🕷️ Crawler Inspector

URL Lookup

Direct Parameter Lookup

Raw Queries and Responses

1. Shard Calculation

Query:

Response:

Calculated Shard: 98 (from laksa023)

2. Crawled Status Check

Query:

curl -X POST \
  'http://laksa098.int.ahrefs:8124/' \
  -H 'Content-Type: text/plain' \
  -H 'X-ClickHouse-Database: crawler3' \
  -H 'Authorization: Basic YXBpOg==' \
  -d 'SELECT getAhrefsURLFromUnparsed(src_unparsed) AS found_url, ifNull(toUnixTimestamp(download_stamp), 0) AS crawl_time, ifNull(toUnixTimestamp(props_url_first_seen), 0) AS first_indexed_time, download_http_code AS http_code, src_unparsed AS src_unparsed, src_root_hash AS src_root_hash, history_drop_reason AS history_drop_reason, meta_title AS meta_title, meta_descriptions AS meta_descriptions, attrs_boilerpipe_text AS attrs_boilerpipe_text, attrs_markdown AS attrs_markdown, attrs_readable_markdown AS attrs_readable_markdown, meta_canonical AS meta_canonical FROM crawler3.page_info_local FINAL PREWHERE (src_root_hash, src_unparsed) IN ((getAhrefsRootHashFromUnparsed(getAhrefsUnparsedNoserviceFromURL(\'https://www.healthline.com/health/chronic-fatigue-syndrome\')), getAhrefsUnparsedNoserviceFromURL(\'https://www.healthline.com/health/chronic-fatigue-syndrome\'))) FORMAT JSONEachRow'

Response:

{"found_url":"https:\/\/www.healthline.com\/health\/chronic-fatigue-syndrome","crawl_time":1775020606,"first_indexed_time":1506550182,"http_code":200,"src_unparsed":"com,healthline!www,\/health\/chronic-fatigue-syndrome s443","src_root_hash":"11478817528691466898","history_drop_reason":null,"meta_title":"Chronic Fatigue Syndrome: Causes, Symptoms, and Treatment","meta_descriptions":["Chronic fatigue syndrome is a disorder characterized by extreme tiredness that can’t be explained by an underlying condition. This means it can be difficult to diagnose."],"attrs_boilerpipe_text":"The extreme and persistent fatigue from CFS lasts for at least 6 months and doesn’t go away with bed rest. Medications along with diet and lifestyle changes may help you manage symptoms.\nChronic fatigue syndrome (CFS) is a disorder characterized by extreme\nfatigue\nor tiredness that doesn’t go away with rest and can’t be explained by an underlying medical condition.\nCFS can also be referred to as myalgic encephalomyelitis (ME) or systemic exertion intolerance disease (SEID).\nThe causes of CFS aren’t fully understood yet. Some theories include\nviral infection\n, psychological\nstress\n, or a combination of factors.\nBecause no single cause has been identified, and because many other conditions produce similar symptoms, CFS can be difficult to diagnose.\nThere are no tests for CFS. Your doctor will have to rule out other causes for your fatigue when determining a diagnosis.\nWhile CFS was previously a controversial diagnosis, it’s now\nwidely accepted\nas a medical condition.\nCFS can affect anyone, though it’s most common among\nwomen\nin their\n40s and 50s\n. There’s currently no cure, but treatment can relieve symptoms.\nHere’s what you need to know about CFS, including symptoms, treatment options, and outlook.\nThe cause of CFS is unknown. Researchers speculate that contributing factors may include:\nviruses\na\nweakened immune system\nstress\nhormonal imbalances\nIt’s also possible that some people are genetically predisposed to develop CFS.\nThough CFS can sometimes develop after a viral infection, no single type of infection has been found to cause CFS. Some viral infections that have been studied in relation to CFS include those caused by:\nEpstein-Barr virus (EBV)\nhuman herpesvirus 6\nRoss River virus (RRV)\nrubella virus\nIn fact, about\n1 in 10 people\nwith EBV, Ross River virus, or\nCoxiella burnetii\ninfection will develop a condition that meets the criteria for a CFS diagnosis.\nAdditionally, researchers say that those who’ve had severe symptoms with any of these three infections are at a higher risk for later developing CFS.\nPeople with CFS sometimes have weakened immune systems, but doctors don’t know whether this is enough to cause the disorder.\nPeople with CFS can also sometimes have\nabnormal hormone levels\n. Doctors haven’t yet concluded whether this is significant, either.\nSome people with CFS may concomitantly have some deficiencies in vitamins including B2 (riboflavin) or B12, but it is unclear if they improve with vitamin supplementation.\nCFS is most commonly seen among people in their 40s and 50s.\nSex also plays an important role in CFS, as women are\ntwo to four times\nmore likely to be diagnosed with CFS than men.\nOther factors that may increase your risk for CFS include:\ngenetic predisposition\nallergies\nstress\nenvironmental factors\nSymptoms of CFS vary based on the individual and the severity of the condition.\nThe most common symptom is fatigue that’s severe enough to interfere with your daily activities.\nFor CFS to be diagnosed, a significantly reduced ability to perform your usual daily activities with fatigue must last for at least 6 months. It must not be curable with bed rest.\nCFS can also introduce sleep problems, such as:\nfeeling unrefreshed after a night’s sleep\nchronic insomnia\nother\nsleep disorders\nIn addition, you may also experience:\nloss of memory\nreduced\nconcentration\northostatic intolerance (going from lying or seated to standing positions makes you light-headed, dizzy, or faint)\nPhysical symptoms of CFS may include:\nmuscle pain\nfrequent\nheadaches\nmulti-joint pain without redness or swelling\nfrequent\nsore throat\ntender and\nswollen lymph nodes\nin your neck and armpits\nCFS affects some people in cycles, with periods of feeling worse and then better.\nSymptoms may sometimes even disappear completely, which is referred to as remission. However, it’s still possible for symptoms to return later, which is referred to as a relapse.\nThis cycle of remission and relapse can make it difficult to manage your symptoms, but it’s possible.\nCFS is a very challenging condition to diagnose.\nAccording to the\nInstitute of Medicine\n, as of 2015, CFS occurs in about 836,000 to 2.5 million Americans. It’s estimated, however, that 84 to 91 percent have yet to receive a diagnosis.\nThere are no medical tests to screen for CFS. Its symptoms are similar to many other conditions. Many people with CFS don’t “look sick,” so doctors may not recognize that they indeed have a health condition.\nIn order to receive a CFS diagnosis, your doctor will rule out other potential causes and review your medical history with you.\nThey’ll confirm that you at least have the core symptoms previously mentioned. They’ll also ask about the duration and severity of your unexplained fatigue.\nRuling out other potential causes of your fatigue is a key part of the diagnosis process. Some conditions with symptoms that resemble those of CFS include:\nmononucleosis\nLyme disease\nmultiple sclerosis\nlupus (SLE)\nhypothyroidism\nfibromyalgia\nmajor depressive disorder\nsevere obesity\nsleep disorders\nThe side effects of certain drugs, such as\nantihistamines\nand\nalcohol\n, can mimic symptoms of CFS as well.\nBecause of the similarities between symptoms of CFS and many other conditions, it’s important to not self-diagnose. Talk to your doctor about your symptoms. They can work with you to get relief.\nThere’s currently no specific cure for CFS.\nEach person has different symptoms and therefore may require different types of treatment to manage the disorder and relieve their symptoms.\nAs mentioned above, some people with CFS may also have functional vitamin deficiencies and theoretically may feel better with vitamin supplementation but much more study is needed.\nWork with your team of healthcare providers to create the best treatment plan for you. They can go over the possible benefits and side effects of the therapies with you.\nAddressing post-exertional malaise (PEM) symptoms\nPEM occurs when even minor physical, mental, or emotional exertion results in CFS symptoms becoming worse.\nWorsening symptoms usually occur\n12 to 48 hours\nafter the activity and last for days or even weeks.\nActivity management, also called pacing, can help balance rest and activity to avoid PEM flare-ups. You’ll need to find your individual limits for mental and physical activities, plan these activities, and then rest to stay within these limits.\nSome doctors refer to staying within these limits as the “energy envelope.” Keeping a diary of your activities may help you find your personal limits.\nIt’s important to note that while vigorous aerobic exercise is good for most chronic conditions, people with CFS don’t tolerate such exercise routines.\nHome remedies and lifestyle changes\nLimiting or eliminating your\ncaffeine intake\ncan help you sleep better and ease your insomnia. You should limit or avoid nicotine and alcohol too.\nTry to avoid napping during the day if it’s hurting your ability to sleep at night.\nCreate a\nsleep routine\n. Go to bed at the same time every night and aim to wake up around the same time every day.\nMedications\nTypically, no one medication can treat all of your symptoms. Also, your symptoms may change over time, so your medications may have to as well.\nIn many cases, CFS can trigger depression. You may need low-dose\nantidepressant therapy\nor a referral to a mental health provider.\nIf lifestyle changes don’t give you a restful night’s sleep, your doctor may suggest a sleep aid. Pain-reducing medication can also help you cope with aches and joint pain caused by CFS.\nIf medication therapy is needed, it will have to be tailored for your needs. Work closely with your doctor. There’s no one-size-fits-all treatment for CFS.\nAlternative medicine\nAcupuncture\n, tai chi,\nyoga\n, and massage may help relieve the pain associated with CFS. Always talk to your doctor before beginning any alternative or complementary treatments.