Understanding Symptoms, Causes and Treatment of Chronic Fatigue Syndrome

Research Based
Medically reviewed by - Dr Rabia Akram, MD Written by - Dr. Shaheen Shah


What is Chronic Fatigue Syndrome?

Chronic Fatigue Syndrome (CFS) is a severe continual disease of extreme tiredness that doesn’t go away with rest and impacts the person’s ability to carry out everyday activities. It can last for six months or longer, and the person’s condition worsens if they compel themselves to do the same actions as usual. The disease impacts the entire body with muscle pain, lightheadedness, and a decline in mental ability, concentration, and sleep problems. With time, the condition might make some people bedridden and unwanted home confinement.

The manifestation varies from mild to severe, and sometimes the symptoms come and go without any indication.

There is no remedy for Chronic Fatigue Syndrome (CFS), but treatment is available to manage the problem and improve the standard of living 1Overview| Researched based study from

Chronic Fatigue Syndrome (CFS) is a severe continual disease of extreme tiredness that doesn't go away with rest and impacts the person's ability to carry out everyday activities. It can last for six months or longer, and the person's condition worsens if they compel themselves to do the same actions as usual.

Here are some quick facts about Chronic Fatigue Syndrome

  • The other names of Chronic Fatigue Syndrome are systemic exertion intolerance disease (SEID) and myalgic encephalomyelitis (ME) and
  • Chronic Fatigue Syndrome can impact people of all ages, but it is more frequent in adults between the age group of 40 to 60 years.
  • The prevalence is higher in females (age 20 to 40) than males.
  • In the United States, around 2.5 million people have Chronic Fatigue Syndrome.
  • Globally around 24 million people have Chronic Fatigue Syndrome 2Overview| Researched based study from


Symptoms of Chronic Fatigue syndrome.

Symptoms of Chronic Fatigue Syndrome

CFS symptoms vary from person to person based on the disease severity.

The main symptoms are :

  • Extreme fatigue (exhaustion) while carrying out regular physical activity
  • Extreme exhaustion without any previous physical activity

Symptoms of Post-exertional malaise (PEM)

Post-exertional malaise is when a person experience total exhaustion after performing any mental or physical activity. It can last a day or more without leaving the house or bed.

Some common symptoms of PEM are as follows:

  • Tiredness
  • Headaches
  • Sore throat
  • Difficult sleeping
  • Not feeling refreshed after sleep
  • Difficult concentrating
  • Muscle pain

Symptoms of sleep disorder

  • Restless legs
  • Nighttime muscle ache
  • Shallow breathing during sleep
  • Intensive dreaming

Other symptoms of Chronic Fatigue Syndrome are as follows:

  • Memory loss
  • Anxiety and depression
  • Tenderness under the armpits
  • Joint pain
  • Abdominal pain
  • Eye pain
  • Muscle weakness
  • Night sweats
  • Vision problem
  • Irregular heartbeat
  • Difficulty walking
  • Difficult breathing
  • Lightheadedness
  • Faint 3Symptoms| Researched based study from


Causes of Chronic Fatigue Syndrome

  • Health professionals do not know the accurate cause of Chronic Fatigue Syndrome. However, researchers believe that specific illnesses can lead to Chronic Fatigue Syndrome.
  • According to the CDCP (Centers for Disease Control and Prevention), Chronic Fatigue Syndrome is the last stage of multiple infections. Health professionals can pinpoint no single condition for Chronic Fatigue Syndrome 4Causes| Researched based study from


Diagnosis of Chronic Fatigue Syndrome

  • The doctor will conduct a detailed physical and mental examination to diagnose Chronic Fatigue Syndrome (CFS). He will further enquire about the patient’s family and medical history and the illness’s severity and duration.
  • Subsequently, he might order urine tests and blood tests to confirm infections.
  • In some cases, doctors refer to other specialists to rule out other health conditions that might cause the symptom.

