Updated at: 29-03-2022 - By: Jane

Myalgic encephalomyelitis (ME/CFS) is a long-term illness with substantial potential for debilitation. Chronic fatigue syndrome is defined as a long-term exhaustion that inhibits a person from engaging in their typical activities. Estimates range from 0.5 percent to 1 percent of adults fit the criteria for the disorder.

Chronic fatigue syndrome is more common in women than in males. People of various ages, including children and adolescents, can be affected by ME/CFS, but the majority of sufferers are between the ages of 40 and 60. In the United States, white individuals are more likely to be diagnosed with ME/CFS than patients of any other ethnicity or race. 90% of persons with ME/CFS go undiagnosed, and this is a particular problem for people of color in the United States.

ME/CFS is still a mystery to experts, therefore they continue to look for plausible causes and therapies. Chronic fatigue syndrome and coronavirus illness may be linked, according to researchers (COVID-19). According to early findings from the CDC, COVID-19 may prolong an already-prolonged disease. Fatigue is one of the most common and lasting side effects of this long-term illness. To determine if COVID-19 is the cause of ME/CFS, more research is required.

What Is Fatigue?

An adequate amount of sleep will often restore your energy levels when you’re feeling run down. Fatigue, on the other hand, is a state of chronic exhaustion and low energy that does not go away with sleep. Approximately half of the population suffers with weariness at some point in their lives. Stress, sleep deprivation and physical exercise all contribute to fatigue. In some cases, though, exhaustion might be a sign of a more serious health issue.

The 7 Types of Fatigue which lead to Chronic Fatigue and ME - Kim Knight Health

Fatigue can be categorized into one of three types, according to experts.

  • Acute Fatigue is defined as fatigue that lasts for less than a month.
  • Persistent Illness: lasting more than a month but no longer than six months
  • Fatigue that persists for more than six months is referred to as chronic fatigue syndrome.

Chronic fatigue is commonly caused by ME/CFS.

What Is Chronic Fatigue Syndrome?

For more than six months, people with chronic fatigue syndrome suffer from persistent exhaustion that does not improve with rest. In other cases, they are confined to bed due to an abnormal lack of energy. Because of their extreme exhaustion, patients with ME/CFS are forced to cut back on their normal activities by half. Every aspect of daily living can be negatively affected by the disease, from taking a shower to keeping a job.

For some persons with ME/CFS, physical and mental activities might exacerbate the exhaustion, even if these activities were previously unproblematic. Post-exertional malaise is the medical word for what you’re feeling (PEM). “Crash” and “relapse” are terms used by those with ME/CFS to describe the growing tiredness.

Effects of chronic fatigue syndrome

ME/CFS can produce a wide range of disabilities in different persons, depending on the severity of their illness. ME/CFS can be mild, moderate, or severe, much like any other chronic condition.

  • Mild – at least a 50% reduction in the individual’s activity level.
  • moderate – the individual is confined to their home
  • The person is bed-bound and completely reliant on others for all of their daily needs.

They may not be able to work, attend school, or socialize because of their ME/CFS. Many people find themselves in financial trouble. Some in the ME/CFS community mistakenly believe that a person’s condition is “in their head” or that they should “just push through” because they are “just being tired”. A person who has this misconception may end up pushing themselves to the limit, leading to relapses and further aggravating their disease.

Chronic fatigue syndrome and exercise

People with ME/CFS respond differently to physical exertion. Physical activity might exacerbate the symptoms of some people, making it difficult for them to exercise. People with ME/CFS are divided over whether or not they should engage in regular exercise.

Athletes who suffer from ME/CFS must learn to pace themselves in order to avoid the post-exertional malaise that is common to many other chronic illnesses. It’s critical that patients work with their doctors to develop a weekly schedule tailored to their specific needs, one that emphasizes getting as much exercise as possible without their symptoms getting worse over the course of the week.

