CFS: Why you feel extreme tiredness

  • Chronic fatigue syndrome (CFS) is a disorder that makes you feel extremely fatigued all the time but with no underlying medical condition.
  • CFS is more common in women and unfortunately, it has no known cause nor cure.
  • Treatments for CFS only help manage the symptoms, including fatigue, pain, unrefreshing sleep, and worsening of condition after exertion

What Is Chronic Fatigue Syndrome?

If you feel extremely fatigued, experience unrefreshing sleep, and feel worse after exerting effort in any activity, you have Chronic Fatigue Syndrome (CFS). It is also called Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) or systemic exertion intolerance disease (SEID).

Photo Credit: Verywell / Emily Roberts

It has no known cause but is believed to be a combination of hereditary and environmental factors. It can also be triggered by genetic mutations combined upon exposure to viruses or toxins. Diagnosis is through a medical history check to know other causes, ruling out similar conditions and based on symptoms shown.

A change in lifestyle and treatment through medications and therapies are the two known treatments for CFS.

Symptoms of Chronic Fatigue Syndrome

Each person with CFS exhibits a unique set of symptoms with varying intensities.

  • Fatigue – The person should be feeling fatigued for at least 4 months and is not relieved even with sleep or rest. Fatigue is not caused by strenuous exertion, and makes the person unable to function normally.   
  • Post-exertional Malaise (PEM) – The CDC descibes PEM as the worsening of symptoms following even minor physical or mental exertion, with symptoms typically worsening 12 to 48 hours after activity and lasting for days or even weeks. 
  • Sleep problems
  • Cognitive impairment (brain fog) or a worsening of symptoms while you are upright (orthostatic intolerance)
  • Sudden and distinct onset, especially following a flu-like illness
  • Pain — including muscle aches, joint aches, or headaches
  • Flu-like symptoms that may include low-grade fever, sore throat, and swollen lymph glands
  • Intolerances and sensitivities to alcohol, noise, heat, and cold
  • Anxiety or irregular heartbeat sensation.

A person can also experience common overlapping conditions such as premenstrual syndrome for women, endometriosis, depression, tinnitus or ringing in the ears, and irritable bowel syndrome (IBS).

Causes of CFS

There is no exact known cause f CFS but a combination of genetic and environmental factors and exposure to certain toxins and viruses. Other suspects include: Immune system pattern irregularities, Pathogens like HHV-6, Epstein-Barr virus, enterovirus, Lyme disease, Hypothalamic-pituitary-adrenal (HPA) axis dysregulation, and disruptions of the hormones and sympathetic nervous system.

The HPA axis is responsible for the regulation of response to mood disorders such as depression, regulates sleep, and how a person responds to stress.


Exclusion or ruling out of other conditions with similar or overlapping symptoms is the first thing to do. Hence, the taking of medical history.

Conditions to look put for: autoimmune disorders, sleep disorders, chronic infections, hyperthyroidism, clinical depression, and heart disease which have overlapping conditions with ME/CFS.

Chronic Fatigue vs. Fibromyalgia

Both disorders have no definitive marker for diagnosis and are diagnosed through exhibited symptoms.  ME/CFS primary symptom is fatigue and Fibromyalgia is pain. 

Symptoms Common to both ME/CFS and Fibromyalgia:

  • Fatigue
  • Chronic widespread pain
  • Unrefreshing sleep
  • Brain Fog
  • Dizziness and impaired coordination

Treatment for CFS

  • Lifestyle changes to manage sleep problems, fatigue, and post-exertional malaise. Stress reduction techniques, counseling, and support groups also helps lessen stress.
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  • No common regimen or specific FDA-approved drugs but over-the-counter or prescription medications, supplements, and alternative therapies like emotional support are recommended.
  • Yoga, dietary changes, and acupuncture.
  • Fibromyalgia is treated with Lyrica (pregabalin) or anti-seizure medication for nerve pain.  Antidepressants Cymbalta (duloxetine) and Savella (milnacipran) are used differently. For ME/CFS, treatment for overlapping depression and for FMS, as therapy.
Photo Credit: Getty Images

Source: Very Well Health

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