# Chronic Fatigue vs. Chronic Fatigue Syndrome



## M&M (Jan 20, 2002)

This is a short article that just points out the difference in having "chronic fatigue" and actually having diagnosable Chronic Fatigue Syndrome.Link to article: http://bmj.bmjjournals.com/cgi/content/full/327/7426/0-h


> quote: *Only a third of people with chronic fatigue have chronic fatigue syndrome * Question: How common is chronic fatigue syndrome among patients with chronic fatigue? Synopsis In this cross sectional British study, patients aged 16 to 75 years with fatigue lasting more than six months were evaluated with the Centers for Disease Control's 1994 case definition for chronic fatigue syndrome (CFS). The criteria require patients to have severe chronic fatigue of six months or longer, with other known medical conditions excluded by clinical diagnosis, and concurrently to have four or more of the following symptoms: substantial impairment in short term memory or concentration; sore throat; tender lymph nodes; muscle pain; multijoint pain without swelling or redness; headaches of a new type, pattern, or severity; unrefreshing sleep; and postexertional malaise lasting more than 24 hours. The patients in the study completed questionnaires assessing depression, anxiety, function, and perception of the aetiology of their fatigue. They had had normal laboratory results, including thyroid, blood count, and erythrocyte sedimentation rate, in the preceding six months. The authors excluded patients with psychotic illness, organic brain syndrome, or substance dependency; those with concurrent physical problems that the doctor felt could have caused fatigue symptoms; and those obtaining mental health care. Of 178 eligible patients, 141 consented to participate in the study. Only 44 (31%) of the patients had CFS. Patients with CFS average about one consultation a month compared with one consultation about every two months for the patients with chronic fatigue. Additionally, patients with CFS were more likely to be unemployed (27% v 12.4%; P = 0.03), to be in a self help group (20% v 0%), and to have concomitant depression (48% v 18%). Half of all patients, regardless of CFS status, attributed their fatigue to psychological causes.


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## Guest (Dec 8, 2003)

From the list you posted, I have the following symptoms:Overwhelming fatigue that has waxed and waned but lasted for yearsShort term memory and concentration problems (but just last week I was diagnosed with A.D.H.D, so that may account for this...don't know for sure yet)Muscle painMulti-joint pain (both without swelling or redness)Unrefreshing sleep (Heck, I can't sleep at all unless I take Trazadone)Post-exertional malaise that often lasts up to 3 daysI do have an organic brain syndrome (Dyslimbia) so does that disqualify me? Even with the Depakote, I still experience the pain and fatigue.I don't think my pain and fatigue have ever been the result of psychological issues because I've had both of them all of my life at different levels of severity, even through very happy times in my life, and they are both still progressively getting worse.I also have very tender to the touch inner legs, especially around my knees.What do you think MM? Not being sarcastic... I really don't know... Two doctors said I probably had CFS.I tend to push myself to do things to the point of exhaustion, perhaps out of stubbornness? Not sure. I think the reason I can still dance a bit is because I love it so much, but I am gradually becoming more intolerant of the technique workouts. Walking is painful with every step, but I still do it up and down hills. When I get so tired that I just can't go on anymore, sometimes I sit down or lie down whereever I am. I have to take drugs to sleep and I have to get 7-9 hours every night or I can't function.


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## M&M (Jan 20, 2002)

Gosh Evie, thanks for the vote of confidence







, but I'm really not qualified to even pretend to know if you have CFS or not. I can share with you some information I've come across in my research. The CDC here in the U.S. has criteria that patients must meet to be diagnosed with CFS. Since we're in the U.S. I'm going to only use their diagnostic criteria. I mention this, because in other countries, where ME is officially recognized, the diagnostic criteria are a bit different. So, here we go!Let's look at a part of the CDC's criteria:


> quote: the following core criteria for CFS are applied: "A case of the chronic fatigue syndrome is defined by the presence of the following:1) clinically evaluated, unexplained persistent or relapsing chronic fatigue that is of new or definite onset (has not been lifelong);


So, we see 2 criteria mentioned in this statement. 1) The chronic fatigue must be "unexplained" (which means it can't be a symptom of any current medical or psychological issue), and 2) it must be new (not lifelong).Here is how the CDC defines "explainable" chronic fatigue:


> quote:Conditions that explain chronic fatigue should exclude a diagnosis of CFS. These are: - "any active medical condition that may explain the presence of chronic fatigue ..." - any previous condition which might explain fatigue and which has not documentably come to an end; - "any past or current diagnosis of a major depressive disorder with psychotic or melancholic features; bipolar affective disorders; schizophrenia of any subtype; delusional disorders of any subtype; dementias of any subtype; anorexia nervosa; or bulimia"; - substance abuse within 2 years prior to onset; - severe obesity.


So, according to the CDC, if you have one of these disorders, your fatigue is "explainable", and therefore is not CFS.I don't know what (if any) psychological issues you have (and you don't need to tell me, it's none of my beeswax), or what (if any) current other medical problems you have, so you will be able to read these criteria and see if they apply to you or not. Please keep in mind, I'm not passing judgement, and I'm not sure I think the CDC's criteria are all that great. However, it's all we have to work with (for now at least). I hope soon, as research continues, the criteria will be much better, and hopefully not nearly so subjective.I hope this information helps Evie! Also, I've known of many doctors who still diagnose patients with CFS, even if they don't meet all of the CDC's diagnostic criteria. If someone is sick, most doctors like to try to find a way to help them. Who's to say who's right and who's wrong! Maybe some day in the future we'll know!


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## Guest (Dec 9, 2003)

It helps, MM... however, I can't help but wonder if more than one "illness" can occur in the same person?My fatigue and pain began long before I was ever diagnosed with any behavioral health dysfunctions. In fact, my first memories of it were around the age of 15. I was 38 before I was diagnosed with depression/anxiety.Outside of what I am already doing as in taking medications to promote restful sleep, exercising moderately and being good to myself, what else could I do even if I were to be officially diagnosed with CFS?


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## M&M (Jan 20, 2002)

I don't really know Evie!


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## celticlady (Aug 6, 2001)

Evie- how wonderful for you that you can work outside the home,dance,etc. If I did any type of dancing for more than 5-10 minutes,I would be flat or my back for 2 weeks(or longer). Unfortunately at this point in time I am amoung the 10%(approx) of fibro patients who cannot work outside the home due to the severity of the level of fibro.Heck,most days I cannot even work AT home,do housework,etc.Its hard to do much when you have to sleep 16 hours out of 24,and when even taking a shower/bath is the one hurdle that is so hard that it only gets done once a week(sponge baths in meantime)I would like to point out it is not just a matter of "willpower"or pushing oneself hard, simply because of being stubborn.i am VERY stubborn and persistant,I just have the disease(syndrome,whatever) more severely than most.I am really happy for those who a milder case of fibro who can actually go out and work!What a blessing!To be able to go ut and get ones own groceries,lift heavy bags,go shopping for more than 30 minutes, to be able to clean around the house,.paint,even to care for a furry friend(cat or dog)all these things I hope I can do someday. I hope to be among this group someday. I actually have fatigue so severe I fall asleep when i have visitors over at my house for an hour,sometimes! Makes me a rotten host







Just wanted to point out that it is NOT a matter of just willpower,or i would be running some corporation somewhere.I dont think you were trying to come across like this,Evie,but it kinda sounded like you were saying you are able to do all you can do simply because you try hard....those of us more severely ill try hard,too,as you know.







Good luck to you Evie,Mrs m and to all! Have a great week.


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