Paperback,
Bylen again gives a good list of considerations and unfortunately it sometimes takes a process of elimination to arrive at a more definitive diagnosis, especially if it is CFS causing your fatigue.
Helicobacter Pylori infection symptoms can include fatigue according to many sources out there but especially true if it has caused ulcers and/or anemia.
Hashimoto's thyroiditis can be present even when thyroid antibodies tests are very low positive or even negative and can only be diagnosed in these cases with a tissue biopsy called "Fine Needle Aspiration" (FNA). The reason labs have a range that goes up a bit before having a high-normal cut-off is because people can have TPO and/or TG antibodies present but they never reach a level that can cause thyroid tissue damage or inflammation (Hashimoto's). Other people have abnormal tissue texture picked up on thyroid ultrasound (echo-texture) even when TPO & TG ABs are negative and Hashimoto's is diagnosed but FNA is the most diagnostic for it.
Another virus you might to have lab test ordered for is the EBV (Epstein-Barr Virus), which can be found in high titers in the blood of people with CFS.
I have CFS comorbid to my thyroid disease and was found to have high EBV in my blood ("218" Range: <20).
Yet one more suggestion I might add is being tested for Mitral Valve Prolapse, a common heart murmur that is notorious for causing fatigue. If you commonly feel palpitations like rapid heart (tachycardia), skips or flutters, this is a possibility. Some Dr.s are good at detecting it with stethoscope but some cases can only be detected by echocardiogram. With MVP, some people have fatigue, dizzyness when first standing and other signs that their involuntary nervous system is dysfunctioning. They call this dysautonomia and has been associated with CFS in med studies. They sometimes give patients a tilt-table test to detect postural hypotension (sudden drops in BP with changes in body position), also called orthostatic hypotension. If it's present they sometimes refer to it as Mitral Valve Prolapse Dysautonomia or Mitral Valve Prolapse Syndrome.
I hope these aren't too many suggestions but as you go through the diagnostic process, they are things to consider and discuss with your Doc if the fatigue problem continues to be elusive as to cause.
Last edited by JimLow - Thyroid Health; 10/15/08 01:30 PM.