\nDespite increased research efforts, CFS remains a complex condition with no exact known cause and cure. The recovery rate is\nonly 5%\n. Managing CFS can therefore be challenging.\nYou’ll likely need to make lifestyle changes to adapt to your chronic fatigue. As a result, you may experience depression,\nanxiety\n, or social isolation. You might find that joining a\nsupport group\ncan be helpful as you’re making decisions and transitions.\nCFS progresses differently in everyone, so it’s important to work with your doctor to create a treatment plan that meets your needs.\nMany people benefit from working with a team of healthcare providers. This can include doctors, therapists, and rehabilitation specialists.\nIf you’re living with CFS, the\nSolve ME\/CFS Initiative\nhas resources that you may find helpful. The\nCDC\nalso offers recommendations for managing and living with CFS.","attrs_markdown":"- Health Conditions\n  Health Conditions\n  \n  [All](https:\/\/www.healthline.com\/directory\/topics)\n  \n  - [Breast Cancer](https:\/\/www.healthline.com\/breast-cancer)\n  - [Cancer Care](https:\/\/www.healthline.com\/cancer-care)\n  - [Caregiving for Alzheimer's Disease](https:\/\/www.healthline.com\/alzheimers-disease)\n  - [Chronic Kidney Disease](https:\/\/www.healthline.com\/ckd)\n  - [Chronic Obstructive Pulmonary Disease (COPD)](https:\/\/www.healthline.com\/copd)\n  - [Digestive Health](https:\/\/www.healthline.com\/digestive-health)\n  - [Eye Health](https:\/\/www.healthline.com\/eye-health)\n  - [Heart Health](https:\/\/www.healthline.com\/heart-health)\n  - [Menopause](https:\/\/www.healthline.com\/menopause)\n  - [Mental Health](https:\/\/www.healthline.com\/mental-health)\n  - [Migraine](https:\/\/www.healthline.com\/migraine)\n  - [Multiple Sclerosis (MS)](https:\/\/www.healthline.com\/multiple-sclerosis)\n  - 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Connect with us for all things health.\n\nSubscribe\n\n# CFS (Chronic Fatigue Syndrome)\n![](https:\/\/i0.wp.com\/post.healthline.com\/wp-content\/uploads\/2022\/01\/Megan-Soliman-500x500-Bio.png?w=105&h=105)\n\n[Medically reviewed]() by [Megan Soliman, MD]() — Written by [Stacy Sampson, D.O.]() —  [Updated on October 31, 2023]()\n\n- [Causes](https:\/\/www.healthline.com\/health\/chronic-fatigue-syndrome#causes)\n- [Risk factors](https:\/\/www.healthline.com\/health\/chronic-fatigue-syndrome#risk-factors)\n- [Symptoms](https:\/\/www.healthline.com\/health\/chronic-fatigue-syndrome#symptoms)\n- [Diagnosis](https:\/\/www.healthline.com\/health\/chronic-fatigue-syndrome#diagnosis)\n- [Treatment](https:\/\/www.healthline.com\/health\/chronic-fatigue-syndrome#treatment)\n- [Outlook](https:\/\/www.healthline.com\/health\/chronic-fatigue-syndrome#outlook)\n\nThe extreme and persistent fatigue from CFS lasts for at least 6 months and doesn’t go away with bed rest. Medications along with diet and lifestyle changes may help you manage symptoms.\n\nChronic fatigue syndrome (CFS) is a disorder characterized by extreme [fatigue](https:\/\/www.healthline.com\/symptom\/fatigue) or tiredness that doesn’t go away with rest and can’t be explained by an underlying medical condition.\n\nCFS can also be referred to as myalgic encephalomyelitis (ME) or systemic exertion intolerance disease (SEID).\n\nThe causes of CFS aren’t fully understood yet. Some theories include [viral infection](https:\/\/www.healthline.com\/health\/mononucleosis), psychological [stress](https:\/\/www.healthline.com\/health\/stress\/effects-on-body), or a combination of factors.\n\nBecause no single cause has been identified, and because many other conditions produce similar symptoms, CFS can be difficult to diagnose.\n\nThere are no tests for CFS. Your doctor will have to rule out other causes for your fatigue when determining a diagnosis.\n\nWhile CFS was previously a controversial diagnosis, it’s now [widely accepted](https:\/\/www.healthline.com\/health-news\/evidence-found-that-chronic-fatigue-is-a-physical-illness-022715) as a medical condition.\n\nCFS can affect anyone, though it’s most common among [women](https:\/\/www.womenshealth.gov\/a-z-topics\/chronic-fatigue-syndrome) in their [40s and 50s](https:\/\/www.mayoclinic.org\/diseases-conditions\/chronic-fatigue-syndrome\/symptoms-causes\/syc-20360490). There’s currently no cure, but treatment can relieve symptoms.\n\nHere’s what you need to know about CFS, including symptoms, treatment options, and outlook.\n\n## [What causes CFS?]()\nThe cause of CFS is unknown. Researchers speculate that contributing factors may include:\n\n- viruses\n- a [weakened immune system](https:\/\/www.healthline.com\/health\/immunodeficiency-disorders)\n- [stress](https:\/\/www.healthline.com\/health\/stress)\n- [hormonal imbalances](https:\/\/www.healthline.com\/nutrition\/balance-hormones)\n\nIt’s also possible that some people are genetically predisposed to develop CFS.\n\nThough CFS can sometimes develop after a viral infection, no single type of infection has been found to cause CFS. Some viral infections that have been studied in relation to CFS include those caused by:\n\n- [Epstein-Barr virus (EBV)](https:\/\/www.healthline.com\/health\/epstein-barr-virus-test)\n- human herpesvirus 6\n- Ross River virus (RRV)\n- [rubella virus](https:\/\/www.healthline.com\/health\/rubella)\n\nInfections caused by bacteria, including [*Coxiella burnetii*](https:\/\/www.healthline.com\/health\/q-fever) and [*Mycoplasma pneumoniae*](https:\/\/www.healthline.com\/health\/mycoplasma-pneumonia), have also been studied in relation to CFS.\n\nThe [Centers for Disease Control and Prevention (CDC)](https:\/\/www.cdc.gov\/me-cfs\/about\/possible-causes.html) has suggested that CFS may be the end stage of multiple different conditions, rather than one specific condition.\n\nIn fact, about [1 in 10 people](https:\/\/www.cdc.gov\/me-cfs\/about\/possible-causes.html) with EBV, Ross River virus, or *Coxiella burnetii* infection will develop a condition that meets the criteria for a CFS diagnosis.\n\nAdditionally, researchers say that those who’ve had severe symptoms with any of these three infections are at a higher risk for later developing CFS.\n\nPeople with CFS sometimes have weakened immune systems, but doctors don’t know whether this is enough to cause the disorder.\n\nPeople with CFS can also sometimes have [abnormal hormone levels](https:\/\/www.healthline.com\/health\/hormonal-imbalance). Doctors haven’t yet concluded whether this is significant, either.\n\nSome people with CFS may concomitantly have some deficiencies in vitamins including B2 (riboflavin) or B12, but it is unclear if they improve with vitamin supplementation.\n\n## [Risk factors for CFS]()\nCFS is most commonly seen among people in their 40s and 50s.\n\nSex also plays an important role in CFS, as women are [two to four times](https:\/\/www.womenshealth.gov\/a-z-topics\/chronic-fatigue-syndrome) more likely to be diagnosed with CFS than men.\n\nOther factors that may increase your risk for CFS include:\n\n- genetic predisposition\n- [allergies](https:\/\/www.healthline.com\/health\/allergies)\n- stress\n- environmental factors\n\n## [What are the symptoms of CFS?]()\nSymptoms of CFS vary based on the individual and the severity of the condition.\n\nThe most common symptom is fatigue that’s severe enough to interfere with your daily activities.\n\nFor CFS to be diagnosed, a significantly reduced ability to perform your usual daily activities with fatigue must last for at least 6 months. It must not be curable with bed rest.\n\nYou will also experience [extreme fatigue after physical or mental activities](https:\/\/www.nap.edu\/resource\/19012\/MECFS_ProposedDiagnosticCriteria.jpg), which is referred to as post-exertional malaise (PEM). This can last for [more than 24 hours](https:\/\/www.mayoclinic.org\/diseases-conditions\/chronic-fatigue-syndrome\/symptoms-causes\/syc-20360490) after the activity.\n\nCFS can also introduce sleep problems, such as:\n\n- feeling unrefreshed after a night’s sleep\n- [chronic insomnia](https:\/\/www.healthline.com\/health\/insomnia-concerns)\n- other [sleep disorders](https:\/\/www.healthline.com\/health\/sleep\/disorders)\n\nIn addition, you may also experience:\n\n- [loss of memory](https:\/\/www.healthline.com\/symptom\/memory-loss)\n- reduced [concentration](https:\/\/www.healthline.com\/symptom\/unable-to-concentrate)\n- orthostatic intolerance (going from lying or seated to standing positions makes you light-headed, dizzy, or faint)\n\nPhysical symptoms of CFS may include:\n\n- [muscle pain](https:\/\/www.healthline.com\/symptom\/muscle-pain)\n- frequent [headaches](https:\/\/www.healthline.com\/health\/headache)\n- multi-joint pain without redness or swelling\n- frequent [sore throat](https:\/\/www.healthline.com\/health\/sore-throat)\n- tender and [swollen lymph nodes](https:\/\/www.healthline.com\/health\/swollen-lymph-nodes) in your neck and armpits\n\nCFS affects some people in cycles, with periods of feeling worse and then better.\n\nSymptoms may sometimes even disappear completely, which is referred to as remission. However, it’s still possible for symptoms to return later, which is referred to as a relapse.\n\nThis cycle of remission and relapse can make it difficult to manage your symptoms, but it’s possible.\n\n## [How is CFS diagnosed?]()\nCFS is a very challenging condition to diagnose.\n\nAccording to the [Institute of Medicine](http:\/\/www.nationalacademies.org\/hmd\/~\/media\/Files\/Report%20Files\/2015\/MECFS\/MECFS_KeyFacts.pdf), as of 2015, CFS occurs in about 836,000 to 2.5 million Americans. It’s estimated, however, that 84 to 91 percent have yet to receive a diagnosis.