There is no currently accepted, definitive test for CFS. The currently most widely accepted criteria for diagnosing Chronic-Fatigue-Syndrome were published in the Annals of Internal Medicine, Vol 121, No 12, PP953 -959 on December 15, 1994. For a Chronic-Fatigue-Syndrome diagnosis all other possible conditions must be excluded and the following 2 criteria must be present:

1. Clinically evaluated, unexplained, persistent or relapsing chronic fatigue that is of new or definite onset (has not been lifelong); is not the result of ongoing exertion; is not substantially alleviated by rest; and results in substantial reduction in previous levels of occupational, educational, social, or personal activities.
2. The concurrent occurrence of four or more of the following symptoms, all of which must have persisted or recurred during 6 or more consecutive months of illness and must not have predated the fatigue:
   1. self-reported impairment in short-term memory or concentration severe enough to cause substantial reduction in previous levels of occupational, educational, social, or personal activities,
   2. sore throat,
   3. tender cervical or axillary lymph nodes,
   4. muscle pain,
   5. multi-joint pain without joint swelling or redness,
   6. headaches of a new type, pattern, or severity,
   7. unrefreshing sleep, and
   8. post-exertional malaise lasting more than 24 hours.

This 1994 definition liberalises a more restrictive 1988 definition.

What conditions should be excluded before a diagnosis of Chronic-Fatigue-Syndrome is made?

While you doctor should exclude the possibility of all these conditions, particular attention should be paid to phosphate diabetes, sleep problems and coeliac's disease as these conditions are commonly missed by GPs.

• Neuromuscular Disease: Multiple Sclerosis, Myasthenia Gravis, Parkinson's Disease, rare muscle disorders.
• Chronic Infections: Brucellosis, Giardia, Hepatitis A,B,C, HIV, Leptospirosis hardjo, Lyme Disease, Parvovirus, Post-polio Syndrome, Toxocara (children), Toxoplasmosis.
• Gastric Disorders: Coeliac's Disease, Crohn's Disease, food allergies , Irritable Bowel Syndrome.
• Hormonal Imbalance: Addison's Disease, Fluid Retention Syndrome, Hypothyroidism, Haemochromatosis, Hypocalcaemia, Hyponatraemia, Thyrotoxicosis, Pituitary Tumour .
• Psychiatric Disorders: Anxiety, Depression, Post Traumatic Stress Disorder.
• Rheumatic Disorders: Fibromyalgia, Sjogren's Syndrome, Systemic Lupus Erythematosus.
• Miscellaneous: Alcohol abuse, Anaemia, Cervical Canal Stenosis, Chiari Syndrome, Hodgkin's Lymphoma, Organophosphate pesticides, Phosphate Diabetes, Sarcoidosis, Sick Building Syndrome, Sleep Apnoea and Narcolepsy, TB.