|Why Are So Few Patients With CFS Diagnosed?
According to the Centers for Disease Control and Prevention (CDC) 3 in 4 Americans who have chronic fatigue syndrome (CFS) remain undiagnosed. A number of factors have contributed to this low rate of diagnosis, including:
1. There is no specific test to diagnose it.
2. Fatigue, one of the primary symptoms of chronic fatigue syndrome, is common to many illnesses.
3. It may not be obvious to a doctor that someone with CFS is ill.
4. CFS has a pattern of coming and going.
5. Symptoms vary from person to person.
How Is Chronic Fatigue Syndrome Diagnosed?
The CDC have set down specific criteria to help doctors diagnose patients. These criteria are:
The patient suffers chronic (persistent) fatigue that is severe enough to interfere with everyday activities. Symptoms are new, and experienced for at least 6 or more consecutive months. Chronic fatigue is different to the sort of tiredness you feel at the end of a long day. A person with chronic fatigue feels exhausted all day long and is not significantly refreshed by sleep or rest.
2. Ruling Out Other Causes
The doctor performs tests to rule out all other possible causes before coming to a diagnosis of CFS. These disorders include fibromyalgia, lupus, Lyme disease, Epstein-Barr virus, multiple sclerosis (MS), insomnia and major depression. Commonly a blood test will be performed and a urine sample taken. Levels of the following substances in the blood will be checked:
Alanine aminotransferase (ALT)
Alkaline phosphatase (ALP)
Blood urea nitrogen (BUN)
Calcium, protein and phosphorus levels
Complete blood count
Erythrocyte sedimentation rate (ESR)
Blood sugar (glucose) levels
Thyroid stimulating hormone (TSH).
If your initial test results come back indicating another explanation for your fatigue, more tests may be necessary to complete your diagnosis. For example, further blood tests may be necessary if an infection is considered. An MRI scan can help diagnose MS, sleep studies can diagnose sleep problems, an exercise stress test or a table tilting test can be used to check for heart and other cardiovascular problems.
3. Checking For Other Symptoms
If other conditions have been ruled out, the doctor will look for 4 or more of the following symptoms which should be present for at least 6 months:
• Memory and concentration problems
• General weakness
• Muscle pain or soreness
• Sore throat that is persistent or recurring
• Painful swollen lymph nodes under the armpit or in the neck
• Headaches that differ from the sort you had before
• Pain in multiple joints although there is no redness or swelling
• Sleep problems, you not refreshed after sleeping.
My Doctor Says My Condition Is Idiopathic. What Does That Mean?
If your fatigue is not severe enough, or you do not have at least 4 other symptoms of CFS, your doctor may describe your condition as idiopathic fatigue. Idiopathic means the cause is unknown. A diagnosis of CFS is not warranted.
If you are diagnosed with CFS, your doctor may also evaluate you for the following conditions which sometimes co-exist with CFS:
• Insulin resistance
• Metabolic syndrome
• Allergies to chemicals
• Irritable bowels
Important: Because CFS resembles so many other conditions, it is important not to self-diagnose. You may in fact have another condition which is easily treatable.
Next: Treatment for chronic fatigue syndrome