\n\nThere are no medical tests to screen for CFS. Its symptoms are similar to many other conditions. Many people with CFS don’t “look sick,” so doctors may not recognize that they indeed have a health condition.\n\nIn order to receive a CFS diagnosis, your doctor will rule out other potential causes and review your medical history with you.\n\nThey’ll confirm that you at least have the core symptoms previously mentioned. They’ll also ask about the duration and severity of your unexplained fatigue.\n\nRuling out other potential causes of your fatigue is a key part of the diagnosis process. Some conditions with symptoms that resemble those of CFS include:\n\n- [mononucleosis](https:\/\/www.healthline.com\/health\/mononucleosis)\n- [Lyme disease](https:\/\/www.healthline.com\/health\/lyme-disease)\n- [multiple sclerosis](https:\/\/www.healthline.com\/health\/multiple-sclerosis)\n- [lupus (SLE)](https:\/\/www.healthline.com\/health\/systemic-lupus-erythematosus)\n- [hypothyroidism](https:\/\/www.healthline.com\/health\/hypothyroidism\/symptoms-treatments-more)\n- [fibromyalgia](https:\/\/www.healthline.com\/health\/fibromyalgia)\n- [major depressive disorder](https:\/\/www.healthline.com\/health\/clinical-depression)\n- severe obesity\n- sleep disorders\n\nThe side effects of certain drugs, such as [antihistamines](https:\/\/www.healthline.com\/health\/allergies\/antihistamine-brands) and [alcohol](https:\/\/www.healthline.com\/health\/alcohol\/effects-on-body), can mimic symptoms of CFS as well.\n\nBecause of the similarities between symptoms of CFS and many other conditions, it’s important to not self-diagnose. Talk to your doctor about your symptoms. They can work with you to get relief.\n\n## [How is CFS treated?]()\nThere’s currently no specific cure for CFS.\n\nEach person has different symptoms and therefore may require different types of treatment to manage the disorder and relieve their symptoms.\n\nAs mentioned above, some people with CFS may also have functional vitamin deficiencies and theoretically may feel better with vitamin supplementation but much more study is needed.\n\nWork with your team of healthcare providers to create the best treatment plan for you. They can go over the possible benefits and side effects of the therapies with you.\n\n### Addressing post-exertional malaise (PEM) symptoms\nPEM occurs when even minor physical, mental, or emotional exertion results in CFS symptoms becoming worse.\n\nWorsening symptoms usually occur [12 to 48 hours](https:\/\/www.cdc.gov\/me-cfs\/treatment\/index.html) after the activity and last for days or even weeks.\n\nActivity management, also called pacing, can help balance rest and activity to avoid PEM flare-ups. You’ll need to find your individual limits for mental and physical activities, plan these activities, and then rest to stay within these limits.\n\nSome doctors refer to staying within these limits as the “energy envelope.” Keeping a diary of your activities may help you find your personal limits.\n\nIt’s important to note that while vigorous aerobic exercise is good for most chronic conditions, people with CFS don’t tolerate such exercise routines.\n\n### Home remedies and lifestyle changes\nMaking some [lifestyle changes](https:\/\/www.healthline.com\/health\/diet-hacks-to-reduce-chronic-fatigue) may help reduce your symptoms.\n\nLimiting or eliminating your [caffeine intake](https:\/\/www.healthline.com\/health\/caffeine-effects-on-body) can help you sleep better and ease your insomnia. You should limit or avoid nicotine and alcohol too.\n\nTry to avoid napping during the day if it’s hurting your ability to sleep at night.\n\nCreate a [sleep routine](https:\/\/www.healthline.com\/health\/sleep-disorders-prevention). Go to bed at the same time every night and aim to wake up around the same time every day.\n\n### Medications\nTypically, no one medication can treat all of your symptoms. Also, your symptoms may change over time, so your medications may have to as well.\n\nIn many cases, CFS can trigger depression. You may need low-dose [antidepressant therapy](https:\/\/www.healthline.com\/health\/depression\/medication-list) or a referral to a mental health provider.\n\nIf lifestyle changes don’t give you a restful night’s sleep, your doctor may suggest a sleep aid. Pain-reducing medication can also help you cope with aches and joint pain caused by CFS.\n\nIf medication therapy is needed, it will have to be tailored for your needs. Work closely with your doctor. There’s no one-size-fits-all treatment for CFS.\n\n### Alternative medicine\n[Acupuncture](https:\/\/www.healthline.com\/health\/dry-needling-vs-acupuncture), tai chi, [yoga](https:\/\/www.healthline.com\/nutrition\/13-benefits-of-yoga), and massage may help relieve the pain associated with CFS. Always talk to your doctor before beginning any alternative or complementary treatments.\n\n## [What can be expected in the long term?]()\nDespite increased research efforts, CFS remains a complex condition with no exact known cause and cure. The recovery rate is [only 5%](https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/15699087\/). Managing CFS can therefore be challenging.\n\nYou’ll likely need to make lifestyle changes to adapt to your chronic fatigue. As a result, you may experience depression, [anxiety](https:\/\/www.healthline.com\/health\/anxiety), or social isolation. You might find that joining a [support group](https:\/\/ammes.org\/find-a-support-group\/) can be helpful as you’re making decisions and transitions.\n\nCFS progresses differently in everyone, so it’s important to work with your doctor to create a treatment plan that meets your needs.\n\nMany people benefit from working with a team of healthcare providers. This can include doctors, therapists, and rehabilitation specialists.\n\nIf you’re living with CFS, the [Solve ME\/CFS Initiative](http:\/\/solvecfs.org\/) has resources that you may find helpful. The [CDC](https:\/\/www.cdc.gov\/me-cfs\/treatment\/index.html) also offers recommendations for managing and living with CFS.\n\n### How we reviewed this article:\nSources\n\nHistory\n\nHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our [editorial policy](https:\/\/www.healthline.com\/about\/process).\n\n- Beyond myalgic encephalomyelitis\/chronic fatigue syndrome: Redefining an illness. (2015).  \n  <https:\/\/nap.nationalacademies.org\/catalog\/19012\/beyond-myalgic-encephalomyelitischronic-fatigue-syndrome-redefining-an-illness>\n- Cairns R, et al. (2005). A systematic review describing the prognosis of chronic fatigue syndrome.  \n  <https:\/\/pubmed.ncbi.nlm.nih.gov\/15699087\/>\n- Chronic fatigue syndrome. (2021).  \n  <https:\/\/www.womenshealth.gov\/a-z-topics\/chronic-fatigue-syndrome>\n- Myalgic encephalomyelitis\/chronic fatigue syndrome (2023).  \n  <https:\/\/www.cdc.gov\/me-cfs\/>\n- Proposed diagnostic criteria for ME\/CFS. (n.d.).  \n  <https:\/\/www.nap.edu\/resource\/19012\/MECFS_ProposedDiagnosticCriteria.jpg>\n- Russell-Jones G. (2022). Functional vitamin B12 deficiency in chronic fatigue syndrome.  \n  <https:\/\/www.researchgate.net\/publication\/362644480_Functional_Vitamin_B12_deficiency_in_Chronic_Fatigue_Syndrome_International_Journal_of_Psychiatry_Corresponding_author>\n\nShare this article\n\n![](https:\/\/i0.wp.com\/post.healthline.com\/wp-content\/uploads\/2022\/01\/Megan-Soliman-500x500-Bio.png?w=105&h=105)\n\n[Medically reviewed]() by [Megan Soliman, MD]() — Written by [Stacy Sampson, D.O.]() —  [Updated on October 31, 2023]()\n\n## related stories\n- [‘Robust’ Evidence Found That Chronic Fatigue Syndrome Is a Physical Illness](https:\/\/www.healthline.com\/health-news\/evidence-found-that-chronic-fatigue-is-a-physical-illness-022715?utm_source=ReadNext)\n- [So Much More Than Tired: 3 Ways to Explain What Chronic Fatigue Is Really Like](https:\/\/www.healthline.com\/health\/how-i-explain-chronic-fatigue-syndrome?utm_source=ReadNext)\n- [Causes of Fatigue and How to Manage It](https:\/\/www.healthline.com\/health\/fatigue?utm_source=ReadNext)\n- [Life with Chronic Fatigue Syndrome: 11 Lessons from My “Mother-in-Law”](https:\/\/www.healthline.com\/health\/life-with-chronic-fatigue-syndrome-11-lessons-ive-learned?utm_source=ReadNext)\n- [What’s Causing My Fatigue and Nausea?](https:\/\/www.healthline.com\/health\/fatigue-and-nausea?utm_source=ReadNext)\n\n© 2026 Healthline Media LLC. All rights reserved. Healthline Media is an RVO Health Company. Our website services, content, and products are for informational purposes only. Healthline Media does not provide medical advice, diagnosis, or treatment. [See additional information](https:\/\/www.healthline.com\/additional-information).\n\n- [About Us](https:\/\/www.healthline.com\/about)\n- [Contact Us](https:\/\/www.healthline.com\/about\/contact-us)\n- [Privacy Policy](https:\/\/www.healthline.com\/privacy-policy)\n- Privacy Settings\n- [Advertising Policy](https:\/\/www.healthline.com\/advertising-policy)\n- [Health Topics](https:\/\/www.healthline.com\/directory\/topics)\n\n- [Sitemap](https:\/\/www.healthline.com\/sitemap)\n- [Medical Affairs](https:\/\/www.healthline.com\/medical-team)\n- [Content Integrity](https:\/\/www.healthline.com\/about\/content-integrity)\n- [Newsletters](https:\/\/www.healthline.com\/newsletter-signup)\n- © 2026 Healthline Media LLC. All rights reserved. Healthline Media is an RVO Health Company. Our website services, content, and products are for informational purposes only. Healthline Media does not provide medical advice, diagnosis, or treatment. [See additional information](https:\/\/www.healthline.com\/additional-information).