Chronic fatigue syndrome: symptoms, causes and treatment

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

Interestingly, in the 70s and 80s it was called the yuppie flu because it mainly affected young workers living in cities and the stress and fast pace of life caused them to be severely exhausted.

    What is chronic fatigue?

    Chronic Fatigue Syndrome (CFS) it is an alteration that causes the person to feel tired or extremely tired, Which may prevent the person from performing any usual activity or task.

    To distinguish chronic fatigue from severe fatigue, a person must have symptoms for more than six months. In addition, if he tries to relieve them through rest or physical or mental tasks, it is very likely that the situation will get worse.

    This disease is a chronic, extremely complex disease whose causes are still poorly understood, interfering with the cardiovascular, endocrine, neurological and immune systems.

    Today, this condition is assumed to affect around 0.5% of the world’s population, Being the woman most affected in 90% of cases. Outraged. it usually appears with other diseases such as fibromyalgia or irritable bowel syndrome.

    Other known names for Chronic Fatigue (CFS) are Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (MS / CFS) or Systemic Stress Intolerance Disease (Aeuesis).


    As stated above, to consider this fatigue as an extreme fatigue syndrome, they must last at least six months. The patient with chronic fatigue syndrome has the following symptoms, among others:

    • intense fatigue
    • Hyperthermia or fever
    • Photophobia
    • hyperacusis
    • They are in the repairman
    • Headache
    • muscle pain
    • Intolerance to temperature changes
    • Concentration deficits
    • Short-term memory loss
    • Spatial orientation deficit

    Thus, the symptoms of chronic fatigue syndrome can be noticed in many aspects of life and affect both the way a person relates to others and the way they interact with the elements of the environment in which they live. , the thing affects its achievement of goals, whether itself -image, etc.

    the causes

    Long ago, chronic fatigue was considered a psychosomatic disorderHowever, it is now accepted that it cannot be considered as a psychiatric disorder, but rather as a disease of organic origin, but the causes are not yet fully understood.

    Despite the large body of research on chronic fatigue syndrome around the world, the origin of this phenomenon is still far from being discovered. However, some research has drawn reliable conclusions that oxidative stress is an important part of the disease, although it is not known whether this is a cause or a consequence of CFS.

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

    Over time and the advancement of science, it has been hypothesized that the possibility of an accelerated pace of life and poor nutrition, among other causes, causes the candidiasis fungus to develop abnormally, thereby triggering chronic fatigue syndrome. However, this theory has been widely criticized and refuted.

    On another side, some studies assume that toxic substances are found in the environment and chemical elements found in certain foods also contribute to weakening the person and causing CFS.

    Finally, the influence of the quality of sleep, recurrent physical and psychological stress or certain disorders such as post-traumatic stress syndrome has also been highlighted.


    Chronic fatigue syndrome is distinguished by its difficult diagnosis. For a better assessment of the patient’s condition, the clinician should begin by preparing a medical history and a physical examination, with the aim of ruling out any disease hidden after these symptoms.

    Taking into account that between 39% and 47% of patients with CFS also suffer from depressionAn assessment of the patient’s mental state should also be done. In addition to excluding a possible influence of certain drugs by the analysis of blood and urine.

    Despite the difficulties with diagnosing CFS, eight criteria have been developed over time, and although there is no consensus on which of all is the most effective, there are two methods that stand out from the rest. These are the diagnostic criteria of Fukuda (1994) and the most recent developed by the National Academy of Medicine of the United States (2015).

    Diagnostic criteria of Fukuda (1994)

    In order to diagnose CFS according to these criteria, the patient must present:

    1. Severe fatigue

    Chronic and intense fatigue for at least six months and for no apparent reason. In addition, this fatigue does not bring you to rest.

    2. Discard other conditions that can cause fatigue

    Rule out any illness that is a potential cause of feeling tired.

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

    • Memory and concentration deficits
    • Sore throat when swallowing
    • muscle pain
    • Non-inflammatory joint pain
    • headache
    • They are in the repairman
    • Tired after having made an effort with a course of more than 24 hours

    US National Academy of Medicine Diagnostic Criteria (2015)

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

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

    • Significant decrease in energy for carrying out any activity, for at least six months and without apparent causes.
    • Feelings of anxiety after exercise.
    • Rest at the repairer
    • Have one of these two symptoms: cognitive congestion or orthostatic intolerance.

    Other aspects to be taken into account in the diagnosis are attendance and their degree of occurrence, and must be given, at least in half of the cases, in a primary or severe manner.


    Since it is a chronic disease, there is no cure for it. however, drug treatment to manage symptoms such as muscle pain, trouble sleeping, anxiety, or depression, Has proven to be effective and flourishing symptoms over time.

    In other words, the health intervention is palliative, to cushion the impact of the disease on the quality of life and prevent it from generating additional problems that do not have to exist with effective symptom management and interaction with the patient. ‘environment.

    Likewise, cognitive-behavioral intervention to work on emotional aspects and nutritional rehabilitation may also be successful in addition to pharmacological treatment.

    Bibliographical references:

    • Bested, AC; Marshall, LM (2015). Review of Myalgic Encephalomyelitis / Chronic Fatigue Syndrome: An Evidence-Based Approach to Physician Diagnosis and Management. Rev Environ Health, 30 (4): 223-49.
    • Haney, E., Smith, ME, McDonagh, M., Pappas, M., Daeges, M., Wasson, N., Nelson, HD (2015). Methods of Diagnosis of Myalgic Encephalomyelitis / Chronic Fatigue Syndrome: A Systematic Review for a Workshop of National Institutes of Health Pathways to Prevention. Ann Intern Med, 162 (12): 834-40.
    • Reeves, WC, Lloyd, A., Vernon, SD, Klimas, N., Jason, LA, Bleijenberg, G., Evengard, B., White, PD, Nisenbaum, R., Unger, ER et al. at. (2003). Identification of ambiguities in the 1994 chronic fatigue syndrome research case definition and recommendations for resolution. Nothing. 3 (1): 25.

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