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In this article, there is a selection of questions and answers concerning chronic fatigue syndrome. These questions were asked and answered in interviews I have given to Greek newspapers (ΒΗΜΑ, ΠΑΡΟΝ, ΚΑΘΗΜΕΡΙΝΗ etc) and TV stations (ALPHA, ATHENS TV, ΚΑΝΑΛΙ 10, SKY, ALTER etc).
1. What is chronic fatigue syndrome?
This syndrome consists of severe fatigue symptoms lasting more than six months. This fatigue affects both physical and mental functioning.
2. How is chronic fatigue distinguished from common weakness?
Chronic fatigue is persistent or relapsing whereas common weakness lasts for less than a week. Simple measures, such as sleep and healthy diet, are often sufficient, in case of common weakness.
3. What causes chronic fatigue?
The chronic fatigue syndrome could be associated with the following:

• Alcohol abuse

• Insomnia

• Drugs such as benzodiazepines

• Over-fatigue

• Menopause

• Malnutrition

• Anemia

• Hypotension

• B12 deficiency

• Infectious diseases

• Biochemical disturbances

• Cardiovascular diseases

• Endocrine disorders

• Thyroid disease

• Autoimmune disorders

• Sleep apnea

• Depression

• Psychosis

• Anorexia nervosa
This type is called secondary chronic fatigue syndrome.
For idiopathic syndromes, no specific cause can be found.
If four or more of the following criteria are present for more than six months, the syndrome is called idiopathic chronic fatigue syndrome:
• Impaired memory or concentration unrelated to drugs or alcohol use
• Unexplained muscle pain
• Polyarthralgia
• Sleep disturbances
• Post exertional malaise lasting over 24 hours
• Sore throat not caused by infection
• Tender cervical or axillary nodes.
If these criteria are not fully met, then the disease is called idiopathic chronic fatigue. Idiopathic syndromes come with a variety of implications such as immunologic disturbances, neurologic disturbances, abnormal gene expression and psychological disturbances.
4. What is the treatment?
Patients with secondary chronic fatigue syndrome have a secondary correctable or specifically treatable cause. Special treatment is the cornerstone of therapy.
In case of idiopathic syndromes, treatment includes exercise programmes, cognitive therapy and special drugs.
Department of Internal Medicine, Athens Medical Center, Greece
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