When a patient presents multiple specific symptoms, it is important to include chronic fatigue syndrome in the differential diagnosis. A complete and detailed medical history is paramount. A physician needs to determine if there is an initiating event, such as an infection, and if that event caused several specific symptoms.
Those symptoms are significant sleep deprivation or unrefreshed sleep for greater than six months, new onset of headaches, joint or muscle pains that are unexplained, major fatigue and cognitive dysfunction such as diminished concentration, memory loss, and brain fog. To determine if you are suffering from such a condition, it is important that you contact a chronic fatigue syndrome physician to employ the proper examination and testing for chronic fatigue syndrome.
Source of the Problem
Unrelenting and persistent fatigue is a common symptom of CFS, but cannot be confirmed without proper examination and testing. This is usually precipitated by unrefreshed sleep. CFS patients have difficulty falling asleep, or more likely have the inability to sleep through the night. Many patients have used the entire spectrum of sleep medications, starting from over-the-counter products ranging through prescription sedatives to the most potent sleep medications.
Sleep deprivation has a negative impact on the immune system, affects the production and function of adrenal hormones such as cortisol, testosterone, DHEA, and thyroid hormone. Mitochondria, the source of energy for the body cells, also demonstrate impaired function. This cascade of negative events eventually produces chronic fatigue.
A physician will start the examination and testing process for chronic fatigue syndrome by first listening to the patient. This may take some time and is not always easy for the professional. Further, there may be time limitations and the professional’s innate desire is to ask questions. The history and physical examination need to be supported by appropriately ordered radiologic imaging and laboratory testing.
It is extremely important to establish a timeline of events and to make certain other important illnesses are not overlooked when examining and testing for chronic fatigue syndrome. For instance, certain metabolic diseases, cancers, and psychiatric conditions can present as if they are CFS. It is important that these life-threatening illnesses not be overlooked.
Depending upon the examiner, a thorough history with and examination and testing for chronic fatigue syndrome by a practitioner should typically take 60 to 90 minutes. It would be ideal if the patient could bring their past medical records. Appropriate radiologic imaging should be ordered and an ECG will be performed. Blood, urine and saliva testing should be drawn at this time.
If the doctor suspects CFS, certain specific laboratory testing should be undertaken beyond the general health panels of CBC, electrolytes, and cholesterol. All hormone levels should be evaluated. Evidence of active or previous bacterial and viral infections need to be determined. Evaluation of the immune system and blood clotting systems are paramount. Diet, nutritional deficiencies, and lifestyle can have a major influence on the expression of CFS and needs to be determined through proper examination and testing.
In order not to overlook other disease conditions which may not be a cause of CFS but can have an impact upon it is necessary to do some specific testing. Systemic lupus, rheumatoid arthritis, and Sjogren’s syndrome need to be diagnosed or ruled out by testing for antinuclear antibodies.
HIV/AIDS can mimic certain aspects of CFS and cannot be overlooked as a life-threatening disease. Insulin resistance states such as prediabetes and diabetes, Vitamin B deficiencies, and even parasitic infections have to be considered. A travel and occupational history is exceedingly important.