I am always tired! Join the club. However, it could be a sign of brain damage

Now we are not talking about regular old exhaustion. We all get tired and worn down. What we are talking about here is an illness that makes a person so incredibly tired that they are unable to function in society. The illness is called Chronic Fatigue Syndrome (CFS) / Myalgic Encephalomyelitis (or Encephalopathy) (ME). The symptoms can be as disabling as multiple sclerosis, systemic lupus erythematosus, rheumatoid arthritis, congestive heart failure and other chronic conditions.

So What Is Chronic Fatigue Syndrome?

Let’s turn to our friends at the US Centers for Disease Control and Prevention (CDC) for a proper definition. The CDC says “[c]hronic fatigue syndrome, or CFS, is a debilitating and complex disorder characterized by profound fatigue that is not improved by bed rest and that may be worsened by physical or mental activity. Persons with CFS most often function at a substantially lower level of activity than they were capable of before the onset of illness.” That is pretty general right? That definition could describe depression or one hundred other diseases. This is why doctors use this condition as a “bucket diagnosis”. If a doctor can’t figure it out he will but it in the bucket so you will go away satisfied. This general description of a serious condition opens the field for people to not take chronic fatigue seriously.

CFS/ME is not rare. The CDC estimates that there are as many as 500,000 persons in the United States who have CFS-like symptoms. However, the disorder remains debilitating, complex and mysterious in origin, natural history, understanding and treatment.

Look Out For Fatigue, Tiredness, Headaches, and Pain After Vaccination

CFS/ME comprises a range of symptoms that includes fatigue, malaise, headaches, sleep disturbances, difficulties with concentration and muscle pain. A person’s symptoms may fluctuate in intensity and severity, and there is also great variability in the symptoms different people experience. CFS/ME is characterized by debilitating fatigue that is unlike everyday fatigue and can be triggered by minimal activity. This raises especially complex issues in adults and children with severe CFS/ME.

At present, there are no physical signs that identify CFS/ME specifically. And, because there is no blood test, brain scan or other lab test to diagnose CFS, it’s a diagnosis of exclusion. If a patient has had 6 or more consecutive months of severe fatigue that is reported to be unrelieved by sufficient bed rest and that is accompanied by nonspecific symptoms, including flu-like symptoms, generalized pain, and memory problems, the physician should further investigate the possibility that the patient may have CFS.

Your health care professional will first take a detailed patient history, including a review of medications that could be causing your fatigue. A thorough physical and mental status examination will also be performed. Next, a battery of laboratory screening tests will be ordered to help identify or rule out other possible causes of your symptoms. Your professional may also order additional tests to follow up on results of the initial screening tests. A diagnosis of insufficient fatigue could be made if a patient has been fatigued for 6 months or more, but does not meet the symptom criteria for CFS.

In other words, a positive diagnosis of CFS/ME should only be made after other known causes for the symptoms have been excluded and where the symptoms are causing functional impairment.

Managing chronic fatigue syndrome can be as complex as the illness itself. There is no cure, no prescription drugs developed specifically for CFS, and symptoms vary considerably over time. These factors complicate the treatment process and require patients and health care professionals to constantly monitor and frequently revise treatment strategies.

One report on CFS/ME concluded that the natural course of CFS/ME is such that most patients will show some degree of improvement over time, especially with treatment, that a substantial number of patients will pursue a fluctuating course with periods of relative remission and relapse, and a significant minority become severely, and perhaps permanently, disabled.