Chronic fatigue syndrome
Chronic fatigue syndrome (CFS) refers to severe, continued tiredness (fatigue). It does not get better with rest and is not directly caused by other medical problems.
CFS; Fatigue - chronic; Immune dysfunction syndrome; Myalgic encephalomyelitis (ME); Myalgic encephalopathy chronic fatigue syndrome (ME-CFS); Systemic exertion intolerance disease (SEID)
The exact cause of chronic fatigue syndrome (CFS) is unknown. It may be due to:
The following may also play a role in the development of CFS:
CFS is most common in women ages 30 to 50.
The hallmark symptom is persistent and profound fatigue, which often worsens after physical or mental exertion.
Symptoms may also include muscle aches, headache, and extreme fatigue.
The main symptom of CFS is extreme tiredness that is:
Other symptoms include:
Exams and Tests
The Centers for Disease Control (CDC) describes CFS as a distinct disorder with specific symptoms and physical signs. Diagnosis is based on ruling out other possible causes.
Your health care provider will try to rule out other possible causes of fatigue, including:
A diagnosis of CFS must include:
There are no specific tests to confirm the diagnosis of CFS. However, there have been reports of people with CFS having abnormal results on the following tests:
There is currently no cure for CFS. The goal of treatment is to relieve symptoms.
Treatment includes a combination of the following:
Some drugs can cause reactions or side effects that are worse than the original symptoms of the disease.
People with CFS are encouraged to maintain an active social life. Mild physical exercise may also be helpful. Your health care team will help you figure out how much activity you can do, and how to slowly increase your activity. Tips include:
Relaxation and stress-reduction techniques can help manage chronic (long-term) pain and fatigue. They are not used as the primary treatment for CFS. Relaxation techniques include:
It also may be helpful to work with a therapist to help you deal with your feelings and the impact of the illness on your life.
Newer medicine approaches are being researched.
Some people may benefit from taking part in a CFS support group.
The long-term outlook for people with CFS varies. It is hard to predict when symptoms first start. Some people completely recover after 6 months to a year.
About 1 in 4 people with CFS are so severely disabled that they cannot get out of bed or leave their home. Symptoms can come and go in cycles, and even when people feel better, they may experience a relapse triggered by exertion or an unknown cause.
Some people never feel like they did before they developed CFS. Studies suggest that you are more likely to get better if you receive extensive rehabilitation.
Complications may include:
When to Contact a Medical Professional
Call your provider if you have severe fatigue, with or without other symptoms of this disorder. Other more serious disorders can cause similar symptoms and should be ruled out.
Bennett RM. Fibromyalgia, chronic fatigue syndrome, and myofascial pain. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 274.
Centers for Disease Control and Prevention website. Myalgic encephalomyelitis/chronic fatigue syndrome: Treatment. www.cdc.gov/me-cfs/treatment/index.html. Updated July 3, 2017. Accessed September 29, 2017.
Engleberg NC. Chronic fatigue syndrome. In: Bennett JE, ed. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition. 8th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2015:chap 133.
IOM (Institute of Medicine). Beyond myalgic encephalomyelitis/chronic fatigue syndrome: redefining an illness. Washington, DC: The National Academies Press; 2015. www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2015/MECFS/MECFS_ReportBrief.pdf. Accessed April 20, 2016.
Nijs J, Roussel N, Van Oosterwijck J, et al. Fear of movement and avoidance behaviour toward physical activity in chronic-fatigue syndrome and fibromyalgia: state of the art and implications for clinical practice. Clin Rheumatol. 2013;32(8):1121-1129. PMID: 23639990 www.ncbi.nlm.nih.gov/pubmed/23639990.
Santhouse AM, Hotopf M, David AS. Chronic fatigue syndrome. BMJ. 2010;340:c738. PMID: 20150199 www.ncbi.nlm.nih.gov/pubmed/20150199.
Smith ME, Haney E, McDonagh M, et al. Treatment of myalgic encephalomyelitis/chronic fatigue syndrome: a systematic review for a National Institutes of Health Pathways to Prevention Workshop. Ann Intern Med. 2015;162:841. PMID: 26075755 www.ncbi.nlm.nih.gov/pubmed/26075755.
Review Date: 1/16/2016
Reviewed By: Gordon A. Starkebaum, MD, Professor of Medicine, Division of Rheumatology, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Editorial update 09/29/2017.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.