What is chronic fatigue syndrome?
Chronic fatigue syndrome is a chronic illness characterized by symptoms such as severe fatigue, difficulty thinking clearly, and pain. Although CFS is estimated to be fairly common (some sources suggest it affects 1 in 100 people), many individuals remain undiagnosed due to the condition’s unclear cause, varying symptoms, and inadequate treatments.[1][2]
What are the main signs and symptoms of chronic fatigue syndrome?
The symptoms of CFS can be unpredictable, and may improve or get worse over time. Common symptoms include:[3]
- Severe fatigue that doesn’t improve with rest
- Sleep disturbances
- Difficulty thinking/concentrating
- Pain
- Dizziness (especially after standing up)
- Gastrointestinal discomfort
- Postexertional malaise (i.e., The worsening of symptoms following relatively small amounts of physical or mental effort.)
How is chronic fatigue syndrome diagnosed?
There are no definitive diagnostic tests for CFS, so diagnosis is mainly centered on identifying the characteristic signs and symptoms after ruling out other possible conditions (e.g., hypothyroidism, anemia, lupus erythematosus, cancer).[1]
What are some of the main medical treatments for chronic fatigue syndrome?
There are no medical treatments that target CFS directly; they focus exclusively on managing symptoms. Not all symptoms have good treatment options (e.g., postexertional malaise), but there are medications for sleep issues (e.g., trazodone, benzodiazepines, antihistamines like Benadryl), cognitive issues (e.g., stimulants), and pain (e.g., nonsteroidal anti-inflammatory drugs, muscle relaxants, cannabis).[1]
Have any supplements been studied for chronic fatigue syndrome?
There are many supplements that are mechanistically compelling for CFS, but there’s very little high-quality research on this subject. Currently, the most promising supplements include magnesium, l-carnitine, and s-Adenosyl Methionine. Some supplements, such as probiotics, dark chocolate, and NADH, may improve symptoms of CFS (notably fatigue), but aren’t likely to improve the condition itself.[4]
How could diet affect chronic fatigue syndrome?
If individuals experience gastrointestinal discomfort, it is recommended that they avoid ultraprocessed food (although there isn’t much evidence to directly tie ultraprocessed foods to CFS) and experiment with removing potentially problematic foods (e.g., caffeine, alcohol, spicy foods, dairy, gluten).[1]
Are there any other treatments for chronic fatigue syndrome?
Because mental and physical effort can worsen symptoms, it’s important for people with CFS to pace themselves. Ideally, individuals should aim to estimate their energy levels/tolerance for certain activities, and plan out their days to avoid overexertion.[1][2]
There are many symptom-oriented options for CFS, although the degree to which they help individuals may vary. Such options include meditation/mindfulness, light therapy, behavioral changes (e.g., memory aids), physical therapy, massage, acupuncture, and neurofeedback.[1]
What causes chronic fatigue syndrome?
The cause of CFS is still very much debated. Currently, the prevailing attitude is that CFS is fundamentally a neurological condition — individuals with CFS show subtle but distinct changes to cognition (e.g., slower information processing, reduced working memory, and poor learning). That said, CFS still lacks characteristic signs (neurological, immunological, or otherwise).[2]
Examine Database: Myalgic Encephalomyelitis (Chronic Fatigue Syndrome)
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In this meta-analysis of randomized controlled trials, traditional Chinese mind-body exercise improved fatigue, anxiety, depression, sleep quality, and mental quality of life among adults with chronic fatigue syndrome.
Frequently asked questions
Chronic fatigue syndrome is a chronic illness characterized by symptoms such as severe fatigue, difficulty thinking clearly, and pain. Although CFS is estimated to be fairly common (some sources suggest it affects 1 in 100 people), many individuals remain undiagnosed due to the condition’s unclear cause, varying symptoms, and inadequate treatments.[1][2]
The symptoms of CFS can be unpredictable, and may improve or get worse over time. Common symptoms include:[3]
- Severe fatigue that doesn’t improve with rest
- Sleep disturbances
- Difficulty thinking/concentrating
- Pain
- Dizziness (especially after standing up)
- Gastrointestinal discomfort
- Postexertional malaise (i.e., The worsening of symptoms following relatively small amounts of physical or mental effort.)
