Chronic Fatigue Syndrome | Johns Hopkins Medicine

What is chronic fatigue syndrome?

Chronic fatigue syndrome (CFS) is characterized by profound tiredness, regardless of bed rest. Its symptoms may worsen with physical or mental activity. CFS can happen suddenly and last for years. The condition affects more females than males.

What causes chronic fatigue syndrome?

The cause of CFS is not known.

Who is at risk for chronic fatigue syndrome?

Because the cause of CFS is not known, it’s hard to know what might put someone at risk for getting the condition. However, certain factors are seen more often in people with CFS. These factors include:

• Gender. CFS happens up to 4 times more often in women than in men.
• Age. CFS commonly affects middle-aged people, but people of any age can get it.

What are the symptoms of chronic fatigue syndrome?

Symptoms of CFS often mimic the flu. The following are the most common symptoms of CFS. However, each person may experience symptoms differently. Symptoms may include:

• Sensitivity to light
• Headache
• Tender lymph nodes
• Fatigue and weakness
• Muscle and joint pain
• Inability to concentrate
• Insomnia
• Forgetfulness
• Mood swings
• Confusion
• Low-grade fever
• Depression

The symptoms of CFS may look like other medical conditions. Always talk with your healthcare provider for a diagnosis.

How is chronic fatigue syndrome diagnosed?

CFS diagnosis depends on two criteria:

1. Severity and duration. The severe and chronic tiredness lasts for more than 6 months and other medical conditions have been ruled out.
2. Number of symptoms.  Four or more symptoms of CFS are present.

A specific treatment for CFS has yet to be proven effective. Vitamin supplements and medicines have some benefit. Many treatments just relieve the symptoms of CFS.

How is chronic fatigue syndrome treated?

Treatment is determined by your healthcare provider and based on:

• Your overall health and medical history
• Extent of the condition
• Your tolerance for specific medicines, procedures, or therapies
• Expectations for the course of the condition
• Your opinion or preference

Treatment may include:

• Medicine, including corticosteroids, antidepressants, and others
• Light-intensity aerobic exercise (but avoid moderate to vigorously intense physical activity) 
• Dietary supplements and herbal preparations
• Psychotherapy and supportive counseling

Living with chronic fatigue syndrome

There is currently no cure for chronic fatigue syndrome. Dealing with the severe fatigue can be very challenging. It is important that you work with your healthcare provider to find treatments that help you. Some people find counseling or support groups helpful.

When should I call my healthcare provider?

If your symptoms get worse or you have new symptoms, let your healthcare provider know.

Key points about chronic fatigue syndrome

• Chronic fatigue syndrome is characterized by profound tiredness.
• Symptoms often worsen with physical or mental activity.
• In addition to severe fatigue, symptoms include light sensitivity, headache, muscle and joint pain, difficulty concentrating, mood swings, and depression.
• Treatments may include medicines, exercise, supplements, and counseling.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.

Myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS)

Myalgic encephalomyelitis, also called chronic fatigue syndrome or ME/CFS, is a long-term condition with a wide range of symptoms. The most common symptom is extreme tiredness.

ME/CFS can affect anyone, including children. It’s more common in women, and tends to develop between your mid-20s and mid-40s.

Symptoms of ME/CFS

Common symptoms of ME/CFS include

• feeling extremely tired all the time – you may find it very hard to do daily activities
• still feeling tired after resting or sleeping
• taking a long time to recover after physical activity
• problems sleeping, such as waking up often during the night
• problems with thinking, memory and concentration

Some people with ME/CFS may also have other symptoms, including:

• muscle or joint pain
• headaches
• a sore throat
• flu-like symptoms
• feeling dizzy or sick
• fast or irregular heartbeats (heart palpitations)

The severity of symptoms can vary from day to day, or even within a day.

The symptoms of ME/CFS are similar to the symptoms of some other illnesses, so it’s important to see a GP to get a correct diagnosis.

Find out more about the symptoms of ME/CFS

Diagnosing ME/CFS

There is not a specific test for ME/CFS, so it’s diagnosed based on your symptoms and by ruling out other conditions that could be causing your symptoms.

