Chronic Fatigue

Chronic Fatigue

Chronic Fatigue Syndrome (CFS) is a disorder characterized by extreme fatigue that cannot be explained by any underlying medical condition. The fatigue may worsen with physical or mental activity, but does not improve with rest. Other symptoms may include difficulty sleeping, headaches, muscle and joint pain, and tender lymph nodes. The cause of CFS is not well understood, and there is no specific test for the condition. Diagnosis is typically made by ruling out other possible causes of fatigue. Treatment may include a combination of medications, counseling, and lifestyle changes to help manage symptoms.

Chronic Fatigue Syndrome

Chronic Fatigue Syndrome (CFS), also known as Myalgic Encephalomyelitis (ME), is a debilitating and complex disorder characterized by persistent fatigue that lasts for six months or longer and cannot be explained by any underlying medical condition. Fatigue is often accompanied by a range of symptoms that can include difficulty sleeping, headaches, muscle and joint pain, tender lymph nodes, and cognitive difficulties such as memory and concentration problems. The cause of CFS is not well understood, and no specific test or biomarker has been identified for the condition. Diagnosis is typically made by ruling out other possible causes of fatigue.

The condition affects people of all ages, genders, and ethnic groups, but it is more common in women than in men and often starts in a person's late 20s to mid-40s.

Treatment for CFS can include a combination of medications, counseling, and lifestyle changes to help manage symptoms. However, since the causes of CFS are still not well understood, there is no specific cure for the disorder and symptoms can vary greatly from person to person.

It is important to note that CFS is a serious medical condition, and people with CFS should not be told that their symptoms are "all in their head."

Chronic Fatigue Syndrome symptoms

The symptoms of Chronic Fatigue Syndrome (CFS) can vary widely from person to person, but common symptoms include:

  1. Persistent fatigue: This is the most prominent symptom of CFS and can be described as a feeling of exhaustion, weakness, or a lack of energy that lasts for six months or longer and cannot be explained by any underlying medical condition.
  2. Difficulty sleeping: Many people with CFS have trouble sleeping or may feel unrefreshed after a night's sleep.
  3. Cognitive difficulties: This can include problems with memory, concentration, and attention.
  4. Muscles and joints pain: The pain can be widespread and can be accompanied by a feeling of weakness or tenderness in the muscles.
  5. Headaches: This can be of different types and severity, and is reported by many individuals with CFS.
  6. Tender lymph nodes: Individuals with CFS may feel swollen lymph nodes, especially in the neck or armpit areas.
  7. Sore throat: Some individuals report frequent sore throat or pain in the throat
  8. Post-exertional malaise : Often after physical or mental activity, individuals with CFS report a worsening of symptoms.

It is important to note that not everyone with CFS will experience all of these symptoms, and the severity of symptoms can also vary greatly from person to person.

Chronic Fatigue Syndrome test

There is currently no specific test or biomarker to diagnose Chronic Fatigue Syndrome (CFS). Instead, a diagnosis of CFS is typically made by ruling out other possible causes of the patient's symptoms. This is done through a process of elimination, which typically includes a thorough physical examination and a series of tests to rule out other medical conditions that can cause fatigue.
The process of diagnosing CFS may include:

  1. Medical history: Your doctor will make a detailed history of your symptoms and any other medical conditions you have.
  2. Physical examination: Your doctor will do a physical examination to check for signs of underlying medical conditions that could be causing your fatigue.
  3. Blood tests: Blood tests can be used to rule out other medical conditions that can cause fatigue, such as anemia, hypothyroidism, and autoimmune disorders.
  4. Imaging studies: Imaging studies, such as an MRI, can be used to rule out underlying neurological conditions that could be causing your fatigue.
  5. Sleep studies: If your doctor suspects a sleep disorder is contributing to your fatigue, you may be referred for a sleep study.

Once other potential causes have been ruled out, a diagnosis of CFS can be considered if the person has severe fatigue that has lasted for at least six months, along with other symptoms such as cognitive difficulties, muscle and joint pain, headaches, and tender lymph nodes, and that their fatigue worsen with physical or mental activity and does not improve with rest.
It is important to note that there is currently no one definitive diagnostic criteria for CFS/ME and different countries have different sets of criteria to diagnose it.

