Dr James Schaller
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Chronic Fatigue Syndrome

The definition of chronic fatigue syndrome (CFS) has been developing over many decades. Increasingly, if a physician is not cynical, and respects the data that this is a real patient experience, here are some possible sample ways of diagnosing CFS.

  1. The first step is to rule out persistent, relapsing or increasing causes of fatigue that last at least half a year. My first problem with this is that the CDC is grossly clinically inexperienced in three very common causes of chronic fatigue—many strains of American Lyme and Babasia, and indoor mold mycotoxins. The former is hardly handled well in light of the fact only 1/40 physicians report Lyme (even when they use junk labs that miss it to diagnosis it). The latter mold spore surface chemicals might be an issue in as many as 25% of USA structures.
  2. You should have four of these in at least the last six months:
    • impairment in short term memory or concentration
    • sore throat
    • tender cervical or axillary lymph nodes
    • muscle pain
    • multiple joints with pain without swelling or redness
    • new headaches
    • unsatisfying sleep
    • modest exertion causes significant malaise

    Keiji Fukuda, Stephen Straus, Ian Hickie, Michael Sharpe, James Dobbins, Anthony Komaroff, and the International CFS Study Group. "The Chronic Fatigue Syndrome: A Comprehensive Approach to Its Definition and Study". Annals of Internal Medicine. 1994;121:953-959.

    Others Have Complied Interview Symptom Lists
    from Chronic Fatigue Patients

    One study of people who met the criteria above also listed this:

    Symptom/signFrequency (%)
    low fever60 - 95
    muscle aches20 - 95
    sleep problems15 - 90
    thinking problems50 - 85
    depression70 - 85
    headache35 - 85
    sore throat50 - 75
    anxiety50 - 70
    muscle weakness40 - 70
    wiped out after exertion0 - 60
    worse PDD/PMS50 - 60
    stiffness50 - 60
    blurred vision50 - 60
    night urination50 - 60
    nausea50 - 60
    dizziness30 - 50
    joint aches40 - 50
    heart rate over 10040 - 50
    dry eyes30 - 40
    dry mouth30 - 40
    diarrhea30 - 40
    poor appetite30 - 40
    cough30 - 40
    joint swelling30 - 40
    night sweats30 - 40
    painful lymph nodes30 - 40
    rash30 - 40

    Komaroff AL, Buchwald D. Symptoms and signs of chronic fatigue syndrome. Review of Infectious Diseases 1991;13(S1):S8-11.

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