Chronic fatigue syndrome

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at March 11, 2016
StartDiseasesChronic fatigue syndrome

Chronic fatigue syndrome (CFS) remains one disorder that continues to puzzle doctors and researchers. Those who have the disorder experience extreme fatigue without having any other medical problem that might account for it.


Definition & Facts

The CDC reports that there are about 500,000 cases of chronic fatigue syndrome in the United States, although many more cases are believed to not have been officially diagnosed yet. Most of the sufferers are women, but some men suffer from it too. As many as 2.3 percent of children have the syndrome.

CFS involves fatigue that is strong enough to interfere with normal activities of life. The disorder was first observed in 1860, and the doctor who identified it thought that it was related to a neurological disorder, but no identifiable cause has yet been agreed upon by medical professionals.

Symptoms & Complaints

People who suffer from chronic fatigue syndrome are often extremely tired, but may not always be tired. There may be periods of time in which normal energy levels occur, or varying degrees of tiredness. Other conditions that are often observed are muscle pain, insomnia, inability to concentrate, and possibly impairment of memory.

While the individual may feel fine for a day, if there is physical or mental exertion, much pain and extreme fatigue will likely be felt for more than 24 hours afterward. In addition to the above symptoms, the following symptoms may also be experienced:

The pain associated with CFS can be isolated or felt all over the body at the same time. There may also be sensitivity to light, some problems with coordination, trouble with trying to think of the right word, dizziness, cold hands or feet, nausea, sweating, and weight loss or weight gain. The symptoms of CFS may only be short-lived, or may be continuous. An individual with chronic fatigue syndrome could have the symptoms for years, or not have them for some time, and then experience a recurrence of symptoms. Patients may also suffer from depression, which could worsen the symptoms.

Some cases of chronic fatigue syndrome have occurred after another illness, such as the flu, mononucleosis (mono), or after a very stressful period of life. The symptoms may not appear all at once, but gradually, which may make it harder to identify a cause.


Doctors are not in agreement as to the cause. The most popular beliefs about the cause are that it is from infections; nutritional deficiency; stress that affects the hypothalamus, adrenal glands, and the pituitary gland; a possible dysfunction of the immune system; or unusually low blood pressure that can produce fainting.

Part of the problem of identifying an exact cause is that there are many diseases or conditions that can produce some of the same symptoms. The CDC has made the suggestion that it could be the final stage of conditions caused by the Epstein-Barr virus (mono), the Coxiella burnetti bacterium (Q fever), or the Ross River virus (Ross River fever). Another problem is that some people with the syndrome have unusually high hormone levels, but doctors are not yet sure whether that is significant or not.

Diagnosis & Tests

At the present time, there is no single test that can diagnose chronic fatigue syndrome. Instead, doctors must make sure that other health problems are not the cause of the symptoms. By eliminating other possibilities, such as medical problems, sleep disorders, and mental disorders, doctors will only be left with the possibility of CFS.

Some doctors do not believe that it is a real condition, and may never give this type of diagnosis, which can mean a patient receives the wrong type of treatment. In order to get a diagnosis of having chronic fatigue syndrome, a patient must have had a minimum of four of the following symptoms for six or more months:

  • Unexplained pain in the muscles
  • A sore throat
  • Sleep that does not refresh
  • A new type of headache
  • Extreme exhaustion that last more than 24 hours following periods of mental or physical exertion
  • Lymph nodes that are enlarged in the neck or armpits
  • Loss of memory or difficulty concentrating
  • Pain in the joints that occurs in various joints, and with which there is no swelling or redness.

Treatment & Therapy

There is no recognized treatment plan for people with CFS. There also are not any prescription medicines available for it, and the symptoms can vary considerably from one person to another. Doctors will typically deal with symptoms as they occur. A number of patients have indicated that they are sensitive to various medications used to help alleviate symptoms.

Coping techniques will often be recommended to try and help provide some relief as well as tips on healthy diet, some forms of mild exercise, and cognitive behavioral therapy (CBT) – a form of psychotherapy.

Some techniques that may help reduce symptoms include stress reduction and trying to develop better sleep habits. Keeping to a regular sleep schedule can help those with CFS to obtain significant amounts of sleep. It is also necessary to avoid overexertion. About 90 percent of children will recover. With adults, the symptoms are often worse in the beginning, and then tend to gradually taper off.

Prevention & Prophylaxis

Since the cause is unknown, it is not known how to prevent CFS. Researchers are testing the use of some medications to help with sleep issues. It is believed that CFS may somehow be caused by the interaction between the nervous system and the immune system.

Research is ongoing to try and find out the cause and a cure as well as medications to help provide relief. Chronic fatigue syndrome continues to be debated among doctors which limits funding for research.