Chronic Fatigue Syndrome treatments

There is currently no known cure for Chronic Fatigue Syndrome (CFS), and treatment typically focuses on managing symptoms. Treatment plans may vary depending on an individual's symptoms and medical history, and may include a combination of the following:

  1. Medications: Some medications, such as anti-depressants, can be used to help with specific symptoms such as sleep problems or pain.
  2. Counseling: Talking therapies, such as cognitive-behavioral therapy or counseling can help individuals to manage the emotional and psychological aspects of CFS.
  3. Graded exercise therapy (GET) and Cognitive behavioral therapy (CBT) :GET is a form of physical therapy that involves gradually increasing activity levels to help improve physical fitness and reduce fatigue. CBT can help individuals to change negative thought patterns that may be contributing to the experience of fatigue.
  4. Pacing: This technique involves setting realistic goals, breaking down activities into smaller manageable parts, and alternating rest and activity throughout the day.
  5. Complementary and alternative therapies: Some people with CFS find relief from symptoms through the use of complementary and alternative therapies, such as acupuncture, massage, or herbal supplements.
  6. Medications such as rituximab, and Ampligen and other experimental treatments are being studied but it still not FDA approved.

It is important to note that CFS is a complex condition, and treatment plans should be tailored to meet the specific needs of each individual. It's also important to have good and open communication with your healthcare provider and to be aware that the symptoms can vary greatly and so does the success of the treatment.

What is chronic fatigue syndrome?

Chronic Fatigue Syndrome (CFS), also known as Myalgic Encephalomyelitis (ME), is a debilitating and complex disorder characterized by persistent fatigue that lasts for six months or longer and cannot be explained by any underlying medical condition. Fatigue is often accompanied by a range of symptoms that can include difficulty sleeping, headaches, muscle and joint pain, tender lymph nodes, and cognitive difficulties such as memory and concentration problems.
The cause of CFS is not well understood, and there is no specific test or biomarker that has been identified for the condition. People with CFS have a symptom complex, which means that it's a collection of symptoms that frequently co-occur together, and in CFS, those are severe fatigue, difficulty sleeping, headaches, muscle and joint pain, and cognitive difficulties.
CFS affects people of all ages, genders, and ethnic groups, but it is more common in women than in men and often starts in a person's late 20s to mid-40s. The condition can be debilitating and can significantly impact a person's quality of life.

How to treat Chronic Fatigue ?

Treatment for Chronic Fatigue Syndrome (CFS) can include a combination of medications, counseling, and lifestyle changes to help manage symptoms. However, since the causes of CFS are not well understood, there is no specific cure for the disorder. Treatment plans should be tailored to meet the specific needs of everyone, and may include the following:

  1. Medications: Some medications, such as anti-depressants, can be used to help with specific symptoms such as sleep problems or pain.
  2. Counseling: Talking therapies, such as cognitive-behavioral therapy or counseling can help individuals to manage the emotional and psychological aspects of CFS.
  3. Graded exercise therapy (GET) and Cognitive behavioral therapy (CBT) :GET is a form of physical therapy that involves gradually increasing activity levels to help improve physical fitness and reduce fatigue. CBT can help individuals to change negative thought patterns that may be contributing to the experience of fatigue.
  4. Pacing: This technique involves setting realistic goals, breaking down activities into smaller manageable parts, and alternating rest and activity throughout the day.
  5. Complementary and alternative therapies: Some people with CFS find relief from symptoms through the use of complementary and alternative therapies, such as acupuncture, massage, or herbal supplements.
  6. Medications such as rituximab, Ampligen and other experimental treatments are being studied but it is still not FDA approved.

It is important to work closely with a healthcare provider to develop an individualized treatment plan that addresses the unique symptoms and needs of the person with CFS. This approach typically involves a multidisciplinary team of healthcare professionals, including primary care providers, specialists, and therapists.

What triggers chronic fatigue syndrome?

