Many doctors and others have dismissed people with chronic fatigue syndrome as depressed, lazy or just plain whiny. Now a slew of research -- more than 2,000 scientific papers by some counts -- is suggesting that chronic fatigue is not a psychiatric illness, but a nasty mix of immunological, neurological and hormonal abnormalities.
Several types of brain scans, for instance, have shown abnormalities -- such as different patterns of blood flow to certain regions of the brain -- in patients with chronic fatigue, and other studies have shown that patients have difficulty thinking and processing information and are unable to do several mental tasks at once.
"There are objective brain abnormalities in many patients with CFS that are consistent with the symptoms patients describe," said Dr. Anthony Komaroff, a chronic fatigue expert and editor in chief of Harvard Health Publications, a division of Harvard Medical School.
Chronic fatigue, which has no known cure, is more than feeling tired all the time. Definitions vary, but the one used by the federal government says the condition is characterized by persistent, unexplained fatigue that lasts at least six months, as well as four of the following: sore throat, tender lymph nodes, muscle pain, multi-joint pain, headaches, unrefreshing sleep, malaise after exercise and impaired memory or concentration.
The syndrome -- which can come on after an acute infection, a head injury or a major life stress, or from no obvious triggers at all -- affects 800,000 to 2.5 million Americans, most of them women, said Dr. William Reeves, chief of chronic fatigue syndrome research at the federal Centers for Disease Control and Prevention.
But the ailment is tricky to diagnose because its symptoms overlap with those of other conditions, such as depression, Gulf War syndrome and fibromyalgia.
A federal study now underway is designed to measure the activity of thousands of genes in 190 people, some with the disease, some without, to find a distinctive genetic fingerprint for chronic fatigue. The ultimate goal, Reeves said, is a blood test for the condition.
"This illness is a nightmare that is extraordinary," said Dr. David Bell, a specialist in Lyndonville, N.Y. "If you're lucky, you get over CFS in a couple of years. If you're not, it stays with you for the rest of your life."
