Chronic Fatigue Syndrome (cont.)
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Jerry R. Balentine, DO, FACEP
Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.
In this Article
- Chronic fatigue syndrome (CFS) or systemic exertion intolerance disease (SEID) facts
- What is chronic fatigue syndrome (CFS or SEID)?
- What causes chronic fatigue syndrome or systemic exertional intolerance disease?
- What are risk factors for CFS/SEID?
- What are systemic exertion intolerance disease or chronic fatigue syndrome symptoms and signs?
- What are CFS/SEID symptoms in men?
- What are SEID/CFS symptoms in women?
- How is chronic fatigue syndrome (or systemic exertion intolerance disease) diagnosed?
- What is the treatment for CFS/SEID?
- Is there a cure for CFS/SEID?
- What is the prognosis (outcome) for CFS/SEID?
- Is it possible to prevent CFS/SEID?
- Where can people find additional information about CFS/SEID?
- Chronic Fatigue Syndrome FAQs
- Find a local Rheumatologist in your town
What are CFS/SEID symptoms in men?
CFS/SEID symptoms in men need to fit the time and type (six months and four symptoms) criteria stated above to be diagnosed with the disease. Currently, chronic fatigue syndrome is diagnosed much more frequently in females than in males. General symptoms in men that can occur that are described by male patients are similar to those in females, but clinicians speculate that many men are reluctant to say they have symptoms of muscle pain, malaise, headaches, and other symptoms due to cultural inhibitions and training. Many doctors speculate that men need to be more open in describing their symptoms to their doctors.
What are SEID/CFS symptoms in women?
As stated above for men, CFS/SEID symptoms in women need to fit the time and type (six months and four symptoms) criteria stated above to be diagnosed with the disease. Women are much more likely to be diagnosed with chronic fatigue syndrome than men. Clinicians speculate that women are more forthcoming with their doctors about chronicity of symptoms, including the four major symptom criteria (substantial impairment in short-term memory or concentration; sore throat; tender lymph nodes; muscle pain; multi-joint pain without swelling or redness; headaches of a new type, pattern or severity; unrefreshing sleep; and post-exertion malaise lasting more than 24 hours) than are men because of cultural expectations and training.
How is chronic fatigue syndrome (or systemic exertion intolerance disease) diagnosed?
Chronic fatigue syndrome (CFS) or SEID is a diagnosis made by excluding many diseases that have chronic fatigue as a major or frequent symptom. Unfortunately, there are no physical signs or diagnostic tests that identify CFS. The diagnosis is made by fitting the two major criteria set out by a group of CFS research experts.
The first criteria states the patient must have severe chronic fatigue of six months or longer duration with other known medical conditions excluded by clinical diagnosis (a diagnosis by exclusion).
The second criteria requires the patients have four or more of the following symptoms that either occurred at the same time or after the severe chronic fatigue. The symptoms are substantial impairment in short-term memory or concentration; sore throat; tender lymph nodes; muscle pain; multi-joint pain without swelling or redness; headaches of a new type, pattern or severity; unrefreshing sleep; and post-exertion malaise lasting more than 24 hours.
Although there are no lab studies that identify CFS, lab studies do provide some supportive evidence for a diagnosis. Lab studies that confirm either the presence or absence of cause of other diseases help define the diagnosis of exclusion. Additionally, many patients with CFS have certain lab findings listed below:
- Very low erythrocyte sedimentation rate (ESR)
- Elevated immunoglobulins against Coxsackie B virus, HHV-6 (human herpes virus strain 6), and/or Chlamydia pneumoniae
- Decreased number of natural killer cells
- Normal CBC, liver function tests, and normal urinalysis
When taken as a group, these tests support a diagnosis of CFS but are not definitive; only the patients who meet the two established criteria for CFS are definitively diagnosed with CFS.
Below is the new proposed criteria for SEID; the new report used an older designation (ME/CFS) but the criteria are for SEID; this fact shows the medical terminology problems when new names of diseases are proposed.
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