Chronic fatigue syndrome (CFS) is a complicated disorder characterized by extreme fatigue that can't be explained by any underlying medical condition. The fatigue may worsen with physical or mental activity, but doesn't improve with rest.
This condition is also known as systemic exertion intolerance disease (SEID) or myalgic encephalomyelitis (ME). Sometimes it's abbreviated as ME/CFS.
The cause of chronic fatigue syndrome is unknown, although there are many theories — ranging from viral infections to psychological stress. Some experts believe chronic fatigue syndrome might be triggered by a combination of factors.
There's no single test to confirm a diagnosis of chronic fatigue syndrome. You may need a variety of medical tests to rule out other health problems that have similar symptoms. Treatment for chronic fatigue syndrome focuses on symptom relief.
Signs and symptoms may include:
- Loss of memory or concentration
- Sore throat
- Enlarged lymph nodes in your neck or armpits
- Unexplained muscle or joint pain
- Unrefreshing sleep
- Extreme exhaustion lasting more than 24 hours after physical or mental exercise
When to see a doctor
Fatigue can be a symptom of many illnesses, such as infections or psychological disorders. In general, see your doctor if you have persistent or excessive fatigue.
People who have chronic fatigue syndrome appear to be hypersensitive to even normal amounts of exercise and activity.
Why this occurs in some people and not others is still unknown. Some people may be born with a predisposition for the disorder, which is then triggered by a combination of factors. Potential triggers include:
- Viral infections. Because some people develop chronic fatigue syndrome after having a viral infection, researchers question whether some viruses might trigger the disorder. Suspicious viruses include Epstein-Barr virus, human herpes virus 6 and mouse leukemia viruses. No conclusive link has yet been found.
- Immune system problems. The immune systems of people who have chronic fatigue syndrome appear to be impaired slightly, but it's unclear if this impairment is enough to actually cause the disorder
- Hormonal imbalances. People who have chronic fatigue syndrome also sometimes experience abnormal blood levels of hormones produced in the hypothalamus, pituitary glands or adrenal glands. But the significance of these abnormalities is still unknown.
Factors that may increase your risk of chronic fatigue syndrome include:
- Age. Chronic fatigue syndrome can occur at any age, but it most commonly affects people in their 40s and 50s.
- Sex. Women are diagnosed with chronic fatigue syndrome much more often than men, but it may be that women are simply more likely to report their symptoms to a doctor.
- Stress. Difficulty managing stress may contribute to the development of chronic fatigue syndrome.
Possible complications of chronic fatigue syndrome include:
- Social isolation
- Lifestyle restrictions
- Increased work absences
Oct. 05, 2017
- Goldman L, et al., eds. Fibromyalgia, chronic fatigue syndrome and myofascial pain. In: Goldman-Cecil Medicine. 25th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. https://www.clinicalkey.com. Accessed June 6, 2017.
- Gluckman SJ. Clinical features and diagnosis of systemic exertion intolerance disease (chronic fatigue syndrome). https://www.uptodate.com/contents/search. Accessed June 6, 2017.
- Ferri FF. Chronic fatigue syndrome. In: Ferri's Clinical Advisor 2018. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Accessed June 6, 2017.
- Gluckman SJ. Treatment of systemic exertion intolerance disease (chronic fatigue syndrome). https://www.uptodate.com/contents/search. Accessed June 6, 2017.
- AskMayoExpert. Chronic fatigue syndrome. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015.
- Bennett JE, et al., eds. Chronic fatigue syndrome. In: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2015. https://www.clinicalkey.com. Accessed June 7, 2017.
- Institute of Medicine. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness. Washington, D.C.: The National Academies Press; 2015. http://www.nationalacademies.org/hmd/Reports/2015/ME-CFS.aspx. Accessed June 7, 2017.
- Chronic fatigue syndrome (CFS): General information. Centers for Disease Control and Prevention. https://www.cdc.gov/cfs/general/index.html. Accessed June 7, 2017.
- Larun L, et al. Exercise therapy for chronic fatigue syndrome. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003200.pub7/full. Accessed June 7, 2017.
- Chronic fatigue syndrome. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed June 8, 2017.
- Fleming KC (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 4, 2017.
- Staud R, et al. Evidence for sensitized fatigue pathways in patients with chronic fatigue syndrome. Pain. 2015;156:750.