Chronic Fatigue Syndrome or CFS is a name given to a poorly understood, variably debilitating disorder or disorders of uncertain causation.  

The symptoms of CFS include, widespread muscle and joint pain, cognitive difficulties, chronic, often severe mental and physical exhaustion in a previously healthy person.  Fatigue is common to most disorders, but here it is chronic fatigue of physical and mental kind which is unrelieved by rest.  CFS patients may report muscle weakness, cognitive dysfunction, hypersensitivity,  digestive disturbance, depression, poor immune response, and cardiac and respiratory problems.

For unknown reasons, CFS occurs mostly in women than in men.

The onset can be sudden, starting with flu like symptoms.  In some cases the onset will be gradual.  There are eight categories of symptoms:

Fatigue:  Unexplained, persistent mental and physical fatigue not relieved by rest.

Post exertional malaise:  An inappropriate loss of physical and mental stamina after exertion.

Sleep dysfunction:  Disturbed sleep and insomnia.

Pain:  Pain is often migratory in nature, and there is muscle pain and joint pain.  Other symptoms include headaches, nerve pain, sore throat, etc.

Neurological/cognitive manifestations:  Confusion, disorientation, forgetfulness, difficulties processing information, etc.

Autonomic manifestation:  Lightheadedness, extreme pallor, nausea, irritable bowel syndrome, urinary frequency and bladder dysfunction, etc.

Neuroendocrine manifestation:  Common occurrences include poor temperature control, sweating episodes, frequent feelings of feverishness and cold extremities, digestive disturbances, etc.

Immune manifestation:  Tender lymph nodes, recurrent colds, recurrent sore throat, general malaise, etc.

There is no conclusive diagnostic test for CFS.

The mechanisms and processes of CFS are unknown.  Some study says exposure to chemicals, stress, and other insults in early life may be responsible, and some say it is caused by a virus.  The Central Nervous System is important in CFS.  Some study says it is genetic in nature, where the genetic predisposition leads to enhanced serotonin levels.  Another study says low cortisol levels is the reason for CFS. 

Many patients do not fully recover even with treatments.  Treatments include medications, medical treatments, and alternative therapies.  Anti-depressants are considered to alleviate the symptoms, where even a fraction of the normal medications are sufficient due to sensitivity to chemicals by these patients.

Cognitive behavior therapy is considered an effective therapy.  Interventions include rehabilitation therapies.  Analysis of multiple randomized, controlled trials of exercise therapy of patients with CFS show improvements in fatigue symptoms in control.  Other therapies that help some patients are adaptive therapies and yoga.

Many patients complain that CFS has a social stigma as it is frequently being viewed as malingering, hypochondria,  phobia, wanting attention, etc. Since there is no objective test, it is very easy to feign the symptoms of CFS for financial, social or emotional benefits.

A lack of information and awareness has led to many patients feeling stigmatized.  CFS patients may not receive total social and medical acceptance and these patients feel others trivialize the disorder.

For many years professional in the medical profession did not recognize CFS as a real condition nor were there any consensus on its prevalence.  There has been much disagreement over the causes, diagnosis or treatment of this disorder. This disagreement may affect the lives of those patients who have CFS, affect the doctor-patient relationship, and lead to the doctors not being confident of their ability to treat.

The condition of CFS can be managed only. There is no full treatment since the causation is not known.  According to a study only 5-10% of patients fully recover.

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