What is Chronic Fatigue Syndrome?
Chronic Fatigue Syndrome (CFS) is a complex, multi-system, fluctuating condition characterised by physical, emotional, neuroendocrine, mental fatigue.
Typical symptoms include fatigue, post-exertional malaise/fatigue, pain, sleep dysfunction, cognitive impairment, headaches, sore throat, and painful swollen lymph nodes.
The cause of CFS, which might also be known as Myalgic encephalomyelitis (ME), Post Viral Fatigue Syndrome (PVFS) or Systemic Exertion Intolerance Disease (SEID), are not yet fully understood.
Clinics are held on a Wednesday.
We are a multi-disciplinary team which consists of consultants, registrars, junior doctors, physician associates and occupation therapists.
Our service is focused on the following aims:
- Offer a specific diagnosis of CFS and exclude other conditions that can mimic these.
- Offer support and advice on the patient’s concerns, including treatment of some symptoms.
- Promote self-management of the condition.
Restructuring GEH CFS Service
Upon review of current case load, the service will be undergoing restructuring. The primary objective of which is to ensure that our service is clinically effective and clinically efficient, allowing us to maintain a high standard in the quality of care provided. The information below is the proposed pathway we will be adopting going forward.
- Review referral and if appropriate to our service, book appointment.
- Consider sending screening blood test
New patients (first visit)
- Clinical Assessment: History & Focused examination
- Diagnosis if screening bloods abnormal
- Information leaflet
Follow-up patients (visit two)
- Final Review
- Confirm diagnosis
Follow-up patients (visit three)
- Transfer to appropriate specialty clinic if alternate clinical diagnosis
- Refer to other speciality and/or CFS OT service if indicated
CFS Group Clinic
A bi-monthly [six sessions in a year] group discussion ‘clinic’ with a one clinician.
Re-referrals
Referrals by General Practitioners [GPs] possible after 6- 12 months in may cases +/- Occupational Therapy input.
GEH Switchboard
- 02476 351 351
Jo Moore, Diabetes & Endocrine Secretary
- 02476 865 212
CFS OT Services
ME/CFS is estimated to affect 0.4% [250,000] of people in England and Wales according to ME/CFS Association UK.
Incidence of CFS and fibromyalgia from UK primary care database found the overall annual incidence of recorded cases of CFS was 14.8 per 100,000 people, and the annual incidence rates for CFS diagnoses decreased from 17.5 in 2001 to 12.6 in 2013.
- The overall annual incidence of recorded fatigue symptoms was 2246 per 100,000 people.
- Fatigue is one of the most frequent presenting complaints in primary care.
- Approximately 25 percent of patients with severe ME/CFS are house or bed bound.
- Women are 2.4 times affected in comparison to men.
- Eighty-five percent of CFS sufferers have experienced some form of lost employment due to the illness.
Results of a cross-sectional questionnaire study in Sweden that sampled 1557 adults and investigated four categories including: general fatigue, physical fatigue, reduced activity, and mental fatigue, found that:
- On all subscales, women had higher fatigue scores in comparison to men.
- Lower socioeconomic status was linked to higher levels of fatigue.
- Lower physical activity was connected to higher levels of fatigue for all subscales, except mental fatigue, and longer time spent sitting was also related to more fatigue on all subscales, except mental fatigue.
- Lower self-rated health was strongly associated with higher levels of fatigue for all subscales.
Results of a cross-sectional survey of 2848 Swiss people complaining of fatigue revealed the following:
- Person more likely to be female.
- Person had a higher body mass index (BMI).
- Person was more likely to have lower educational attainment.
- Less common in adults aged 64–74 years.
A comprehensive clinical assessment including detailed and relevant history; physical examination and investigations to exclude other similar causes will be conducted. When a diagnosis of CFS is made, it can be categorised as mild, moderate, severe, or very severe.
- Mild: People with CFS can self-manage with some problems mobilising. Most are working or in education but need to rest to recuperate and, as a result, may avoid leisure activities.
- Moderate: People with CFS are unable to engage in activities of daily living. They may have stopped working or education and experience unrefreshing sleep.
- Severe: Individuals struggle to carry out basic daily tasks, spend most of the time in bed and can be housebound. They may experience severe cognitive impairment and need a wheelchair for mobility.
- Very severe: Individuals need help with personal care and eating and are bed-bound all day.
There is no curative treatment.
NICE guidance divides CFS treatment into four categories:
- Therapeutic interventions: The severity of symptoms for each patient varies so an individualised person-centred programme aimed at managing, sustaining and if possible, restoring to their baseline the patient’s physical, cognitive, and emotional capacity. This may include advice on pacing, sleep, rest, and relaxation management.
- Pharmacological interventions: Effective treatment of fatigue remains elusive however medication can be used to relieve other symptoms of CFS.
- Dietary interventions and supplements: A balanced diet with all essential nutrients is advised. Some patients report good benefits from supplements (specific vitamins, multivitamins and minerals) as part of their self-management. In these instances, it is important they adhere to and not exceed the safe level recommended by the Food Standards Agency.
- Complementary therapies: For people with moderate or severe CFS additional support/modifications may be indicated to help maintain their independence.
Covid-19 is likely to exacerbate existing symptoms and/or protracted relapse in patients with CFS. It can also trigger the onset of CFS.
Booklets
Support Groups
- Find Local Support Groups: Local Support Groups | The ME Association
Helpful Websites