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What to Expect When You Visit the Doctor

What Your Doctor Might Do

If you think you might have CFS, begin your medical evaluation with a visit to your primary doctor. Your doctor may start with a routine physical examination, including asking you certain questions to help him or her rule out other causes of your symptoms. Because there is not a single definitive test, it can be difficult to make the diagnosis of CFS and taking a good medical history is very important. Other medical conditions must be excluded before the diagnosis of CFS can be made. Questions your doctor might ask include:
  • When did your fatigue start?
  • How have your energy and activity levels been affected?
  • Do you have any trouble with sleep, such as snoring, trouble falling asleep, or staying asleep?
  • Do you have any problems with your memory or concentration?
  • Do you have any pain?
  • What medications, prescription or over-the-counter, including vitamins and supplements, are you taking?
  • Do you use any other drugs or do you drink alcoholic beverages?
  • Have you had any problems with your mood or stress or stressful events in your life?
Your doctor will also probably order some lab tests. The exact tests ordered will depend on your symptoms but likely tests include a urinalysis, a complete blood count, thyroid hormone, and some standard chemistry tests.

Other Evaluations the Doctor Might Do

CFS symptoms can overlap with symptoms of many other illnesses, including some aspects of anxiety disorders, depression, and other conditions of psychiatric origin. Don't be surprised or upset if your doctor asks you about current and past emotional problems such as depression and anxiety. Fatigue, sleep disturbances, and difficulty concentrating-all symptoms of CFS-are also common in clinical depression and chronic anxiety. Similarly, people with CFS often feel anxious or depressed about their health, as do many people with other hard-to-diagnose conditions. Some of these medical conditions that are hard to diagnose include sleep apnea, hormone abnormalities, and neurological conditions such as multiple sclerosis. Many patients with CFS are often puzzled by such questions and wonder if the doctor believes they are sick. They then feel they must prove to their doctors that they have a real, physical illness. Don't let negative feelings interfere with the visit to your doctor. Go to your visit ready with the facts for all the questions that might be asked and try to work with your doctor to solve the problem. Because CFS symptoms can overlap with so many other conditions that are difficult to diagnose and because there is no single diagnostic test for CFS, don't be upset if your doctor asks you to see a psychiatrist or to fill out questionnaires about sleep, mood, activity, or general well-being or orders more lab studies to help in the assessment of your illness.


Evaluating CFS is often an ongoing process. Your doctor may recommend follow-up visits for additional lab tests, if necessary, and to monitor new and continuing symptoms. These visits can also help in continuing to rule out other conditions and further supporting a diagnosis of CFS.

What's next?

There is no simple, sure way to diagnose CFS. But you can work with your doctor to identify and treat your symptoms. Ask for help in:
  • overcoming sleep difficulties
  • regulating your activity pattern
  • managing your pain
  • reducing or at least managing stress
  • finding support systems
  • finding ways to work around your symptoms to maintain an active lifestyle
You can also play a major role in determining the outcome of your illness by keeping informed, managing your symptoms, and seeking emotional support.

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