# How CFS is diagnosed



## Susan Purry (Nov 6, 2001)

Hi Hockey, this one's for you!







You asked about how you could find out if you have Chronic Fatigue Syndrome (CFS).Well, the first thing, is to ask your doctor. S/he is really the best person to ask this question of.







If your doctor suspects another illness on top of (or instead of) the Fibromyalgia, s/he will probably do the following: take blood tests, examine you, listen to you describing your symptoms, and take down your medical history. The blood tests are to rule out other conditions; there is no blood test to diagnose CFS. In fact, there are no clinical signs (findings upon examination) to diagnose CFS, so your examination may not bring up anything unusual. You may be referred to a hospital consultant, such as a rheumatologist. Here are the diagnostic criteria, they may help you in understanding it all:


> quote:* Centre for Disease Control (CDC) Criteria* (used in the USA)CFS is a syndrome, characterised by fatigue that is:- medically unexplained- of new onset- of at least six month's duration- not the result of ongoing exertion- not substantially relieved by rest- causing a substantial reduction in previous levels of occupational, educational, social or personal activities. In addition, there must be _four or more_ of the following symptoms:- self-reported problems with short-term memory or concentration (cognitive defects)- sore throats- tender neck (cervical) or armpit (axillary) glands- muscle pain (myalgia)- headaches of a new type, pattern or severity- unrefreshing sleep- post-exertional malaise lasting more than 24 hours- multi-joint pain (arthralgia) without swelling or redness.Conditions which would _exclude_ a diagnosis of CFS include:- established medical disorders known to cause chronic fatigue- major depressive illness with psychotic or melancholic features (but _not_ anxiety states, somatisation disorder or non-melancholic/psychotic depression)- any medication which causes fatigue as a side-effect- eating disorders - anorexia, bulimia or severe obesity- alcohol or substance abuse. *Oxford Criteria* (used in the UK)CFS is a syndrome that is characterised by:- a definate onset- fatigue as the principal symptom- fatigue which is severe, disabling and affects both physical and mental functioning - fatigue which has been present for a minimum of 6 months during which it was present for more that 50 per cent of the time- other symptoms which may be present, particularly myalgia, mood and sleep disturbancesSpecific exclusion criteria include:- an established medical condition known to produce chronic fatigue (severe anemia, hypothyroidism)- a current diagnosis of schizophrenia, manic depression, substance abuse, eating disorder of proven organic brain disease. Other psychiatric disorders (including depressive illness, anxiety disorders and hyperventillation) are not necessarily reasons for exclusion.


taken from pages 6 & 7 of 'Living with M.E.: the chronic/post-viral fatigue syndrome' by Dr Charles Shepherd. ISBN: 0 09 181679 3. Shepherd is the medical director to the M.E. Association, and has (had) M.E himself. (FYI, 'M.E' is the term for CFS that is often used in the UK). I hope this is of some help to you. Best wishes,


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## ilovehockey (May 30, 2001)

Thanks for the great information, Susan!


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## UNBEARABLE (Dec 9, 2001)

Hi , I was reading all the symptoms oc cfs and I seen to have all of them , I suffer from Ibs but have all the symptoms of chronic fatigue in fact my husband always asks me why I always seem so tired and I sleep but canot seem to really get enough rest .


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## trbell (Nov 1, 2000)

Susan, I think it depends on what kind of CFS you have. My doctor suspected CFS and said one common kind is diagnosable from blood tests. He gave me the tests and I have it. I think it has to do with white blood count.tom


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## Susan Purry (Nov 6, 2001)

Tom, I would be very interested to hear how your CFS was diagnosed using blood tests. Please could you tell more more about this?It's starting to be understood that there are markers for the illlness - cytokine production and changes to the RNaseL antiviral pathway. But these are not routine blood tests that the average doctor would do if they suspect a diagnosis of CFS. Plus they may only be relevant to certain subsets (can't remember the correct word, sorry) of CFS. And as yet, the diagnostic criteria for CFS remains unchanged. Do you fit the symptom criteria for CFS?


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## trbell (Nov 1, 2000)

Susan, cfs is a syndrome and what my doctor told me hea has seen a lot of patients like me who meet the diagnostic criteraia ands it turns out we pciked up an virus of some sort which generally gets better in a year or so. The blood tests confirmed this for him. On the other hand that was a year ago. My impression is that there is not one specific disease that has one specific cure and that it will turn out there are three or four things with the same symptoms. Right now I'm puzzled that zelnorm which I started for IBS is not helping with that but seem to have helped the cfs.tom


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## Susan Purry (Nov 6, 2001)

Ah, Tom, I'm totally with you now (forgive me if it takes a little while, I'm sure you know what the brain fog is like







).Here in the UK, we have a name for what you have experienced - it's Post Viral Fatigue Syndrome. Originally the name was used to describe cases of what we now call CFS or ME (ME is often used in Britain - means the same thing as CFS). Now, PVFS is sometimes used to describe CFS-like illness which happens after a distinct viral infection, and recovers in a relatively short amount of time - a year, like you mentioned, rather than the CFS which persists for many years. Like, with glandular fever (mononucleosis I think it's called in the US) you can take a long time to recover from it, although the initial illness has long passed. Of course, the caveat here is that CFS of acute onset often occurs after a viral like illness (often subclinical). Makes my head spin, what about you?!About the Zelnorm - wow, how unexpected!Best wishes,


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## trbell (Nov 1, 2000)

I think you might be right about it being the acute post-viral type of cfs at least that's what my doctor thought but these things are difficult to put in perspective since I also have had depression and IBS-C for years. we definitely need more and better research on all these things.tom


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## LoriAnn (Jan 31, 2002)

Hi everyone, I had to respond to this thread,please check out www.celiac.com.Conditions which are actually symptoms of Celiac diease can include IBS, graves disease & abnormal bloot count. There is alot of information at this site but if you look check it out you will be shocked at how much your life looks like celiac disease, I was. According to Dr Murry of the Mayo Clinic, EVERYONE who presents with IBS symptoms, or skin rashes or anemia should be tested for celiac disease.Lori


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