Detect Chronic Fatigue

It can be easy to dismiss fatigue. While everyone is tired sometimes, it’s important to realize when it’s becoming a chronic condition. Fatigue is a symptom of many conditions — from depression to Lyme disease to nutritional deficiencies — so it is important you talk to your doctor about potential underlying conditions for your tiredness. On the other hand, if you have felt tired every day for a long period of time, find yourself exhausted after physical exertion, and aren’t feeling any better, or it's getting worse, you may have chronic fatigue syndrome (CFS).

Steps

Recognizing Physical Symptoms

1. Monitor how you feel. Symptoms for chronic fatigue often come and go. When you have a number of the following symptoms for extended period of time, such as greater than six months, and seems to be worsening, you need to be evaluated by a physician. Symptoms of chronic fatigue syndrome (CFS) include:
   • You feel tired for more than 24 hours after exertion. Notice if you are excessively tired for long periods of time after exerting yourself through intensive physical or mental activities. This is an important symptom to notice, as most of the time, exercise should leave you feeling energized, not fatigued.
   • You feel unrefreshed after sleep. Sleep should make you feel better. If you don’t feel better after sleep or suffer from insomnia, you may be suffering from CFS.
   • You lack short-term memory. You may easily misplace things or forget what someone has just told you. You also may experience general confusion or have trouble concentrating.
   • You suffer from muscle pain. You may experience soreness or muscle weakness not due to exertion.
   • You experience joint pain. Your joints may hurt even though you do not have swelling or redness.
   • You have mild to severe headaches. These headaches differ from those you’ve had in the past and you can find no cause for them.
   • You feel enlarged lymph nodes in your neck or armpits. Swollen glands mean your body is fighting illness or an infection.
   • You have a sore throat. Your throat may be sore, but is not linked to other cold or flu-like symptoms.
2. Think about potential causes. Your chronic fatigue may be linked to changes in your lifestyle. Consider any recent changes in your life.
   • If you’ve recently had a viral infection, this may be a sign of CFS. Viral infections can be triggers for chronic fatigue.
   • Problems with the immune system can also lead to chronic fatigue. Remember if you’ve had any recent issues with your immune system.
   • Low blood pressure is often found in CFS patients. Monitor your blood pressure to see if it falls within the normal range.
3. Note any pain you are feeling. Make sure it’s not due to injury or excessive exertion, but daily pain not linked to specific causes. If you experience any of the following, they may be linked to chronic fatigue:
   • Muscle soreness
   • Joint pain without redness or swelling
   • Headaches
4. Determine how you are sleeping. Write down how much you sleep each night and how often you wake up. If you discover that you are sleeping well but still feeling exhausted, then CFS may be behind your fatigue.
   • You can download apps on your smartphone that will track and analyze your sleep quality.
   • Some nights you will sleep better than others. Recognize when you sleep less due to outside factors like work or other obligations as opposed to problems getting a restful night of sleep.
   • Know that sleep totals will change. You may experience problems for weeks and then sleep well for a long period of time.
   • Track if you wake up excessively early. If you are waking up hours before your alarm clock on a regular basis, write down how often that happens.
   • Note any instances of insomnia you may have. Even if it’s just for a few hours, write down any time you have significant trouble falling asleep.
   • Remember if you wake up often during the night. If you have one, ask your partner to note if you are sleeping fitfully.
   • Make yourself as comfortable as possible. Give yourself the best chance to sleep by dressing comfortably and keeping your sleeping area dark and cool.
5. See if your physical activities are limited. You may have changed your non-essential activities to compensate for your increased fatigue. Look further into whether CFS is a factor if the following is true:
   • You have reduced all other outside activities besides work. You do not meet with friends or family unless absolutely necessary.
   • Your weekends are spent recovering or resting for the week. You cannot imagine doing anything on the weekends, since you need the time to recover and prepare for work.
   • You have stopped all leisure activities. You may have quit any athletics you are involved in or any groups that you have joined.