The exact cause of Chronic Fatigue Syndrome (CFS) is not known, and there is ongoing research to better understand the condition. Some possible triggers that have been suggested including:

  1. Viral infections: Some research has suggested that a viral infection, such as the Epstein-Barr virus or HHV-6 may trigger CFS in some people.
  2. Immune dysfunction: Some studies have found abnormal functioning of the immune system in people with CFS, which may contribute to the development of the condition.
  3. Hormonal imbalances: Abnormalities in hormones such as cortisol have been found in some people with CFS.
  4. Genetic factors: Some research suggests that CFS may run in families and that there may be a genetic component to the condition
  5. Psychological factors: Trauma, stress and emotional distress have been suggested as triggers for the onset of CFS.
  6. Environmental factors: Exposure to toxins or chemicals, or living in close proximity to certain types of power stations, have been suggested as possible triggers.

It's important to note that CFS is a complex condition and it is likely that there are multiple factors that contribute to the development of the condition. Many different theories have been proposed, but the underlying cause of CFS is not yet fully understood, and more research is needed to identify the triggers.

How do you test for chronic fatigue syndrome?

There is currently no specific test or biomarker to diagnose chronic fatigue syndrome  (CFS). Instead, a diagnosis of CFS is typically made by ruling out other possible causes of the patient's symptoms. This is done through a process of elimination, which typically includes a thorough physical examination and a series of tests to rule out other medical conditions that can cause fatigue.
The process of diagnosing CFS may include:

  1. Medical history: Your doctor will take a detailed history of your symptoms and any other medical conditions you have.
  2. Physical examination: Your doctor will do a physical examination to check for signs of underlying medical conditions that could be causing your fatigue.
  3. Blood tests: Blood tests can be used to rule out other medical conditions that can cause fatigue, such as anemia, hypothyroidism, and autoimmune disorders.
  4. Imaging studies: Imaging studies, such as an MRI, can be used to rule out underlying neurological conditions that could be causing your fatigue.
  5. Sleep studies: If your doctor suspects a sleep disorder is contributing to your fatigue, you may be referred for a sleep study.

Once other potential causes have been ruled out, a diagnosis of CFS can be considered if the person has severe fatigue that has lasted for at least six months, along with other symptoms such as cognitive difficulties, muscle and joint pain, headaches, and tender lymph nodes, and that their fatigue worsen with physical or mental activity and does not improve with rest.
It is important to note that there is currently no one definitive diagnostic criteria for CFS/ME and different countries have separate sets of criteria to diagnose it. Also, it is not uncommon for people with CFS to have to visit several doctors, and go through a long diagnostic process before receiving a diagnosis.

What is the best treatment for chronic fatigue syndrome?

Currently, there is no known cure for Chronic Fatigue Syndrome (CFS) and the best treatment approach can vary widely depending on the individual's specific symptoms and needs.
Treatment plans should be tailored to meet the specific needs of each individual, and may include a combination of the following:

  1. Medications: Some medications, such as anti-depressants, can be used to help with specific symptoms such as sleep problems or pain.
  2. Counseling: Talking therapies, such as cognitive-behavioral therapy or counseling can help individuals to manage the emotional and psychological aspects of CFS.
  3. Graded exercise therapy (GET) and Cognitive behavioral therapy (CBT) :GET is a form of physical therapy that involves gradually increasing activity levels to help improve physical fitness and reduce fatigue. CBT can help individuals to change negative thought patterns that may be contributing to the experience of fatigue.
  4. Pacing: This technique involves setting realistic goals, breaking down activities into smaller manageable parts, and alternating rest and activity throughout the day.
  5. Complementary and alternative therapies: Some people with CFS find relief from symptoms using complementary and alternative therapies, such as acupuncture, massage, or herbal supplements.
  6. Medications such as rituximab, Ampligen and other experimental treatments are being studied but it is still not FDA approved.

It's important to work closely with a healthcare provider to develop an individualized treatment plan that addresses the unique symptoms and needs of the person with CFS. This approach typically involves a multidisciplinary team of healthcare professionals, including primary care providers, specialists, and therapists.
It is also important to be aware that no single treatment approach has been found to be effective for everyone and that the symptoms of people with CFS can vary widely. A treatment plan that works well for one person may not work for another, and it may take some trial and error to find the best approach for each individual.

