allDiseases & Conditions

What is Chronic Fatigue Syndrome?

fatigueChronic fatigue syndrome (CFS) is described in the Encyclopedia of Natural Medicine as “a newly defined syndrome that describes varying combinations of symptoms, including recurrent fatigue sore throat, low-grade fever, lymph node swelling, headache, muscle and joint pain, intestinal discomfort, emotional distress and/or depression and loss of concentration.”

The entry goes on to explain that in fact this is not a new syndrome at all, rather a relatively new name. References to this cluster of symptoms are highly similar to symptoms of a disorder named neurasthenia and first described in i860 according to this source, although other references mention it as early as 1820. The name literally means ‘weakness of the nerves’ (meaning actual nerves, not the emotions of anxiety that we now also refer to as nerves). A medical sleuth might take the hint that it was also referred to as Americanitis, from an observation that Americans were more prone to it than others, and wonder what causes were more prevalent in America at that time than others. However, that is beyond the scope of this book, merely a matter of curiosity for the author.

At various times since the syndrome was first described, it has been known by many other names: post-infectious neuromyasthenia (literally, weakness of nerves and muscles), chronic EBV (Epstein-Barr Virus) syndrome, post-viral fatigue syndrome, chronic mononucleosis-like syndrome, chronic fatigue and immune disorder syndrome (CFIDS), Yuppie flu and others. Some of these names provide a hint at a possible triggering factor, which we will discuss in a later section.

In 1988, the US Center for Disease Control (CDC) established a set of diagnostic criteria in an attempt to provide a framework for diagnosis for the use of medical practitioners. It has not been modified since then to our knowledge, in spite of being controversial for including psychological symptoms as both a minor criterion and as grounds for exclusion. The diagnostic criteria include the major criteria of 1) new onset of fatigue, causing at least a 50% reduction in activity for at least six months and 2) exclusion of other illnesses that can cause fatigue. Minor criteria include eight of 11 listed symptoms or six of those symptoms and two of the three signs listed (also discussed in a later section).

Controversy also exists around physician complaints that the definition seems better suited to research than to diagnostics, and that the listed symptoms ignore many of those commonly reported by actual patients. The definition in other countries is not so strict, leading one to believe that the condition is under diagnosed in the US. In fact, the Australian definition includes only the major criterion of fatigue that disrupts daily activities in the absence of other medical conditions associated with fatigue.