Differential diagnosis

Some examples of the conditions that resemble CFS and doctors need to rule out are as follows:

  • Lyme disease (bacterial infection)
  • Multiple sclerosis (a condition of the brain and spinal cord)
  • Lupus (an illness when the immune system attacks the healthy cells of the body)
  • Hypothyroidism (thyroid problem)
  • Major depressive disorder
  • Severe obesity
  • Sleep disorders

For a person to diagnose positive for CFS, he must have three specific symptoms:

  • Severe fatigue for the previous six months that does not improve with rest
  • Fatigue that worsens following mental or physical activity
  • Sleep problem

Moreover, he must have at least one symptom, such as mental difficulties or inability to stand upright and experience lightheadedness and fainting 5Diagnosis| Researched based study from

Risk factors

Risk factors for Chronic Fatigue Syndrome

  • Family history of Chronic Fatigue Syndrome
  • Continual anxiety and stress
  • Weakened immune system
  • Viral infection viz; herpes virus, rubella virus, Ross River virus
  • Bacterial infection viz; pneumonia
  • Hormonal imbalance
  • Surgical operation
  • Upper respiratory tract infections such as flu, cold
  • Continual Vitamin B2 and B12 deficiency 6Risk factors| Researched based study from


Complications of Chronic Fatigue Syndrome

  • Symptoms can come and go with significant deterioration of mental and physical condition.
  • It might make retaining their regular work schedule challenging.
  • It can also hamper the basic life activities at home.
  • Many people lose their physical strength and might require to stay in bed. They need a wheelchair or other people’s help to carry out their daily activities. The condition, in turn, leads to severe depression in many people’s lives later on 7Complications| Researched based study from


Treatment of Chronic Fatigue Syndrome

To date, there is no cure or specific treatment for CFS. A doctor will give a treatment plan to manage the symptoms based on the patient’s condition.

Post-exertional malaise (PEM) management

  • The doctor will suggest specific periods of rest after each activity. He will also make the patient identify the exertion he can take up at once.

Sleep management

  • The doctor will suggest the patient adopt regular time sleeping habits. However, if the strategy does not work, medicines are prescribed to the patient.

Pain management

Generally, doctors prescribe over-the-counter medications for pain. But most CFS patients are sensitive to the chemical in drugs. In that case, doctors might advise non-drug therapy to manage pain. Some of them are as follows:

  • Mild massage
  • Gentle exercise
  • Water therapy
  • Heat therapy

Anxiety and depression management

  • Doctors prescribe an anti-depressant to manage the symptoms. But in some people, sometimes it might make the CFS symptoms worse.

Alternative treatments for anxiety and depression are as follows:

  • Deep breathing
  • Meditation
  • Mind & body relaxation techniques
  • Light exercises such as yoga

Cognitive behavioral therapy (for anxiety and depression)

  • Cognitive behavioral therapy is a type of talk therapy given by experienced psychotherapists or counselors to nullify the negative thought in a patient’s mind. It makes the patient visualize the positive aspects of life 8Treatment| Researched based study from

Support groups for Chronic Fatigue Syndrome

Some of the Support groups that assist people with Chronic Fatigue Syndrome are as follows:

  • Solve ME/CFS initiative
  • American ME and CFS Society
  • Smart Patients Myalgic Encephalomyelitis Community
  • CDC Patient Toolkit 10Treatment| Researched based study from


Lifestyle Modification for Chronic Fatigue Syndrome

  • Maintaining a nutritious, balanced diet
  • Consulting with a healthcare provider that better understands the situation
  • Take help from a counselor to deal with emotional stress
  • Complete cessation of alcohol and smoking
  • Avoiding daytime napping
  • Wake up and go to bed at the same time every day
  • Keeping notes or a calendar to tackle the memory issues
  • Adopting relaxation techniques such as yoga to deal with stress
  • Taking supplements on time in case of vitamin deficiencies
  • Keeping household help for managing other activities at home
  • Scheduling the activity times each day to better the quality of life 9Lifestyle| Researched based study from


The Outlook

  • Chronic Fatigue Syndrome remains a complicated condition with no accurate cause and cure.
  • Treatment options for managing the symptoms are challenging, and the recovery rate is only 5%.
  • Adopting oneself proper lifestyle modification helps in appropriately managing the condition.
  • Many people with the condition are likely to experience depression, anxiety, and social isolation in later life. Joining support groups can help in that case to better the quality of life.
  • The progression of Chronic Fatigue Syndrome varies from person to person, so it is essential to consult with the health care professional for the specific treatment plan.
  • Many people get better by working with a team of health professionals such as rehabilitation specialists, therapists, and doctors.
Disclaimer: The user acknowledges that this article's information is being offered for informational purposes only. Every attempt has been made to guarantee that the article is informational and correct. If they have any doubts or questions about their health, we firmly advise our readers to visit a doctor or other healthcare professional.

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