Dear Dr. Donohue: Is there a truly diagnosable condition known as chronic fatigue syndrome? I recall hearing of it some years ago. Now my granddaughter might have it. -- H.L.

Dear H.L.: Most doctors subscribe to the existence of chronic fatigue syndrome. It's a complicated illness without a known cause, without any diagnostic test and without a medicine that works for all patients.

We all understand acute fatigue -- the weariness that comes from hard physical or mental work and that responds to a night's rest.

Chronic fatigue, on the other hand, is fatigue that lasts at least six months. Sleep doesn't relieve it. People wake up as tired as they were when they went to bed.

Often, they have a hard time concentrating, and their memory doesn't work as well as it used to.

Some complain of a sore throat that lingers, others of tender muscles, and still others of frequent headaches or swollen lymph nodes.

In approaching patients suspected of having chronic fatigue syndrome, doctors must look for medical and psychiatric conditions where fatigue is prominent.

They have to consider such things as multiple sclerosis, a misfiring thyroid gland, anemia, diabetes, depression, infections like TB and even cancers.

Only when fatigue-causing illnesses have been checked and not found can the diagnosis stand on firm ground.

What to do for the syndrome is as perplexing as the syndrome itself. Staying as active as possible allows patients to avoid a breakdown in muscle conditioning. And a modest exercise program generates body chemicals that fight fatigue.

Ten minutes of walking, or even less if 10 minutes is too exhausting, is a good starting point.

People should increase the walking sessions to two and then three times a day, and then lengthen the amount of time they walk.

Amitriptyline, an antidepressant, is often prescribed for its ability to restore normal sleep.

Cognitive behavioral therapy helps patients regain control of their lives.

Your granddaughter should seek help from her family doctor.


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