Chronic fatigue syndrome

It is a condition which can easily affect the quality of life along with mental peace and happiness. There is no particular cause for this syndrome but it may be triggered by various factors combined.

It is more common after the age of 40, factors like stress, viral infections, weak immune system, hormonal imbalances may be attributed as cause. A combination of factors can aggravate the condition.

Fatigue, can be a common symptom of many medical conditions, but CFS is very different from these conditions in many aspects. The onset of the condition is usually sudden. Main symptom of fatigue along with  other symptoms may occur suddenly, before which they did not exist. Chronic unexplained fatigue which is not relieved by rest is the hallmark of CFS.


  • Fatigue
  • Headache
  • Heaviness in the head
  • Muscle and joint pains
  • Loss of memory
  • Loss of concentration
  • Sore throat
  • Insomnia
  • Feeling tired even after a good sleep
  • Enlarged lymph nodes in neck and armpits
  • Weakness lasting more than 24 hours after a physical exercise

Diagnosis: Health conditions should be excluded first before we come into conclusion

Common conditions that need exclusion:

  • Chronic obstructive pulmonary disease
  • End-stage renal disease (CRF)
  • Systemic lupus erythematosus
  • Rheumatoid arthritis
  • Multiple sclerosis
  • Chronic renal failure
  • Type II diabetes mellitus
  • Hypothyroidism
  • Anemia
  • Major depression
  • Schizophrenia
  • Bipolar disorders
  • Anorexia nervosa
  • Bulimia
  • Alcohol abuse
  • Substance abuse

To diagnose CFS many diagnostic criteria came into existence but one among them which we use to diagnose CFS  is CDC diagnostic criteria which include:

  1. Fatigue: A new onset of persistent fatigue for 6 continuous months or greater duration which is unrelated to exertion, is not immediately relieved by rest, and is not a result of other medical conditions.
  2. Significant reduction in previous activity levels
  3. At least four or more of the following symptoms that last 6 months or longer:      
  •  Weakness after physical or mental exertion
  • Impaired memory or concentration
  • Unrefreshing sleep
  • Muscle pain (myalgia)
  • Pain in multiple joints (arthralgia)
  • Headaches of a new kind or greater severity or heaviness in the head
  • Frequent sore throat
  • Enlarged lymph nodes in neck and armpits


There is no particular treatment for this syndrome but there can be a symptomatic treatment.

 Some alternate methods of treatment includes:

  1. Cognitive behavioral therapy (CBT): This is basically a psychological therapy. Used to treat patients with severe CFS. It helps in understanding the symptoms and disease and help to plan strategies to improve their day to day functioning.It also aims to eliminate wrong impressions and beliefs that may perpetuate the disease.
  2. Healthy diet
  3. Sleep management techniques
  4. Medications to reduce pain, discomfort, fever (when present)
  5. Medications to treat anxiety (antianxiety drugs) and depression (antidepressant drugs)
  6. Maintaining active social life through various mediums of contacts
  7. Relaxation and stress reduction techniques such as:
  • Biofeedback
  • Deep breathing techniques
  • Hypnosis
  • Massage therapy
  • Meditation
  • Muscle relaxation techniques
  • Yoga

The review has also provided certain activity management tips such as:

  • Avoid doing activity on days when you feel tired.
  • Important to balance your time between activity, rest and sleep.
  • Make big tasks into smaller, easier and more manageable ones.
  • Plan some challenging tasks throughout the week.



Dr. Y. Alekhya.


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