Chronic Fatigue Syndrome (CFS): Symptoms, Causes, Diagnosis & Treatment

Are you always feeling tired and drained, no matter how much you rest or eat? While it is easy to blame poor diet or lack of sleep, the real reason might go deeper. You could be experiencing chronic fatigue syndrome (CFS), a condition that many people do not even realise they are living with. The scariest part? It often goes undiagnosed while silently impacting your health.

In this blog, we break down everything you need to know about chronic fatigue syndrome, its symptoms, causes, and how to spot the difference between ordinary tiredness and something more serious. Early awareness can make all the difference in managing this condition and protecting your long-term wellbeing.

What is Chronic Fatigue Syndrome (CFS)?

Chronic Fatigue Syndrome (CFS), also known as Myalgic Encephalomyelitis (ME), is a long-term condition characterised by extreme and persistent fatigue that doesn't improve with rest or sleep. Over time, symptoms can worsen, leading to a significant decline in daily functioning. Individuals with CFS often struggle to carry out everyday activities due to the overwhelming exhaustion, even after extended bed rest.^{1, 2}

Common Symptoms Of Chronic Fatigue Syndrome (Cfs)

Research indicates that there is currently no single clinical test to definitively diagnose Chronic Fatigue Syndrome (CFS). Diagnosis is typically made based on a combination of symptoms and by ruling out other possible conditions. Since CFS can vary greatly from person to person, recognising the most common symptoms is key. 

Let's take a look at the common symptoms.¹

• Severe fatigue lasting at least six months that doesn’t improve with rest or sleep.
• Difficulty sleeping (falling or staying asleep).
• Headaches.
• Joint pain.
• Muscle aches.
• Difficulty with thinking, attention, concentration and memory.
• Vision problems.
• Chills.
• Night sweats.
• Swollen lymph nodes.
• Irritable bowel, painful bloating, gas, constipation and diarrhea.
• Mood swings, irritability and anxiety.
• Tingling or numbness in your feet, hands or face.
• Dizziness, weakness and fainting.

4 Causes Of Chronic Fatigue Syndrome

The exact cause of chronic fatigue syndrome is unknown, but there are few key factors that are involved, which include the following.^{3, 4}

1. Genetics

Some studies suggest that CFS can run in families, indicating a possible genetic predisposition. This means certain individuals may be born with a higher risk of developing the condition. Specific genetic markers related to immune response and mitochondrial function are being investigated for their role in ME/CFS.

2. Infections

Many ME/CFS cases begin after a viral or bacterial infection. Pathogens like the Epstein-Barr virus (EBV), human herpesvirus 6 (HHV-6), and enteroviruses have been associated with post-infectious fatigue syndromes. These infections may trigger immune system changes that persist long after the infection has cleared.

3. Physical or Emotional Trauma

Many people with CFS report that their symptoms began after a major physical injury, surgery, or significant emotional stress. These events may act as stressors that disrupt the body's regulatory systems, including the nervous system, immune response, and hormone balance.

4. Problems with Energy Production

Emerging research shows that individuals with ME/CFS may have mitochondrial dysfunction, which means their cells have difficulty converting fats and sugars into energy. This could explain the profound fatigue and post-exertional malaise seen in patients.Who Is At Risk Of Chronic Fatigue Syndrome?

Chronic Fatigue Syndrome (CFS), also known as Myalgic Encephalomyelitis (ME), can affect anyone. However, researchers have identified certain factors that may increase a person’s likelihood of developing the condition.³

Age Plays a Role

ME/CFS can occur at any stage of life, but it is most commonly seen in young to middle-aged adults. This age group tends to report symptoms more frequently, possibly due to increased stress and lifestyle demands.

Gender Matters

Women are diagnosed with ME/CFS far more often than men. While biological differences might play a role, it’s also believed that women may be more likely to seek medical care or report ongoing symptoms like chronic fatigue, leading to higher diagnosis rates.

Pre-existing Health Conditions

People with a history of complex chronic conditions may be more prone to developing ME/CFS. These include:

• Fibromyalgia
• Postural Orthostatic Tachycardia Syndrome (POTS)
• Other overlapping disorders that involve fatigue, pain, or dysregulated autonomic function

How Is Chronic Fatigue Syndrome Diagnosed?

