How do I know if I have Chronic Fatigue Syndrome?

By Cara Lan, N.D.

You wake up in the morning. You’re so tired. Your eyelids feel like lead, nearly impossible to lift open. There’s a throbbing pain in your head, your throat is nearly always sore, your neck is stiff and your whole body aches. Most people waking up in this state would wonder if they had the flu… but not you. You have been waking up in this state for years upon years in varying degrees of tiredness and achiness. You know this level of fatigue is not normal. You see people everywhere able to go about their days with a good deal of energy, tired at the end of the day but not wiped out completely. You on the other hand, must rest for days after going for a walk around the block. You are out of breath just taking a short walk from your bedroom to your kitchen. You have been suffering with this level of insidious fatigue for so long, you barely remember what it was like to have energy, to work out, to be able to accomplish multiple tasks in a day and still be able to work out or spend time with loved ones as well.

Sound familiar?

My guess is that you did not land on this page by accident.

My guess is that you would do anything to figure out what is wrong with your health and energy so that you can get your life back.

My guess is you are feeling completely alone and like your health is an aberration of nature.

My guess is that doctors, coworkers, friends and possibly even loved ones may have begun to regard you as being overly dramatic or as exaggerating your symptoms. These well-meaning people may try to push you harder into functioning at your previous level and being the person you used to be, as though you could will yourself to get better.

My guess is you push yourself to the limit daily, only to feel worse the next day.

My guess is you finally break down and allow yourself to sleep for hours upon hours multiple days in a row only to find that you do not feel even the tiniest bit better after doing so.

My guess is you’ve met with many doctors only to have them finally tell you that the only solution is for you to get on antidepressants, try a graded exercise regimen and talk to a Cognitive Behavioral Therapist.

If any of the above statements resonate with you, welcome struggling survivor, I am so glad you’re here.

My name is Dr. Cara Lan and I lived with chronic fatigue and Chronic Fatigue Syndrome for many, many years.

Answers were not forthcoming. I visited many doctors before I finally received a diagnosis of Chronic Fatigue Syndrome (also called Myalgic Encephalomyelitis (ME), here after referred to as ME/CFS). I was taught in medical school ME/CFS was a diagnosis of exclusion, as there is still to date no test that can diagnose the condition, it is primarily diagnosed on the collection of presenting symptoms as well as a lack of diagnosis for other medical conditions that can cause fatigue. This meant that after excluding autoimmune, metabolic, neurologic, or acute infectious disease, the doctor was left with no other diagnosis to give me except Chronic Fatigue Syndrome. I was hesitant to receive this diagnosis as I knew there were no obvious treatments for a diagnosis of exclusion.

The word “syndrome” in medicine refers to a collection of symptoms. It does not tell you what is the cause of the illness, only gives a name to that particular pattern of symptoms.

It was helpful to have someone name what was “wrong” with me and yet, at the same time, not helpful at all, as the diagnosis itself could not tell me how I’d gotten where I was and how I could get back to my usual state of health.

My well-meaning doctor had suggested I do more yoga. My eyes welled with tears at his suggestions, “I used to have a vigorous and consistent yoga practice, I can barely hold a downward facing dog now… how will more exercise help me?” was my reply. “Well, other options are antidepressants and cortiocosteroids to help bring down the pain”. As an ND I knew these would just be band aids, would only numb my body a bit only to add to the problem down the road.

I knew the depression I was experiencing came from the ME/CFS and my inability to function. And I knew if I healed the ME/CFS and got my life back, the depression would completely go away all on it’s own. (And when I fully healed, it did).

I quickly came realize Western medicine had nothing to offer me by way of healing from this tragic, bewildering, chronic illness. It could only offer me drugs to suppress my immune system or my mood, ultimately adding to my suffering down the road. Western medicine was a dead end for me.

You may have arrived at this page with no idea of why you feel so tired despite how much sleep you get. Or perhaps you have already been diagnosed with ME/CFS and you’re looking for answers outside those given to you by conventional medicine.

Much has changed in the field of ME/CFS in the last two decades since I first learned about it in medical school. Advances in research have suggested neurological, immunological, autonomic and mitochondrial impairments underlying the illness.

It is highly important to note that ME/CFS is a serious medical illness and is not laziness, depression, or a psychosomatic disorder.

I cannot stress this point enough.

You are not lazy or crazy.

The root cause of your physical illness not depression (although you very likely suffer from depression and as most people would whose ability to function in life has been all but annihilated).

You should not be shooed away from your doctor, only to be referred to the psychiatrist’s office for antidepressants and talk therapy.

These methods DO not work for treating ME/CFS. They only serve to worsen your self-esteem and keep you entrenched in the illness.

As Eleanor Stein M.D., FRCP(C) states in her Clinical Guidelines for Psychiatrists who are referred patients with ME/CFS, “The research is increasingly clear that CFS is not a primary psychiatric disorder though psychiatric symptoms may be prominent, the World Health Organization has classified ME/CFS as a neurological disorder” and “rates of psychiatric disorder found in CFS are similar to rates in other chronic medical conditions”. She also states, “psychiatric disorders in ME/CFS is most often secondary to the loss of health, lifestyle, social role and financial means as well as the social stigma of having a serious disabling but poorly understood illness” [1].  

ME/CFS is a very isolating illness but you are NOT alone. It is estimated that up to 2.5 million Americans are currently diagnosed with ME/CFS. However, this number does not include the hundreds of thousands of people who are suffering but have not yet sought medical treatment or those who have but whose practitioners are largely unfamiliar with ME/CFS and were inaccurately diagnosed.

In the following pages we will dive in to what exactly is Chronic Fatigue Syndrome, how it differs from plain old fatigue, how it’s treated in conventional (Western) medicine, known root causes and how you can fully recover your health and regain your strength and stamina naturally.  

[1] ‘Chronic Fatigue Syndrome: Assessment and Treatment of Patients with ME/CFS: Clinical Guidelines for Psychiatrists’ by Eleanor Stein, M.D., FRCP(CP