Chronic Fatigue Syndrome (ME/CFS)
What Is It?
Complex neuroimmune disorder characterized by profound, unexplained fatigue for 6 or more months that worsens with exertion (PEM), unrefreshing sleep, cognitive impairment, and orthostatic intolerance.
How Is It Diagnosed?
Clinical diagnosis by exclusion. Rule out anemia, thyroid disease, diabetes, depression, sleep apnea, malignancy, autoimmune disease. Tilt table test for POTS.
How Is It Treated?
Pacing and energy management (avoid post-exertional malaise). Treat orthostatic symptoms (salt, fluid, compression, low-dose fludrocortisone or beta-blockers). Address sleep and pain. No curative therapy yet.
Tests and Imaging Typically Needed
CBC, BMP, TSH, glucose, B12, folate, cortisol, ANA, ESR, CRP, liver function, urinalysis. Sleep study if apnea suspected.
Approximate Self-Pay Costs
Office visit: $95-$150. Comprehensive lab panel: $100-$200. Ongoing management varies.