There's no single test to confirm a diagnosis of chronic fatigue syndrome. Because the symptoms of chronic fatigue syndrome can mimic so many other health problems, you may need patience while waiting for a diagnosis.
Your doctor must rule out a number of other illnesses before diagnosing chronic fatigue syndrome. These may include:
- Sleep disorders. Chronic fatigue can be caused by sleep disorders. A sleep study can determine if your rest is being disturbed by disorders such as obstructive sleep apnea, restless legs syndrome or insomnia.
- Medical problems. Fatigue is a common symptom in several medical conditions, such as anemia, diabetes and underactive thyroid (hypothyroidism). Lab tests can check your blood for evidence of some of the top suspects.
- Heart and lung impairments. Problems with your heart or lungs can make you feel more fatigued. An exercise stress test can assess your heart and lung function.
- Mental health issues. Fatigue is also a symptom of a variety of mental health problems, such as depression, anxiety, bipolar disorder and schizophrenia. A counselor can help determine if one of these problems is causing your fatigue.
There is no cure for chronic fatigue syndrome. Treatment focuses on symptom relief.
Many people who have chronic fatigue syndrome are also depressed. Treating your depression can make it easier for you to cope with the problems associated with chronic fatigue syndrome. Low doses of some antidepressants also can help improve sleep and relieve pain.
The most effective treatment for chronic fatigue syndrome appears to be a two-pronged approach that combines cognitive training with a gentle exercise program.
- Cognitive training. Talking with a counselor can help you figure out options to work around some of the limitations that chronic fatigue syndrome imposes on you. Feeling more in control of your life can improve your outlook dramatically.
- Graded exercise. A physical therapist can help determine what exercises are best for you. Inactive people often begin with range-of-motion and stretching exercises for just a few minutes a day. Gradually increasing the intensity of your exercise over time may help reduce your hypersensitivity to exercise, just like allergy shots gradually reduce a person's hypersensitivity to a particular allergen.
Many alternative therapies have been promoted for chronic fatigue syndrome. It's difficult to determine whether these therapies actually work, partly because the symptoms of chronic fatigue syndrome often respond to placebos.
Coping and support
The experience of chronic fatigue syndrome varies from person to person. Emotional support and counseling may help you and your loved ones deal with the uncertainties and restrictions of this disorder.
You may find it therapeutic to join a support group and meet other people with chronic fatigue syndrome. Support groups aren't for everyone, and you may find that a support group adds to your stress rather than relieves it. Experiment and use your own judgment to determine what's best for you.
Preparing for your appointment
If you have signs and symptoms of chronic fatigue syndrome, you're likely to start by seeing your family doctor or a general practitioner. It can be difficult to absorb all the information provided during an appointment, so you might want to arrange for a friend or family member to accompany you. Having someone else hear the information can help you later in case there's something you missed or forgot.
What you can do
Before your appointment, you may want to write a list that includes:
- Your signs and symptoms. Be thorough. While fatigue may be affecting you most, other symptoms — such as memory problems or headache — also are important to share with your doctor.
- Key personal information. Recent changes or major stressors in your life can play a very real role in your physical well-being.
- Health information. List any other conditions for which you're being treated and the names of any medications, vitamins or supplements you take regularly.
- Questions to as your doctor. Creating your list of questions in advance can help you make the most of your time with your doctor.
For chronic fatigue syndrome, some basic questions to ask your doctor include:
- What are the possible causes of my symptoms or condition?
- What tests do you recommend?
- If these tests don't pinpoint the cause of my symptoms, what additional tests might I need?
- On what basis would you make a diagnosis of chronic fatigue syndrome?
- Are there any treatments or lifestyle changes that could help my symptoms now?
- Do you have any printed materials I can take with me? What websites do you recommend?
- What activity level should I aim for while we're seeking a diagnosis?
- Do you recommend that I also see a mental health provider?
Don't hesitate to ask other questions during your appointment as they occur to you.
What to expect from your doctor
Your doctor is likely to ask you a number of questions, such as:
- What are your symptoms and when did they begin?
- Does anything make your symptoms better or worse?
- Do you have problems with memory or concentration?
- Are you having trouble sleeping?
- How often do you feel depressed or anxious?
- How much do your symptoms limit your ability to function? For example, have you ever had to miss school or work because of your symptoms?
- What treatments have you tried so far for this condition? How have they worked?