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Tests and diagnosis
By Mayo Clinic staffTo meet the diagnostic criteria of chronic fatigue syndrome, you must have unexplained, persistent fatigue for six months or more, along with at least four of the eight primary signs and symptoms.
Primary signs and symptoms of CFS include:
- Loss of memory or concentration
- Sore throat
- Painful and mildly enlarged lymph nodes in your neck or armpits
- Unexplained muscle pain
- Pain that moves from one joint to another without swelling or redness
- Headache of a new type, pattern or severity
- Unrefreshing sleep
- Extreme exhaustion lasting more than 24 hours after physical or mental exercise
There's no diagnostic or laboratory procedure to confirm the presence of chronic fatigue syndrome. The diagnosis is based on exclusion. This means that before arriving at the diagnosis, your doctor has ruled out other well-defined diseases or conditions that may be causing your fatigue and related symptoms. Conditions your doctor may rule out or identify as contributing factors early on include:
- Low levels of thyroid hormone (hypothyroidism)
- Sleep apnea
- Depression
- Eating disorders
- Substance abuse
- A relapse of a previously treated illness, such as cancer
- Severe obesity, defined by a body mass index (BMI) of 40 or greater
- Bennett RM. Fibromyalgia and chronic fatigue syndrome. In: Goldman L, et al., eds. Goldman: Cecil Medicine. 23rd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/133386890-3/833235176/1492/1050.html#4-u1.0-B978-1-4160-2805-5..50300-1_13277. Accessed April 22, 2009.
- Engleberg CN. Chronic fatigue syndrome. In: Mandell, GL, et al. Mandell, Bennett, & Dolin: Principles and Practice of Infectious Diseases. 6th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2005. http://www.mdconsult.com/das/book/body/133386890-5/833235546/1259/1004.html#4-u1.0-B0-443-06643-4..50130-6_4604. Accessed April 22, 2009.
- Chronic fatigue syndrome: Symptoms. Centers for Disease Control and Prevention. http://www.cdc.gov/cfs/cfssymptomsHCP.htm. Accessed April 22, 2009.
- Chronic fatigue syndrome: Possible causes. Centers for Disease Control and Prevention. http://www.cdc.gov/cfs/cfscauses.htm. Accessed April 22, 2009.
- Chronic fatigue syndrome: Who's at risk. Centers for Disease Control and Prevention. http://www.cdc.gov/cfs/cfsatrisk.htm. Accessed April 22, 2009.
- Marshall GS, et al. Chronic fatigue syndrome.. In: Long SS, et al., eds. Long: Principles and Practice of Pediatric Infectious Diseases. 3rd ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2008. http://www.mdconsult.com/das/book/body/133386890-6/0/1679/204.html#4-u1.0-B978-0-443-06687-0..50203-4--chapter1. Accessed April 22, 2009.
- Gluckman SJ. Treatment of chronic fatigue syndrome. http://www.uptodate.com/home/index.html. Accessed April 22, 2009.
- Teitelbaum J. Chronic fatigue syndrome. In: Rakel RE. Integrative Medicine. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/133386890-7/833236431/1494/94.html#4-u1.0-B978-1-4160-2954-0..50051-X_2429. Accessed April 22, 2009.
- Chronic fatigue syndrome: Treatment options. Centers for Disease Control and Prevention. http://www.cdc.gov/cfs/cfstreatmentHCP.htm. Accessed April 22, 2009.
- Chronic fatigue syndrome: Support groups. Centers for Disease Control and Prevention. http://www.cdc.gov/cfs/cfssupport.htm. Accessed April 22, 2009.
- Patel G, et al. Complementary and alternative medicine for noncancer pain. Medical Clinics of North America. 2007;91:141.
