CFS is a condition of extreme, disabling fatigue for which no other cause can be identified.  Like its “cousin” fibromyalgia, CFS features impairments in concentration and memory along with disordered sleep and musculoskeletal pain.  While the constellation of symptoms is nearly identical for these two conditions, they differ in the degree to which individual symptoms are experienced; in CFS, fatigue is the most pronounced symptom, whereas in fibromyalgia, the most pronounced symptom is usually pain.Sometimes labelled “Yuppie Flu”, the onset of CFS tends to occur around the age of 30 with the typical range being 20 to 50 years.  There have been cases of CFS in adolescents and it may have occasionally been seen in children younger than 12 but in these cases it’s not clear if the condition was actually CFS or another condition with similar symptoms.  While both men and women can be affected, CFS is more common in women.

What It Feels Like
Like fibromyalgia, CFS feels a bit like having a never-ending case of the flu.  The fatigue is so extreme and persistent that one feels like crying or dying.  It starts suddenly, in people with no prior history of unusual fatigue.  Abrupt increases in activity make it worse.  It is often associated with depression.

Other symptoms, such those that follow below, may also occur:

• persistent aches and pains that began around the time the fatigue set in
• sore throat with tender lymph nodes
• recurrent headaches
• unrefreshing sleep
• cognitive impairments (memory, concentration)

Less commonly, people may experience: abdominal pain, bloating, nausea, diarrhea,  dry eyes or mouth, earaches, alcohol intolerance, chest pain, chronic cough, shortness of breath, palpitations, jaw pain, morning stiffness, night sweats, depression, irritability, dizziness, anxiety, panic attacks, tingling sensations, and weight loss.

Diagnosis
CFS is a diagnosis of exclusion.  This means that there are no clinical or diagnostic tests that will reliably confirm the diagnosis so other potential causes of the symptoms must first be ruled out.

Diagnostic criteria currently require that the symptoms have been present for 6 months or more, at least 50% of the time in cases where they have a relapse/remit type of pattern.

One study found that low blood pressure and CFS symptoms could be induced in 96% of people with CFS by making sudden postural alterations.  Only 29% of the control subjects had a similar response.  Although this does suggest a physiological basis for the syndrome, no causes have been conclusively identified.

Treatment Options
There are no definitive treatments for CFS but improvement often does occur over time.  The key treatment is a graduated return to normal activity, supported by therapies to manage symptoms such as disturbed sleep and musculoskeletal pain.

Naturopathic Care
The focus in natural health care is the same as it is on the conventional side: a graduated return to normal activity, supported by therapies to manage symptoms.  If that sounds like a cop-out, let me assure you it’s not.

CFS is a mystery.  We don’t know what causes it.  Until we have a better understanding of what’s going wrong, we won’t have any clear ideas about how to fix it.

Having said that, there is still reason for hope.  We know that people improve significantly over time.  This implies that the body eventually figures out how to right what’s wrong.  By supporting the body to be as healthy as possible (apart from the CFS), we promote the healing process.

“Helping the body to be as healthy as possible” is a highly individualized undertaking.  Research does not provide clear support for treatments like supplementation and acupuncture but they can make a difference in individual cases.  For most people with CFS, patience and experimentation are needed to determine what treatment or combination of treatments will work best.

Outlook
A 2013 study found that recovery from CFS is possible, using graduated exercise therapy and cognitive behavioural therapy as the key forms of treatment.  Find a clinician who will support exploration of different types of treatment with you, and keep your determination up.  A cure may be elusive, but wellness and an improved quality of life are within reach.