What is Chronic Fatigue Syndrome? Causes, Symptoms and Treatment

chronic fatigue syndrome diagnosis

Chronic Fatigue Syndrome (or myalgic encephalomyelitis, ME) is a disease characterized by extreme, persistent fatigue that fails to disappear after sleeping.

Description and Symptoms

For people who suffer this condition, exercise can make the symptoms worse. Other symptoms include pain in the muscles and joints, headaches, sleep problems such as insomnia, sore throat, intestinal discomfort, poor memory and concentration, and tender lymph nodes.

It is intense and continuous fatigue (fatigue). This is not relieved by rest and is not caused directly by other diseases.

Not every sufferer will have every one of these following symptoms. People with chronic fatigue syndrome may also suffer from depression, although the two conditions are distinct.

There is no agreed physical test for chronic fatigue syndrome. Many other diseases can give similar symptoms, so most of those who manifest these sings need to rule out any other possible condition before a diagnosis of chronic fatigue syndrome is made. At one time chronic fatigue syndrome was referred to as “yuppie flu,” an unhelpful name since it doesn’t disproportionally affect affluent young urbanites, and usually takes many months or years for recovery to occur.


The causes of chronic fatigue syndrome (also known as myalgic encephalomyelitis) remain unknown. In some cases, the condition begins following a viral infection, such as glandular fever. It’s normal to feel very tired while recovering from a viral infection, but in the case of chronic fatigue syndrome the tiredness continues long after all trace of the initial infection has gone. Some sufferers seem to get the syndrome without having any detectable viral disease.

Some think that is possible a few abnormalities in the immune system cause chronic fatigue syndrome, but no convincing evidence has yet been found to show that this is the case. Recent results on a small number of patients have suggested that the disease may be caused by inflammation of the brain. Research is continuing in this area.

The disease is somewhat more prevalent in women than men. There may be a slight genetic component to the disease.

Some experts proposed that the retrovirus XMRV caused the condition, but later research proved that this was not the case. Some researchers believe that the disease, at least in some patients, is mainly due to psychological factors, although this is disputed by patients’ groups. The debate is often extremely heated. Many researchers in the field have been subject to a great deal of abuse and even death threats.

The exact cause of chronic fatigue syndrome (CFS) is unknown. It may be due to:

Epstein-Barr virus or human herpesvirus type 6 (HHV-6). However, no one has identified a specific virus as the cause.
Inflammation of the nervous system, due to weak immune system response.
The following may also be involved in the onset of CFS:

Previous illness
Environmental factors
This syndrome occurs more frequently in women 30 to 50 years.

Chronic Fatigue Syndrome Treatment

Lifestyle changes may help sufferers to some extent. Pacing your activities, so that any activity is followed by periods of rest, is recommended. Avoiding caffeine and alcohol may also help. Sufferers are advised to rest when tired but to try not to nap during the day, as this can make insomnia worse.

Cognitive Behavioral Therapy (CBT) has been used to treat chronic fatigue syndrome. The scientific evidence seems to be that it is moderately effective in lessening the symptoms, although not all patients benefit from it. CBT is a talking therapy, aiming to break down the patient’s problems into smaller parts. It focuses on avoiding negative thought patterns. The use of CBT does not imply that chronic fatigue syndrome is a purely psychological condition since it is also sometimes used to help patients who have diseases with well-known physical causes, such as cancer.

Graded Exercise Therapy is a type of physical therapy. It can lead to an initial improvement in the symptoms, although often this is not maintained. Since sufferers often react badly to exercise, the treatment can sometimes make symptoms worse.

Painkillers can be used to reduce pain in the joints and muscles. Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, can be used. These do have some side-effects, such as causing an increased risk of stomach bleeding. Acetaminophen (paracetamol) is a possible alternative.

Antidepressants may help with sleeping and low morale. The tricyclic antidepressant, amitriptyline, is sometimes prescribed. All antidepressants have various side-effects, so long-term use may not be beneficial.

Melatonin may help those suffering from insomnia

St. John’s Wort has been shown to be effective for depression, but there is as yet no clear evidence that it is useful for the treatment of chronic fatigue syndrome. Do tell your physician if you are taking this herb since it can give severe adverse reactions if taken with various other medications.

Tests and exams.

The Centers for Disease Control and Prevention (CDC) describe chronic fatigue syndrome as a different disorder with specific physical symptoms and signs. Such diagnosis is just ruling out other possible causes.

Your health care provider will try to rule out other possible causes of fatigue, including:

Drug addiction
Autoimmune or immune disorders
Muscular or neurological diseases (such as multiple sclerosis)
Endocrine conditions (such as hypothyroidism)
Other diseases (such as heart disease, nephropathy or liver disease)
Psychiatric or psychological illnesses, particularly depression
A diagnosis of chronic fatigue syndrome should include:

Absence of other causes of chronic fatigue
At least four of the other CFS-specific symptoms
Extreme and prolonged fatigue
There are no specific tests to confirm the diagnosis of CFS. However, there have been reports of patients with CFS who show abnormal results in the following tests:

Magnetic Resonance of the Brain
White blood cell count

Expectations (prognosis).

The long-term prognosis for patients with chronic fatigue syndrome varies and is difficult to predict when symptoms first begin. Some patients recover completely after six months to 1 year.

Almost 1 in 4 people with CFS are so severely disabled that they can not get out of bed or leave their home. Symptoms can come and go in cycles, and even when people feel better, they may experience relapse triggered by exercise or an unknown cause.

Some people never feel that they will return to perform as before presenting the disease. Studies suggest that you are more likely to get better if you undergo intensive rehabilitation.