Reviewing Risk Factors

1. See if you have difficulty with mental activities. Keep track of any problems you have doing daily activities you are used to doing with ease. Pay attention if you:
   • Experience problems concentrating. Note if you have difficulty completing tasks in a reasonable time frame.
   • Lack short-term memory. You often may forget things that people just told you or events that recently happened.
   • Cannot concentrate or retain attention. You may not be able to pay attention for a long period of time without zoning out.
   • Feel scatter-brained or have difficulty organizing your life. You may forget appointments or meetings with colleagues or friends.
   • Struggle to find the right word or to maintain your stream of thought. Talking when prompted may be difficult for you.
   • Have blurry vision during daily activities. Even if you are wearing glasses or contacts, you struggle seeing clearly and distinctly.
2. Keep track of external factors. If anything has changed recently in your stress, sleep, or health patterns, it may be time to make an appointment with a physician.
   • If your stress level has increased, this can cause chronic fatigue. Think about your daily life and if anything has changed substantially.
   • Think about any recent health problems you’ve had and how they may contribute to your fatigue.
   • Make a list of questions to ask a doctor if you decide to make an appointment. Think of questions to ask them as well as what information you need to have to help them answer your questions.
3. Consider additional risk factors that may make you susceptible to chronic fatigue. CFS is more likely to occur in specific groups of people. If you are in these target groups, consider chronic fatigue as a potential diagnosis.
   • Chronic fatigue can affect people of all ages. It is most common though in people in the 40s and 50s.
   • Women are generally diagnosed with chronic fatigue more than men. This may be due to their reporting it more rather than acquiring it more.
   • Being unable to manage stress can be a problem that contributes to chronic fatigue.
4. Assess your quality of life. If you've felt differently, changed your social life, daily, work, or school schedule because you're tired, it may be a sign of chronic fatigue.
   • Consider if you feel more depressed recently than normal. Depression can be due to feeling tired and lacking sleep.
   • Think about your social life. Consider if you go out less than you used to because you are too tired.
   • Reflect on if you’ve changed your lifestyle in substantial ways. Think about the ways you’ve adapted your daily schedule if you’re feeling fatigued.
   • Realize if you’re missing work or school more often due to feelings of tiredness. Absences at work or school may increase with chronic fatigue.

