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NeurologicalICD-10: G93.32Affects an estimated 836,000 to 2.5 million Americans

Chronic Fatigue Syndrome

Also known as: CFS, Myalgic Encephalomyelitis, ME/CFS, Systemic Exertion Intolerance Disease

Chronic fatigue syndrome (ME/CFS) is a complex, debilitating disorder characterized by extreme fatigue that does not improve with rest and worsens with physical or mental exertion (post-exertional malaise). The exact cause remains unknown, and there is no single diagnostic test or cure. Management focuses on symptom relief and activity pacing to improve quality of life.

Symptoms

Severe, persistent fatigue lasting at least 6 months
Post-exertional malaise (symptom worsening after physical or mental effort)
Unrefreshing sleep despite adequate hours
Cognitive difficulties (brain fog, memory problems, difficulty concentrating)
Orthostatic intolerance (dizziness or worsening symptoms upon standing)
Muscle pain and joint pain without swelling
Headaches of a new type, pattern, or severity
Sore throat and tender lymph nodes

Causes

  • Exact cause unknown; likely multifactorial
  • Viral infections may trigger onset (EBV, HHV-6, enteroviruses)
  • Immune system dysfunction
  • Hormonal imbalances (hypothalamic-pituitary-adrenal axis)
  • Autonomic nervous system dysregulation

Risk Factors

  • Female sex (2-4 times more common in women)
  • Age between 40 and 60 (peak onset)
  • History of allergies or autoimmune conditions
  • High levels of stress or emotional trauma
  • Genetic predisposition

Diagnosis

  • Diagnosis of exclusion—ruling out other medical and psychiatric conditions
  • Criteria require fatigue for 6+ months with substantial reduction in activity
  • Must include post-exertional malaise and unrefreshing sleep
  • Blood tests, imaging, and sleep studies to exclude other causes

Treatment

  • Activity pacing and energy management (staying within energy envelope)
  • Cognitive behavioral therapy adapted for ME/CFS
  • Medications for specific symptoms (sleep aids, pain relievers, low-dose naltrexone)
  • Graded exercise therapy (controversial; gentle approaches only)
  • Treatment of co-occurring conditions (depression, sleep disorders)

Prevention

  • No proven prevention methods exist
  • Prompt treatment of infections and stress management may reduce risk
  • Adequate rest during and after illness

When to See a Doctor

  • Persistent, unexplained fatigue significantly limits your daily activities
  • You experience post-exertional malaise after minor activities
  • Cognitive difficulties and unrefreshing sleep are ongoing
  • You need help managing symptoms that don't improve with rest

Frequently Asked Questions

Related Conditions

Depression

Mental Health

Burnout Syndrome

Mental Health

Chronic Pain

Neurological

Related from the Supplement Library

CoQ10 (Ubiquinone)

Strong

Compound · Mitochondrial energy production (ATP)

Vitamin B12

Strong

Vitamin · Nervous system health and myelin formation

Magnesium Glycinate

Strong

Mineral · Improves sleep quality and onset

Rhodiola Rosea

Moderate

Adaptogen · Reduces fatigue and burnout

Iron

Strong

Mineral · Oxygen transport via hemoglobin

These supplements have been studied in relation to Chronic Fatigue Syndrome. Always consult your healthcare provider before starting any supplement, especially if you take medications.

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Medical Disclaimer: This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider.

Content reviewed against peer-reviewed medical literature and clinical guidelines. Read our editorial standards.