Chronic Fatigue Syndrome - Topic Overview

What is chronic fatigue syndrome (CFS)?

Chronic fatigue syndrome (CFS), sometimes called myalgic encephalomyelitis (ME), is a condition that makes you feel so tired that you can't do all of your normal, daily activities. There are other symptoms too, but being very tired is the main one. Some people have severe fatigue and other symptoms for many years.

CFS is not well understood. Most experts now believe that it is a separate illness with its own set of symptoms. But some doctors don't believe this.

There are no tests for CFS. Because of this, many people have trouble accepting their disease or getting their friends and family to do so. Having people who believe your diagnosis and support you is very important. Having a doctor you can trust is critical.

Your tiredness is real. It's not "in your head." It is your body's reaction to a mix of factors.

What causes CFS?

Doctors don't know what causes CFS. Sometimes it begins after a viral infection, but there is no proof of any connection. It's likely that a number of factors or triggers come together to cause CFS.

What are the symptoms?

Extreme tiredness, or fatigue, is the main symptom. If you have CFS:

  • You may feel exhausted all or much of the time.
  • You may have problems sleeping. Or you may wake up feeling tired or not rested.
  • It may be harder for you to think clearly, to concentrate, and to remember things.
  • You may also have headaches, muscle and joint pain, a sore throat, and tender glands in your neck or armpits.
  • Your symptoms may flare up after a mental or physical activity that used to be no problem for you. You may feel drained or exhausted.

Depression is common with CFS, and it can make your other symptoms worse.

How is CFS diagnosed?

There are no tests for CFS. Doctors can diagnose it by ruling out other possible causes of your fatigue and by using a set of rules. Many other health problems can cause fatigue. Most people with fatigue have something other than chronic fatigue syndrome.

Here is one set of criteria (rules) that doctors use to diagnose chronic fatigue syndrome:1

  • The fatigue and the other symptoms must last, or come and go, for at least 6 months in adults or 3 months in children.
  • The symptoms cannot be explained by another illness.
  • All of these symptoms must be present:
    • Extreme physical or mental fatigue
    • Not feeling well after being active (post-exertional malaise)
    • Sleep problems
    • Pain
  • Two or more of these symptoms related to brain function must be present:
    • Problems with concentration, short-term memory, or thinking of the right word
    • Being very sensitive to light, noise, or emotions
    • Confusion, slow thinking, or feeling disoriented
    • Muscle weakness or muscle coordination problems
  • One or more symptoms from two of these groups must be present:
    • Recurrent flu-like symptoms, sore throats, tender lymph nodes, or new sensitivities to food, medicines, odors, or chemicals
    • Low body temperature, cold hands and feet, sweating, or feeling worse when under stress
    • Lightheadedness and dizziness, very fast heartbeat, or shortness of breath when active


How is it treated?

There is no treatment for CFS itself, but many of its symptoms can be treated. A good relationship with your doctor is important. That's because the two of you will need to work together to find a combination of medicines and behavior changes that will help you get better. Some trial and error may be needed, because no single combination of treatments works for everyone.

Home treatment is very important. You may need to change your daily schedule, learn better sleep habits, and use regular gentle movement or exercise to fight fatigue. Even at times when you have more energy, keep a low-key pace throughout each day. Rest often.

Living with CFS can be as much a mental health challenge as it is a physical one. Take steps to avoid getting caught in a cycle of frustration, anger, and depression. Learning to cope with your symptoms and talking to others who have CFS can help. So can working with a counselor.

Frequently Asked Questions

Learning about chronic fatigue syndrome (CFS):

Being diagnosed:

Getting treatment:

Living with chronic fatigue syndrome (CFS):

WebMD Medical Reference from Healthwise
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