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Chronic fatigue syndrome (CFS, also called chronic fatigue immune dysfunction syndrome, or CFIDS) is a chronic disorder characterized by several debilitating conditions including severe fatigue. In order to be diagnosed with chronic fatigue syndrome, a patient must have severe and chronic fatigue that lasts six months or more, and other medical conditions that could cause the fatigue must be excluded.
There are many other illnesses that are treatable that need to be ruled out to arrive at a diagnosis of chronic fatigue syndrome. There are a number of secondary symptoms that are also associated with chronic fatigue syndrome. As if diagnosing lupus was not difficult enough, we are going to add to the complexity by discussing how lupus and Lyme disease (or chronic Lyme disease) might get confused when trying to make an accurate diagnosis.
Here is where the clarification between Lyme disease, lupus, mixed connective tissue disorders (MCTD), chronic fatigue syndrome (CFS), fibromyalgia, and other autoimmune diseases needs to be made. One glaring similarity between lupus and the complex of infections known as Lyme disease, is the multiple possible symptoms of each illness and their ability to affect multiple body systems at the same time. Other common symptoms of Lyme disease may begin any time between three and 30 days after infection and may resemble a flu-like illness with fever, joint and muscle pain, chills, mental confusion, headache, and stiff neck. Both lupus patients and those with Lyme disease may have arthritis symptoms where affected joints are swollen and painful. In lupus, the knees and large joints may be affected but the smaller joints of the hands, wrists, ankles and toes are also often involved.
Cognitive dysfunction (brain fog) and other neurological problems can occur in both Lyme disease and in lupus but for different reasons.
Lupus brain fog may cause confusion, feeling detached or fuzzy, and trouble with quickly coordinating hand-eye movements. People with lupus may experience problems in any area of the GI (gastrointestinal) system, including the surrounding organs such as the liver, pancreas, bile ducts, and gallbladder. Because the symptoms are so varied, a complete and proper diagnosis requires highly experienced and specialized doctors. Treatment for lupus is very different to that of Lyme disease and is often dependent on the symptoms that the patient is experiencing.
In lupus, there will typically be periods of flares, with high disease activity, and remissions, where there is little to no activity. If your symptoms continue to persist, become more severe over time, or you have no indication of the antibodies for Lyme in your system please ask your doctor to check for other underlying causes such as a thyroid condition, anemia, viral infection (like Epstein-Barr virus), or other autoimmune conditions such lupus, fibromyalgia and the others mentioned above.
Other symptoms include weakness, impaired memory or concentration, insomnia, muscle pain, and fatigue following exertion that lasts more than 24 hours. It is possible to have these other conditions and also have CFS; if the conditions are treated and the patient still has chronic fatigue then CFS may be considered as a diagnosis. Up to half of patients with CFS may experience symptoms including abdominal pain, alcohol intolerance, bloating, chest pain, chronic cough, diarrhea, dizziness, dry eyes or mouth, earaches, irregular heartbeat, jaw pain, morning stiffness, nausea, night sweats, psychological problems (depression, irritability, anxiety, panic attacks), shortness of breath, skin sensations, tingling sensations, and weight loss. Many others have symptoms of severe fatigue but do not meet the diagnostic criteria for CFS. To complicate matters, patients often may not appear ill, and the disease may go into remission and then relapse.
Treatment usually involves a combination of medication and lifestyle changes such as preventing overexertion, reducing stress, managing diet, and nutritional supplements. It is intended for general informational purposes only and does not address individual circumstances.
The fatigue is severe enough to interfere with daily activities and is not relieved by bed rest. The term “chronic Lyme disease” (CLD), a highly debated term and topic, has been used to describe people with many different illnesses.

