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CFIDS: A List of Symptoms by
David S. Bell, M.D.

CFIDS Symptoms

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 exhaustion95 %*
Headache90 %*
Malaise80 %*
Short-term memory loss80 %*
Muscle pain75 %*
Difficulty concentrating70 %*
Joint pain65 %*
Depression65 %*
Abdominal pain60 %*
Lymph node pain50 %*
Sore throat 50 %*
Lack of restful sleep90 %*
Muscle weakness30 %
Bitter or metallic taste25 %
Balance disturbance30 %
Diarrhea50 %
Constipation40 %
Bloating60 %
Panic attacks30 %
Eye pain30 %
Scratchiness in eyes60 %
Blurring of vision80 %
Double vision10 %
Sensitivity to bright lights80 %
Numbness and/or tingling in extremities60 %
Fainting spells40 %
Light-headedness75 %
Dizziness30 %
Clumsiness30 %
Insomnia65 %
Fever or sensation of fever85 %
Chills30 %
Night sweats50 %
Weight gain40 %
Allergies60 %
Chemical sensitivities25 %
Palpitations55 %
Shortness of breath30 %
Flushing rash of the face and cheeks40 %
Swelling of the extremities or eyelids20 %
Burning on urination20 %
Sexual dysfunction20 %
Hair loss20 %

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]. Reproduced here with the permission of the author. )

[Webmaster's Note: In the United States, the term CFIDS (Chronic Fatigue and Immune Dysfunction Syndrome) is used interchangeably with CFS (Chronic Fatigue Syndrome).]

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