I do, but I wake up well-rested and well-rested

18. Do you take a vacation for good rest during the working year?

I haven’t taken it for a long time

I go on vacation once a year

I go on vacation more than once a year

I take a vacation, but it takes place at the dacha at work

I take a vacation, but it doesn’t bring the feeling of a rested person

9 0002 Always take and I rest, gaining new strength and energy

19. Do you have good nutrition?

Yes, varied and balanced

Yes, normal

Often at fast food and dry food

When like

No

20. Are there any mental or personality disorders, neuroses?

Yes

It seems to be

I don’t know

It seems not to be

No

50 by 50

60 by 40

80 by 20

Only mental, very little mobility

Only physical, very little mental

22. Do you have two days full weekend in a row?

Always

Occasionally

Rarely

Never

23. Do you often experience stress and mental stress?

Constantly

Occasionally

Sometimes

Rarely, almost never

24. Do you have hepatitis C?

Yes

Don’t know

No

25. Do you have intestinal disorders, dysbacteriosis?

Yes, always

Periodically

Rarely

No

26. Do you have problems with your immune system?

Some… (or one specific)

Immune deficiency

Don’t know

No

27. Are there any problems with hemoglobin values?

Yes, decreased

Don’t know

Increased

normal

28. Do you have an endocrine disease?

Yes

Don’t know

No

29. Do you have tumors?

Yes, benign

Yes, malignant

Don’t know

No

30. Do you have chronic depression?

Yes, yes

Yes, but not very protracted

Seemingly no

No

31. Do you often go outdoors?

Constantly

Periodically

Little

Almost never

Permanent

Periodically

Rarely

Almost never, or only in clothes

I visit a solarium

33. What is your main way of life?

Sedentary, indoors

Sedentary

Move moderately

Outdoors, mobile

34. Do you lead a healthy lifestyle?

Yes, all the time

Sometimes

Rarely

No

35. Are you a vegetarian?

Yes, for a long time

Yes, recently

Sometimes, in order to improve health

No

36. Do you diet?

Constantly

Periodically

Rarely

No

37. In what locality do you live?

Megacity

Large industrial city

Big city

Small town

Township

Village

38. Do you often overeat?

Permanent

Periodically

Rarely

No

39. Do you have psychosomatic, vegetative disorders?

Many

Have one (two)

Don’t know

No

40. Do you take any medications: antidepressants, sedatives, sleeping pills, psychotropics, alcohol, drugs…? No0003

41. How responsible is your job?

Extremely

Severe

Moderate

So-so

42. If you already felt chronic fatigue, did your symptoms disappear after normal rest?

Yes

A little

No

I did nothing (did not rest)

Treatment of chronic fatigue syndrome

The treatment of chronic fatigue syndrome should be approached in a complex manner, based on the main symptoms and the identified cause of CFS.

The best way to restore vitality and energy is professional psychoanalysis and psychotherapy

Treatment of chronic fatigue at home — if there are no other psycho-emotional disorders and viruses that are the main cause of the syndrome, self-treatment begins with a healthy lifestyle and proper nutrition; the use of psycho-training (breathing exercises and auto-training), relaxation and muscle relaxation exercises, the use of methods of body-oriented psychotherapy, physical and psychological massage to remove the “muscle shell”.