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Your physician will take a medical history, asking questions about your past health (you will probably be asked to complete a written form - often done before your appointment time). It is likely that you will be asked about your past and current mental health as well. You can expect to receive a basic physical exam. Several types of routine blood tests and those that exclude alternative diagnoses are almost certain to be ordered. Other tests that are designed to identify central nervous system problems or viral syndromes may be ordered as well, depending on your symptoms. It's important to answer questions honestly and completely - and don't hesitate to ask your own questions. If you have thought of questions before your appointment, it's a good idea to write these down and bring them with you. Also, bring a list of medications and supplements that you're taking - be sure to include dosages. In addition, bring paper and pen with you to write down instructions. If cognitive problems interfere with the ability to write instructions or understand them, ask a friend or family member to accompany you.

In 1994 an updated case definition was developed by an international working group of CFIDS experts. Although the criteria were designed to be used for research purposes, physicians utilize them as diagnostic guidelines for CFIDS. The case definition criteria calls for four of eight symptoms to be present along with fatigue that interferes with physical, mental, social and educational activities. Both the fatigue and symptoms must have occurred for [at least] a six month period. Persons with CFIDS may experience many more than the eight symptoms named in the case definition, so knowledgeable physicians will take this fact into consideration when making a diagnosis (after other possible reasons for symptoms have been ruled out).

After testing has been completed and the physician has ruled out alternative diagnoses, he or she will inform you of the probable diagnosis. If you have research articles and other CFIDS factual information, you may wish to share this with your doctor while in the diagnostic process. With CFIDS, it's not uncommon for patients to be better informed than many physicians, so feel free to courteously share your knowledge. The diagnostic process may be lengthy - some persons wait many months (or years) to be diagnosed. It may take an enormous amount of patience. In the meantime, talk with your doctor to work out the best treatment plan for symptom relief and to improve function.

Treating chronic fatigue and immune dysfunction syndrome (CFIDS) presents a significant challenge to persons with CFIDS and their physicians. As yet, there is no known cause, cure, or universal treatment for CFIDS. Until a treatment is developed which will improve all the symptoms of
CFIDS, or correct the underlying cause, therapy is based upon the individual's presenting symptoms.
Medical Treatments
Medications that provide symptom relief are frequently the first line of treatment chosen by primary care providers for the person with CFIDS. These include medications for pain; sleep disturbances; digestive problems such as nausea; flu-like symptoms and if present depression and anxiety. Medications may be supplemented by supportive therapies.
Supportive Treatments
Therapies that help persons to relax and improve coping skills fall into this category and may include counseling for emotional and mental health, cognitive behavioral therapy, sleep management therapy, and massage. 
Alternative Treatment
Many persons find complementary therapies such as acupuncture, tai chi, and alternative food and herbal supplements to be helpful. Please note that adding food and herbal supplements to your therapy regimen needs to be done with care and with your physician's and pharmacist's knowledge to prevent undesirable side effects.
Lifestyle Alterations
Altered digestion, food intolerances, decreased energy, fatigue, cognitive problems, and sleeplessness create the need for revisions in daily living routines. These can include changes in diet; exercise modifications; alterations in activities of daily living according to one's energy level; and sleep/rest management. All may require the assistance of professional clinicians, such as a dietitian, physical and/or occupational therapist, mental health professional, and sleep therapist.
Other Treatment Options
For persons who have been diagnosed with an autonomic nervous system abnormality such as Orthostatic Intolerance, fluid and salt loading may be a treatment of choice. Surgery for Chiari Malformation, a defect in the area where the lower brain/spinal cord meet, is a treatment option for persons who have been found to have this malformation.
 
Treatment may incorporate any, or all, of the above categories as persons with CFIDS seek to improve their condition. The person with CFIDS can experience much frustration when attempting to secure treatment. Keeping an open mind and speaking candidly with a health care provider is important to any treatment plan.

Of every 100,000 Americans, 422 have CFS, and only 10% who meet the definition have been diagnosed. It is most common in women (522 cases per 100,000) and minorities, especially Latinos (726 cases per 100,000). CFS is not limited to any specific race, age or socioeconomic group.
Improvement is uncommon, with only 4% of patients recovering and 39% showing some symptom improvement after four years. Persons with CFS (PWCs) who have been ill for many years have special needs; please see our resources for long-term PWCs.

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