The magnitude and duration of one’s fatigue, and the degree to which fatigue impairs daily activities will help distinguish CFS from ordinary fatigue. According to the criteria set by the Institute of Medicine (IOM) in 2015, one’s fatigue must feel profound, last for more than six months, and significantly reduce one’s ability to engage in daily activities compared to before symptoms began. Additionally, symptoms like extreme fatigue following exercise and the inability to get restful sleep are more characteristic of CFS than regular fatigue.
There are no definitive diagnostic tests for CFS, so diagnosis is mainly centered on identifying the characteristic signs and symptoms after ruling out other possible conditions (e.g., hypothyroidism, anemia, lupus erythematosus, cancer).[1]
While CFS is often a condition associated with adults, younger children and adolescents can also get CFS, and it is estimated that around 2 in 1,000 children may suffer from CFS.[6] Many of the signs and symptoms of CFS in children are the same as those in adults. Unfortunately, very little is known about CFS in children due to a lack of scientific research.
There are no medical treatments that target CFS directly; they focus exclusively on managing symptoms. Not all symptoms have good treatment options (e.g., postexertional malaise), but there are medications for sleep issues (e.g., trazodone, benzodiazepines, antihistamines like Benadryl), cognitive issues (e.g., stimulants), and pain (e.g., nonsteroidal anti-inflammatory drugs, muscle relaxants, cannabis).[1]
There are many supplements that are mechanistically compelling for CFS, but there’s very little high-quality research on this subject. Currently, the most promising supplements include magnesium, l-carnitine, and s-Adenosyl Methionine. Some supplements, such as probiotics, dark chocolate, and NADH, may improve symptoms of CFS (notably fatigue), but aren’t likely to improve the condition itself.[4]
If individuals experience gastrointestinal discomfort, it is recommended that they avoid ultraprocessed food (although there isn’t much evidence to directly tie ultraprocessed foods to CFS) and experiment with removing potentially problematic foods (e.g., caffeine, alcohol, spicy foods, dairy, gluten).[1]
Because mental and physical effort can worsen symptoms, it’s important for people with CFS to pace themselves. Ideally, individuals should aim to estimate their energy levels/tolerance for certain activities, and plan out their days to avoid overexertion.[1][2]
There are many symptom-oriented options for CFS, although the degree to which they help individuals may vary. Such options include meditation/mindfulness, light therapy, behavioral changes (e.g., memory aids), physical therapy, massage, acupuncture, and neurofeedback.[1]
For many CFS patients, common activities of daily living like cleaning, taking a shower, and yard work can be extremely difficult and need to be broken down into short bouts of activity. Exercise programs that are recommended for healthy people are not well-tolerated by individuals with CFS. However, some evidence suggests that patients with CFS may see improvements in sleep, physical function, and general health after engaging in an exercise treatment program.[7] It is recommended that CFS patients “listen to their bodies” regarding physical activity and use an individualized, flexible, and careful approach to any exercise program.[8]
The cause of CFS is still very much debated. Currently, the prevailing attitude is that CFS is fundamentally a neurological condition — individuals with CFS show subtle but distinct changes to cognition (e.g., slower information processing, reduced working memory, and poor learning). That said, CFS still lacks characteristic signs (neurological, immunological, or otherwise).[2]
It is not uncommon for several members of the same family to be diagnosed with CFS. [5] Therefore, genetic factors probably contribute to the risk of CFS, but studies have not consistently identified one single gene or gene variant that increases the risk for CFS. In other words, CFS, like many conditions, is a multifactorial disorder in which many genetic and environmental risk factors are involved.