What kind of doctor diagnoses Chronic Fatigue ?

Chronic Fatigue Syndrome (CFS) is a complex condition, and a variety of healthcare professionals may be involved in the diagnosis and treatment process. The primary care physician (PCP) is often the first point of contact for people with symptoms of CFS. The PCP can perform initial evaluations and can rule out other medical conditions that may be causing the symptoms. PCPs can also provide referrals to specialists if necessary.
Some of the specialists who may be involved in the diagnosis and treatment of CFS include:

  1. Infectious disease specialists: Some research suggests that viral infections may trigger CFS, so an infectious disease specialist may be consulted to rule out or treat underlying infections.
  2. Rheumatologists: Rheumatologists specialize in the diagnosis and treatment of musculoskeletal conditions and can be helpful in ruling out conditions that may mimic CFS such as fibromyalgia.
  3. Neurologists: Neurologists specialize in the diagnosis and treatment of conditions that affect the brain and nervous system, and can rule out underlying neurological conditions that may be causing fatigue.
  4. Psychiatrists or psychologists: Mental health specialists can help to rule out or treat underlying psychological conditions that may be contributing to the symptoms of CFS and can help to provide support and coping strategies to people with CFS
  5. Occupational and physical therapists: can assist with rehabilitation and providing strategies to improve the quality of life

Diagnosis and treatment of CFS requires a multidisciplinary approach and it's important for the healthcare professional who diagnose CFS to have a comprehensive knowledge of the condition and its symptoms.

Patients Medical’s Treatment of Chronic Fatigue  Syndrome

Most people find that CFS prevents them from leading a healthy, active lifestyle on their own. Their continuous exhaustion can make it extremely difficult to eat well, exercise their muscles, and take diligent care of themselves. Our goal is to help support a healthy future for you as you work to overcome the symptoms of CFS.

During your initial visits to us, we will take your medical history and perform some diagnostic tests in the laboratory. We find that fatigue is very often due to hormone imbalances, so we will specifically test for thyroid and adrenal gland function. If these hormones do not fall within normal range, we may recommend bio-identical hormone supplements to help re-establish balance and restore your energy. (Please see our article on bio-identical hormones for more information.)

We will also help you design a nutritional plan that will help reduce the risks of developing further complications as you slowly get the strength to begin physical activities once again. As always, we recommend a diverse diet based on fruits, vegetables, lean meat, and whole grains. Because oxidative stress may play a role in CFS, we will also recommend a diet rich in antioxidant foods, particularly berries, beans, artichokes, and nuts. Researchers have found that L-carnitine, a potent antioxidant contained in red meat and dairy products, has also improved recovery of CFS patients. Essential fatty acids have also been shown to improve Chronic Fatigue  in some patients, so fish oil and oil of evening primrose may be suggested. Additional vitamins, minerals, and antioxidant supplements may also be prescribed. Herbal supplements, such as ginseng, may also help increase energy.

Maintaining physical strength is also a critical part of keeping the body healthy. Our physicians will also help you design a graded exercise therapy (GET) program tailored to your personal goals. We will help you monitor your progress as you gradually increase your physical endurance. Depending on your case, acupuncture or acupressure may be recommended to relieve muscle pains or headaches.

Begin Your Journey with Patients Medical

Our job at Patients Medical is to connect the dots between a patient's medical history, symptoms, and their underlying causes. Patients Medical is a superb place for people to secure integrative and holistic health care from providers who give personalized care, partner with the patient to focus on the root cause of their illness, support their recovery, and help them maintain good health.


Request your consultation today!

Fill out the form at the top of this page,
or call us today at 1-212-794-8800. We are here to listen and to help.


Our medical center in New York City.

Patients Medical PC
1148 Fifth Avenue, Suite 1B
New York, NY 10128

Request an Appointment

Next Steps for Supplement Therapy

Interested In the supplement products recommended in this article as part of your treatment?

To order these supplements,
please click here

And Get an Extra

10% Instant Discount

Just enter your email on logging on to the website and get an exclusive discount coupon!

Buy Now