TOC  |  Rheumatology  

Chronic Fatigue Syndrome (CFS)                 RX  

Incidence of CFS:

Findings indicated that CFS occurs in about 0.42% (95% confidence interval, 0.29%-0.56%) of this random community-based sample. The highest levels of CFS  were consistently found among women, minority groups, and persons with lower levels of education and occupational status.  Chronic fatigue syndrome is a common chronic health condition, especially for women, occurring across ethnic groups. Earlier findings suggesting that CFS is a syndrome primarily affecting white, middle-class patients were not supported by our findings.
(Arch Intern Med. Oct.11, 1999;159:2129-2137 - Leonard A. Jason)

Classify as CFS if both of the following criteria are met:
See CDC Definition of CDC        

Clinically evaluated, unexplained chronic fatigue cases can be classified as chronic fatigue syndrome if the patient meets both the following criteria:

  1. Clinically evaluated, unexplained persistent or relapsing chronic fatigue that is of new or definite onset (i.e., not lifelong), is not the result of ongoing exertion, is not substantially alleviated by rest, and results in substantial reduction in previous levels of occupational, educational, social, or personal activities ; and
  2. Four or more of the following symptoms are concurrently present for 6 months or longer:

A note on the use of laboratory tests in the diagnosis of CFS:

A minimum battery of laboratory screening tests should be performed. Routinely performing other screening tests for all patients has no known value. However, further tests may be indicated on an individual basis to confirm or exclude another diagnosis, such as multiple sclerosis. In these cases, additional tests should be done according to accepted clinical standards.

In clinical practice, no tests can be recommended for the specific purpose of diagnosing chronic fatigue syndrome. Tests should be directed toward confirming or excluding other possible clinical conditions.

Examples of specific tests that do not confirm or exclude the diagnosis of chronic fatigue syndrome include serologic tests for Epstein-Barr virus, enteroviruses, retroviruses, human herpesvirus 6, and Candida albicans; tests of immunologic function, including cell population and function studies; and imaging studies, including magnetic resonance imaging scans and radionuclide scans (such as single-photon emission computed tomography and positron emission tomography).

Treatment of CFS:                                   See    CDC    CFS Rx Guidelines

  1. Nonpharmocologic Therapy
  2. Pharmocologic Therapy

Medication Rx:

REF:  -  National Chronic Fatigue Syndrome & Fibromyalgia Association  -  Centers for Disease Control & Prevention CFS 888-232-3228
Conn's Current Therapy 1998
Ann Intern Med 1994;121:953 The Chronic Fatigue Syndrome - Fukuda K, etc.


CFS Foundation


Chronic Fatigue Syndrome (JAMA May 23/30, 2001;285:2557  Benjamin H Natelson) April 2002 - Chronic Fatigue Syndrome - Patient Note