Chronic Fatigue Syndrome

Chronic fatigue syndrome (KRAH-nik fuh-TEEG SIN-drome), or CFS, is a condition that makes people feel exhausted and affects their participation in normal activities, such as work or school.

Keith Jarrett's Story

In November 1996, the enormously popular American jazz pianist and composer Keith Jarrett found himself completely drained of energy in the middle of a concert tour in Italy. The only way he could get through his performances was to stay in bed most of the day and get up just for the concert at night. Too tired even to cross the street, Jarrett did not play in public again for two years. The illness was so severe that he said he felt as though aliens had entered his body. He was eventually diagnosed with chronic fatigue syndrome.

What Is Chronic Fatigue Syndrome?

Chronic fatigue syndrome is a condition that causes almost constant exhaustion. People with CFS typically cannot get more sleep to feel better, because their fatigue does not improve with rest. In addition, physical or mental work may make the fatigue worse. Doctors and scientists do not know what causes CFS. In the mid-20th century, people with CFS were often told their symptoms were psychological * .

In the 1980s, healthcare professionals began to recognize CFS as a medical condition associated with the physical symptoms of severe fatigue and weakness.

CFS affects all racial groups and occurs in teens and adults. According to the National Institutes of Health, females are two to four times more likely than males to develop CFS. Some studies have estimated that as many as 1 million people in the United States have the syndrome.

What Are the Symptoms of Chronic Fatigue Syndrome?

For a diagnosis of CFS, individuals must have a sudden onset of exhaustion that continues for six months or recurs during that length of time. For a doctor to diagnose CFS according to guidelines from the Centers for Disease Control and Prevention, individuals must also have experienced at least four of the following eight symptoms after the fatigue began:

  • Sore throat
  • Just because individuals experience the symptoms of CFS does not necessarily mean they have this condition. Other medical problems may be the cause of the symptoms. For this reason, medical professionals order many tests in order to rule out other health conditions. If these tests are negative, CFS is considered as the diagnosis.

    What Causes Chronic Fatigue Syndrome?

    Doctors do not know what causes CFS. Because many people first experience the symptoms of CFS after an illness caused by a virus (such as mononucleosis * or hepatitis * ), some scientists think that a viral illness can trigger the condition. Some researchers have also suggested toxins (poisons), stress, and physical or emotional injury as possible causes of CFS. In addition, some researchers think that CFS stems from a problem in the immune system, which helps the body fight disease. Because many people with CFS experience depression, other doctors believe that a psychological condition produces the physical symptoms of CFS. Previously CFS was blamed on many other conditions, such as allergies, hypoglycemia * , infection with Epstein-Barr virus (the virus that causes mononucleosis), candidiasis * , and Lyme disease * .

    How Is Chronic Fatigue Syndrome Diagnosed and Treated?

    CFS is diagnosed if a person has at least four of the specified symptoms described previously, and medical professionals have ruled out other causes, such as multiple sclerosis * , hypothyroidism * , or heart or kidney disease.

    Individuals need to undergo blood tests and physical examinations to eliminate other possible causes of symptoms, because no specific laboratory tests can confirm the diagnosis of CFS. A diagnosis of CFS often is made when nothing else is found to account for the symptoms.

    Because the cause of CFS has been unknown, treatment for CFS has focused on relieving the symptoms. Treatment or recommendations for handling symptoms include engaging in moderate exercise, such as yoga or tai chi; taking a prescribed antidepressant (medication to ease depression); and taking an over-the-counter nonsteroidal anti- inflammatory drug, such as ibuprofen. People with CFS should also watch their stress levels, because mental, physical, or emotional over-exertion can aggravate CFS symptoms. Some patients with CFS may respond to drinking extra fluids and eating extra salt. Some people also find cognitive behavioral therapy * and rehabilitative therapy *

    See also Lyme Disease • Mononucleosis, Infectious


    Books and Articles

    Teitelbaum, Jacob. The Fatigue and Fibromyalgia Solution: The Essential Guide to Overcoming Chronic Fatigue and Fibromyalgia, Made Easy! New York: Avery, 2013.


    Solve ME/CFS Initiative. “Do You Have ME/CFS?” (accessed November 28, 2015).


    Centers for Disease Control and Prevention. 1600 Clifton Rd., Atlanta, GA 30333. Toll-free: 800-311-3435. Website: (accessed November 28, 2015).

    International Association for CFS/ME. 27 N. Wacker Dr., Suite 416, Chicago, IL 60606. Telephone: 847-258-7248. Website: (accessed November 28, 2015).

    National Institute of Allergy and Infectious Diseases. Office of Communications and Public Liaison, 6610 Rockledge Dr., MSC 6612, Bethesda, MD 20892-6612. Toll-free: 866-284-4107. Website: (accessed November 28, 2015).

    * psychological (SI-ko-LOJ-i-kal) refers to mental processes, including thoughts, feelings, and emotions.

    * lymph nodes (LIMF) are small, bean-shaped masses of tissue containing immune system cells that fight harmful microorganisms. Lymph nodes may swell during infections.

    * mononucleosis (mah-no-nuklee-O-sis) is an infectious illness caused by a virus with symptoms that typically include fever, sore throat, swollen glands, and tiredness.

    * hepatitis (heh-puh-TIE-tis) is an inflammation of the liver. Hepatitis can be caused by viruses, bacteria, and a number of other noninfectious medical conditions.

    * hypoglycemia (hi-po-gly-SEEmee-uh) is a condition that occurs when the amount of glucose, or sugar, in the blood becomes too low.

    * candidiasis (kan-dih-DYE-uh-sis) is an overgrowth of Candida, a type of yeast, in or on the body.

    * Lyme disease (LIME) is a bacterial infection that is spread to humans by the bite of an infected tick.

    * multiple sclerosis (skluh-RO-sis), or MS, is an inflammatory disease of the nervous system that disrupts communication between the brain and other parts of the body.

    * hypothyroidism (hi-po-THY-roydih-zum) is an impairment of the functioning of the thyroid gland that causes too little thyroid hormone to be produced by the body.

    * cognitive behavioral therapy (KOG-nih-tiv be-HAY-vyuh-rul THAIR-uh-pee) is treatment that helps people identify negative ways of thinking and behaving and change them to more positive approaches.

    * rehabilitative therapy helps people return to more normal physical, mental, or emotional function following an illness or injury.

    Disclaimer:   This information is not a tool for self-diagnosis or a substitute for professional care.

    (MLA 8th Edition)