The GP will ask about your symptoms and medical history. You may also have blood and urine tests.

As the symptoms of ME/CFS are similar to those of many common illnesses that usually get better on their own, a diagnosis of ME/CFS may be considered if you do not get better as quickly as expected.

Find out more about diagnosing ME/CFS

Treating ME/CFS

Treatment for ME/CFS aims to relieve the symptoms. Your treatment will depend on how the condition is affecting you

While there is currently no cure for ME/CFS, there are treatments that may help you manage the condition.

Treatments include:

• cognitive behavioural therapy (CBT)
• energy management – where you’re given advice about how to make best use of the energy you have without making your symptoms worse
• medicine to control symptoms such as pain and sleeping problems

Some people with ME/CFS will improve over time, especially with treatment.

Many people with ME/CFS will need to adapt their daily routine and pattern of activities on a long-term basis. There may be periods when your symptoms get better or worse.

Find out more about treatments for ME/CFS

Causes of ME/CFS

It’s not known what causes ME/CFS, but there are a number of theories – for example, it may be triggered by an infection, or certain factors could make you more likely to develop the illness.

Suggested causes or triggers for ME/CFS include:

• viral infections, such as glandular fever
• bacterial infections, such as pneumonia
• problems with the immune system
• a hormone imbalance
• your genes – ME/CFS seems to be more common in some families

Living with ME/CFS

Living with ME/CFS can be difficult. Extreme tiredness and other physical symptoms can make it hard to carry out everyday activities. You may have to make some major lifestyle changes.

ME/CFS can also affect your mental and emotional health, and have a negative effect on your self-esteem.

As well as asking your family and friends for support, you may find it useful to talk to other people with ME/CFS.

ME Association is a charity that provides information, support and practical advice for people affected by the condition.

You can find a local support group on the ME Association website

Video: myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS)

In this video, a doctor describes the symptoms, diagnosis and treatments for ME/CFS.

Media last reviewed: 23 November 2022
Media review due: 23 November 2025

Page last reviewed: 29 October 2021
Next review due: 29 October 2024

symptoms, diagnosis, treatment of chronic fatigue – Department of Neurology NCC No. 2 (Central Clinical Hospital RAS)

Chronic Fatigue Syndrome (CFS) is a disease that is characterized by an endless feeling of fatigue, loss of strength, overwork, which does not go away even after sound sleep and long rest. Psycho-emotional stress on the human nervous system is the main cause of this disease. Residents of megacities aged 25 to 45 are most susceptible to chronic fatigue syndrome, and women suffer more from this disease. Until recently, it was believed that only adults were susceptible to the disease, but now the diagnosis of “chronic fatigue syndrome” has begun to haunt children, especially of school age.

Causes of chronic fatigue.

Until now, the exact causes leading to chronic fatigue syndrome have not yet been established. However, risk factors that can provoke the onset of this disease exist:

• Wrong lifestyle (frequent lack of sleep, lack of sunlight and fresh air, nicotine and alcohol use, etc.)
• Chronic diseases (lead to emaciation)
• Psychological disorders (constant stress, frequent depression, anxiety)
• Unbalanced diet (poor quality food, excess or lack of food, lack of vitamins)
• Unfavorable environment (ecological situation in cities is much worse than in rural areas)
• Infections and viruses (the constant struggle of the body with viruses leads to general fatigue)

Symptoms of the disease.

A distinctive feature of chronic fatigue is constant overwork, which does not disappear after a sound sleep and a long rest. This painful condition can last for more than six months.

Other symptoms of chronic fatigue:

• Insomnia
• Migraine
• Fatigue
• Decreased immunity
• Spinal and muscular pain
• Mental impairment
• Constant exhaustion
• Enlarged lymph nodes (armpits and neck)

This disease must be treated, so that in the future it does not lead to the development of serious neuropsychiatric diseases.

Diagnosis of chronic fatigue.

