Patients are usually very cold, especially in their hands and feet, but they usually complain of excessive sweating, even at times when they are otherwise freezing. There are few who complain of flushing. Examination of the fingernails will show that many of these patients have poor quality nails which are brittle. I have seen two patients with this syndrome who had intriguing problems with their nails. One had ugly, pitting psoriasis of the nails until he got Chronic Fatigue Syndrome and they cleared up when he became ill.
Palpitations occur and the cardiologist invariably comes up with normal findings.
Appetites become disturbed, varying between anorexia and excessive interest in food. Irritable bowels occur, with the usual confusion between constipation and diarrhoea, along with nausea and bloating. Sometimes the patients exhibit weight loss or weight gain. Thyroid function tests are often done and found to be normal but, along with many other tests e.g ESR, there are often strange discrepancies in the tests which fluctuate from one examination to the next. Sensitivities to chemicals in food, drugs and environmental products are the rule in Chronic Fatigue Syndrome .