What are the primary symptoms of Chronic Fatigue Syndrome. How is CFS diagnosed. What treatment options are available for managing Chronic Fatigue Syndrome. Who is at higher risk of developing CFS. How does Chronic Fatigue Syndrome impact daily life. What are the potential causes of this condition. How can individuals cope with the challenges of living with CFS.

Understanding Chronic Fatigue Syndrome: A Comprehensive Overview

Chronic Fatigue Syndrome (CFS), also known as Myalgic Encephalomyelitis (ME), is a complex and debilitating condition characterized by extreme fatigue that cannot be explained by any underlying medical condition. This disorder affects millions of people worldwide, significantly impacting their quality of life and ability to perform daily activities.

CFS is a multifaceted illness that presents with a wide array of symptoms, making it challenging to diagnose and treat. The condition can affect individuals of all ages, but it is more commonly observed in women and typically develops between the mid-20s and mid-40s.

The Prevalence of Chronic Fatigue Syndrome

While exact figures are difficult to determine due to the complexity of diagnosis, it is estimated that CFS affects between 836,000 and 2.5 million Americans. Globally, the prevalence varies, with some studies suggesting rates between 0.2% and 2.6% of the population. These numbers highlight the significant impact of this condition on public health and the importance of continued research and awareness.

Recognizing the Symptoms of Chronic Fatigue Syndrome

The symptoms of Chronic Fatigue Syndrome can vary widely from person to person, but there are several core symptoms that are commonly experienced by those with the condition. Understanding these symptoms is crucial for both patients and healthcare providers in the diagnostic process.

Primary Symptoms of CFS

• Extreme fatigue that lasts for at least six months
• Post-exertional malaise (PEM)
• Unrefreshing sleep
• Cognitive impairment (often referred to as “brain fog”)

Additional Symptoms

In addition to the primary symptoms, individuals with CFS may experience a range of other health issues, including:

• Muscle pain and weakness
• Joint pain without swelling or redness
• Headaches
• Sore throat
• Tender lymph nodes
• Sensitivity to light, sound, and temperature
• Digestive issues
• Dizziness and balance problems

Is there a specific pattern to how CFS symptoms manifest? While the presentation can vary, many individuals with CFS report that their symptoms tend to fluctuate in intensity over time. Some may experience periods of relative improvement followed by sudden relapses or “crashes.” This unpredictable nature of the condition can make it particularly challenging for patients to manage their daily lives and plan for the future.

The Diagnostic Challenges of Chronic Fatigue Syndrome

Diagnosing Chronic Fatigue Syndrome can be a complex process, as there is no single test that can definitively confirm the condition. Instead, healthcare providers must rely on a combination of clinical criteria and the exclusion of other potential causes of fatigue.

Diagnostic Criteria for CFS

The most widely accepted diagnostic criteria for CFS include:

1. Severe fatigue lasting at least six months that is not alleviated by rest
2. Post-exertional malaise
3. Unrefreshing sleep
4. Either cognitive impairment or orthostatic intolerance (difficulty standing upright)

Additionally, patients must have a significant reduction in their ability to engage in pre-illness levels of occupational, educational, social, or personal activities.

Exclusion of Other Conditions

Before a diagnosis of CFS can be made, healthcare providers must rule out other medical conditions that could be causing the symptoms. This process may involve:

• Comprehensive medical history
• Physical examination
• Blood tests to check for underlying conditions
• Sleep studies to rule out sleep disorders
• Psychological evaluations to assess for mental health conditions

How long does it typically take to receive a CFS diagnosis? Due to the complexity of the condition and the need to rule out other potential causes, it can often take several months or even years for individuals to receive a definitive diagnosis of Chronic Fatigue Syndrome. This delay in diagnosis can be frustrating for patients and may impact their ability to access appropriate treatment and support.

Exploring the Potential Causes of Chronic Fatigue Syndrome

Despite extensive research, the exact cause of Chronic Fatigue Syndrome remains unknown. However, scientists have identified several factors that may contribute to the development of the condition.

Possible Triggers for CFS

• Viral infections (e.g., Epstein-Barr virus, human herpesvirus 6)
• Immune system dysfunction
• Hormonal imbalances
• Genetic predisposition
• Stress and trauma
• Environmental factors

Can a single event trigger the onset of CFS? While some individuals report that their symptoms began after a specific event, such as a severe viral infection or period of intense stress, it’s more likely that CFS results from a combination of factors. The condition may develop when a person with a genetic predisposition is exposed to certain environmental triggers or stressors.

The Role of the Immune System

Research suggests that immune system dysfunction may play a significant role in the development of CFS. Some studies have found abnormalities in the immune systems of individuals with the condition, including:

• Elevated levels of certain cytokines (immune system signaling molecules)
• Altered T-cell function
• Reactivation of latent viruses

These immune system abnormalities may contribute to the persistent fatigue and other symptoms experienced by those with CFS.

Treatment Approaches for Managing Chronic Fatigue Syndrome

While there is currently no cure for Chronic Fatigue Syndrome, various treatment approaches can help manage symptoms and improve quality of life for individuals with the condition.

