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How to Service Connect Chronic Fatigue Syndrome

Chronic Fatigue Syndrome


Chronic Fatigue Syndrome (CFS) is a serious chronic illness that is common with the general population and especially veterans. Studies have shown that it is more common for Gulf War Veterans compared to non-Gulf War Veterans to develop CFS, but the reason for this remains unknown. Of those who suffer from CFS, approximately one out of four will become bedridden or housebound for periods of their illness.

CFS is also known as Systemic Exertion Intolerance Disease (SEID) and Myalgic Encephalomyelitis (ME) is characterized by extreme fatigue without explanation from any other underlying condition. Symptoms can become worse with exertion by either physical or mental activity, such as going shopping and having to take a nap in the car before driving home, or staying on task at work and needing the evenings and weekends to recover, taking a shower and becoming bed bound for a couple of days afterward.

Major symptoms of Chronic Fatigue Syndrome

  • Fatigue not relieved by sleep which was not always present throughout life
  • Worsening of symptoms after activities. These are sometimes referred to as a crash, relapse, or collapse, and some patients can tell when they will happen.
  • Problems with sleep which include not being rested after sleep or difficulty staying and/or falling asleep.

For a true diagnosis of CFS the patient must also have one of the two following symptoms:

  • Thinking and memory issues such as not able to think quickly, difficulty remembering things, and unable to pay attention to details. This is described as being “foggy” by patients.
  • Worsening of symptoms while sitting upright or standing, known as Orthostatic Intolerance. This may cause dizziness, weakness, fainting while standing or sitting, as well as vision becoming blurry or seeing spots.

There are other symptoms that some but not all experience:

  • Muscle aches and pains.
  • Joint pain without swelling or redness.
  • Digestion issues like IBS.
  • Chills and night sweats as well as low-grade fevers.
  • Tender lymph nodes usually in the neck and underarms.
  • Headaches which are new or have become worse.
  • Sore throat
  • Allergies or sensitivities to foods, odors, chemicals, or noise.

How is Chronic Fatigue Syndrome Diagnosed?

Diagnosis of Chronic Fatigue Syndrome can be a bit tricky and understandably so because there is no set test to make the determination. What the doctor may do is multiple tests to rule out some other underlying cause. For instance, if you complain of being tired all the time your doctor may order blood tests to check for anemia, diabetes, and hypothyroidism all of which cause fatigue. Also, to check for the cause of fatigue a doctor may order an exercise stress test to check on the function of the heart and lungs. Sleep studies can be done to rule out Obstructive Sleep Apnea (OSA) or other sleep disorders preventing restful sleep. What the doctor is trying to do is check all possible outcomes for the symptoms to make sure a clear diagnosis can be given. As the patient, this can be a stressful time, which is why it is so important to tell your doctor all the symptoms you have even if they seem silly or strange.

Is there a Cure?

Since there is no cure for CFS the treatment focuses on relief of the symptoms. Medications can be prescribed that help with depression caused by living with CFS, also low dose antidepressants have been shown to improve sleep patterns. Physical therapy can be given to help maintain and improve mobility. Joints and muscles can have a lot of pain during flare-ups, and, due to the fatigue, mobility may not be something a patient can easily do. It is common to have a range of motion (ROM) exercises, stretching a few minutes each day and steadily increase to build a tolerance. Cognitive training is important to be able to talk to someone about CFS and its limiting factors on life, and how to cope on a daily basis. Complimentary therapies such as meditation, gentle massage, deep breathing, or relaxation therapies may be beneficial to help reduce symptoms.

What Causes this Chronic Condition?

The cause of Chronic Fatigue Syndrome is unknown; however, there are a few theories as to what may cause this condition. Some people have developed CFS after having a viral infection like Epstein – Barr virus, Herpes virus 6, and mouse leukemia virus, but there has been no conclusive evidence. Most people with CFS seem to have an impaired immune system which is thought to possibly be the cause of having CFS. Another theory is a hormonal imbalance because elevated hormones are seen in the blood work of those who have CFS, but the importance of this is unknown as well. Even without a definitive cause of the disorder there are noted risk factors including being between the ages of 40-50, difficulty managing stress, and women are more commonly diagnosed (possibly because they report symptoms more often).

Living with Chronic Fatigue Syndrome can have a huge impact on a person’s life and those around them. Simple tasks that we take for granted every day may cause great exhaustion for those with CFS. This disorder can also lead to more complications like depression, social isolation, lifestyle restrictions, and an increase in absences from work/school.

Service Connecting Your Chronic Fatigue

When filing a VA Claim for Chronic Fatigue Syndrome there are specific things the VA has to see before service connection can be considered.

  1. New or onset of debilitating fatigue severe enough to reduce daily activity to less than 50% of the usual level for at least six months,
  2. History of studies and lab work showing the doctor ruled out other possible conditions that may be causing the same symptoms,
  3. Six or more of the following symptoms:
    • Acute onset of the condition
    • Low-grade fever
    • Nonexudative pharyngitis (swelling of the back of the throat with no mucus)
    • Tender/palpable lymph nodes (neck or underarms)
    • Generalized muscle aches or weakness
    • Fatigue lasting longer than 24 hours after exercise
    • Headaches
    • Migratory joint pain
    • Neuropsychological symptoms (burning, numbness, tingling sensation, sensitivity)
    • Sleep disturbances

If you or a loved one suffers from CFS do not be afraid to report symptoms to your doctor. This illness can be hard to diagnose due to its seemingly unrelated symptoms, but do not let that discourage you. In the U.S. it has been acknowledged that more education needs to be provided to doctors and nurses to give them the skills to detect CFS sooner for the well being of the patient. Your voice is important especially when it comes to your own health care. If you need assistance in appealing your claim for CFS, let us know here!


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