\n\n© 2026 Healthline Media LLC. All rights reserved. Healthline Media is an RVO Health Company. Our website services, content, and products are for informational purposes only. Healthline Media does not provide medical advice, diagnosis, or treatment. [See additional information](https:\/\/www.healthline.com\/additional-information).\n\n[About](https:\/\/www.healthlinemedia.com\/?utm_source=healthline.com&utm_medium=site&utm_campaign=footer&utm_content=about)[Careers](https:\/\/rvohealth.com\/careers)[Advertise with us](https:\/\/www.healthlinemedia.com\/advertise?utm_source=healthline.com&utm_medium=site&utm_campaign=footer&utm_content=advertise)\n\nOUR BRANDS\n\n[Healthline](https:\/\/www.healthline.com\/)[Medical News Today](https:\/\/www.medicalnewstoday.com\/)[Greatist](https:\/\/greatist.com\/)[Psych Central](https:\/\/psychcentral.com\/)[Bezzy](https:\/\/bezzy.com\/)\n\n![](http:\/\/b.scorecardresearch.com\/p?c1=2&c2=38584006&cv=3.9&cj=1&comscorekw=main)","attrs_readable_markdown":"The extreme and persistent fatigue from CFS lasts for at least 6 months and doesn’t go away with bed rest. Medications along with diet and lifestyle changes may help you manage symptoms.\n\nChronic fatigue syndrome (CFS) is a disorder characterized by extreme [fatigue](https:\/\/www.healthline.com\/symptom\/fatigue) or tiredness that doesn’t go away with rest and can’t be explained by an underlying medical condition.\n\nCFS can also be referred to as myalgic encephalomyelitis (ME) or systemic exertion intolerance disease (SEID).\n\nThe causes of CFS aren’t fully understood yet. Some theories include [viral infection](https:\/\/www.healthline.com\/health\/mononucleosis), psychological [stress](https:\/\/www.healthline.com\/health\/stress\/effects-on-body), or a combination of factors.\n\nBecause no single cause has been identified, and because many other conditions produce similar symptoms, CFS can be difficult to diagnose.\n\nThere are no tests for CFS. Your doctor will have to rule out other causes for your fatigue when determining a diagnosis.\n\nWhile CFS was previously a controversial diagnosis, it’s now [widely accepted](https:\/\/www.healthline.com\/health-news\/evidence-found-that-chronic-fatigue-is-a-physical-illness-022715) as a medical condition.\n\nCFS can affect anyone, though it’s most common among [women](https:\/\/www.womenshealth.gov\/a-z-topics\/chronic-fatigue-syndrome) in their [40s and 50s](https:\/\/www.mayoclinic.org\/diseases-conditions\/chronic-fatigue-syndrome\/symptoms-causes\/syc-20360490). There’s currently no cure, but treatment can relieve symptoms.\n\nHere’s what you need to know about CFS, including symptoms, treatment options, and outlook.\n\nThe cause of CFS is unknown. Researchers speculate that contributing factors may include:\n\n- viruses\n- a [weakened immune system](https:\/\/www.healthline.com\/health\/immunodeficiency-disorders)\n- [stress](https:\/\/www.healthline.com\/health\/stress)\n- [hormonal imbalances](https:\/\/www.healthline.com\/nutrition\/balance-hormones)\n\nIt’s also possible that some people are genetically predisposed to develop CFS.\n\nThough CFS can sometimes develop after a viral infection, no single type of infection has been found to cause CFS. Some viral infections that have been studied in relation to CFS include those caused by:\n\n- [Epstein-Barr virus (EBV)](https:\/\/www.healthline.com\/health\/epstein-barr-virus-test)\n- human herpesvirus 6\n- Ross River virus (RRV)\n- [rubella virus](https:\/\/www.healthline.com\/health\/rubella)\n\nIn fact, about [1 in 10 people](https:\/\/www.cdc.gov\/me-cfs\/about\/possible-causes.html) with EBV, Ross River virus, or *Coxiella burnetii* infection will develop a condition that meets the criteria for a CFS diagnosis.\n\nAdditionally, researchers say that those who’ve had severe symptoms with any of these three infections are at a higher risk for later developing CFS.\n\nPeople with CFS sometimes have weakened immune systems, but doctors don’t know whether this is enough to cause the disorder.\n\nPeople with CFS can also sometimes have [abnormal hormone levels](https:\/\/www.healthline.com\/health\/hormonal-imbalance). Doctors haven’t yet concluded whether this is significant, either.\n\nSome people with CFS may concomitantly have some deficiencies in vitamins including B2 (riboflavin) or B12, but it is unclear if they improve with vitamin supplementation.\n\nCFS is most commonly seen among people in their 40s and 50s.\n\nSex also plays an important role in CFS, as women are [two to four times](https:\/\/www.womenshealth.gov\/a-z-topics\/chronic-fatigue-syndrome) more likely to be diagnosed with CFS than men.\n\nOther factors that may increase your risk for CFS include:\n\n- genetic predisposition\n- [allergies](https:\/\/www.healthline.com\/health\/allergies)\n- stress\n- environmental factors\n\nSymptoms of CFS vary based on the individual and the severity of the condition.\n\nThe most common symptom is fatigue that’s severe enough to interfere with your daily activities.\n\nFor CFS to be diagnosed, a significantly reduced ability to perform your usual daily activities with fatigue must last for at least 6 months. It must not be curable with bed rest.\n\nCFS can also introduce sleep problems, such as:\n\n- feeling unrefreshed after a night’s sleep\n- [chronic insomnia](https:\/\/www.healthline.com\/health\/insomnia-concerns)\n- other [sleep disorders](https:\/\/www.healthline.com\/health\/sleep\/disorders)\n\nIn addition, you may also experience:\n\n- [loss of memory](https:\/\/www.healthline.com\/symptom\/memory-loss)\n- reduced [concentration](https:\/\/www.healthline.com\/symptom\/unable-to-concentrate)\n- orthostatic intolerance (going from lying or seated to standing positions makes you light-headed, dizzy, or faint)\n\nPhysical symptoms of CFS may include:\n\n- [muscle pain](https:\/\/www.healthline.com\/symptom\/muscle-pain)\n- frequent [headaches](https:\/\/www.healthline.com\/health\/headache)\n- multi-joint pain without redness or swelling\n- frequent [sore throat](https:\/\/www.healthline.com\/health\/sore-throat)\n- tender and [swollen lymph nodes](https:\/\/www.healthline.com\/health\/swollen-lymph-nodes) in your neck and armpits\n\nCFS affects some people in cycles, with periods of feeling worse and then better.\n\nSymptoms may sometimes even disappear completely, which is referred to as remission. However, it’s still possible for symptoms to return later, which is referred to as a relapse.\n\nThis cycle of remission and relapse can make it difficult to manage your symptoms, but it’s possible.\n\nCFS is a very challenging condition to diagnose.\n\nAccording to the [Institute of Medicine](http:\/\/www.nationalacademies.org\/hmd\/~\/media\/Files\/Report%20Files\/2015\/MECFS\/MECFS_KeyFacts.pdf), as of 2015, CFS occurs in about 836,000 to 2.5 million Americans. It’s estimated, however, that 84 to 91 percent have yet to receive a diagnosis.\n\nThere are no medical tests to screen for CFS. Its symptoms are similar to many other conditions. Many people with CFS don’t “look sick,” so doctors may not recognize that they indeed have a health condition.\n\nIn order to receive a CFS diagnosis, your doctor will rule out other potential causes and review your medical history with you.\n\nThey’ll confirm that you at least have the core symptoms previously mentioned. They’ll also ask about the duration and severity of your unexplained fatigue.\n\nRuling out other potential causes of your fatigue is a key part of the diagnosis process. Some conditions with symptoms that resemble those of CFS include:\n\n- [mononucleosis](https:\/\/www.healthline.com\/health\/mononucleosis)\n- [Lyme disease](https:\/\/www.healthline.com\/health\/lyme-disease)\n- [multiple sclerosis](https:\/\/www.healthline.com\/health\/multiple-sclerosis)\n- [lupus (SLE)](https:\/\/www.healthline.com\/health\/systemic-lupus-erythematosus)\n- [hypothyroidism](https:\/\/www.healthline.com\/health\/hypothyroidism\/symptoms-treatments-more)\n- [fibromyalgia](https:\/\/www.healthline.com\/health\/fibromyalgia)\n- [major depressive disorder](https:\/\/www.healthline.com\/health\/clinical-depression)\n- severe obesity\n- sleep disorders\n\nThe side effects of certain drugs, such as [antihistamines](https:\/\/www.healthline.com\/health\/allergies\/antihistamine-brands) and [alcohol](https:\/\/www.healthline.com\/health\/alcohol\/effects-on-body), can mimic symptoms of CFS as well.\n\nBecause of the similarities between symptoms of CFS and many other conditions, it’s important to not self-diagnose. Talk to your doctor about your symptoms. They can work with you to get relief.\n\nThere’s currently no specific cure for CFS.\n\nEach person has different symptoms and therefore may require different types of treatment to manage the disorder and relieve their symptoms.\n\nAs mentioned above, some people with CFS may also have functional vitamin deficiencies and theoretically may feel better with vitamin supplementation but much more study is needed.\n\nWork with your team of healthcare providers to create the best treatment plan for you. They can go over the possible benefits and side effects of the therapies with you.\n\nAddressing post-exertional malaise (PEM) symptoms\n\nPEM occurs when even minor physical, mental, or emotional exertion results in CFS symptoms becoming worse.\n\nWorsening symptoms usually occur [12 to 48 hours](https:\/\/www.cdc.gov\/me-cfs\/treatment\/index.html) after the activity and last for days or even weeks.\n\nActivity management, also called pacing, can help balance rest and activity to avoid PEM flare-ups. You’ll need to find your individual limits for mental and physical activities, plan these activities, and then rest to stay within these limits.