References
- ^Bateman L, Bested AC, Bonilla HF, Chheda BV, Chu L, Curtin JM, Dempsey TT, Dimmock ME, Dowell TG, Felsenstein D, Kaufman DL, Klimas NG, Komaroff AL, Lapp CW, Levine SM, Montoya JG, Natelson BH, Peterson DL, Podell RN, Rey IR, Ruhoy IS, Vera-Nunez MA, Yellman BPMyalgic Encephalomyelitis/Chronic Fatigue Syndrome: Essentials of Diagnosis and Management.Mayo Clin Proc.(2021-11)
- ^Sandler CX, Lloyd ARChronic fatigue syndrome: progress and possibilities.Med J Aust.(2020-05)
- ^MedlinePlusChronic Fatigue Syndrome
- ^Geir Bjørklund, Maryam Dadar, Joeri J Pen, Salvatore Chirumbolo, Jan AasethChronic fatigue syndrome (CFS): Suggestions for a nutritional treatment in the therapeutic approachBiomed Pharmacother.(2019 Jan)
- ^Dibble JJ, McGrath SJ, Ponting CPGenetic risk factors of ME/CFS: a critical review.Hum Mol Genet.(2020-09-30)
- ^CDCME/CFS in Children
- ^Larun L, Brurberg KG, Odgaard-Jensen J, Price JRExercise therapy for chronic fatigue syndrome.Cochrane Database Syst Rev.(2017-04-25)
- ^CDCTreating the Most Disruptive Symptoms First and Preventing Worsening of Symptoms
Examine Database References
- Insomnia Signs and Symptoms - Won-Suk Sung, Ha-Ra Kang, Chan-Yung Jung, Seong-Sik Park, Seung-Ho Lee, Eun-Jung KimEfficacy of Korean red ginseng (Panax ginseng) for middle-aged and moderate level of chronic fatigue patients: A randomized, double-blind, placebo-controlled trialComplement Ther Med.(2020 Jan)
- Depression Symptoms - Ross SMRhodiola rosea (SHR-5), Part I: a proprietary root extract of Rhodiola rosea is found to be effective in the treatment of stress-related fatigueHolist Nurs Pract.(2014 Mar-Apr)
- Fatigue Symptoms - Lekomtseva Y, Zhukova I, Wacker ARhodiola rosea in Subjects with Prolonged or Chronic Fatigue Symptoms: Results of an Open-Label Clinical TrialComplement Med Res.(2017)
- Depression Symptoms - Sanoobar M, Dehghan P, Khalili M, Azimi A, Seifar FCoenzyme Q10 as a treatment for fatigue and depression in multiple sclerosis patients: A double blind randomized clinical trialNutr Neurosci.(2016)
- Depression Symptoms - Warren G, McKendrick M, Peet MThe role of essential fatty acids in chronic fatigue syndrome. A case-controlled study of red-cell membrane essential fatty acids (EFA) and a placebo-controlled treatment study with high dose of EFAActa Neurol Scand.(1999 Feb)
- Fatigue Symptoms - Jacob E Teitelbaum, Clarence Johnson, John St CyrThe use of D-ribose in chronic fatigue syndrome and fibromyalgia: a pilot studyJ Altern Complement Med.(2006 Nov)
- Fatigue Symptoms - Sugino T, Aoyagi S, Shirai T, Kajimoto Y, Kajimoto OEffects of Citric Acid and l-Carnitine on Physical FatigueJ Clin Biochem Nutr.(2007 Nov)
- Fatigue Symptoms - Vermeulen RC, Scholte HRExploratory open label, randomized study of acetyl- and propionylcarnitine in chronic fatigue syndromePsychosom Med.(2004 Mar-Apr)
- Fatigue Symptoms - Malaguarnera M, Cammalleri L, Gargante MP, Vacante M, Colonna V, Motta ML-Carnitine treatment reduces severity of physical and mental fatigue and increases cognitive functions in centenarians: a randomized and controlled clinical trialAm J Clin Nutr.(2007 Dec)
- Fatigue Symptoms - Baicus C, Baicus ASpirulina did not ameliorate idiopathic chronic fatigue in four N-of-1 randomized controlled trialsPhytother Res.(2007 Jun)