Chronic Fatigue Syndrome

[AmateurScientist]

Is Chronic Fatigue Syndrome a real illness?

Is it just chronic depression?

Anybody know anyone with an independent diagnosis of CFS from two or more medical doctors?

AS

[arcticpenguin]

Originally posted by AmateurScientist
Is Chronic Fatigue Syndrome a real illness?

Is it just chronic depression?

Anybody know anyone with an independent diagnosis of CFS from two or more medical doctors?

AS
I believe it's real. It is not depression. I don't know what it is. My boss has been diagnosed with it, I don't know how many diagnoses he has.

[arcticpenguin]

Apparently diagnosis is still not definitive. I highlighted one interesting line by bolding.

Authors: Prins, JB; Elving, LD; Koning, H; Bleijenberg, G; van der Meer, JWM
Title: Diagnosing chronic fatigue syndrome: comparison of a protocol and computerised questionnaires
Source: NETHERLANDS JOURNAL OF MEDICINE, 61 (4): 120-126 APR 2003
Abstract:
Background: In the context of outpatient care and within the framework of scientific research, guidelines and measuring instruments have been developed to help improve CFS diagnostics. The purpose of this study was to measure the agreement between the evaluations of chronically fatigued patients by physicians using a CFS protocol and by researchers using computerised questionnaires.

Methods: The sample consisted of 516 patients referred to an internal medicine outpatient clinic with complaints of chronic fatigue. Retrospectively the medical records and the computerised questionnaires were checked separately and compared to see whether the criteria for diagnosis of CFS had been met. In addition, the reasons for not diagnosing CFS were evaluated.

Results: Agreement between the physicians' and the researchers' evaluations was 84%. Disagreement mostly concerned severity of fatigue and functional impairment, or premorbid exclusion criteria. A physical cause for the chronic fatigue was only found in 3% of the cases.

Conclusions: For physicians, questionnaire assessment may be complementary to the CFS protocol in optimising the process of diagnosing CFS.

[arcticpenguin]

Same conclusion - diagnosis is not definite, cause is unknown.

Authors: Eidelman, D
Title: Chronic fatigue syndrome - medical fact or artifact
Source: MEDICAL HYPOTHESES, 60 (6): 840-842 JUN 2003
Abstract:
Despite extensive investigation, the enigma of Chronic Fatigue Syndrome (CFS) continues to confound medical researchers. It is suggested that this may be due to two impediments inherent in their overall approach to the problem. Firstly, although fatigue is central to CFS, medical scientists appear not to understand what fatigue itself really is, nor what is its purpose or mode of function. A functional definition of fatigue is suggested to help resolve this. Secondly, physicians and other researchers - psychologists and alternative medicine practitioners - fail to observe an elementary and fundamental procedure of clinical medicine, namely, that of properly examining their patients before making a diagnosis or providing treatment. The notion of the 'black hole' of medicine is introduced. Recognizing the existence of these impediments is considered a self-evident precondition for further significant progress being made in this field. (C) 2003 Elsevier Science Ltd. All rights reserved.

[Ruby]

Originally posted by AmateurScientist
Is Chronic Fatigue Syndrome a real illness?

Is it just chronic depression?

Anybody know anyone with an independent diagnosis of CFS from two or more medical doctors?

AS

Yep, it's for real. I live with it. :(

[Number Six]

Originally posted by AmateurScientist
Is Chronic Fatigue Syndrome a real illness?

Is it just chronic depression?

Anybody know anyone with an independent diagnosis of CFS from two or more medical doctors?

AS

How ironic that this is a topic on here because I was just talking about this today with a friend of mine that is a physician. (As a bit of background, he loaned me a book about Seabiscuit, who was a very famous racehorse in the 1930s, and who Hollywood is coincidentally making a movie about right now, and in the afterward of the book the author noted how hard it was for her to do this book because she suffers from chronic fatigue syndrome).

So as we were talking about that book I remarked how it was interesting that the author had to struggle to do it all because she had chronic fatigue syndrome. He replied by saying that he didn't believe that was a real affliction. I really don't know much about it myself so I can't comment and neither challenged him nor agreed with him.

Just because he says it doesn't necesarily mean it's right. I'm sure we can find physicians that say it is a real affliction. I just thoght I'd pass it along.

I haven't had many discussions about questionable medical practices, etc, with him so I don't know his general view on things, although I do remember once that he said he thought acupuncture probably really works, but the context in which said it was clear that he hadn't looked into it that deeply.

[Dr. Imago]

Recent evidence suggests that CFS (and fibromyalgia) may indeed be a legitimate, diagnosable illness. In the past, there have been many speculations as to what causes it (e.g., a "slow" virus, autoimmune-type disorder, etc.), but I have a hunch that what we now collectively call CFS will probably someday be teased out and prove to be a constellation of diseases with slightly different etiologies.