Talking to a Doctor

1. Know your facts. Make sure you are aware of the most important facts about CFS.
   • Chronic fatigue is not very common. It is estimated to affect 836,000 to 2.5 million people in the United States.
   • Chronic fatigue is diagnosed four more times more often in women than men.
   • There is no test for chronic fatigue. It can be diagnosed through symptoms or signs that are happening at the same time.
   • There is no cure for chronic fatigue; however, symptoms can be treated and reduced.
   • Adults have a fair to poor prognosis for chronic fatigue. Children have a better to good prognosis. In both cases, treatment of the symptoms is important.
   • Having a healthy lifestyle is the best advice given by physicians to treat chronic fatigue.
   • In younger people, the most common group diagnosed is teenagers.
2. Know the difficulties of diagnosing chronic fatigue syndrome (CFS). It is very difficult for doctors to diagnose CFS since there is no test and the symptoms mirror a number of other diseases.
   • Know the difference between CFS and ME (myalgic encephalomyelitis). CFS is the preferred term for doctors, while ME is used by those suffering from the condition. For many, fatigue seems too everyday of a word to describe the syndrome.
   • Realize there is no test for CFS. The doctor will not be able to provide a simple and easy test, so make sure to have patience.
   • Know the common symptoms as described above. If you have CFS, you will experience four of the eight symptoms close to the same time.
   • Talk to your doctor about getting tested for other potential causes of fatigue. Because CFS is relatively rare, it is more likely you are suffering from a different condition, including thyroid, anemia, sleep disorders, medication side effects, infections, nutritional deficiencies, fibromyalgia, autoimmune disorders, depression, and so on. Many of these are more treatable than CFS.
   • Realize that CFS goes through cycles of remission and relapse. You may feel better for a time and then feel much worse. There is no cure, but only the symptoms can be managed.
   • Your symptoms may vary. Some symptoms will be prominent than others. Additionally, some may change and become more or less of an issue through time.
   • There is a low rate of diagnosis for CFS. Only about 20% of people who have it have been diagnosed.
   • Chronic fatigue syndrome is often not taken seriously by doctors or by friends and family. Make sure to be consistent and firm with your doctor regarding the severity of your symptoms.
3. Provide your doctor with all necessary information. Make sure she can make an informed diagnostic decision about your chronic fatigue.
   • Have your medical history available and complete. Provide your doctor with any information from other doctors as well as your own recent observations.
   • Take any physical or mental exams the doctor suggests. These tests can help determine additional issues as well as fully explain any symptoms you may be experiencing.
   • Be prepared to give blood or fluid samples. Your doctor may want to test your blood to rule out any additional diseases.
4. Consider sleep disorders. Your doctor may want to test you for sleep disorders outside of chronic fatigue. Even though these disorders can lead to fatigue, they are not symptoms of chronic fatigue.
   • Test for sleep apnea. Sleep apnea causes you to stop breathing temporarily during sleep. It can can cause you to be drowsy and elevate your blood pressure.
   • Test for restless legs syndrome. Restless leg syndrome causes you to desire to move your legs throughout the night. You can have difficulty maintaining a consistent night of sleep.
   • Test for insomnia. Insomnia is when you have difficulty falling or staying asleep. If you suffer from insomnia, it can also lead you to be fatigued since you are not sleeping regularly and consistently.
5. Make sure to test for a variety of conditions besides chronic fatigue. You may be experiencing mental health issues, problems with medication, fibromyalgia, mono, lupus, or Lyme disease. Don’t go into the doctor determined to get a specific diagnosis of chronic fatigue syndrome.
   • Depression is often affiliated with similar symptoms as chronic fatigue.
   • Different medications can have side effects that affect sleep, fatigue, memory, or muscle and joint pain. Make sure your doctor knows all of your medications.
   • Fibromyalgia is also linked to pain, difficulties with memory, and difficulties sleeping. Have your doctor look into this as well as chronic fatigue.
   • Mononucleosis can also cause you to be tired and fatigued for long periods of time; however, it eventually goes away, so it’s important for your doctor to rule it out.
   • Lupus is a chronic disease that affects your immune system. It can also cause many of the same symptoms as chronic fatigue.
   • Lyme disease is transmitted to humans through a tick bite. It is pretty serious, so make sure to check your body for rashes and bites.
6. Make management plan with doctor. If you have chronic fatigue, you cannot cure it; however, you can address the symptoms in a variety of ways.
   • People who suffer from chronic fatigue may also be depressed. Small doses of antidepressants can help with sleep and pain management.
   • Sleeping pills may be useful if avoiding caffeine does not work. They will at least help you get a slightly better rest at night.
   • Physical therapy and moderate exercise may help you to improve your range of motion that has suffered due to chronic fatigue. Don’t overdo it. You don’t want to be even more fatigued and exhausted the next day.
   • Counseling may help you to gain a different perspective on your syndrome. Try to feel like you can gain control over your life despite experiencing chronic fatigue.
7. Change your lifestyle. Follow your doctor’s management plan while also trying lifestyle changes that can help alleviate your symptoms.
   • Reduce stress. Try to reduce the number of stressors in your life. Taking it easier can help you to feel less tired all the time.
   • Examine your diet. You may not be getting enough nutrients from your food to function properly, leaving you feeling fatigued.
   • Improve your sleep habits. Don’t do anything too demanding before bedtime.
   • Pace yourself. Slow down your life. Don’t try to get everything done at once.
8. Look into alternative medicine. Alternative medicine may help you to relax, which can help to alleviate some symptoms of chronic fatigue.
   • Acupuncture is often used for pain relief. It may be able to help with muscle soreness or joint pain.
   • Massage can be useful for soothing your sore muscles. Try massage that focuses on the problem areas that are sore most often.
   • Yoga can also help you to stretch your muscles and gain flexibility. Don’t try anything too strenuous since you don’t want to tire yourself out even more.
9. Get emotional support. Chronic fatigue is draining. Make sure you are staying in touch with your loved ones and getting outside help when you need it.
   • Talk to your loved ones about your chronic fatigue. They may be able to help you if your mobility is limited. Confide in them when chronic fatigue is really wearing on you.
   • Look into psychological counseling. Counseling can help you to learn how to deal with the psychological effects of chronic fatigue. Try to get an outside perspective.
   • Find a support group. A support group of fellow sufferers of chronic fatigue can help you to commiserate about your syndrome. You can help each other out during the roughest times.

Tips

• Remember that there are many different causes for fatigue, and that chronic fatigue is actually relatively rare. Be open to other suggestions from your doctor, and get tested for any more likely candidates for the cause of your symptoms.
• Stress management, good sleep, healthy eating and living a healthy lifestyle all can help alleviate fatigue.

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