Diagnosing Chronic Fatigue Syndrome (CFS) can be challenging, as there is no specific test to confirm it. Healthcare providers typically rely on a thorough medical history, physical examination, and mental health evaluation — primarily to rule out other conditions that cause similar symptoms.

To support the diagnosis, your doctor may recommend blood or urine tests to check for infections, thyroid issues, anaemia, or autoimmune disorders. 

The diagnostic criteria for Chronic Fatigue Syndrome (CFS) include:

• Severe fatigue lasting at least six months that does not improve with rest or sleep.
• Difficulty achieving restful, restorative sleep.
• Worsening fatigue following mental or physical activity.
• Orthostatic intolerance, meaning difficulty sitting or standing upright without experiencing symptoms, and/or problems with cognitive function, such as issues with thinking and memory.

Treatment and Management Options

Treatment for Chronic Fatigue Syndrome (CFS) focuses on easing symptoms and helping you regain as much function as possible. While some people may not return to their previous level of health, the goal is to improve quality of life through several approaches: ¹

Changes to Your Sleep Routine

Improving sleep is often the first step. Your healthcare provider might suggest practical habits to enhance your rest before considering medications, such as:

• Going to bed and waking up at the same time every day to establish a regular sleep schedule.
• Avoiding naps longer than 30 minutes during the day.
• Using your bed and bedroom only for sleep and intimacy, and keeping electronics out of the bedroom.
• Avoiding large meals, alcohol, and caffeine before bedtime.

Medications

Medications may be prescribed to manage specific symptoms, including:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain.
• Tricyclic antidepressants to help with sleep, pain, and fatigue.
• SSRIs and SNRIs for depression and pain relief.
• Antiviral drugs if an infection is suspected.
• Intravenous immunoglobulin (IVIG) to support immune function.
• Corticosteroids to reduce fatigue.

Ongoing clinical trials continue to explore new treatment options.

Activity Management

Because both physical and mental exertion can worsen symptoms — a phenomenon called post-exertional malaise — managing activity is crucial. Your healthcare provider may recommend a strategy called pacing, which involves balancing rest and activity to avoid overexertion.

Pacing helps you understand your personal limits, which act like a “fence” that keeps your body within safe boundaries. Going beyond these limits can worsen symptoms. Keeping a diary of your activities and symptoms can help identify what your body can handle. Planning your daily tasks within these limits helps maintain your well-being.

Strenuous exercises like aerobic workouts may trigger symptom flare-ups, so your healthcare provider will guide you in finding safe, manageable physical activities.¹

Conclusion

If you’re constantly feeling exhausted despite getting enough rest, it might be more than just ordinary tiredness. Chronic Fatigue Syndrome (CFS) is a complex condition that often goes unrecognised but can have a profound impact on your daily life and wellbeing. Understanding the symptoms, causes, and how CFS is diagnosed is the first step towards managing it effectively.

While there is no cure yet, treatments focused on improving sleep, managing symptoms, and balancing activity can help you regain control and improve your quality of life. Early awareness and support from healthcare professionals are key to living better with CFS.

If you’re experiencing persistent fatigue, don’t wait. Early diagnosis through urine and blood tests can help uncover the root cause and guide effective treatment. To book any regular or advanced health check, you can consider choosing LifeCell Diagnostics. We provide accurate testing and expert analysis to support your health journey.

FAQs

What causes extreme fatigue in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome?

The exact cause of extreme fatigue in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is unknown. However, several factors are believed to play a role, including viral infections (such as Epstein-Barr virus), immune system problems, hormonal imbalances, genetic predisposition, and physical or emotional trauma. These factors may disrupt the body’s normal function, leading to prolonged and severe fatigue that doesn’t improve with rest.³

What is Myalgic Encephalomyelitis/Chronic Fatigue Syndrome?

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex, long-term illness characterised by extreme fatigue that lasts for at least six months and isn’t relieved by rest. It affects multiple body systems and can cause a range of symptoms, including problems with sleep, memory, focus, pain, and worsening symptoms after physical or mental exertion (called post-exertional malaise). The cause of ME/CFS remains unclear, and diagnosis is typically made by ruling out other conditions.³