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Chronic fatigue syndrome: symptoms, causes and treatment

Chronic fatigue syndrome: symptoms, causes and treatment

May 17, 2023

Chronic fatigue syndrome is a complex disease, with multiple symptoms and manifestations , and of which very little is known about its origin and treatment. Hence, it is still a very big mystery within the scientific community.

Interestingly, in the 70s and 80s it was called yuppie flu, since it affected mostly young workers who lived in the city and stress and the rapid pace of life caused them intense exhaustion.

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What is chronic fatigue?

Chronic fatigue syndrome (CFS) it is an alteration that causes the person a feeling of fatigue or extreme fatigue , which can prevent the person from getting to perform any usual activity or task.

To distinguish chronic fatigue from intense fatigue, the person must present symptoms for more than six months. Also, if it tries to alleviate them through rest, or physical or mental tasks, it is very likely that it will even get worse.

This disease is constituted as a chronic condition, extremely complex and of which its causes are still clear, reaching to interfere in the cardiovascular, endocrine, neurological and immune system.

Today, it is speculated that this condition affects about 0.5% of the world's population , being the most affected women in 90% of cases. Further. It usually appears along with other diseases such as fibromyalgia or irritable bowel syndrome.

Other names with which chronic fatigue is known (CFS) are myalgic encephalomyelitis / chronic fatigue syndrome (ME / CFS) or systemic disease of intolerance to exertion (ESIE).


As noted above, to consider this fatigue as extreme fatigue syndrome, they must last for a minimum of six months. The patient affected by chronic fatigue syndrome has, among many others, the following symptoms :

  • Intense fatigue
  • Hyperthermia or fever
  • Photophobia
  • Hyperacusis
  • Restless sleep
  • Headache
  • Muscle pain
  • Intolerance to temperature changes
  • Deficits in concentration
  • Short-term memory loss
  • Deficit in spatial orientation

Thus, the symptoms of chronic fatigue syndrome can be felt in many aspects of life and affect both the way in which the person relates to others and their way of interacting with elements of the environment in which they live. which affects its achievement of objectives, its self-image, etc.


Some time ago, chronic fatigue was considered a psychosomatic disorder However, it has now been accepted that it can not be considered as a psychiatric disorder, but rather as a disease with an organic basis but whose causes are not yet fully known.

Despite the large amount of research around chronic fatigue syndrome worldwide, the origin of this phenomenon is still a long way from being discovered. Even so, some investigations have obtained reliable conclusions in which it is pointed out that oxidative stress is an important element of the disease, in spite of not knowing if this is a cause or a consequence of CFS.

A study conducted in 2001 concluded that an increase in both nitrous oxide (NO) and peroxynitrites would be linked to the origin of several diseases, including chronic fatigue syndrome, post-traumatic stress and multiple chemical sensitivity.

With the passage of time and the advance of science, it was hypothesized about the possibility that an accelerated rhythm of life and a poor diet, among other causes, would cause an abnormal development of the fungus of candidiasis, thus triggering in chronic fatigue syndrome. However, this theory has been widely criticized and rejected.

On the other hand, some studies conjecture that toxic substances found in the environment and chemical elements present in some foods also contribute to weaken the person and cause CFS.

Finally, it has also been pointed to the influence of sleep quality, recurrent physical and psychological stress or some disorders such as post-traumatic stress disorder.


Chronic fatigue syndrome is characterized by its difficult diagnosis. For a better assessment of the patient's condition, the clinician should start with the preparation of a clinical history and physical examination, in order to rule out any hidden disease after these symptoms.

If one takes into account that between 39% and 47% of patients with CFS also suffer from depression , it is necessary that an assessment of the mental state of the patient is also made. As well as ruling out a possible influence some drugs through blood and urine tests.

Despite the difficulties involved in diagnosing CFS, there are eight criteria developed over time, and although there is no agreed opinion on which of them is most effective, there are two methods that stand out above the rest. These are the diagnostic criteria of Fukuda (1994) and other more recent ones elaborated by the National Academy of Medicine of the United States (2015).

Diagnostic criteria of Fukuda (1994)

To be able to diagnose CFS according to these criteria, the patient must present:

1. Severe fatigue

Chronic and intense fatigue for at least six months and without apparent reasons. In addition, this fatigue does not remit with rest.

2. Discard other conditions that may cause fatigue

Exclude any disease that a potential cause of the feeling of tiredness.

3. Present at least four of the following signs for six or more months:

  • Deficits in memory and concentration
  • Sore throat when swallowing
  • Muscle pain
  • Noninflammatory joint pain
  • Headaches
  • Restless sleep
  • Tiredness after making an effort with a course of more than 24 hours

Diagnostic criteria of the National Academy of Medicine of the United States (2015)

These guidelines, much more current, were the first to highlight the possible organic features of the disease.

According to this organization, to make a valid diagnosis of chronic fatigue syndrome, the patient must present the following symptoms:

  • Significant decrease in energy for the performance of any activity, for at least six months and without apparent causes.
  • Feelings of discomfort after exercising.
  • Restless rest
  • Present one of these two symptoms: cognitive jam or orthostatic intolerance.

Other aspects to take into account in the diagnosis are the assiduity and the degree to which they occur, and should be given, at least half of the time, in a major or severe manner.


Since it is a chronic disease, there is no remedy for it. But nevertheless, Pharmacological therapy to manage symptoms such as muscle pain, sleep disturbance, anxiety or depression , has been effective, prospering the symptoms over time.

That is to say, that the health intervention is of palliative type, to cushion the impact that the disease has on the quality of life and to avoid that it generates additional problems that do not have to exist with an effective management of the symptoms and the interaction with the patient. environment.

Likewise, the cognitive-behavioral intervention to work on emotional aspects, and a food reeducation, can also be successful as a complement to pharmacological treatment.

Chronic Fatigue Syndrome: Scientific Discoveries and Future Targeted Treatments (May 2023).

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