Internal Medicine Physician
Dr. DeBanto is a medical doctor and gastroenterologist with 20 years of experience in obesity management and related issues such as sleep apnea.
Chronic fatigue syndrome, or myalgic encephalomyelitis (ME/CFS), is a potentially serious, debilitating, long-term illness. As per definition, people with chronic fatigue syndrome experience fatigue for longer than six months that prevents them from doing their usual activities. Estimates vary, but approximately 0.5% to 1% of adults meet the criteria for the condition.
Women are much more likely to have chronic fatigue syndrome than men. Most people with ME/CFS are between ages 40 and 60, though people of all ages, including children and adolescents, may be affected. White patients are more commonly diagnosed with ME/CFS in the U.S. than any other race or ethnicity. However, as many as 90% of people with ME/CFS go undiagnosed, which is especially a problem among minority groups in the U.S.
Current medical knowledge and understanding of ME/CFS is limited, so researchers continue to explore possible causes and treatments. Additionally, experts are studying a potential relationship between chronic fatigue syndrome and coronavirus disease 2019 (COVID-19). Preliminary research from the Centers for Disease Control and Prevention indicates that COVID-19 may lead to prolonged illness. Fatigue is among the top, persistent symptoms of that prolonged illness. More research is needed to determine if COVID-19 can cause ME/CFS.
When you feel tired, a good night’s sleep can usually help you feel refreshed. In contrast, fatigue is a prolonged feeling of tiredness and lack of energy that typically isn’t resolved by sleeping. As much as 50% of the people report symptoms of fatigue at some point. Fatigue is common after sleep deprivation, long periods of stress, and physical activity. However, fatigue can also be a symptom of an underlying health concern.
Experts classify fatigue in one of three categories:
ME/CFS is a common cause of chronic fatigue.
People with chronic fatigue syndrome experience persistent fatigue lasting longer than six months that does not get better with rest. They have an abnormal lack of energy and sometimes are confined to bed. In fact, the fatigue of patients with ME/CFS is so severe that they must reduce their usual activities by 50%. The disorder can negatively impact everything in daily life, from taking a shower to holding a job.
For some people with ME/CFS, day-to-day activities, both physical and mental, can worsen the fatigue, even if these activities would not have been a problem before the onset of the syndrome. The medical term for this experience is post-exertional malaise (PEM). People who experience ME/CFS describe the worsening fatigue as a “crash” or “relapse.”
Most people diagnosed with ME/CFS were functioning at a normal level prior to their diagnosis. The arrival of ME/CFS is often abrupt and sometimes follows a stressful medical or psychological event.
The core symptoms of ME/CFS are:
People with ME/CFS also experience one or both of the following:
Additional symptoms may include:
Children exhibit symptoms of ME/CFS similarly to adults, with a few exceptions:
While most fatigue has an identifiable cause, such as a sleep disorder, depression, or cancer, the cause of ME/CFS is not yet clear.
Researchers have hypothesized the following possible causes:
People who meet one or more of the following criteria may have a higher likelihood of developing the syndrome:
There are no known preventative measures for reducing the risk of ME/CFS.
As more research is done on ME/CFS, the criteria for diagnosis continue to be updated. There are a few possible sets of criteria physicians may choose to use in their diagnosis. However, most of these criteria sets require the following:
There is no chronic fatigue syndrome test to verify whether or not a person has the syndrome. Instead, physicians take a history of patient symptoms, including family history. They often conduct tests to rule out the possibility of other diseases, including urine and blood tests. Physicians may also refer patients to specialists to ensure other diagnoses are ruled out.
Experts note that patients may be diagnosed with both ME/CFS and an additional source of chronic fatigue. Some comorbidities of ME/CFS include:
Unfortunately, there is no cure for ME/CFS. People with the disorder shouldn’t give up hope, however. A variety of treatments may be used to lessen or eliminate symptoms.
If you suspect you may have ME/CFS, consult your doctor. You might keep an activity log or health journal to note changes in your wellbeing and help your physician understand your situation. With the aid of your physician, you can eliminate other possible causes of your fatigue. Then, together you can develop a plan for treatment and relief of symptoms.