\n\nSome doctors refer to staying within these limits as the “energy envelope.” Keeping a diary of your activities may help you find your personal limits.\n\nIt’s important to note that while vigorous aerobic exercise is good for most chronic conditions, people with CFS don’t tolerate such exercise routines.\n\nHome remedies and lifestyle changes\n\nLimiting or eliminating your [caffeine intake](https:\/\/www.healthline.com\/health\/caffeine-effects-on-body) can help you sleep better and ease your insomnia. You should limit or avoid nicotine and alcohol too.\n\nTry to avoid napping during the day if it’s hurting your ability to sleep at night.\n\nCreate a [sleep routine](https:\/\/www.healthline.com\/health\/sleep-disorders-prevention). Go to bed at the same time every night and aim to wake up around the same time every day.\n\nMedications\n\nTypically, no one medication can treat all of your symptoms. Also, your symptoms may change over time, so your medications may have to as well.\n\nIn many cases, CFS can trigger depression. You may need low-dose [antidepressant therapy](https:\/\/www.healthline.com\/health\/depression\/medication-list) or a referral to a mental health provider.\n\nIf lifestyle changes don’t give you a restful night’s sleep, your doctor may suggest a sleep aid. Pain-reducing medication can also help you cope with aches and joint pain caused by CFS.\n\nIf medication therapy is needed, it will have to be tailored for your needs. Work closely with your doctor. There’s no one-size-fits-all treatment for CFS.\n\nAlternative medicine\n\n[Acupuncture](https:\/\/www.healthline.com\/health\/dry-needling-vs-acupuncture), tai chi, [yoga](https:\/\/www.healthline.com\/nutrition\/13-benefits-of-yoga), and massage may help relieve the pain associated with CFS. Always talk to your doctor before beginning any alternative or complementary treatments.\n\nDespite increased research efforts, CFS remains a complex condition with no exact known cause and cure. The recovery rate is [only 5%](https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/15699087\/). Managing CFS can therefore be challenging.\n\nYou’ll likely need to make lifestyle changes to adapt to your chronic fatigue. As a result, you may experience depression, [anxiety](https:\/\/www.healthline.com\/health\/anxiety), or social isolation. You might find that joining a [support group](https:\/\/ammes.org\/find-a-support-group\/) can be helpful as you’re making decisions and transitions.\n\nCFS progresses differently in everyone, so it’s important to work with your doctor to create a treatment plan that meets your needs.\n\nMany people benefit from working with a team of healthcare providers. This can include doctors, therapists, and rehabilitation specialists.\n\nIf you’re living with CFS, the [Solve ME\/CFS Initiative](http:\/\/solvecfs.org\/) has resources that you may find helpful. The [CDC](https:\/\/www.cdc.gov\/me-cfs\/treatment\/index.html) also offers recommendations for managing and living with CFS.","meta_canonical":null}

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Meta Description	Chronic fatigue syndrome is a disorder characterized by extreme tiredness that can’t be explained by an underlying condition. This means it can be difficult to diagnose.
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Boilerpipe Text	The extreme and persistent fatigue from CFS lasts for at least 6 months and doesn’t go away with bed rest. Medications along with diet and lifestyle changes may help you manage symptoms. Chronic fatigue syndrome (CFS) is a disorder characterized by extreme fatigue or tiredness that doesn’t go away with rest and can’t be explained by an underlying medical condition. CFS can also be referred to as myalgic encephalomyelitis (ME) or systemic exertion intolerance disease (SEID). The causes of CFS aren’t fully understood yet. Some theories include viral infection , psychological stress , or a combination of factors. Because no single cause has been identified, and because many other conditions produce similar symptoms, CFS can be difficult to diagnose. There are no tests for CFS. Your doctor will have to rule out other causes for your fatigue when determining a diagnosis. While CFS was previously a controversial diagnosis, it’s now widely accepted as a medical condition. CFS can affect anyone, though it’s most common among women in their 40s and 50s . There’s currently no cure, but treatment can relieve symptoms. Here’s what you need to know about CFS, including symptoms, treatment options, and outlook. The cause of CFS is unknown. Researchers speculate that contributing factors may include: viruses a weakened immune system stress hormonal imbalances It’s also possible that some people are genetically predisposed to develop CFS. Though CFS can sometimes develop after a viral infection, no single type of infection has been found to cause CFS. Some viral infections that have been studied in relation to CFS include those caused by: Epstein-Barr virus (EBV) human herpesvirus 6 Ross River virus (RRV) rubella virus In fact, about 1 in 10 people with EBV, Ross River virus, or Coxiella burnetii infection will develop a condition that meets the criteria for a CFS diagnosis. Additionally, researchers say that those who’ve had severe symptoms with any of these three infections are at a higher risk for later developing CFS. People with CFS sometimes have weakened immune systems, but doctors don’t know whether this is enough to cause the disorder. People with CFS can also sometimes have abnormal hormone levels . Doctors haven’t yet concluded whether this is significant, either. Some people with CFS may concomitantly have some deficiencies in vitamins including B2 (riboflavin) or B12, but it is unclear if they improve with vitamin supplementation. CFS is most commonly seen among people in their 40s and 50s. Sex also plays an important role in CFS, as women are two to four times more likely to be diagnosed with CFS than men. Other factors that may increase your risk for CFS include: genetic predisposition allergies stress environmental factors Symptoms of CFS vary based on the individual and the severity of the condition. The most common symptom is fatigue that’s severe enough to interfere with your daily activities. For CFS to be diagnosed, a significantly reduced ability to perform your usual daily activities with fatigue must last for at least 6 months. It must not be curable with bed rest. CFS can also introduce sleep problems, such as: feeling unrefreshed after a night’s sleep chronic insomnia other sleep disorders In addition, you may also experience: loss of memory reduced concentration orthostatic intolerance (going from lying or seated to standing positions makes you light-headed, dizzy, or faint) Physical symptoms of CFS may include: muscle pain frequent headaches multi-joint pain without redness or swelling frequent sore throat tender and swollen lymph nodes in your neck and armpits CFS affects some people in cycles, with periods of feeling worse and then better. Symptoms may sometimes even disappear completely, which is referred to as remission. However, it’s still possible for symptoms to return later, which is referred to as a relapse. This cycle of remission and relapse can make it difficult to manage your symptoms, but it’s possible. CFS is a very challenging condition to diagnose. According to the Institute of Medicine , as of 2015, CFS occurs in about 836,000 to 2.5 million Americans. It’s estimated, however, that 84 to 91 percent have yet to receive a diagnosis. There are no medical tests to screen for CFS. Its symptoms are similar to many other conditions. Many people with CFS don’t “look sick,” so doctors may not recognize that they indeed have a health condition. In order to receive a CFS diagnosis, your doctor will rule out other potential causes and review your medical history with you. They’ll confirm that you at least have the core symptoms previously mentioned. They’ll also ask about the duration and severity of your unexplained fatigue. Ruling out other potential causes of your fatigue is a key part of the diagnosis process. Some conditions with symptoms that resemble those of CFS include: mononucleosis Lyme disease multiple sclerosis lupus (SLE) hypothyroidism fibromyalgia major depressive disorder severe obesity sleep disorders The side effects of certain drugs, such as antihistamines and alcohol , can mimic symptoms of CFS as well. Because of the similarities between symptoms of CFS and many other conditions, it’s important to not self-diagnose. Talk to your doctor about your symptoms. They can work with you to get relief. There’s currently no specific cure for CFS. Each person has different symptoms and therefore may require different types of treatment to manage the disorder and relieve their symptoms. As mentioned above, some people with CFS may also have functional vitamin deficiencies and theoretically may feel better with vitamin supplementation but much more study is needed. Work with your team of healthcare providers to create the best treatment plan for you. They can go over the possible benefits and side effects of the therapies with you. Addressing post-exertional malaise (PEM) symptoms PEM occurs when even minor physical, mental, or emotional exertion results in CFS symptoms becoming worse. Worsening symptoms usually occur 12 to 48 hours after the activity and last for days or even weeks. Activity management, also called pacing, can help balance rest and activity to avoid PEM flare-ups. You’ll need to find your individual limits for mental and physical activities, plan these activities, and then rest to stay within these limits. Some doctors refer to staying within these limits as the “energy envelope.” Keeping a diary of your activities may help you find