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Chronic Fatigue Diagnosis

Chronic Fatigue Diagnosis
Chronic fatigue
Causes and Risk Factors

Chronic fatigue syndrome is a poorly understood condition and there is no clear consensus about its diagnosis and treatment. Chronic fatigue syndrome is not well understood, and many health-care providers have a hard time recognizing it. Some don't even believe it is an actual condition.  Managing chronic fatigue syndrome requires teamwork between the doctor and patient, so it's important for you to have a positive relationship and choose the right doctor.

Finding a doctor
The more you know about chronic fatigue syndrome (CFS or ME/CFS), the better prepared you'll be when trying to find a doctor. It's a difficult process, and you may need to educate a few professionals along the way. All this means that it is your responsibility to find someone qualified to diagnose and treat you. However, you have a number of resources to use in your search.

Local support groups - People involved in local support groups will most likely be able to recommend qualified doctors. To find a support group in your area, you can check with your doctor, local clinics and hospitals.

Other care providers - If you see a physical therapist, massage therapist or chiropractor, ask who s/he would recommend.

Referral services - Check with local clinics and hospitals to see if they have referral services. Also, call your insurance company to see if they have any doctors listed as specializing in ME/CFS.

Your family doctor - If your regular doctor isn't well educated about ME/CFS, see if s/he is either willing to learn or knows of someone who's more knowledgeable.

Medical exams
A chronic fatigue syndrome diagnosis is a diagnosis of exclusion, meaning that other medical conditions must be ruled out in order to confirm CFS by excluding other possible diagnoses. In other words, CFS is diagnosed if there is no other explanation for the fatigue and if the other symptoms did not develop before the fatigue.  Thus diagnosis may be a time-consuming process for the patient and may become frustrating.  Specific tests that support (but do not necessarily confirm) a diagnosis of chronic fatigue include the following:

  • Exercise testing may show decreased cortisol levels after exercise, decreased cerebral blood flow after exercise, inefficient glucose utilization, and erratic breathing patterns
  • Immune system tests, including low natural killer (NK) cell counts, elevated interferon alpha, tumor necrosis factor-alpha, interleukins 1 and 2, T-cell activation, altered T4/T8 cell ratios, low T-cell suppressor cell (T8) count, fluctuating B- and T-cell counts, antinuclear antibodies (ANA), immunoglobulin deficiency, anti-thyroid antibodies
  • Tests for viral infections, such as cytomegalovirus, Epstein-Barr virus, human herpes virus 6, and coxsackie virus

Laboratory tests -
Doctors might also perform the following laboratory tests, when attempting to diagnose a patient with chronic fatigue:

  • Chem-20 panel
  • Complete blood count (CBC) with differential
  • Erythrocyte sedimentation rate (ESR), a marker of inflammation
  • Urinalysis

Optional tests - These tests are also useful when trying to rule out potential causes for symptoms of chronic fatigue:

  • Adrenal tests (a.m. and p.m. cortisol levels)
  • Antinuclear antibodies (ANA) and rheumatoid factor (RF) to test for rheumatoid arthritis and SLE, systemic lupus erythematosus
  • Lyme titers and HIV serology
  • Thyroid tests (T3, T4, TSH)

Other diagnoses
It should be noted that doctors may accept a co-diagnosis of chronic fatigue syndrome in people who have other illnesses that involve chronic fatigue. Many people who report symptoms of CFS may also have serious, treatable, previously unrecognized medical or psychiatric conditions (such as diabetes, thyroid disease, substance abuse).  If such conditions have been treated adequately and no longer explains the fatigue and other symptoms, doctors then consider diagnosing chronic fatigue syndrome as the possible cause for symptoms. 

How do doctor treat chronic fatigue syndrome?  What can you do at home to relieve symptoms?  To learn more about treating chronic fatigue, continue reading.  Our next section on how to treat chronic fatigue outlines treatment goals and options and informs you about what are the treatments for cf.

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Tags: chronic fatigue syndrome, chronic fatigue, chronic, fatigue, systemic lupus erythematosus, antinuclear antibodies, Rheumatoid arthritis, lupus erythematosus, thyroid disease, after exercise, antinuclear, infections, activation, treatments, diagnosis, Arthritis, treatment, Diabetes, Exercise, symptoms
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