Chronic Fatigue Syndrome and Fibromyalgia Checklist

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Having a family or personal history of conditions, including:
____ Irritable Bowel Syndrome
____ Endometriosis
____ Thyroid disease – hypothyroidism, hyperthyroidism
____ Mood disorder
____ Chronic or persistent nasal symptoms/sinusitis/sinus infections
____ Ear infections (particularly with CFS)
____ Hysterectomy (particularly with CFS)
____ Miscarriage
____ Irregular Menstrual Cycle
____ Ovarian Cysts
____ Mononucleosis/Glandular fever
____ Epstein-Barr Virus
____ A family history of CFS or fibromyalgia
____ Family or personal history of autoimmune disease

Other Factors:
____ Female gender
____ Having had a recent infection
____ Physical Injuries/Trauma
____ Hypermobile Joints
____ Toxic Exposures
____ Severe Life Stress
____ Type A Personality
____ Recent Immunizations/Vaccinations
____ Use of medications/drugs known to have a link to CFS/Fibromyalgia (full overview provided in Living Well With Chronic Fatigue Syndrome and Fibromyalgia)


CFS Symptoms -- Official Criteria

The official criteria for CFS include the following symptoms:

____ Fatigue that is medically unexplained; of new onset; lasts at least six months; is not the result of ongoing exertion; is not substantially relieved by rest; and causes a substantial reduction in activity levels.

Plus, four or more of the following symptoms:
____ substantially impaired memory/concentration
____ sore throat
____ tender neck or armpit lymph nodes
____ muscle pain
____ headaches of a new type, pattern or severity
____ unrefreshing sleep
____ relapse of symptoms after exercise (also known as post-exertional malaise) that lasts more than 24 hours
____ pain in multiple joints without joint swelling or redness.

Fibromyalgia Symptoms -- Official Criteria

The official American College of Rheumatology criteria for fibromyalgia include:

____ Widespread pain for at least 3 months. Pain should be on both the left side of the body and the right side, and pain both above and below the waist. Cervical spine, anterior chest, thoracic spine or low back pain must also be present.

Plus, pain in at least 11 of 18 specific tender point sites, which include:
____ The area where the neck muscles attach to the base of the skull, left and right sides (Occiput)
____ Midway between neck and shoulder, left and right sides (Trapezius)
____ Muscles over left and right upper inner shoulder blade, left and right sides (Supraspinatus)
____ 2 centimeters below side bone at elbow of left and right arms (Lateral epicondyle)
____ Left and right upper outer buttocks (Gluteal)
____ Left and right hip bones (Greater trochanter)
____ Just above left and right knees on inside
____ Lower neck in front, left and right sides (Low cervical)
____ Edge of upper breast bone, left and right sides (Second rib)


____ Muscle, joint pain, stiffness, burning, soreness, spasms, cramps
____ Carpal tunnel syndrome-like pains
____ Painful menstrual periods
____ Headaches
____ Fatigue, extreme exhaustion
____ Sleep Disturbances
____ Shortness of breath
____ Sore throat (known as pharyngitis)
____ Brain fog – general difficulty concentrating
____ Impaired attention span
____ Confusion with memory, words, numbers, math, etc.

____ Mood swings, anxiety, depression, panic attacks
____ Numbness or tingling sensations
____ Sensitivity to temperature changes
____ Chemical sensitivities, allergies
____ Allergies and or sensitivities – to pollen, foods, molds
____ Sensitivity to medicines
____ Sensitivity or intolerance to alcohol
____ Eye/vision problems
____ Constipation or diarrhea
____ Nausea, indigestion, stomach problems
____ Hypoglycemia, low blood sugar, “fibroglycemia”
____ Dizziness
____ Low blood pressure
____ Recurrent low-grade fever
____ Heart palpitations, skipped heartbeats
____ More frequent infections
____ Weight changes -- gain or loss, not associated with change in eating habits

This is an adapted version of the 30-page "Risk Factors and Symptoms Checklist" featured in the book, Living Well With Chronic Fatigue and Fibromyalgia: What Your Doctor Doesn't Tell You...That You Need to Know, by Mary Shomon.

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