your personal limits. It’s important to note that while vigorous aerobic exercise is good for most chronic conditions, people with CFS don’t tolerate such exercise routines. Home remedies and lifestyle changes Limiting or eliminating your caffeine intake can help you sleep better and ease your insomnia. You should limit or avoid nicotine and alcohol too. Try to avoid napping during the day if it’s hurting your ability to sleep at night. Create a sleep routine . Go to bed at the same time every night and aim to wake up around the same time every day. Medications Typically, no one medication can treat all of your symptoms. Also, your symptoms may change over time, so your medications may have to as well. In many cases, CFS can trigger depression. You may need low-dose antidepressant therapy or a referral to a mental health provider. If lifestyle changes don’t give you a restful night’s sleep, your doctor may suggest a sleep aid. Pain-reducing medication can also help you cope with aches and joint pain caused by CFS. If medication therapy is needed, it will have to be tailored for your needs. Work closely with your doctor. There’s no one-size-fits-all treatment for CFS. Alternative medicine Acupuncture , tai chi, yoga , and massage may help relieve the pain associated with CFS. Always talk to your doctor before beginning any alternative or complementary treatments. Despite increased research efforts, CFS remains a complex condition with no exact known cause and cure. The recovery rate is only 5% . Managing CFS can therefore be challenging. You’ll likely need to make lifestyle changes to adapt to your chronic fatigue. As a result, you may experience depression, anxiety , or social isolation. You might find that joining a support group can be helpful as you’re making decisions and transitions. CFS progresses differently in everyone, so it’s important to work with your doctor to create a treatment plan that meets your needs. Many people benefit from working with a team of healthcare providers. This can include doctors, therapists, and rehabilitation specialists. If you’re living with CFS, the Solve ME/CFS Initiative has resources that you may find helpful. The CDC also offers recommendations for managing and living with CFS.
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Connect with us for all things health. Subscribe # CFS (Chronic Fatigue Syndrome) ![](https://i0.wp.com/post.healthline.com/wp-content/uploads/2022/01/Megan-Soliman-500x500-Bio.png?w=105&h=105) [Medically reviewed]() by [Megan Soliman, MD]() — Written by [Stacy Sampson, D.O.]() — [Updated on October 31, 2023]() - [Causes](https://www.healthline.com/health/chronic-fatigue-syndrome#causes) - [Risk factors](https://www.healthline.com/health/chronic-fatigue-syndrome#risk-factors) - [Symptoms](https://www.healthline.com/health/chronic-fatigue-syndrome#symptoms) - [Diagnosis](https://www.healthline.com/health/chronic-fatigue-syndrome#diagnosis) - [Treatment](https://www.healthline.com/health/chronic-fatigue-syndrome#treatment) - [Outlook](https://www.healthline.com/health/chronic-fatigue-syndrome#outlook) The extreme and persistent fatigue from CFS lasts for at least 6 months and doesn’t go away with bed rest. Medications along with diet and lifestyle changes may help you manage symptoms. Chronic fatigue syndrome (CFS) is a disorder characterized by extreme [fatigue](https://www.healthline.com/symptom/fatigue) or tiredness that doesn’t go away with rest and can’t be explained by an underlying medical condition. CFS can also be referred to as myalgic encephalomyelitis (ME) or systemic exertion intolerance disease (SEID). The causes of CFS aren’t fully understood yet. Some theories include [viral infection](https://www.healthline.com/health/mononucleosis), psychological [stress](https://www.healthline.com/health/stress/effects-on-body), or a combination of factors. Because no single cause has been identified, and because many other conditions produce similar symptoms, CFS can be difficult to diagnose. There are no tests for CFS. Your doctor will have to rule out other causes for your fatigue when determining a diagnosis. While CFS was previously a controversial diagnosis, it’s now [widely accepted](https://www.healthline.com/health-news/evidence-found-that-chronic-fatigue-is-a-physical-illness-022715) as a medical condition. CFS can affect anyone, though it’s most common among [women](https://www.womenshealth.gov/a-z-topics/chronic-fatigue-syndrome) in their [40s and 50s](https://www.mayoclinic.org/diseases-conditions/chronic-fatigue-syndrome/symptoms-causes/syc-20360490). There’s currently no cure, but treatment can relieve symptoms. Here’s what you need to know about CFS, including symptoms, treatment options, and outlook. ## [What causes CFS?]() The cause of CFS is unknown. Researchers speculate that contributing factors may include: - viruses - a [weakened immune system](https://www.healthline.com/health/immunodeficiency-disorders) - [stress](https://www.healthline.com/health/stress) - [hormonal imbalances](https://www.healthline.com/nutrition/balance-hormones) It’s also possible that some people are genetically predisposed to develop CFS. Though CFS can sometimes develop after a viral infection, no single type of infection has been found to cause CFS. Some viral infections that have been studied in relation to CFS include those caused by: - [Epstein-Barr virus (EBV)](https://www.healthline.com/health/epstein-barr-virus-test) - human herpesvirus 6 - Ross River virus (RRV) - [rubella virus](https://www.healthline.com/health/rubella) Infections caused by bacteria, including [Coxiella burnetii](https://www.healthline.com/health/q-fever) and [Mycoplasma pneumoniae](https://www.healthline.com/health/mycoplasma-pneumonia), have also been studied in relation to CFS. The [Centers for Disease Control and Prevention (CDC)](https://www.cdc.gov/me-cfs/about/possible-causes.html) has suggested that CFS may be the end stage of multiple different conditions, rather than one specific condition. In fact, about [1 in 10 people](https://www.cdc.gov/me-cfs/about/possible-causes.html) with EBV, Ross River virus, or Coxiella burnetii infection will develop a condition that meets the criteria for a CFS diagnosis. Additionally, researchers say that those who’ve had severe symptoms with any of these three infections are at a higher risk for later developing CFS. People with CFS sometimes have weakened immune systems, but doctors don’t know whether this is enough to cause the disorder. People with CFS can also sometimes have [abnormal hormone levels](https://www.healthline.com/health/hormonal-imbalance). Doctors haven’t yet concluded whether this is significant, either. Some people with CFS may concomitantly have some deficiencies in vitamins including B2 (riboflavin) or B12, but it is unclear if they improve with vitamin supplementation. ## [Risk factors for CFS]() CFS is most commonly seen among people in their 40s and 50s. Sex also plays an important role in CFS, as women are [two to four times](https://www.womenshealth.gov/a-z-topics/chronic-fatigue-syndrome) more likely to be diagnosed with CFS than men. Other factors that may increase your risk for CFS include: - genetic predisposition - [allergies](https://www.healthline.com/health/allergies) - stress - environmental factors ## [What are the symptoms of CFS?]() Symptoms of CFS vary based on the individual and the severity of the condition. The most common symptom is fatigue that’s severe enough to interfere with your daily activities. For CFS to be diagnosed, a significantly reduced ability to perform your usual daily activities with fatigue must last for at least 6 months. It must not be curable with bed rest. You will also experience [extreme fatigue after physical or mental activities](https://www.nap.edu/resource/19012/MECFS_ProposedDiagnosticCriteria.jpg), which is referred to as post-exertional malaise (PEM). This can last for [more than 24 hours](https://www.mayoclinic.org/diseases-conditions/chronic-fatigue-syndrome/symptoms-causes/syc-20360490) after the activity. CFS can also introduce sleep problems, such as: - feeling unrefreshed after a night’s sleep - [chronic insomnia](https://www.healthline.com/health/insomnia-concerns) - other [sleep disorders](https://www.healthline.com/health/sleep/disorders) In addition, you may also experience: - [loss of memory](https://www.healthline.com/symptom/memory-loss) - reduced [concentration](https://www.healthline.com/symptom/unable-to-concentrate) - orthostatic intolerance (going from lying or seated to standing positions makes you light-headed, dizzy, or faint) Physical symptoms of CFS may include: - [muscle pain](https://www.healthline.com/symptom/muscle-pain) - frequent [headaches](https://www.healthline.com/health/headache) - multi-joint pain without redness or swelling - frequent [sore throat](https://www.healthline.com/health/sore-throat) - tender and [swollen lymph nodes](https://www.healthline.com/health/swollen-lymph-nodes) in your neck and armpits CFS affects some people in cycles, with periods of feeling worse and then better. Symptoms may sometimes even disappear completely, which is referred to as remission. However, it’s still possible for symptoms to return later, which is referred to as a relapse. This cycle of remission and relapse can make it difficult to manage your symptoms, but it’s possible. ## [How is CFS diagnosed?]