CFS (Chronic Fatigue Syndrome)

Written by Christine DiMaria | Published on July 18, 2012
Medically Reviewed by George Krucik, MD on July 18, 2012


Chronic fatigue syndrome (CFS) is a debilitating disorder characterized by intense fatigue that cannot be cured with sleep. Mental and physical activities may cause your symptoms to worsen. When your fatigue cannot be linked to a specific cause, your doctor might classify your condition as CFS.

Controversy Surrounding CFS

CFS is a controversial diagnosis. The medical community is still debating how best to diagnose it. However, leading health information organizations, such as the Mayo Clinic and the Centers for Disease Control and Prevention (CDC), recognize CFS as a defined clinical condition.

What Causes CFS?

The cause of CFS is unknown. Researchers speculate that viruses, hypotension, immune impairment, and hormonal problems could all be contributing factors.

Sometimes, CFS develops after a viral infection. Viruses that might possibly be linked to CFS include:

  • human herpes virus six
  • Ross River virus (a mosquito-borne tropical disease)
  • Epstein-Barr
  • human retroviruses
  • mycoplasma (a cause of atypical pneumonia)
  • rubella (also known as German measles)
  • Candida alibicans (which causes yeast infections)

Individuals with CFS sometimes have weakened immune systems, but doctors do not know whether this is enough to cause the disease.

Risk Factors for CFS

Women between the ages of 30 and 50 are the group most often affected by CFS. Therefore, your age and gender may increase your risk. Those who are overweight or inactive are also more likely to have CFS. Genetic predisposition, allergies, stress, and environmental factors may also increase your risk.

What Are the Symptoms of CFS?

The symptoms of CFS vary from patient to patient and based on the severity of the condition. The most common symptom is fatigue that is severe enough to interfere with your daily activities. For CFS to be diagnosed, fatigue must last for at least six months and must not be curable with bed rest.

Other symptoms of CFS may include:

  • loss of memory or concentration
  • feeling unrefreshed after sleep
  • muscle pain
  • headaches
  • multi-joint pain without redness or swelling
  • frequent sore throat
  • tender lymph nodes in your neck and armpits

You may also experience illness or extreme fatigue after physical or mental activities. This can last for more than 24 hours after the activity.

How Is CFS Diagnosed?

The CDC estimates that of the one to four million Americans with CFS, only 20 percent have been diagnosed. There are no lab tests to screen for CFS. If you have the condition, you do not look sick and your symptoms are common to many illnesses. Thus, it is extremely difficult to diagnose.

In order to be diagnosed with CFS, you must have at least four of the above symptoms. Plus, you must have unexplained fatigue that cannot be cured with bed rest. The fatigue and other symptoms must last for six months or longer. Ruling out other causes of your fatigue is a key part of the diagnosis process.

What Other Diseases Can CFS Resemble?

CFS can be confused with many other conditions because the symptoms of CFS are common. The following conditions all have symptoms in common with CFS:

  • Lyme disease
  • mononucleosis
  • lupus
  • fibromyalgia
  • hypothyroidism
  • multiple sclerosis

You may also experience symptoms of CFS if you are severely obese or have depressive disorders or sleep disorders. The side effects of certain drugs, such as antihistamines and alcohol, can mimic CFS as well.

How Is CFS Treated?

At this time, there is no cure for CFS. Each patient has different symptoms; therefore, treatment varies.

Home Remedies and Lifestyle Changes

Modifying your lifestyle can help reduce your symptoms. Limiting or eliminating your caffeine intake will help you sleep better and ease your insomnia. You should limit your nicotine and alcohol intake, too. Try to avoid napping during the day. Create a sleep routine; You should go to bed at the same time every night and aim to wake up around the same time every morning.

Pace yourself during activities. Overexertion can worsen your symptoms and induce an episode of fatigue. Avoid emotional and physical stress. Take time each day to relax or participate in activities you enjoy.


Two types of therapy appear to benefit CFS patients. One is psychological counseling to help you cope with CFS and improve your mindset. The other is physical therapy. A physical therapist can evaluate you and create an exercise routine for you that gradually increases in intensity. This is known as graded exercise therapy, or GET.


No one medication can treat all your symptoms. Also, your symptoms may change over time. In many cases, CFS can trigger depression, and you may need an antidepressant to combat it. If lifestyle changes do not give you a restful night’s sleep, your doctor may suggest a sleep aid. Pain medication can also help you cope with aches and joint pain caused by your CFS.

Alternative Medicine

Acupuncture, tai chi, yoga, and massage may help relieve the pain associated with CFS. Always talk to your doctor before beginning any alternative or complementary treatments.

Complications From CFS

Depression and social isolation can arise as a result of CFS. You will also have some lifestyle restrictions because of your chronic fatigue. You might miss work or not be able to spend as much time with family and friends as you would like.

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