Often, chronic fatigue syndrome is difficult to diagnose due to the fact that most of the symptoms occur in other diseases. At the same time, the symptoms of this disease are manifested in a complex, and not one at a time. Only a specialist can make an accurate diagnosis after a detailed examination and a detailed medical history. Sometimes, in order to exclude other pathologies, the doctor may refer the patient to a blood or urine test. The main diagnostic sign of the disease is the occurrence of a persistent feeling of fatigue, which does not disappear after a good rest, and bad mood, loss of appetite, apathy, general weakness are concomitant factors. This condition can be supplemented by frequent colds, exacerbation of chronic diseases, which significantly reduces efficiency and exacerbates the feeling of constant fatigue.

Depending on the manifestation of the symptoms that provoked this disease, the patient can visit the following specialists:

• Therapist
• Psychologist
• Neurologist
• Endocrinologist
• Immunologist

You can make an appointment with the specialists you are interested in in Moscow at the NCC Clinic No. 2 (Central Clinical Hospital of the Russian Academy of Sciences).

Treatment of chronic fatigue.

• Medication (vitamins, immunomodulators, homeopathic, anti-inflammatory drugs, antidepressants, antivirals)
• Physiotherapy (physiotherapy, acupuncture, soothing massage, hydrotherapy, etc. )
• Recommended good sleep, diet, planned daily routine.

Disease prevention.

• Proper nutrition
• Rational daily routine planning
• Sports activities
• Healthy sleep
• Refusal of bad habits.

If a situation arises in which a professional consultation of a neurologist becomes necessary, please contact the specialists of the NCC No. 2 (Central Clinical Hospital of the Russian Academy of Sciences). The best doctors of the capital will help you restore your health. Registration is available 24 hours a day on the website. You can also make an appointment with a neurologist by phone during working hours of the Central Clinical Hospital.

symptoms and treatment – Harmony of health

Chronic fatigue syndrome is a disease in which the human body experiences constant mental and physical weakness. Weakness occurs for unexplained reasons and may last for six months or more. People faced a similar ailment back in the 30s of the last century, but in fact, the diagnosis of chronic fatigue syndrome was first made only in 1988 year. Until that time, chronic fatigue was considered to be an accompanying symptom of various diseases, including infectious ones.

The feeling of extreme fatigue due to physical or mental overexertion has been experienced by many. As a rule, such a feeling arises after a responsible event or difficult work and disappears due to relaxation. In the case of ordinary overwork, a person is able to easily determine the cause of his fatigue and overcome it. With chronic fatigue syndrome, everything is different: the patient finds it difficult to remember when, why and under what circumstances he felt tired. This condition can deeply disturb and oppress the patient.

Modern medicine associates the appearance of chronic fatigue syndrome with a continuous acceleration of the pace of life and an increase in the flow of information. Any infectious disease can serve as an impetus for the onset of the disease. At the end of the acute period of infection, the patient may experience some weakness, fatigue and depression. Normally, this condition should pass in three weeks. With chronic fatigue syndrome, symptoms persist even after six months, and the patient has to turn to a medical center for professional help sooner or later.

Chronic fatigue syndrome: symptoms

The main symptom is endless fatigue that does not leave a person even after prolonged sleep and rest. Most patients develop a concomitant ailment – constant insomnia. Its appearance can be triggered by any factor – a change in the time zone, a change in work schedule, or banal stress.

Very often, chronic fatigue is accompanied by a significant deterioration in performance and attention, a sharp deterioration in the psycho-emotional state. Apathy, depression, hypochondria may develop. In some cases, against the background of chronic fatigue, phobias occur. There are cases of violation of thermoregulation and a sharp decrease in body weight.

With chronic fatigue syndrome, the patient often complains of dizziness, headaches, photophobia, dry eyes. Possible pharyngitis, tachycardia, soreness of the lymph nodes. Women may experience increased premenstrual syndrome.

Chronic fatigue syndrome: prevention

A healthy lifestyle is the surest way to avoid the development of the syndrome. Eat right, control the level of mental stress, do not forget about the benefits of adequate physical training. A person who adheres to the correct daily routine and knows how to avoid stressful situations is less susceptible to any diseases. Even if stress still overtakes you, allow yourself to relax and unwind.

Take at least short breaks while you work. If your work is associated with mental stress, do not be lazy to interrupt for simple physical exercises. Oddly enough, constant sitting is very tiring, so allowing the body to switch from mental work to physical work from time to time is very useful.