() CFS is a very challenging condition to diagnose. According to the [Institute of Medicine](http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2015/MECFS/MECFS_KeyFacts.pdf), as of 2015, CFS occurs in about 836,000 to 2.5 million Americans. It’s estimated, however, that 84 to 91 percent have yet to receive a diagnosis. There are no medical tests to screen for CFS. Its symptoms are similar to many other conditions. Many people with CFS don’t “look sick,” so doctors may not recognize that they indeed have a health condition. In order to receive a CFS diagnosis, your doctor will rule out other potential causes and review your medical history with you. They’ll confirm that you at least have the core symptoms previously mentioned. They’ll also ask about the duration and severity of your unexplained fatigue. Ruling out other potential causes of your fatigue is a key part of the diagnosis process. Some conditions with symptoms that resemble those of CFS include: - [mononucleosis](https://www.healthline.com/health/mononucleosis) - [Lyme disease](https://www.healthline.com/health/lyme-disease) - [multiple sclerosis](https://www.healthline.com/health/multiple-sclerosis) - [lupus (SLE)](https://www.healthline.com/health/systemic-lupus-erythematosus) - [hypothyroidism](https://www.healthline.com/health/hypothyroidism/symptoms-treatments-more) - [fibromyalgia](https://www.healthline.com/health/fibromyalgia) - [major depressive disorder](https://www.healthline.com/health/clinical-depression) - severe obesity - sleep disorders The side effects of certain drugs, such as [antihistamines](https://www.healthline.com/health/allergies/antihistamine-brands) and [alcohol](https://www.healthline.com/health/alcohol/effects-on-body), can mimic symptoms of CFS as well. Because of the similarities between symptoms of CFS and many other conditions, it’s important to not self-diagnose. Talk to your doctor about your symptoms. They can work with you to get relief. ## [How is CFS treated?]() There’s currently no specific cure for CFS. Each person has different symptoms and therefore may require different types of treatment to manage the disorder and relieve their symptoms. As mentioned above, some people with CFS may also have functional vitamin deficiencies and theoretically may feel better with vitamin supplementation but much more study is needed. Work with your team of healthcare providers to create the best treatment plan for you. They can go over the possible benefits and side effects of the therapies with you. ### Addressing post-exertional malaise (PEM) symptoms PEM occurs when even minor physical, mental, or emotional exertion results in CFS symptoms becoming worse. Worsening symptoms usually occur [12 to 48 hours](https://www.cdc.gov/me-cfs/treatment/index.html) after the activity and last for days or even weeks. Activity management, also called pacing, can help balance rest and activity to avoid PEM flare-ups. You’ll need to find your individual limits for mental and physical activities, plan these activities, and then rest to stay within these limits. Some doctors refer to staying within these limits as the “energy envelope.” Keeping a diary of your activities may help you find your personal limits. It’s important to note that while vigorous aerobic exercise is good for most chronic conditions, people with CFS don’t tolerate such exercise routines. ### Home remedies and lifestyle changes Making some [lifestyle changes](https://www.healthline.com/health/diet-hacks-to-reduce-chronic-fatigue) may help reduce your symptoms. Limiting or eliminating your [caffeine intake](https://www.healthline.com/health/caffeine-effects-on-body) can help you sleep better and ease your insomnia. You should limit or avoid nicotine and alcohol too. Try to avoid napping during the day if it’s hurting your ability to sleep at night. Create a [sleep routine](https://www.healthline.com/health/sleep-disorders-prevention). Go to bed at the same time every night and aim to wake up around the same time every day. ### Medications Typically, no one medication can treat all of your symptoms. Also, your symptoms may change over time, so your medications may have to as well. In many cases, CFS can trigger depression. You may need low-dose [antidepressant therapy](https://www.healthline.com/health/depression/medication-list) or a referral to a mental health provider. If lifestyle changes don’t give you a restful night’s sleep, your doctor may suggest a sleep aid. Pain-reducing medication can also help you cope with aches and joint pain caused by CFS. If medication therapy is needed, it will have to be tailored for your needs. Work closely with your doctor. There’s no one-size-fits-all treatment for CFS. ### Alternative medicine [Acupuncture](https://www.healthline.com/health/dry-needling-vs-acupuncture), tai chi, [yoga](https://www.healthline.com/nutrition/13-benefits-of-yoga), and massage may help relieve the pain associated with CFS. Always talk to your doctor before beginning any alternative or complementary treatments. ## [What can be expected in the long term?]() Despite increased research efforts, CFS remains a complex condition with no exact known cause and cure. The recovery rate is [only 5%](https://www.ncbi.nlm.nih.gov/pubmed/15699087/). Managing CFS can therefore be challenging. You’ll likely need to make lifestyle changes to adapt to your chronic fatigue. As a result, you may experience depression, [anxiety](https://www.healthline.com/health/anxiety), or social isolation. You might find that joining a [support group](https://ammes.org/find-a-support-group/) can be helpful as you’re making decisions and transitions. CFS progresses differently in everyone, so it’s important to work with your doctor to create a treatment plan that meets your needs. Many people benefit from working with a team of healthcare providers. This can include doctors, therapists, and rehabilitation specialists. If you’re living with CFS, the [Solve ME/CFS Initiative](http://solvecfs.org/) has resources that you may find helpful. The [CDC](https://www.cdc.gov/me-cfs/treatment/index.html) also offers recommendations for managing and living with CFS. ### How we reviewed this article: Sources History Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our [editorial policy](https://www.healthline.com/about/process). - Beyond myalgic encephalomyelitis/chronic fatigue syndrome: Redefining an illness. (2015). <https://nap.nationalacademies.org/catalog/19012/beyond-myalgic-encephalomyelitischronic-fatigue-syndrome-redefining-an-illness> - Cairns R, et al. (2005). A systematic review describing the prognosis of chronic fatigue syndrome. <https://pubmed.ncbi.nlm.nih.gov/15699087/> - Chronic fatigue syndrome. (2021). <https://www.womenshealth.gov/a-z-topics/chronic-fatigue-syndrome> - Myalgic encephalomyelitis/chronic fatigue syndrome (2023). <https://www.cdc.gov/me-cfs/> - Proposed diagnostic criteria for ME/CFS. (n.d.). <https://www.nap.edu/resource/19012/MECFS_ProposedDiagnosticCriteria.jpg> - Russell-Jones G. (2022). Functional vitamin B12 deficiency in chronic fatigue syndrome. <https://www.researchgate.net/publication/362644480_Functional_Vitamin_B12_deficiency_in_Chronic_Fatigue_Syndrome_International_Journal_of_Psychiatry_Corresponding_author> Share this article ![](https://i0.wp.com/post.healthline.com/wp-content/uploads/2022/01/Megan-Soliman-500x500-Bio.png?w=105&h=105) [Medically reviewed]() by [Megan Soliman, MD]() — Written by [Stacy Sampson, D.O.]() — [Updated on October 31, 2023]() ## related stories - [‘Robust’ Evidence Found That Chronic Fatigue Syndrome Is a Physical Illness](https://www.healthline.com/health-news/evidence-found-that-chronic-fatigue-is-a-physical-illness-022715?utm_source=ReadNext) - [So Much More Than Tired: 3 Ways to Explain What Chronic Fatigue Is Really Like](https://www.healthline.com/health/how-i-explain-chronic-fatigue-syndrome?utm_source=ReadNext) - [Causes of Fatigue and How to Manage It](https://www.healthline.com/health/fatigue?utm_source=ReadNext) - [Life with Chronic Fatigue Syndrome: 11 Lessons from My “Mother-in-Law”](https://www.healthline.com/health/life-with-chronic-fatigue-syndrome-11-lessons-ive-learned?utm_source=ReadNext) - [What’s Causing My Fatigue and Nausea?](https://www.healthline.com/health/fatigue-and-nausea?utm_source=ReadNext) © 2026 Healthline Media LLC. 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Readable Markdown	The extreme and persistent fatigue from CFS lasts for at least 6 months and doesn’t go away with bed rest. Medications along with diet and lifestyle changes may help you manage symptoms. Chronic fatigue syndrome (CFS) is a disorder characterized by extreme [fatigue](https://www.healthline.com/symptom/fatigue) or tiredness that doesn’t go away with rest and can’t be explained by an underlying medical condition. CFS can also be referred to as myalgic encephalomyelitis (ME) or systemic exertion intolerance disease (SEID). The causes of CFS aren’t fully understood yet. Some theories include [viral infection](https://www.healthline.com/health/mononucleosis), psychological [stress](https://www.healthline.com/health/stress/effects-on-body), or a combination of factors. Because no single cause has been identified, and because many other conditions produce similar symptoms, CFS can be difficult to diagnose. There are no tests for CFS. Your doctor will have to rule out other causes for your fatigue when determining a diagnosis. While CFS was previously a controversial diagnosis, it’s now [widely accepted](https://www.healthline.com/health-news/evidence-found-that-chronic-fatigue-is-a-physical-illness-022715) as a medical condition. CFS can affect anyone, though it’s most common among [women](https://www.womenshealth.gov/a-z-topics/chronic-fatigue-syndrome) in their [40s and 50s](https://www.mayoclinic.org/diseases-conditions/chronic-fatigue-syndrome/symptoms-causes/syc-20360490). There’s currently no cure, but treatment can relieve symptoms. Here’s what you need to know about CFS, including symptoms, treatment options, and