Are you exhausted no matter how much sleep or rest you get? If so, you might have chronic fatigue syndrome (CFS). However, chronic fatigue syndrome is more than just being tired. It can include fever, joint pains, headaches, and many othe symptoms. It can be just as debilitating as other chronic diseases like multiple sclerosis, lupus, rheumatoid arthritis, etc. It affects approximately 3 in 1,000 people, and at least 25% of people with CFS are unemployed or on disability.

The main symptom of chronic fatigue syndrome is severe, prolonged tiredness that lasts longer than six months and is not caused by any other disease or relieved by rest. To be diagnosed with CFS, the tiredness must be severe enough to decrease the ability to perform your normal activities by 50%. Other symptoms may include:

• Severe fatigue after mental or physical exertion
• Nonrestorative sleep regardless of the amount of sleep
• Impaired memory, confusion, lack of concentration, and difficulty concentrating
• Muscular aches or mult-joint pain that may travel without any swelling or redness
• Headaches that are different before the syndrome began in type, pattern, or severity
• Swollen or tender lymph nodes in the neck or armpits
• Mild fever < 100 degrees
• Sore throat

To read about more symptoms, watch the first video at the end of this article.

There are several risk factors for chronic fatigue syndrome. They can include:

• Four times more frequent in women than men.
• Although it can occur at any age, it more commonly occurs in people in their 40s and 50s.
• It occurs across all ethic, racial, and income groups.
• It can occur in families. Researchers believe it may be genetic.

Unfortunately there are no diagnostic tests for chronic fatigue syndrome. Consequently, a diagnosis is made by symptoms present and ruling out other medical conditions. Considering this, it is estimated by researchers at the Center of Disease Control and Prevention that less than 20% of the population with CFS have been diagnosed. Although the cause is unknown, researchers do have some theories. Currently, it is believed that CFS is caused by the Epstein-Barr virus (EBV) or the human herpes virus-6 (HHV-6).

EBV is a member of the herpesvirus family. Although maternal antibodies are present at birth, when they disappear, infants become susceptible to the virus. As a child, the virus can either have no symptoms or may produce a brief and mild illness. However, if you become infected with it in adolescence or young adulthood, it produces infectious mononucleosis 35% to 50% of the time, Symptoms include fever, sore throat, and swollen lymph glands. Occasionally, it can also cause a swollen spleen or affect the liver. It can take one to two months for the symptoms to resolve. After the initial infection, the virus usually remains dormant in the body. In the United States, it's estimated that as many as 95% of adults between 35 and 40 years of age have been infected.

HHV-6 is another herpesvirus. However, it is not associated with cold sores, genital herpes, chicken pox, shingles, or infectious mononucleosis. First discovered in 1986, the virus infects white blood cells, more commonly T lymphocytes. In infants it causes fever, swollen glands, fatigue, nervous system complications, and bone marrow suppression In children, it is the cause of roseola, a distinctive rash and fever Most infants become infected prior to two years of age, and it can produce either no symptoms or mild symptoms in most cases. Like EBV, after the initial infection, the virus remains dormant in the body. However, if the immune system is weak, it can reactiviate. Both HHV-6 and EBV are transmitted by saliva. Approximately 36% of patients diagnosed with CFS have antibodies for HHV-6.

Another potential cause for CFS is a mycoplasma infection. An airborn disease, a mycoplasma infection is caused by the order Mollicutes. Mycoplasmas are the smallest free-living organism on earth. An anaerobic (does not depend on air), self-replicating bacteria, they don't have a cell wall and are dependent on a host for life. Associated with immunodeficiencies and autoimmune disorders, they have been found in the urogenital tract, heart tissues, different bodily fluids, and the bone marrow. They may also be responsible for CFS.

It may also be caused by changes in neurotransmitters, stress hormone deficiencies, and disturbed circadian rythyms. immune system abnormalites, and neurally mediated hypotension. Neurally mediated hypotension is when the blood pressure drops dramatically when standing.

Since researchers do not know the exact cause of CFS, treatment is aimed at relieving the symptoms. Some of the proposed treatments include:

• Antiviral drugs (such as acyclovir) - These are used because the disease may be viral in nature.
• Drugs to fight yeast infections (such as nystatin) - Patients with CFS may be prone to yeast infections since they have a weakened immune system.
• Medications to reduce pain, discomfort, and fever
• Medications to treat anxiety (antianxiety drugs)
• Medications to treat depression (antidepressant drugs) - Since any chronic, debilitating diesease can cause depression, anti-depressants may be used to improve the mental outlook.

Although no one knows for sure what causes chronic fatigue syndrome, it occurs more frequently in adult women. It is suspected viral infections are responsible, and in some cases, it may be genetic. The symptoms can be deabilitating, and over one-quarter of people suffering from this disease are unemployed or on disability. Unfortunately, there is no cure, and treatments are aimed at reducing the symptoms.