Chronic fatigue syndrome (CFS), also referred to as myalgic encephalomyelitis (ME) , is a complex, chronic illness that affects about 3 to 1000 people out of 100,000. Women are two to four times more likely than men to be diagnosed with CFS.

Chronic fatigue syndrome 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. People with ME/CFS experience a range of symptoms that makes it hard to do the daily tasks that most of us do without thinking — like dressing or bathing.

What causes CFS?

No one knows for sure what causes CFS. Many people say it started after a flu-like illness or other infection, such as a cold or tummy upset. It also can follow infection with the Epstein-Barr virus (the virus that causes infectious mononucleosis). Some people with CFS report that it started after a time of great physical stress, such as following surgery or bereavement. It may also be associated with autoimmune conditions.

What are the symptoms of CFS?

Symptoms affect different parts of the body and comprise unrefreshing sleep, weakness, muscle and joint pain, problems with concentration or memory, and headaches. Symptoms may be mild to severe. They may come and go, or they may last for years. They also can happen gradually or come on suddenly. At first, one may feel like she has the flu.

Chronic fatigue syndrome has eight official signs and symptoms, plus the central symptom that gives the condition its name:

Fatigue: feeling extremely exhausted for more than 24 hours after physical or mental exercise

Not feeling refreshed even after sleeping, or having trouble sleeping

Problems with attention and memory and concentration

Feeling dizzy or faint when sitting up or standing (due to a drop in blood pressure)

Unexplained muscle pain or aches

Migratory Pain or aches in joints without swelling or redness

Headaches of a new type, pattern, or intensity

Tender lymph nodes in the neck or under the arm

Sore throat that is constant or goes and comes back often


Less-common symptoms of CFS may be:


Visual problems (blurring, sensitivity to light, eye pain)

Psychological symptoms (irritability, mood swings, panic attacks, anxiety)

Chills and night sweats

Low grade fever or low body temperature

Irritable bowel causing frequent alternating diarrhoea or constipation

Allergies and sensitivities to foods, odours, chemicals, medications, and sound

Numbness, tingling, or burning sensations in the face, hands, or feet

Symptoms of CFS vary widely from person to person and may be serious or mild. Most symptoms are invisible to others, which can make it hard for friends, family members, and the public to appreciate the difficulties a person with CFS faces.

How is  CFS diagnosed?

Because many symptoms of CFS are also symptoms of other illnesses or side effects of medicine, your doctor will need to do physical exams and tests to help determine if you have CFS.

There’s no single test to confirm a diagnosis of chronic fatigue syndrome. Because the symptoms of chronic fatigue syndrome can mimic so many other health problems, you may need patience while waiting for a diagnosis.

Your doctor must rule out a number of other illnesses before diagnosing chronic fatigue syndrome. These may include:

Sleep disorders. Chronic fatigue can be caused by sleep disorders. A sleep study can determine if your rest is being disturbed by disorders such as obstructive sleep apnea, restless legs syndrome or insomnia.

Medical problems. Fatigue is a common symptom in several medical conditions, such as anemia, diabetes and underactive thyroid (hypothyroidism).

Mental health issues. Fatigue is also a symptom of a variety of mental health problems, such as depression, anxiety, bipolar disorder and schizophrenia. A counsellor can help determine if one of these problems is causing your fatigue.

Lab tests:  Based on your symptoms, such as urine and blood tests, to determine if  something other than CFS might be causing your symptoms.

Order tests that check for problems found in people with CFS like autoimmune conditions.

Classify you as having ME/CFS if:

To meet the diagnostic criteria of chronic fatigue syndrome, you must have unexplained, persistent fatigue for six months or more(3 months or longer for children and adolescents) , along with at least four of the main signs and symptoms:


You and your doctor cannot find another explanation for your symptoms.

The process to make a final diagnosis of ME/CFS can take a long time, so try to be patient. It is usually best to develop a relationship – and follow up often – with one doctor so that he or she can get to know you and see how you respond to treatment over time. If you feel your doctor has doubts about it being a “real” illness, you may need to educate your doctor. If disbelief or doubts continue, consider seeing another doctor for a second opinion.

Treatment for chronic fatigue syndrome focuses on symptom relief.


Symptom relief may include certain medications:

Antidepressants. Many people who have chronic fatigue syndrome are also depressed. Treating depression can make it easier for you to cope with the problems associated with chronic fatigue syndrome. Low doses of some antidepressants also can help improve sleep and relieve pain.

Sleeping pills. Measures to help you sleep better may be needed and if not successful, your doctor might suggest trying prescription sleep aids.

Graded exercise:  A physiotherapist can help determine what types of exercise are best for you. Inactive people often begin with range-of-motion and stretching exercises for just a few minutes a day. Don’t exercise till you are exhausted. Build your strength and endurance gradually.

Psychological counselling. Talking with a counsellor can help you figure out options to work around some of the limitations that chronic fatigue syndrome imposes on you. Feeling more in control of your life can improve your outlook dramatically. The most effective treatment for chronic fatigue syndrome combines psychological counselling with a gentle exercise program.