outlook. The cause of CFS is unknown. Researchers speculate that contributing factors may include: - viruses - a [weakened immune system](https://www.healthline.com/health/immunodeficiency-disorders) - [stress](https://www.healthline.com/health/stress) - [hormonal imbalances](https://www.healthline.com/nutrition/balance-hormones) It’s also possible that some people are genetically predisposed to develop CFS. Though CFS can sometimes develop after a viral infection, no single type of infection has been found to cause CFS. Some viral infections that have been studied in relation to CFS include those caused by: - [Epstein-Barr virus (EBV)](https://www.healthline.com/health/epstein-barr-virus-test) - human herpesvirus 6 - Ross River virus (RRV) - [rubella virus](https://www.healthline.com/health/rubella) In fact, about [1 in 10 people](https://www.cdc.gov/me-cfs/about/possible-causes.html) with EBV, Ross River virus, or Coxiella burnetii infection will develop a condition that meets the criteria for a CFS diagnosis. Additionally, researchers say that those who’ve had severe symptoms with any of these three infections are at a higher risk for later developing CFS. People with CFS sometimes have weakened immune systems, but doctors don’t know whether this is enough to cause the disorder. People with CFS can also sometimes have [abnormal hormone levels](https://www.healthline.com/health/hormonal-imbalance). Doctors haven’t yet concluded whether this is significant, either. Some people with CFS may concomitantly have some deficiencies in vitamins including B2 (riboflavin) or B12, but it is unclear if they improve with vitamin supplementation. CFS is most commonly seen among people in their 40s and 50s. Sex also plays an important role in CFS, as women are [two to four times](https://www.womenshealth.gov/a-z-topics/chronic-fatigue-syndrome) more likely to be diagnosed with CFS than men. Other factors that may increase your risk for CFS include: - genetic predisposition - [allergies](https://www.healthline.com/health/allergies) - stress - environmental factors Symptoms of CFS vary based on the individual and the severity of the condition. The most common symptom is fatigue that’s severe enough to interfere with your daily activities. For CFS to be diagnosed, a significantly reduced ability to perform your usual daily activities with fatigue must last for at least 6 months. It must not be curable with bed rest. CFS can also introduce sleep problems, such as: - feeling unrefreshed after a night’s sleep - [chronic insomnia](https://www.healthline.com/health/insomnia-concerns) - other [sleep disorders](https://www.healthline.com/health/sleep/disorders) In addition, you may also experience: - [loss of memory](https://www.healthline.com/symptom/memory-loss) - reduced [concentration](https://www.healthline.com/symptom/unable-to-concentrate) - orthostatic intolerance (going from lying or seated to standing positions makes you light-headed, dizzy, or faint) Physical symptoms of CFS may include: - [muscle pain](https://www.healthline.com/symptom/muscle-pain) - frequent [headaches](https://www.healthline.com/health/headache) - multi-joint pain without redness or swelling - frequent [sore throat](https://www.healthline.com/health/sore-throat) - tender and [swollen lymph nodes](https://www.healthline.com/health/swollen-lymph-nodes) in your neck and armpits CFS affects some people in cycles, with periods of feeling worse and then better. Symptoms may sometimes even disappear completely, which is referred to as remission. However, it’s still possible for symptoms to return later, which is referred to as a relapse. This cycle of remission and relapse can make it difficult to manage your symptoms, but it’s possible. CFS is a very challenging condition to diagnose. According to the [Institute of Medicine](http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2015/MECFS/MECFS_KeyFacts.pdf), as of 2015, CFS occurs in about 836,000 to 2.5 million Americans. It’s estimated, however, that 84 to 91 percent have yet to receive a diagnosis. There are no medical tests to screen for CFS. Its symptoms are similar to many other conditions. Many people with CFS don’t “look sick,” so doctors may not recognize that they indeed have a health condition. In order to receive a CFS diagnosis, your doctor will rule out other potential causes and review your medical history with you. They’ll confirm that you at least have the core symptoms previously mentioned. They’ll also ask about the duration and severity of your unexplained fatigue. Ruling out other potential causes of your fatigue is a key part of the diagnosis process. Some conditions with symptoms that resemble those of CFS include: - [mononucleosis](https://www.healthline.com/health/mononucleosis) - [Lyme disease](https://www.healthline.com/health/lyme-disease) - [multiple sclerosis](https://www.healthline.com/health/multiple-sclerosis) - [lupus (SLE)](https://www.healthline.com/health/systemic-lupus-erythematosus) - [hypothyroidism](https://www.healthline.com/health/hypothyroidism/symptoms-treatments-more) - [fibromyalgia](https://www.healthline.com/health/fibromyalgia) - [major depressive disorder](https://www.healthline.com/health/clinical-depression) - severe obesity - sleep disorders The side effects of certain drugs, such as [antihistamines](https://www.healthline.com/health/allergies/antihistamine-brands) and [alcohol](https://www.healthline.com/health/alcohol/effects-on-body), can mimic symptoms of CFS as well. Because of the similarities between symptoms of CFS and many other conditions, it’s important to not self-diagnose. Talk to your doctor about your symptoms. They can work with you to get relief. There’s currently no specific cure for CFS. Each person has different symptoms and therefore may require different types of treatment to manage the disorder and relieve their symptoms. As mentioned above, some people with CFS may also have functional vitamin deficiencies and theoretically may feel better with vitamin supplementation but much more study is needed. Work with your team of healthcare providers to create the best treatment plan for you. They can go over the possible benefits and side effects of the therapies with you. Addressing post-exertional malaise (PEM) symptoms PEM occurs when even minor physical, mental, or emotional exertion results in CFS symptoms becoming worse. Worsening symptoms usually occur [12 to 48 hours](https://www.cdc.gov/me-cfs/treatment/index.html) after the activity and last for days or even weeks. Activity management, also called pacing, can help balance rest and activity to avoid PEM flare-ups. You’ll need to find your individual limits for mental and physical activities, plan these activities, and then rest to stay within these limits. Some doctors refer to staying within these limits as the “energy envelope.” Keeping a diary of your activities may help you find your personal limits. It’s important to note that while vigorous aerobic exercise is good for most chronic conditions, people with CFS don’t tolerate such exercise routines. Home remedies and lifestyle changes Limiting or eliminating your [caffeine intake](https://www.healthline.com/health/caffeine-effects-on-body) can help you sleep better and ease your insomnia. You should limit or avoid nicotine and alcohol too. Try to avoid napping during the day if it’s hurting your ability to sleep at night. Create a [sleep routine](https://www.healthline.com/health/sleep-disorders-prevention). Go to bed at the same time every night and aim to wake up around the same time every day. Medications Typically, no one medication can treat all of your symptoms. Also, your symptoms may change over time, so your medications may have to as well. In many cases, CFS can trigger depression. You may need low-dose [antidepressant therapy](https://www.healthline.com/health/depression/medication-list) or a referral to a mental health provider. If lifestyle changes don’t give you a restful night’s sleep, your doctor may suggest a sleep aid. Pain-reducing medication can also help you cope with aches and joint pain caused by CFS. If medication therapy is needed, it will have to be tailored for your needs. Work closely with your doctor. There’s no one-size-fits-all treatment for CFS. Alternative medicine [Acupuncture](https://www.healthline.com/health/dry-needling-vs-acupuncture), tai chi, [yoga](https://www.healthline.com/nutrition/13-benefits-of-yoga), and massage may help relieve the pain associated with CFS. Always talk to your doctor before beginning any alternative or complementary treatments. Despite increased research efforts, CFS remains a complex condition with no exact known cause and cure. The recovery rate is [only 5%](https://www.ncbi.nlm.nih.gov/pubmed/15699087/). Managing CFS can therefore be challenging. You’ll likely need to make lifestyle changes to adapt to your chronic fatigue. As a result, you may experience depression, [anxiety](https://www.healthline.com/health/anxiety), or social isolation. You might find that joining a [support group](https://ammes.org/find-a-support-group/) can be helpful as you’re making decisions and transitions. CFS progresses differently in everyone, so it’s important to work with your doctor to create a treatment plan that meets your needs. Many people benefit from working with a team of healthcare providers. This can include doctors, therapists, and rehabilitation specialists. If you’re living with CFS, the [Solve ME/CFS Initiative](http://solvecfs.org/) has resources that you may find helpful. The [CDC](https://www.cdc.gov/me-cfs/treatment/index.html) also offers recommendations for managing and living with CFS.
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