There should never be any pressure put on someone who has ME/CFS to push themselves past their limits, as this might lead to long-term relapse. Maintaining a healthy activity-rest ratio is critical to preventing fitness decline from inactivity and sickness flare-ups from overexertion.

Slowly and gradually, some persons with ME/CFS may find that they can do more and more as time passes and their health improves.

It is critical to begin any new activity plan carefully and gradually increase its intensity. People with ME/CFS may be able to stretch for only a few minutes at the beginning of a new exercise regimen.

Chronic Fatigue Syndrome Symptoms

Prior to being diagnosed with ME/CFS, most persons were able to function at a typical level. The onset of ME/CFS is frequently sudden, and it might occur as a result of a traumatic medical or psychological experience.

Those who suffer from ME/CFS commonly experience the following main signs and symptoms:

  • Extreme exhaustion that does not go away even after rest. Reduced capacity to carry out everyday tasks is a side effect of this exhaustion.
  • Increased exhaustion following mental or physical exertion.
  • Problems with sleep, such as inability to fall or stay asleep.

ME/CFS patients may also have one or more of the following symptoms:

  • Memory, thinking, or concentration problems. For those who suffer from Alzheimer’s, memory loss and “brain fog” are common symptoms.
  • When standing or sitting up, the symptoms worsen. Standing or sitting upright might cause dizziness, lightheadedness, and weakness.

Additional signs and symptoms to watch out for include the following:

  • Muscle aches and pains
  • A bad case of strep throat.
  • Lymph nodes that are a little painful.
  • Horrible headaches, either new or worsening
  • Flu-like symptoms and excessive perspiration at night
  • Intolerance or sensitivity to foods, smells, noise, or light
  • Even if the symptoms intensify, depression

Chronic Fatigue Syndrome Symptoms in Children and Adolescents

As with adults, children have a few exceptions when it comes to ME/CFS symptoms.

  • Diarrhea and vertigo are more common when standing. In children and teenagers, this symptom is the worst and exacerbates other symptoms. It is also known as orthostatic intolerance.
  • Headaches and stomach aches are both present. As a result, youngsters report more headaches and stomach troubles than they did before.
  • Problems falling or staying asleep. Vivid dreams, daytime drowsiness, and insomnia are among the symptoms.

Causes of Chronic Fatigue Syndrome

The origin of ME/CFS remains a mystery, in contrast to the vast majority of fatigue, which can be traced back to anything like insomnia, depression, or even cancer.

What causes chronic fatigue? What we know, don't know and suspect

The following plausible causes have been suggested by researchers:

  • Infection. ME/CFS is often described by patients as having started as a viral illness. Epstein-Barr virus, Ross River virus, or Coxiella burnetti are all possibilities as causes (Q fever). A definitive link between infections and ME/CFS has yet to be established. Infections such as these are not unique to ME/CFS.
  • Genetics. According to recent research, family members of individuals with ME/CFS are more likely to contract the illness themselves. Several other research have shown genetic markers that are associated with ME/CFS as well.
  • Emotional strain on the body. Stress hormone cortisol is less prevalent in patients with ME/CFS than in the general population. ME/CFS sufferers tend to have reduced cortisol levels compared to healthy individuals, however these levels are normally within the acceptable range. As a result, a cortisol test cannot be used to confirm the diagnosis of ME/CFS.
  • Dysregulation of the Immune System. There have been reports of immunologic differences between those with CFS and those who don’t. There is no increased risk of infection for people with CFS.)
  • Serious sleep apnea ME/CFS has been linked to a delayed commencement of melatonin production in the presence of dim light, according to some research. This shows that ME/CFS may be exacerbated by a sluggish circadian rhythm. No evidence has been found to show that melatonin can help alleviate ME/CFS symptoms.

Risk Factors for Chronic Fatigue Syndrome

One or more of the following conditions may increase a person’s risk of acquiring the syndrome:.

  • Woman
  • Age 40 to 60
  • ME/CFS has a strong family history.
  • Caucasian

ME/CFS can’t be prevented, at least not by anything we know of.

