Editor's note: We are in contact with Dr. Reiker for her response and will post an update as soon as we can. We understand that this is a sensitive topic and value your feedback. Thank you for your interest in the subject.
Update: Since medical conditions affect all patients differently, please speak with your physician about specific treatment options that best fit your needs.


You are officially one month into 2018. Maybe it’s the year you pledged to work out more, read more, travel more – do anything and everything more. While it’s great to have goals, it’s hard to implement more into an already hectic schedule, especially when you aren’t allowing yourself adequate time to rest and recharge. Occasional fatigue is perfectly normal, yet if it’s a constant for you, it could signal a larger, overarching problem.

According to the federal Centers for Disease Control and Prevention, an estimated 836,000 to 2.5 million Americans suffer from chronic fatigue syndrome (CFS), approximately 90 percent of which cases have not been diagnosed. Ladue News spoke with Margaret Reiker, MD, at Missouri Baptist Medical Center, about the symptoms, causes and treatments for CFS.

It’s common in our hectic lives to feel exhausted, especially when we likely don’t log enough hours in bed each night. How can one distinguish the difference between everyday exhaustion and CFS?

The difference between CFS and other fatigue is that it begins suddenly, does not improve with rest and is associated with significant new exercise intolerance.

What are common symptoms of CFS?

The common symptoms of CFS are feeling tired all of the time. Often this begins with a sudden onset, such as after a cold or other infection, and then just never seems to get better. Other symptoms include poor exercise tolerance, trouble thinking or fuzzy thinking, trouble sleeping and dizziness when standing up suddenly.

What causes CFS?

The cause for CFS is not clearly defined. A viral infection such as Epstein-Barr, which causes mononucleosis (and may play a role in multiple sclerosis and other diseases), or other specific viral infections may trigger a disturbance in the immune system that causes this in some individuals.

What are the dangers of CFS going undiagnosed?

If CFS is undiagnosed and untreated, some patients may slip into progressive depression or deconditioning [generally, reverting to being out of shape]. By actively working on sleep, nutrition, a graded exercise program and any associated issues that may be aggravating the symptoms, most patients can eventually overcome this.

Why do so many cases go undiagnosed? How does one get tested for CFS?

Many people are undiagnosed that suffer with CFS because there is not a simple well-defined test, the condition is not really well understood, and we do not have a simple, easy fix for it.

There is no simple test for CFS; this is a clinical diagnosis. You have to see a physician or nurse practitioner [and] have other causes of fatigue ruled out. Generally, you feel tired all the time for no reason, and you have some of the other symptoms of poor sleep, poor exercise tolerance, dizziness or difficulty concentrating.

What are treatments for CFS?

The treatments for CFS are supportive. Most patients improve with different approaches to improve their sleep quality. Counseling with cognitive behavioral therapy may help some, and getting good support for the stress that accompanies this. A graded exercise program, where you gradually rebuild your exercise tolerance, sometimes with the help of a physical therapist, is often helpful. Good nutrition for support of the immune system also helps, and this just means an adequate variety of vegetables, adequate protein, limiting sugar.

Alecia is LN’s managing editor. Fueled by coffee and faith, Alecia is a wifey, boy mom and fur mama to two, enjoying this crazy thing called life one moment at a time.