For people who have it, it is very real. So, in my book no point taking a "I don't believe you / you're faking it" attitude towards them. Although, I fully recognize that in many cases there may be other things, such as masked depression, somatoform or even malingering itself (to name a few among many), that are really at the root of the problem.

-TT

[athon]

I agree with TT. It's still in its infancy in terms of detailing the epidemiology of the disease, but I think it would be arrogant to dismiss it simply because it is difficult to pin down yet.

People do have to realise, as well, that conditions and diseases are not simple 'labels' where somebody has it or doesn't. We are all complicated biological machines, and in effect all of us, due to being unique, have conditions which differentiate us from what we call 'the norm'. It would take an eternity to explore each and every difference of biochemistry, biomachinery and neurology we all possess.

Athon

[athon]

Oh, BTW TT, congrat's on passing.

A weight off the old shoulders, I bet.

Athon

[subgenius]

The problem with CFS and other "syndromes" is that different causes can produce similar symptoms, i.e. depression, mono, etc. So, "it" doesn't necessarily have one cause. This leads to much confusion about whether you have "it", and what the treatment should be.
Science/knowledge is power.

[Ruby]

Originally posted by ThirdTwin
Recent evidence suggests that CFS (and fibromyalgia) may indeed be a legitimate, diagnosable illness. In the past, there have been many speculations as to what causes it (e.g., a "slow" virus, autoimmune-type disorder, etc.), but I have a hunch that what we now collectively call CFS will probably someday be teased out and prove to be a constellation of diseases with slightly different etiologies.

For people who have it, it is very real. So, in my book no point taking a "I don't believe you / you're faking it" attitude towards them. Although, I fully recognize that in many cases there may be other things, such as masked depression, somatoform or even malingering itself (to name a few among many), that are really at the root of the problem.

-TT

In my case, CFS is part of having fibromyalgia and being an insomniac. For now, the insomnia is much better...............but only because I take three different meds to get me to sleep. I still suffer with CFS, even though my sleep is better.

[Jon_in_london]

Its just laziness!!! why dont you go get a job!! ;)

joking.........

what did you pass TT?

[AmateurScientist]

Originally posted by ThirdTwin
Recent evidence suggests that CFS (and fibromyalgia) may indeed be a legitimate, diagnosable illness. In the past, there have been many speculations as to what causes it (e.g., a "slow" virus, autoimmune-type disorder, etc.), but I have a hunch that what we now collectively call CFS will probably someday be teased out and prove to be a constellation of diseases with slightly different etiologies.

For people who have it, it is very real. So, in my book no point taking a "I don't believe you / you're faking it" attitude towards them. Although, I fully recognize that in many cases there may be other things, such as masked depression, somatoform or even malingering itself (to name a few among many), that are really at the root of the problem.

-TT

Congratulations, TT.

I think your pragmatic approach is a very good one. It is likely that many diagnoses of CFS are actually cases of depression, as many of the same symptoms are present in each diagnoses. Unfortunately, there simply isn't any objective test or measure which can accurately diagnose either condition. As you say, maybe one day we will learn that one or the other sometimes has a viral cause.

After all, 20 or 30 years ago who would have guessed that stomach ulcers were largely bacterial? It's silly now to look back at the treatments prescribed and how everyone, including very knowledgeable doctors, thought that spicy foods and stress led to ulcers. That's ridiculous now.

AS

[Yahweh]

I'm a self proclaimed workaholic. I never stop working on one thing or another. So I guess I dont understand CFS.

[kookbreaker]

" One Summer, I thought I had Mono. Turns out I was just really, really bored."

-Wayne

Wayne's World

[soccer_ref]

I am unhappy to reveal that Canada is home to an "expert" in this field.

http://www.martinhealth.com/

My computer started making duck-like noises when the browser displayed the site.

"Dr." Martin reveals in a book he wrote that his Ph.D. was obtained from LaSalle University in Mandeville, La. It's a notorius diploma mill, if it's still in operation.

[Dr. Imago]

I passed Step I of the United States Medical Licensing Examination (USMLE) on the road to officially becoming a doctor. So, that's two years down, two years to go. In a few weeks, I will be starting in the hospital full time with clinical clerkships (i.e., years 3 & 4 of med school).

On a related note, I will be sure to let everyone know if I myself develop CFS as a result. :D

Thanks again to everyone that's noticed/wished me well!

-TT

[popsy]

Originally posted by Yahweh
I'm a self proclaimed workaholic. I never stop working on one thing or another. So I guess I dont understand CFS.

You would if you had it. And you'd stop working because you wouldn't be able to continue. CFS is not a 'state of mind' nor is it laziness. One may still desire to do things but lack the energy to do so. It's sort of like you just ran a marathon and then were told you have to walk back.

[Ruby]

Originally posted by ThirdTwin
I passed Step I of the United States Medical Licensing Examination (USMLE) on the road to officially becoming a doctor. So, that's two years down, two years to go. In a few weeks, I will be starting in the hospital full time with clinical clerkships (i.e., years 3 & 4 of med school).

