The nonspecific nature of
the name CFIDS is appropriate because while there are many
symptoms, disabling fatigue and exhaustion are the most
prominent and consistent. However, fatigue, probably the most
universal symptom, is the most severe symptom in only half of
the patients. The rest have either headaches, muscle pain, joint
pain, visual disturbances, emotional changes, memory loss,
confusion, lymph node pain, or abdominal pain as the most severe
symptom. Individual symptoms may vary in intensity, but the
pattern of symptoms remains remarkably constant. These symptoms
can be completely disabling and may persist for years, or they
may be minor to the degree of being no more than a nuisance.
In general, the physical examination shows only subtle
abnormalities, such as throat inflammation or muscle and lymph
node tenderness. It is truly remarkable that a patient can feel
so bad yet look relatively well. The routine laboratory
evaluation, like the physical examination, shows only minimal,
if any, abnormalities. Although sophisticated laboratory testing
may reveal abnormal results, they are difficult for most
physicians to interpret and have been largely ignored. The
combination of numerous severe somatic complaints and only minor
abnormalities on physical exam and routine laboratory testing is
the reason many physicians have dismissed this illness as
hypochondriasis. In the past fifty years, the emphasis in
medicine has been to divide illnesses into categories by the
nature of the symptoms. Therefore, a joint specialist would see
CFIDS as a form of arthritis, a psychiatrist would see it as
mental illness, and an allergist would see it as a manifestation
of allergies. It is ironic that in this day of specialists, the
generalists have been the only group of physicians able to
recognize the spectrum of symptoms in CFIDS as a specific
syndrome. But in our era of technology, it is rare for
specialists to listen to generalists.
And specialists have been unable to make much progress in
studying this illness, primarily because of the lack of "disease"
in the organs in which they specialize. That is to say, although
the muscles hurt, muscle biopsies are normal or show minimal
changes only. Although there are headaches, CT scans of the
brain are normal. Specialists are interested in diseases
originating in their area of specialty. In these days of
specialty medicine, a patient with CFIDS might see more than ten
different specialists, and none will be able to find the cause
of the complaints. In CFIDS, whatever causes the symptoms is
outside of the limited specialties. We are witnessing a disease
so fundamental in its origin that it affects all body systems
but causes little damage.
Following is a list of the myriad symptoms seen in CFIDS,
including a rough estimate of the percentage of patients who
would have each symptom. Those symptoms that cause patients the
greatest discomfort are asterisked (*).
| Fatigue or exhaustion |
95 % |
* |
| Headache |
90 % |
* |
| Malaise |
80 % |
* |
| Short-term memory loss |
80 % |
* |
| Muscle pain |
75 % |
* |
| Difficulty concentrating |
70 % |
* |
| Joint pain |
65 % |
* |
| Depression |
65 % |
* |
| Abdominal pain |
60 % |
* |
| Lymph node pain |
50 % |
* |
| Sore throat |
50 % |
* |
| Lack of restful sleep |
90 % |
* |
| Muscle weakness |
30 % |
|
| Bitter or metallic taste |
25 % |
|
| Balance disturbance |
30 % |
|
| Diarrhea |
50 % |
|
| Constipation |
40 % |
|
| Bloating |
60 % |
|
| Panic attacks |
30 % |
|
| Eye pain |
30 % |
|
| Scratchiness in eyes |
60 % |
|
| Blurring of vision |
80 % |
|
| Double vision |
10 % |
|
| Sensitivity to bright lights |
80 % |
|
| Numbness and/or tingling in extremities |
60 % |
|
| Fainting spells |
40 % |
|
| Light-headedness |
75 % |
|
| Dizziness |
30 % |
|
| Clumsiness |
30 % |
|
| Insomnia |
65 % |
|
| Fever or sensation of fever |
85 % |
|
| Chills |
30 % |
|
| Night sweats |
50 % |
|
| Weight gain |
40 % |
|
| Allergies |
60 % |
|
| Chemical sensitivities |
25 % |
|
| Palpitations |
55 % |
|
| Shortness of breath |
30 % |
|
| Flushing rash of the face and cheeks |
40 % |
|
| Swelling of the extremities or eyelids |
20 % |
|
| Burning on urination |
20 % |
|
| Sexual dysfunction |
20 % |
|
| Hair loss |
20 % |
|
A list of CFIDS symptoms is misleading. At first glance it
appears that almost every symptom possible is part of the list.
This is another reason many physicians have not accepted the
reality of CFIDS-there are simply too many symptoms. But a
patient relating these symptoms does not list them in a random
manner. They fit a precise pattern that is nearly identical from
one patient to the next. The pattern of symptoms is so
reproducible in the usual case that patients are able to
diagnose CFIDS in others in an instant.
(From the book by David S. Bell, M.D., The Disease of a
Thousand Names [Lyndonville, Pollard Publications, 1991].
Reproduced here with the permission of the author. )
[Webmaster's Note: In the United States, the term CFIDS (Chronic
Fatigue and Immune Dysfunction Syndrome) is used
interchangeably with CFS (Chronic Fatigue Syndrome).]