For example, lupus, chronic fatigue syndrome, MCTD, and Fibromyalgia can have a wide array of symptoms that overlap with other chronic disease diagnoses.
This rash can be small or very large and as the infection spreads, the rash may appear on other parts of the body.
Although these symptoms may be very similar to those of common viral infections, such as the flu, Lyme disease symptoms will tend to last longer or may come and go over time.
In both lupus and Lyme disease, the arthritis is described as cyclic, meaning that there are periods of high activity of symptoms and other periods of little to no arthritic symptoms.
This is not a surprising due to the fact that ticks are tiny and their bites are usually painless. Antibodies are molecules or small substances tailor-made by the immune system to lock onto and destroy specific microbial invaders.
The chances of a quicker and more complete the recovery increase the sooner the therapy begins following infection. Almost every lupus patient will be placed on an anti-malarial drug such as Plaquenil (also known as “lupus life insurance”) and some type of anti-inflammatory medication.
The disease can occur again in the same individual if they are bitten again and re-infection takes place.
Serious complications may occur with SLE, as lupus is an unpredictable disease and every patient is very different.
Although the symptoms are similar to those in lupus and other autoimmune conditions, the diagnosis and treatment plans differ vastly.
To make a diagnosis, a doctor will first rule out other conditions that have similar symptoms that can be tested for, including mononucleosis, Lyme disease, thyroid conditions, diabetes, multiple sclerosis, various cancers, depression, vitamin D deficiency, and bipolar disorder. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Although a standard treatment for CFS has yet to be developed, many people improve through individualized exercise and stress management programs. In Lyme disease, like in lupus and many of the autoimmune diseases, it is very uncommon to see two different patients with identical symptoms. Erythmea migrans rash is not to be confused with the lupus butterfly rash, or malar rash, that presents over the bridge of the nose and across the cheeks in some lupus patients.
Experiencing fevers intermittently (off and on) is more common with lupus, but typically happens when the patient is experiencing a lupus flare. Lyme disease, if left untreated, can cause permanent damage to the heart, nervous system, and joints.
If you have been bitten by a tick and treated for Lyme disease, your symptoms should lessen over time, but prolonged fatigue and achiness may linger for some time after treatment has finished. We encourage you to be your strongest advocate and always contact your medical provider with any specific questions or concerns. It is believed that the earlier the diagnosis is made and the sooner treatment starts, the better the outcome will be for patients. Chronic Fatigue: Symptoms, PuzzlesCFS can now be diagnosed by looking for a pattern of specific symptoms -- physical and brain-related. These antibiotics may speed the healing of the rash and will often prevent other more serious symptoms such as arthritis or neurological problems.
The first signs of Lyme disease may develop within days or take months, and in the majority of cases, it is successfully treated with a two to four week course of oral antibiotics. Getting appropriate medical care, taking prescribed medications, and choosing to live a healthy lifestyle are all things people with lupus can do to stay healthy.
Treatment Options for CFSThere is no cure for CFS, and no prescription drugs have been developed specifically for its treatment.

Work with your health care team to develop coping strategies, such as managing your activity level and taking medications to control symptoms. The difference with CFS is that the fatigue is overwhelming and lasts for at least 6 months. Graded exercise therapy starts slowly and gradually increases the duration of exercise over time. It may get worse after physical or mental exertion, and a full night's sleep provides no relief. The goal is to avoid overdoing it and experiencing a "crash." It's important not to avoid all physical activity, or the muscles can become deconditioned.
CFS Symptoms: Recurring PainMany people with CFS develop recurring pain, including headaches, sore throat, muscle pain, and joint pain.
MedicationsMedications are primarily used to relieve symptoms, such as sleep problems and chronic pain. Some medications, such as tricyclic antidepressants, can reduce pain and improve sleep with just one pill.
Be sure to ask your doctor about the benefits and side effects of any drugs you take, even if they are over the counter. CounselingA counselor can help you develop coping skills that will decrease anxiety, depression, anger, and guilt. Although people of any age can get CFS, it occurs most frequently in people in their 40s and 50s. Cognitive behavioral therapy (CBT) aims to enhance coping by changing dysfunctional thinking and behavior.
CFS in Children and TeensCFS is very rare in children and only slightly more common in teenagers. These include stretching therapies, toning exercises, massage, hydrotherapy, and relaxation techniques. If your child is diagnosed with CFS, consult a specialist to create an individualized exercise and management program. Herbs and SupplementsTalk with your doctor about which supplements, if any, are helpful and safe for you. These products are not regulated to the same degree as prescription medications, and most have not gone through extensive testing in people.
CFS and DietDoctors recommend a well-balanced diet for people with CFS, but no specific dietary strategy has been widely accepted. Some people with CFS notice their symptoms are triggered by certain foods or chemicals, including refined sugar, caffeine, and alcohol. This may include difficulty falling asleep, restless legs, vivid dreaming, and frequent awakening.
To create healthy sleep habits, establish a regular bedtime routine and engage in light exercise and stretching at least four hours before bedtime. Depression generally responds well to treatment, and getting it under control can make CFS easier to cope with. Early treatment with stress reduction and graded exercise therapy may increase the chances for improvement.

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