Note: CFIDS Is the American term given to ME/ICD10-CFS.
CFIDS stands for Chronic Fatigue and Immune Dysfunction Syndrome.
CFIDS - A List of Symptoms by David S. Bell, M.D.
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]. #