On a related note, I will be sure to let everyone know if I myself develop CFS as a result. :D

Thanks again to everyone that's noticed/wished me well!

-TT

CONGRATULATIONS!!!!!!!!! :D :D

[Ruby]

Originally posted by popsy


You would if you had it. And you'd stop working because you wouldn't be able to continue. CFS is not a 'state of mind' nor is it laziness. One may still desire to do things but lack the energy to do so. It's sort of like you just ran a marathon and then were told you have to walk back.

Yep, unfortunately, most people who get stricken with CFS do have to stop work. I think it's harder on those who have always been on the go. I feel so bad for them to get CFS....especially if FMS goes hand in hand with it.

I have always been an exercise nut. Aerobics and weights....almost obsessed...once CFS and FMS hit, I started finding it so much harder to work out, let alone get up in the morning. I thought I had some fatal disease and was going to die soon.

Taking care of two little ones takes so much out of me. I work out when I can...but when I do work out, it can't be a big work-out...and no matter what, I am exhausted and very sore for a few days afterwards as if I had ran two marathons!!.:(

[Dancing David]

CFS is real, there is a way to tell if people are malingering or not.

I had heard in tha past that it was related to the mono virus and other subchronic infections.
I have major depression and allergies, I can immagine what it is like to have no energy!

[Hellcat]

Myalgic encephalomyelitis

The size of the problem
CFS/ME is a major world-wide public health problem. There are considerable difficulties in establishing good figures for the number of people affected, but accepting that the figures are approximate, the following generalisations can be made regarding the UK:
CFS/ME affects between 2 and 4 people per 1000 of the population it affects people of all ages, including children as young as five years old the commonest age of onset is between the early twenties to mid-forties
CFS/ME is diagnosed about twice as often in women compared to men it affects all social classes.
There are therefore as many as 200,000 people with CFS/ME in the UK alone – a staggering number for a condition that has attracted so little serious enquiry until recently

Definitions

From the point of view of conducting research on a condition, it is essential that agreement exists on what it is that is being studied, or conclusions made in one centre will have no relevance to anywhere else. Several groups around the world have therefore worked to produce definitions of CFS/ME that attempt to encapsulate the necessary features of the condition. The most widely used are those of the Centre for Disease Control (1994) in the USA, which are:

Fatigue of definite or new onset that is not the result of exertion, is not significantly improved by sleep or rest and which results in substantial reduction in overall performance for a consecutive period of six months or longer.


Plus at least four from the following list:
self-reported significant impairment of short term memory or concentration.
sore throat.
tender lymph glands (small swellings under the skin which are part of the immune system) in the neck region or under the armpits.
muscle pain.
headaches of a new type, pattern or severity.
unrefreshing sleep.
malaise following effort that lasts more than 24 hoursm pains in several joints occurring without joint swelling or redness.


There are several problems using such a system as this. For a start the requirement for the fatigue to be present for six months takes no account of the fact that the disability from CFS/ME starts on day one of the illness, which is often abrupt. In practice no caring doctor would wave a patient out of the consulting room and ask them to make an appointment once the six moths were up so that he could then start discussing the symptoms for real.

In the early weeks of CFS/ME it can be difficult or impossible to distinguish it from other conditions that can cause similar symptoms but which have a different outcome, and it is necessary to search for these. The purpose of these diagnostic criteria therefore should be seen as mainly an aid to research. People who fulfil them are therefore similar at least to a certain extent, so it becomes possible to compare how they fare with different types of treatment. It is quite possible to have CFS/ME and not have all of these symptoms – an individual’s experience of CFS/ME is essentially unique.



International criteria

The ‘Oxford Criteria’ (1990) therefore defined CFS/ME as a syndrome in which: there is a definite onset (ie it is not lifelong)
fatigue is the main symptom the fatigue is severe, disabling and affects both physical and mental functioning. The fatigue has been present for at least six months, during which time it has been present more than 50 per cent of the time other symptoms may be present, particularly myalgia, mood and sleep disturbance.

Tests

In making a diagnosis of CFS/ME it is important to exclude other conditions that can cause some or all of the symptoms although there are really no other conditions that look exactly like it in all its aspects. Fatigue, of a generally smaller degree is however a common accompaniment of anaemia (lack of blood), underactivity of the thyroid gland, diabetes, disturbance of kidney or liver function and persistent infection, especially with some viruses and more unusual bacterial infections. Rarer causes include immune system diseases such as lymphoma, ‘auto-immune’ diseases such as SLE (systemic lupus erythematosus) in which many organs become inflamed, or underproduction of hormones from the pituitary gland of the brain. Simple blood and urine tests can screen for the majority of these conditions and are well within the scope of the GP to arrange.

Read the rest here. (http://www.netdoctor.co.uk/special_reports/depression/cfs.htm)

It is a very real illness and one here in the UK are something like one in four Doctors still do not accept as being real. The same figure that think Depression falls into that not real catagory.