Who Diagnoses Chronic Fatigue Syndrome?

Your GP initially diagnoses Chronic Fatigue Syndrome. However, if there is any doubt, a GP then refers a patient to either CFS/ME clinic, an Internal Medicine doctor, a Rheumatologist or even a Psychiatrist depending on the facilities available.

Understanding the mechanism of a disease is essential to knowing the correlation of the relevant doctors to this syndrome. Therefore, we will be discussing the disease itself, its signs and symptoms and how they help a physician in diagnosing this, so that it can be managed under a suitable supervision.

What Is Chronic Fatigue Syndrome ?

Chronic fatigue syndrome (CFS) is a chronic illness with a wide range of signs and symptoms. The most common of which is extreme fatigue, followed by muscle aches . CFS is also known as ME, which stands for myalgic encephalomyelitis.

CFS/ME is more common in women than men. However, it is not uncommon for young children to be affected with this syndrome, and surprisingly, young patients’ prognosis is far better than the older ones.

Common symptoms :

• Fatigue
• Muscle aches
• Joint pain
• Nausea
• Anxiety
• Insomnia
• Palpitations

Reasons why people remain indecisive while selecting an appropriate physician ?

A matter of concern is uncertainty that arises among people when they choose to go to an appropriate speciality in order for themselves to be diagnosed and managed. Since, there are a number of general symptoms which tend to appear at different occasions, leading people to be indecisive of what type of doctor to consult. This puts them on the brink of being misdiagnosed and hence mismanaged.

Surprisingly, confusion also lies in the disease itself. Chronic Fatigue Syndrome or myalgic encephalomyelitis, also called CSF/ME is a diagnosis of exclusion, meaning that there is not any specific test for the CSF to be diagnosed. This essentially means that the symptoms involved also overlap in a number of health conditions. Therefore, once the lab tests for all the relevant health conditions are carried out and come out negative, only then the diagnosis of CSF is considered and the patient is referred to the relevant department for the treatment.

Referring to a research study conducted on patient’s perception of medical care in CFS,  another factor which can be discussed in this scenario which creates a considerate amount of confusion is the time taken to reach the diagnosis and the type of treatment given. Since it takes at least quite a few months to rule out other diseases where fatigue is the same component, such as hypothyroidism, fibromyalgia, polymyalgia rheumatica or anxiety disorder, patients are often tempted to see other physicians, hence leads to the risk of misdiagnosis. Also, the mainstay of treatment is cognitive behavioral therapy, also called CBT. Because this type of treatment only involves psychiatric therapy without any medicine prescribed, people tend to move to other facilities where they expect some physical form of treatment.

How to proceed to an appropriate physician then ?

So, in the beginning it is extremely important for a person who is suffering from above mentioned symptoms to see his or her GP, who will take your detailed history and offer a physical examination, followed by appropriate laboratory tests if necessary. Once the investigations reveal no significant results and the duration of symptoms have exceeded a minimum of 6 months period, which is one of the diagnostic criteria, your GP would then make a provisional diagnosis and refer you to the Chronic Fatigue Syndrome clinic if that is available in your country, or you will be asked to attend an Internal Medicine physician or atleast a rheumatologist or a psychiatrist where a final diagnosis will be taken into consideration.

References:

https://www.sciencedirect.com/science/article/abs/pii/S0277953600003026

https://www.nature.com/articles/nrn3087

https://www.acpjournals.org/doi/abs/10.7326/0003-4819-108-3-387