Woman with chronic fatigue syndrome
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What Is Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)?

ME/CFS, also called Systemic Exertion Intolerance Disease (SEID) is a complex illness. The severity is variable, but the symptoms are real. The condition can be completely incapacitating and includes debilitating fatigue along with other symptoms. The fatigue is severe enough to interfere with daily activities and is not relieved by bed rest. Though there is no cure for ME/CFS, but improvement and recovery are possible with comprehensive treatment. 

 

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Illustration of chronic fatigue syndrome
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ME/CFS Puzzles

ME/CFS can now be diagnosed by looking for a pattern of specific symptoms -- physical and brain-related. But the causes of the illness are still a mystery. Possible culprits include a faulty immune system, viral infection, or stress affecting body chemistry may trigger ME/CFS. Scientists are also exploring possible connections to other things like long-term low blood pressure and genetics. 
 

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ME/CFS Symptoms: Intense Fatigue

Everyone feels sluggish now and then. The difference with ME/CFS is that the fatigue is overwhelming and lasts for at least 6 months. It may get worse after physical or mental exertion, and a full night's sleep provides no relief. The fatigue is often accompanied by other troubling symptoms, such as chronic pain.

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ME/CFS Symptoms: Recurring Pain

Many people with ME/CFS develop recurring pain, including headaches, sore throat, muscle pain, and joint pain. The joints may hurt without showing signs of redness or swelling. The cause of these symptoms is not well understood, but the pain can often be managed through medication or physical therapy.

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Dizzy spell from chronic fatigue
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Other Symptoms of ME/CFS

Beyond fatigue and pain, people with ME/CFS may experience:

  • Memory problems
  • Trouble concentrating
  • Sleep disturbances
  • Weakness or dizziness
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Who Is at Risk?

More than a million Americans have ME/CFS. Women are four times more likely than men to develop the illness. Although people of any age can get ME/CFS, it occurs most frequently in people in their 40s and 50s. There may be a genetic component, but there is no evidence that ME/CFS is contagious.

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Tired teenage girl on couch
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ME/CFS in Children and Teens

ME/CFS is very rare in children and only slightly more common in teenagers. The good news is young people with ME/ are more likely to improve than older patients. If your child is diagnosed with ME/CFS, consult a specialist to create an individualized exercise and management program. Find constructive ways for your child to cope, and seek out support groups.

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Diagnosing ME/CFS

There are no blood tests or brain scans for ME/CFS, but your health care team may run tests to rule out other conditions. ME/CFS is diagnosed when you have a moderately severe degree of:

  • More than 6 months of severe fatigue not explained by other condition and is not substantially alleviated by rest AND.
  • Post-exertional malaise (Worsening of ME/CFS symptoms after physical or mental activity that would not have caused a problem before illness. This is known as post-exertional malaise (PEM) AND 
  •  Unrefreshing sleep

AND 

  • Cognitive impairment And/or 
  • Orthostatic intolerance- feeling much better when laying down compared to standing up  
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Overwhelmed woman in kitchen
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How ME/CFS Impacts Daily Life

ME/CFS tends to follow a cyclical course. You may experience periods of intense fatigue followed by periods of well-being. It's vital not to overdo it when you're feeling well, because this may trigger a relapse. Most people with ME/CFS experience symptoms that worsen after strenuous physical or mental activity. Work with your health care team to determine the right activity level for you.

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Treatment Options for ME/CFS

There is no cure for ME/CFS, and no prescription drugs have been developed specifically for its treatment. Work with your health care team to develop coping strategies, such as managing your activity level and taking medications to control symptoms. Focus on feeling better rather than feeling "normal."

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Graded Exercise Therapy

Studies indicate gradual, guided physical activity is helpful for people with ME/CFS. Graded exercise therapy starts slowly and gradually increases the duration of exercise over time. The goal is to avoid overdoing it and experiencing a "crash." It's important not to avoid all physical activity, or the muscles can become deconditioned. Graded exercise therapy can help you adapt your activity level to the fluctuations in your condition.

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Medications

Medications are primarily used to relieve symptoms, such as sleep problems and chronic pain. Some medications, such as tricyclic antidepressants, can reduce pain and improve sleep with just one pill. Many people with ME/CFS are sensitive to medications and may need lower doses. Be sure to ask your doctor about the benefits and side effects of any drugs you take, even if they are over the counter.

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Counseling

A counselor can help you develop coping skills that will decrease anxiety, depression, anger, and guilt. A therapist may recommend combining medication and psychotherapy. Cognitive behavioral therapy (CBT) aims to enhance coping by changing dysfunctional thinking and behavior. Recent studies show this form of therapy is a helpful component of ME/CFS treatment. 

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Complementary Therapies

Complementary treatments -- sometimes called alternative therapies -- can aid in pain management. These include stretching therapies, toning exercises, massage, hydrotherapy, and relaxation techniques. Acupuncture may also treat pain. Make sure to seek out qualified practitioners who are knowledgeable about ME/CFS.

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Herbal supplements for chronic fatigue
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Herbs and Supplements

Talk with your doctor about which supplements, if any, are helpful and safe for you. Remember that supplements may interact negatively with prescribed medications. 

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Scam Alert

Many nutritional supplements and vitamins are targeted toward people with ME/CFS. These products are not regulated to the same degree as prescription medications, and most have not gone through extensive testing in people.

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Healthy meal to aid in fighting chronic fatigue
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ME/CFS and Diet

Doctors recommend a well-balanced diet for people with ME/CFS, but no specific dietary strategy has been widely accepted. Essential fatty acids, found in nuts, seeds, and coldwater fish, may reduce fatigue. Some people with ME/CFS notice their symptoms are triggered by certain foods or chemicals, including refined sugar, caffeine, and alcohol.

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ME/CFS and Sleep

Most people with ME/CFS experience sleep disturbances. This may include difficulty falling asleep, restless legs, vivid dreaming, and frequent awakening. To create healthy sleep habits, establish a regular bedtime routine and engage in light exercise and stretching at least four hours before bedtime.

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Depressed man in chair
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ME/CFS and Depression

ME/CFS is not a psychiatric illness, nor a form of depression. However, up to half of people with ME/CFS become depressed during the course of their illness. This may be the result of the difficulty in adjusting to life with a debilitating, chronic condition. Depression generally responds well to treatment, and getting it under control can make ME/CFS easier to cope with.

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Tips for Family Members

Chronic illnesses like ME/CFS may impact the whole family. Consult with a mental health professional to learn how to cope with changes in family dynamics. Don't expect your loved one to "snap out of it" and return to his or her usual activities. Try to be supportive, because emotional health is vital for anyone coping with ME/CFS.

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Outlook for ME/CFS

The percentage of people who make a full recovery from ME/CFS is not known. But some people enjoy long periods of remission, especially by learning to manage their activity levels. Early treatment with stress reduction and graded exercise therapy may increase the chances for improvement. These therapies can be effective when used together to treat the wide range of symptoms. 

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Sources | Medically Reviewed on 08/01/2017 Reviewed by Neha Pathak, MD on August 01, 2017

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REFERENCES:

CDC: “General Information - Chronic Fatigue Syndrome.”

U.S. Department of Health and Human Services: “Origins of XMRV deciphered, undermining claims for a role in human disease.”

KidsHealth: "Chronic Fatigue Syndrome."

TeensHealth: “Chronic Fatigue Syndrome.”

University of Maryland Medical Center: “Chronic Fatigue Syndrome.”

Reviewed by Neha Pathak, MD on August 01, 2017

This tool does not provide medical advice. See additional information.

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