Chronic fatigue and immune dysfunction syndrome (CFIDS, also known as chronic fatigue syndrome, CFS, myalgic encephalomyelitis, ME and by many other names) is a complex and debilitating chronic illness that affects the brain and multiple body systems. Although its name trivializes the illness as little more than mere tiredness, chronic fatigue and immune dysfunction syndrome (CFIDS) brings with it a constellation of debilitating symptoms. CFIDS is characterized by incapacitating fatigue (experienced as profound exhaustion and extremely poor stamina) and problems with concentration and short-term memory. It is also accompanied by flu-like symptoms such as pain in the joints and muscles, unrefreshing sleep, tender lymph nodes, sore throat, and headache.
Persons with CFIDS (PWCs) have symptoms that vary from person to person and fluctuate in severity. Specific symptoms may come and go, complicating treatment and the PWC's ability to cope with the illness. Most symptoms are invisible, which makes it difficult for others to understand the vast array of debilitating symptoms with which PWCs contend.
Chronic fatigue syndrome (CFS) was first defined in 1988 by the U.S. Centers for Disease Control and Prevention (CDC)1 as an illness of at least six months duration which begins suddenly with flu-like symptoms, causes a minimum of 50% reduction in activity and cannot be explained by alternate medical or psychiatric diagnoses.
Since that time, research has tried to solve the mysteries surrounding CFS -- such as its causes and prevalence. There is a long way to go -- there is still no laboratory marker or universal treatment for CFS -- but progress is being made.
In 1994, the CDC revised its CFS case definition. Because no simple laboratory test can identify CFS, a physician must exclude other possible causes of the symptoms before diagnosing a patient with CFS. To meet the definition for CFS, a person must have:
• clinically evaluated, unexplained persistent or relapsing chronic fatigue that is of new or definite onset (i.e., not lifelong), is not the result of ongoing exertion, is not substantially alleviated by rest, and results in substantial reduction in previous levels of occupational, educational, social or personal activities.
• at least four of the following symptom:
° 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 ° post-exertional malaise lasting more than 24 hours
The primary symptoms described in the CDC's case definition are listed above.
Also common to CFIDS are:
• cognitive problems such as difficulties with concentration and short-term memory, word-finding difficulties, inability to comprehend/retain what is read, inability to calculate numbers, and impairment of speech and/or reasoning
• visual disturbances (blurring, sensitivity to light, eye pain, need for frequent prescription changes)
• psychological problems (depression, irritability, anxiety, panic attacks, personality changes, mood swings)
• chills and night sweats
• shortness of breath
• dizziness and balance problems
• sensitivity to heat and/or cold; alcohol intolerance
• irregular heartbeat
• irritable bowel (abdominal pain, diarrhea, constipation, intestinal gas)
• low-grade fever or low body temperature
• numbness, tingling and/or burning sensations in the face or extremities
• dryness of the mouth and eyes (sicca syndrome)
• menstrual problems including PMS and endometriosis
• chest pains
• rashes; ringing in the ears (tinnitus)
• allergies and sensitivities to noise/sound, odors, chemicals and medications
• weight changes without changes in diet
• feeling in a fog
• muscle twitching and seizures
Diagnosis of chronic fatigue and immune dysfunction syndrome (CFIDS), also known as chronic fatigue syndrome (CFS), is a time-consuming and difficult process which is generally arrived at by excluding other illnesses with similar symptoms and comparing a patient's symptoms with the 1994 International case definition. As yet, there is no indicator or diagnostic test that can clearly identify the disorder. Overlapping symptoms can occur with several diseases, such as fibromyalgia, Gulf War Illnesses, and multiple chemical sensitivities. Many diseases have similar symptoms including lupus, hypothyroidism, Lyme disease and these need to be considered when making a diagnosis.