Do I Have Chronic Fatigue Syndrome?

Not an Easy Question to Answer

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Do you feel like you're tired all the time, to the point that you are starting to worry that something is seriously wrong? Have you begun to wonder if you could have chronic fatigue syndrome?

It's difficult to say whether you could have chronic fatigue syndrome. Even for a doctor experienced with it, this is a tough diagnosis to make, and it takes multiple steps.

To answer the question of whether you might have this disease, first, you need to understand that there's a difference between the symptoms of chronic fatigue (being tired all the time) and the illness known as chronic fatigue syndrome, which is also called myalgic encephalomyelitis or ME/CFS.

Chronic Fatigue (the Symptom, Not the Syndrome)

It's important to realize that most people who are tired all the time don't have ME/CFS. Fatigue is one of the top complaints doctors hear because it can be a feature of so many conditions. In addition, fatigue is often caused by lifestyle factors rather than illness.

Lifestyle factors that can lead to a state of chronic fatigue include:

  • poor diet
  • obesity
  • high stress
  • too little sleep

A lot of people these days live with one or more of these factors, so it's good to evaluate them when looking for the source of your fatigue. Most of us would probably benefit from eating healthier, sleeping longer and better, and reducing or better managing our stress. If you suspect lifestyle issues are behind your fatigue, here are some resources to explore:

Just about any illness, whether chronic or short-term, can cause fatigue, so it's important for your doctor to consider your full range of symptoms and look for likely causes other than ME/CFS.

In fact, ruling out other possible causes of fatigue usually step one of the ME/CFS diagnostic process.

Chronic Fatigue Syndrome (ME/CFS)

Don't let the name fool you: ME/CFS is a lot more than just being tired. The fatigue is profound and gets worse after even mild exertion, and it's often accompanied by flu-like symptoms, cognitive dysfunction ("brain fog") and any combination of about 45 other possible symptoms.

Many people describe it as coming down with a nasty flu and never getting any better.

So far, there's no medical test for diagnosing ME/CFS. For a doctor to even consider a diagnosis, you have to have been experiencing fatigue for at least six months. Then, any other possible causes of the fatigue (and other symptoms you may be experiencing) need to be ruled out.

That means a set of basic blood tests and, if indicated, further tests to check for chronic infections, such as mononucleosis and tuberculosis; autoimmune diseases such as lupus or multiple sclerosis; emotional or psychiatric conditions; and the nervous-system disorder fibromyalgia, which is considered a close cousin to ME/CFS.

Your doctor may also want to explore sleep disorders, such as insomnia, sleep apnea, or narcolepsy, which can leave you exhausted all the time.

Without going through this process, it's impossible to say for sure whether somebody has ME/CFS. However, looking over the following guidelines from the Centers for Disease Control and Prevention (CDC) can help you determine whether it seems to fit your specific case.

Questions to Ask

Do you have:

Unexplained persistent fatigue that's not caused by ongoing exertion, is not substantially better after rest or sleep, and has resulted in a significant reduction in your activity level?

No? Then you don't have ME/CFS. Congratulations! Now you can start exploring other possibilities.

Yes? That doesn't mean you have it. Do you also have:

Four or more of the following symptoms for the past six months or more?
  1. impaired memory or concentration
  2. extreme, prolonged exhaustion and feelings of illness after physical or mental activity (post-exertional malaise)
  3. unrefreshing sleep
  4. muscle aches and pains
  5. joint pain with no swelling or redness
  6. a new type of headache or a change in your headache pattern
  7. frequent sore throat
  8. tender lymph nodes in your neck and near your breast

Still saying yes? Then ME/CFS may be something to bring up with your doctor.

A Word from Verywell

If you still think you may have ME/CFS, keep in mind that the criteria above are just a starting point. Your doctor will still need to do a lot of testing before determining whether you have ME/CFS or whether your symptoms are due to something else.

Getting a diagnosis can be a time-consuming and frustrating process, but it's a necessary one. Only an accurate diagnosis can lead to you the right treatments.

Sources

Chronic Fatigue Syndrome: Diagnostic Tests to Exclude Other Causes. Centers for Disease Control and Prevention.

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