Chronic Fatigue Syndrome Diagnosis

The diagnostic criteria for ME/CFS are constantly being revised in light of new findings in the field. Physicians have a variety of options when it comes to determining a patient’s diagnosis. However, the majority of these criteria sets need the following:

  • Fatigue
  • Post-exertional malaise (PEM), or exacerbated exhaustion following routine activities
  • An inability to get a good night’s sleep
  • Discomfort that affects the entire body (such as aches and pains in the muscles and joints)
  • Memory and focus problems are just two examples of neurological or cognitive impairment.
  • For more than six months, a symptom.

There is no way to tell if a person has chronic fatigue syndrome by a simple test. Instead, doctors gather information about a patient’s medical history, including any relevant family history. They frequently do urine and blood tests to rule out other disorders. Patients can be referred to specialists by their primary care doctors to rule out any other possible diagnoses.

There is a possibility that a patient may be identified with both ME/CFS and an extra chronic fatigue source. Complicating ME/CFS are the following:

  • Fibromyalgia
  • Myofascial pain syndrome
  • Cystitis interstitial
  • Migraines
  • Depression
  • Intolerances and sensitivities.

How is CFS treated?

CFS has no known cure at this time.

Symptoms vary from person to person, and so does the type of treatment they need to control and alleviate their symptoms.

Create a treatment plan with the help of your healthcare team. It is possible to discuss the probable benefits and adverse effects of the therapy with them.

Addressing post-exertional malaise (PEM) symptoms

An increase in the severity of CFS symptoms happens as a response of exertion, whether it be physical, mental, or emotional.

Symptoms typically worsen 12 to 48 hours after the event and might continue for days or weeks.

Pacing, also known as activity management, can be used to avoid PEM flare-ups. Find out what you can and can’t do in terms of both mental and physical activity and plan accordingly.

The term “energy envelope” is used by some clinicians to describe the concept of remaining within these parameters. Personal boundaries can be discovered by keeping a diary of your daily routine.

Despite the fact that rigorous aerobic exercise is beneficial for the majority of chronic diseases, people with CFS are unable to perform them.

Home remedies and lifestyle changes

Your symptoms may improve if you make some lifestyle adjustments.

Insomnia might be made easier by reducing or eliminating your caffeine usage. Nicotine and alcohol consumption should be restricted or avoided as well.

If you’re having trouble sleeping at night, try to limit your naps throughout the day.

Set a bedtime routine. Set a consistent bedtime and wakeup time for yourself each day.


All of your symptoms may not be addressed by one drug. In addition, your symptoms and, therefore, your prescriptions, may evolve with time.

Chronic fatigue syndrome (CFS) is frequently linked to or a symptom of depression. A mental health professional or low-dose antidepressant therapy may be necessary for you.

Medications may be used if lifestyle adjustments fail to improve your sleep quality. CFS-related aches and pains might be alleviated with the use of painkillers.

If medication is necessary, it must be adapted to your specific situation. Consult with your physician frequently. CFS is not a one-size-fits-all illness.

Alternative medicine

Massage, tai chi, yoga, and acupuncture all have the potential to alleviate some of the symptoms of CFS. Before embarking on any complementary or alternative therapies, consult with your doctor.

Pacing exercise for people with chronic fatigue syndrome

A good way to avoid overdoing it on your workouts and other forms of physical activity is to pace yourself. The following are some pointers for managing your pace:

  • Determine your maximum weekly exercise level without experiencing any undesirable side effects or post-exertional malaise. An activity pedometer for people with less severe ME/CFS may be useful in determining how much physical activity you engage in on a given day. Using a heart rate monitor will assist you in determining your level of effort.
  • As you gain confidence in your ability to do more, start by doing less than you think you can.
  • As long as you’re able to keep up your current level of activity, you should do so until you’ve built up sufficient energy and are completely at ease. the level of activity or exercise that can be resumed the following day without causing any flare-ups in symptoms is the ideal level (including physical, cognitive or emotional).
  • Before increasing your activities, make sure that you have the reserve necessary to do so without experiencing a flare-up of your symptoms. It’s up to you and your body’s response to symptoms to determine where your limitations lie. Encouragement to “push yourself” may sound encouraging at first, but if they encourage you to go beyond your comfort zone, it can be harmful.
  • Maintaining a steady level of activity or exercise until you can increase it without risking injury is a good strategy. Eventually, you may reach a point where you should stop. For some, the degree of activity they are currently engaged in is all they can handle.
  • Balance physical, mental, and emotional activity by dividing it into short periods of time, followed by periods of relaxation. Keep in mind that your emotions will drain your energy supply. It’s best to avoid following rigid exercise or fitness regimens and instead find a way to incorporate activities that are specific to your abilities. Sitting up for a few minutes at a time may be enough for some people.
  • If you’ve overdone it on the activity or exercise front, or if you’ve had a relapse, take it easy and get extra rest. It’s possible to have a long-lasting and severe relapse if you repeatedly overdo it, resulting in a worsening of many ME/CFS symptoms.

General exercise tips for people with chronic fatigue syndrome

However, here are some broad guidelines for your doctor or specialist’s advice:

  • Find out what form of exercise works best for you by experimenting. Stretching, yoga, tai chi, strolling, and moderate weight training are all examples of mild activities that may be done at any level.
  • Maintain an activity diary to keep track of your performance levels and other factors that may affect your symptoms in the long run.
  • Prevent any symptom flare-ups by ceasing physical activity as soon as you notice any. Setting a reasonable pace for oneself is essential.
  • It’s important to keep in mind that your physical capacity will fluctuate from day to day.
  • Let your body lead the way; if you don’t feel like working out, don’t.
  • Learn everything you can about ME/CFS. Don’t be afraid to seek help from medical specialists who are knowledgeable with ME/CFS as a real biological illness.

Support for people with chronic fatigue syndrome

ME/CFS patients have an aberrant physiologic response to physical exertion, and this must be taken into consideration while providing support and therapy.

Chronic fatigue syndrome: Changes in brain chemistry found

With a greater understanding of ME/CFS, sufferers can better cope with their condition and maintain a positive approach. Learn all you can about ME/CFS. ME/CFS is a condition that can be diagnosed and treated with the help of your doctor, a professional in the field of physical therapy, or a ME/CFS support group.

Among the many resources at your disposal are the following:

  • Research, support, and advocacy
  • Continuing education classes for the general public and for professionals.
  • Self-management classes for persons in need of early intervention (face to face, or via telephone for people in rural areas or people who are housebound)
  • Information on ME/CFS-focused medical professionals
  • Young people’s support services are among the many programs available to individuals in need.

Talk to Your Doctor About Chronic Fatigue Syndrome

Consult your doctor if you feel you have ME/CFS. Keeping a health journal or activity record can assist your doctor better understand your condition. Other possible causes of your exhaustion might be ruled out with the help of your doctor. You and your doctor can then devise a treatment and alleviation plan together.

What can be expected in the long term?

The specific etiology and treatment of chronic fatigue syndrome (CFS) remain a mystery, despite intensified research efforts. Only 5% of Trusted Sources can be recovered. As a result, dealing with CFS can be difficult.

Chronic fatigue may necessitate a modification in your daily routine. Withdrawal can lead to mental health issues such as depression and anxiety. As you’re making decisions and transitions, you may find it beneficial to join a support group.

Everyone’s CFS advances in a different way, so working with your doctor to develop a treatment plan that suits your needs is essential.

Working with a team of healthcare specialists is beneficial to many people. Some examples of this include doctors and therapists.

The Solve ME/CFS Initiative contains resources that may be beneficial to someone with CFS. In addition, the CDCTrusted Source includes suggestions for coping with and adjusting to life with CFS.

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