Pharmacological Interventions

Medications may be prescribed to address specific symptoms of CFS, including:

• Pain relievers for muscle and joint pain
• Antidepressants to help with mood and sleep issues
• Anti-anxiety medications to manage stress and anxiety
• Sleep aids to improve sleep quality

It’s important to note that medication responses can vary significantly between individuals, and what works for one person may not be effective for another.

Non-Pharmacological Approaches

Many individuals with CFS find relief through non-medication-based treatments, such as:

• Cognitive Behavioral Therapy (CBT)
• Graded Exercise Therapy (GET)
• Pacing strategies
• Relaxation techniques and stress management
• Nutritional counseling
• Alternative therapies (e.g., acupuncture, massage)

How effective are these non-pharmacological approaches in managing CFS symptoms? While individual responses vary, many patients report improvements in their overall well-being and ability to cope with symptoms when incorporating these strategies into their treatment plan. It’s essential to work closely with healthcare providers to develop a personalized approach that addresses specific symptoms and needs.

Living with Chronic Fatigue Syndrome: Coping Strategies and Lifestyle Adjustments

Living with Chronic Fatigue Syndrome can be challenging, but there are various strategies that individuals can employ to better manage their condition and improve their quality of life.

Energy Management and Pacing

One of the most crucial aspects of managing CFS is learning to effectively manage energy levels. This often involves:

• Identifying personal energy limits
• Prioritizing activities and tasks
• Breaking activities into smaller, manageable segments
• Incorporating regular rest periods throughout the day
• Avoiding overexertion during “good” periods

By carefully managing energy expenditure, individuals with CFS can help reduce the frequency and severity of post-exertional malaise episodes.

Creating a Supportive Environment

Adapting one’s living and working environment can significantly impact the ability to manage CFS symptoms. Some helpful adjustments may include:

• Organizing living spaces to minimize unnecessary movement
• Using assistive devices to conserve energy
• Creating a calm and restful bedroom environment
• Adjusting lighting and temperature to reduce sensory overload
• Implementing flexible work arrangements when possible

How can friends and family members support someone with CFS? Education about the condition is crucial for loved ones to understand the challenges faced by individuals with CFS. Offering practical help with daily tasks, being understanding of the need for rest and cancellations, and providing emotional support can make a significant difference in the life of someone with CFS.

The Impact of Chronic Fatigue Syndrome on Mental Health

Living with a chronic, debilitating condition like CFS can have a significant impact on an individual’s mental health and emotional well-being. It’s important to address these aspects of the condition as part of a comprehensive treatment approach.

Common Mental Health Challenges

Individuals with CFS may experience various mental health issues, including:

• Depression
• Anxiety
• Frustration and anger
• Grief over lost abilities and lifestyle changes
• Social isolation
• Low self-esteem

These mental health challenges can exacerbate CFS symptoms and make it more difficult to manage the condition effectively.

Strategies for Maintaining Emotional Well-being

There are several approaches that can help individuals with CFS maintain their mental health and emotional resilience:

• Seeking professional mental health support
• Joining support groups or online communities
• Practicing mindfulness and relaxation techniques
• Engaging in creative activities or hobbies within energy limits
• Maintaining social connections, even if primarily virtual
• Setting realistic goals and celebrating small achievements

What role does acceptance play in managing CFS? Learning to accept the reality of living with a chronic condition can be a crucial step in developing effective coping strategies. While it doesn’t mean giving up hope for improvement, acceptance can help individuals focus on making the most of their current situation and finding new ways to find fulfillment and purpose.

Research and Future Directions in Chronic Fatigue Syndrome

As our understanding of Chronic Fatigue Syndrome continues to evolve, ongoing research is crucial for developing more effective diagnostic tools, treatments, and potentially finding a cure for the condition.

Current Research Focus Areas

Some of the key areas of CFS research include:

• Identifying biomarkers for diagnosis and treatment response
• Investigating the role of mitochondrial dysfunction
• Exploring potential autoimmune components of CFS
• Developing targeted therapies based on individual patient profiles
• Studying the long-term effects of CFS on overall health
• Investigating potential connections between CFS and other chronic conditions

Promising Developments

Recent research has yielded some promising developments in the field of CFS, including:

• Identification of potential blood-based biomarkers
• Advances in understanding the neurological aspects of the condition
• Development of more personalized treatment approaches
• Increased recognition of CFS as a serious medical condition by the healthcare community

What impact might these research developments have on individuals with CFS? As our understanding of the condition improves, it’s likely that we’ll see more accurate diagnostic methods, targeted treatments, and potentially even preventive strategies emerging. This could lead to earlier diagnosis, more effective symptom management, and an overall improvement in the quality of life for those affected by CFS.

In conclusion, Chronic Fatigue Syndrome remains a complex and challenging condition that affects millions of people worldwide. While there is still much to learn about its causes and optimal treatment approaches, ongoing research and increased awareness are helping to improve the lives of those living with CFS. By continuing to support research efforts, educating healthcare providers, and advocating for those affected by the condition, we can work towards a future where CFS is better understood, more effectively managed, and potentially even cured.

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.