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Chronic fatigue syndrome (CFS) (also called myalgic encephalomyelitis) is a chronic illness that causes a broad range of symptoms.

Don’t let the name fool you. The “fatigue” associated with CFS isn’t simple tiredness. It can be life altering and make even the smallest routine tasks feel impossible, especially when sleep doesn’t restore energy after each night.

There’s no cure for CFS. As a result, treatment is personalized and focused on relieving symptoms and restoring quality of life. Here’s more about what treatments may be best for you.

CFS isn’t common, as it affects roughly 0.7% of the U.S. population at most. Experts estimate that around 1 million people have CFS. But the actual number of people may sit anywhere between 836,000 and 2.5 million, including those who have yet to receive a clear diagnosis.

People assigned female at birth are two to four times more likely to have the condition than people assigned male at birth.

CFS is serious. The condition makes daily life difficult for people who deal with it.

Symptoms include:

People with CFS may need to spend much of the day in bed. At the very least, they may not be able to carry out their responsibilities or other desired activities without dealing with symptoms. This may eventually lead to missing work, being socially isolated, and dealing with depression.

Even small amounts of activity can trigger something called postexertional malaise (PEM), which can prolong symptoms, make symptoms worse, or both.

The median recovery rate for CFS is around 5%. It’s important to know that many people can manage their condition and energy level by creating a personalized treatment plan with a doctor.

Beyond that, you may find that your symptoms change, get worse, or get better over time. Symptoms may even come and go somewhat unpredictably. Your experience will be unique and tied to your own triggers and coexisting health conditions.

There’s no one medication a person can take to treat CFS. Instead, treatment is highly individual and depends on what symptoms a person is experiencing.

The areas of treatment generally include:

  • PEM
  • sleep
  • pain
  • mental health (anxiety, stress, depression)
  • orthostatic intolerance
  • concentration and cognition issues

Discussing treatment options with a doctor

The medical community differs over the exact treatment courses for those living with CFS. You’ll need to work closely with a healthcare team to determine which symptoms are impacting your quality of life the most.

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You may start with treatment of these issues and progress to others in time. Many treatment options are available, ranging from over-the-counter (OTC) drugs to alternative therapies.

The most effective treatment for CFS is the one that’s catered to you and your specific symptoms. A doctor may suggest a variety of treatments depending on what you’re experiencing and what your treatment goals are.

Cognitive behavioral therapy (CBT)

Cognitive behavioral therapy (CBT) is a treatment that helps people understand and adjust the ways they think and respond to various situations. While CBT is a psychological treatment, it’s appropriate for chronic illnesses like CFS (and others).

This treatment may work best for people with mild to moderate CFS. It involves attending a set number of therapy sessions in which you’ll focus on things like unhelpful ways of thinking, unhelpful behaviors, coping mechanisms, and relaxation techniques.

Activity management

Activity management can be an effective treatment for PEM. Another term you may be more familiar with for this type of energy management is “pacing.”

This treatment is usually carried out by a rehabilitation specialist or exercise physiologist. You may start by keeping a log of your usual activities and how they affect your energy levels. Some refer to this as the “spoon theory” in life with a chronic illness, where a spoon to represents a unit of energy.

From there, a healthcare professional will help you find ways to do these tasks in different ways to conserve energy. For example, you may try folding your laundry while seated or taking frequent breaks throughout the day.

Pacing is all about finding a balance between those activities that zap energy and those that may restore it.

An energy management plan may also include a personalized exercise plan.


Again, there’s no one medication you can take to treat CFS as a condition.

Drugs that may help symptoms include:

  • OTC medications (acetaminophen, ibuprofen, etc.) to help with pain and muscle or joint issues
  • prescription medications to help with more severe pain
  • prescription medications to help with sleep issues
  • antidepressants or anti-anxiety medications to help with mood disorders
  • blood pressure or heart rhythm drugs to help with orthostatic intolerance

Sleep treatment

Sleep is difficult with CFS. You may not get enough sleep, or even if you do, your sleep may not be restorative.

If OTC treatments don’t help with sleep, a healthcare professional may refer you to a sleep specialist to determine if you have other conditions, such as sleep apnea or narcolepsy, that may be contributing to your sleep problems.

Treatment will depend on the diagnosis. With sleep apnea, for example, you may use a continuous positive airway pressure (CPAP) machine to help with breathing overnight.

Lifestyle changes

There are a variety of alternative methods or changes to your lifestyle that may help with CFS as well:

  • People dealing with orthostatic intolerance may try increasing salt intake, drinking more water, or wearing support stockings.
  • People with memory or thinking problems may benefit from using organizers or calendars to keep track of important information.
  • People with anxiety and depression may try meditation, yoga, deep breathing, massage, and other techniques for relaxation and restoration.
  • People with pain may try massage, physical therapy, or acupuncture for pain management.

A doctor may also suggest using certain supplements to address nutrition deficiencies, diet changes to support a balanced diet, or a combination of both traditional and alternative therapies to get you feeling better.

Researchers share that there are some newer treatments or trial treatments for CFS. A doctor may also know of newer treatments or other options available to you.

They include:

  • Rintatolimod: This immunomodulator and antiviral medication is currently only approved in Canada and Europe. While U.S. researchers do believe there’s some promise, the Food and Drug Administration (FDA) says it doesn’t have enough safety or efficacy information to approve it.
  • Rituximab: This monoclonal antibody treatment causes “the depletion of B cells” in the body. Researchers explain that B cells may be responsible for causing CFS in some people.
  • Fecal microbiota transplantation: This treatment involves taking bacteria from a healthy “donor” and transplanting it into another person’s gut (also called bacteriotherapy). More research is needed to assess the full benefit for people with CFS and other conditions, but researchers say it looks promising.
  • Aripiprazole: Traditionally used to treat bipolar disorder (among other conditions), this drug may be a possible treatment for CFS. The study was small, but many of the participants (75 out of 101) experienced an improvement in their fatigue and brain fog symptoms.

CFS does more than just make people tired. It’s a potentially debilitating condition that causes both physical and psychological symptoms. Treatment plans vary from person to person and can include medications, therapy, complementary and alternative medicine, and more.

If you’re struggling, speak with a doctor about your symptoms and your treatment goals. While CFS can’t be cured, certain medications, pacing, and other treatments and lifestyle changes can help you get your life back.