by Rick Alan
Chronic fatigue syndrome (CFS) is a complex condition that causes chronic, debilitating fatigue that is not relieved by bed rest or explained by any other medical condition. People who have CFS perform at a significantly lower level compared to their activity prior to the onset of the illness.
The exact cause of CFS is unknown. Some theories have associated the development of CFS with an infection, though a specific infectious agent has not been identified. Other research has suggested possible associations with abnormalities in the immune, endocrine, and/or nervous systems. CFS may be associated with a single trigger that has yet to be identified or it may be related to a combination of factors. More research may help find causes or triggers.
CFS is more common in women than men. Although CFS can happen at any age, it is generally seen in adults aged 25-55 years old. Other factors that may increase your chance of CFS include:
Symptoms vary from person to person. They may include:
You will be asked about your symptoms and medical history. A physical exam will be done. There are no specific diagnostic tests for CFS. Your doctor may do several other tests to rule out other conditions that can have similar symptoms. Blood, urine, and imaging tests generally appear normal, even when symptoms are present.
CFS diagnosis is a process of elimination. It may take a long time for CFS to be diagnosed. CFS may be diagnosed if there are no signs of other medical conditions, tests reveal nothing out of the ordinary, and the following criteria exist:
There is no cure for CFS, but its symptoms can be managed with the goal of improving the quality of life. Some treatments will work better for some than others. A combination of approaches may also be most effective.
If you have CFS, avoid overexertion and physical and emotional stress. Balancing your activities throughout the day may help you to not overexert yourself. Moderate exercise that is monitored by a doctor or physical therapist may improve symptoms. Slowly increase the duration and intensity of exercise. Light exercise and stretching 4 hours before bedtime may help with sleep.
In addition, your doctor may have you work with a physical therapist. Some therapies that might be helpful for you include:
A well-balanced diet can help prevent nutritional deficiencies and weight fluctuations. Nutritional supplements cannot make up for a poor diet. Avoid foods to which you may be sensitive.
CFS can be mentally and physically debilitating. Depression is common among people with CFS. In fact, as many as half develop depression as a consequence of CFS. Psychotherapy and supportive counseling often help those with CFS cope with the disorder. Learning relaxation training and stress management techniques, as well as changing your sleep routine, may also help.
Talk with your therapist about whether cognitive behavioral therapy (CBT) is right for you to reduce fatigue symptoms. CBT is a problem-solving therapy that helps you change the way you perceive and react to situations, especially ones beyond your control.
There are no current guidelines to prevent CFS because the cause is unknown.
Centers for Disease Control and Prevention
Solve ME/CFS Initiative
Public Health Agency of Canada
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...(Click grey area to select URL)
Updated February 2014. Accessed February 23, 2016.
Chronic fatigue syndrome. Centers for Disease Control and Prevention website. Available at:
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Updated April 7, 2015. Accessed February 23, 2016.
Chronic fatigue syndrome. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115094/Chronic-fatigue-syndrome. Updated August 1, 2016. Accessed September 29, 2016.
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3/3/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115094/Chronic-fatigue-syndrome: White P, Goldsmith K, Johnson AL, et al. Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): a randomised trial. Lancet. 2011;377(9768):823-826.
10/1/2013 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115094/Chronic-fatigue-syndrome: Patterson E, Wan YW, Sidani S. Nonpharmacological nursing interventions for the management of patient fatigue: a literature review. J Clin Nurs. 2013;22(19-20):2668-2678.
Last reviewed December 2015 by Marcin Chwistek, MD
Last Updated: 2/23/2016
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