Temporary exhaustion or chronic fatigue?
Who is most at risk?
What are the causes?
The precise causes of CFS are unknown, but certain factors may be associated with its onset:
- Infections, such as those caused by the Epstein-Barr virus (EBV) and possibly SARS-CoV-2, which causes COVID-19. Infections caused by other viruses or bacteria, such as those responsible for Lyme disease or Q fever, are also suspected.
- Immune system disorders: Although people with chronic fatigue syndrome do not have an immune deficiency (vulnerability to infection), regulation of the immune system in affected individuals differs from that of normal individuals.
- Endocrine and metabolic disorders (hypometabolic state, abnormalities in energy generated through cellular metabolism, defective cortisol secretion, low blood pressure, etc.)
- Depression does not appear to cause chronic fatigue syndrome, but it is important to treat it before focussing on treating chronic fatigue.
- Sleeping problems or non-restorative sleep.
- Genetics: Changes in the sequence of genes associated with brain function, stress response or emotions may make some individuals more prone to developing chronic fatigue syndrome.
What are the symptoms?
The symptoms reported by patients can vary from person to person and day to day. They include the following:
- Pathological fatigue: persistent and unexplained tiredness, forcing the person to reduce their activities and not improving through rest
- Fatigue or dizziness following physical effort
- Sleep disorders and non-restorative sleep
- Unexplained muscle or joint pain (myalgia)
- Neurocognitive disorders (impairment of memory, concentration, verbal skills, etc.)
- Neurological or cognitive disorders (confusion, poor concentration, memory loss, disorientation, etc.)
- Autonomic nervous system disorders (orthostatic hypotension, dizziness when changing position, palpitations, etc.)
- Neuroendocrine disorders (fluctuating body temperature during the day, eating disorders, etc.)
- Immune system disorders (tenderness in the neck or armpit lymph nodes, sore throat, new intolerances or allergies, etc.)
How is it diagnosed?
Is there a treatment?
Unfortunately, there is currently no treatment that cures chronic fatigue syndrome. The treatments available are aimed at relieving the symptoms and improving quality of life. Some individuals report an improvement in symptoms over time, while the opposite is true for many others.
Because the disease presents differently in each individual, treatment should be tailored to each person and focus on relieving the most debilitating symptoms.[5,7] This includes medications to treat pain and promote sleep, as well as maintaining a certain level of physical activity, if possible.
Several other treatments have been proposed, but their efficacy has not been proven:
- Cognitive behavioural therapy
- Medication with antibiotic and antiviral agents, as well as steroids and antihistamines
- Herbal and vitamin supplements of all types
- Dietary restrictions
Learning to live with chronic fatigue syndrome
For professional support, we’re here for you.
- B. M. Carruthers et al. (2003). “Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols. A Consensus Document,” Journal of Chronic Fatigue Syndrome, 11(1):7-115.
- Bruce M. Carruthers and Marjorie I. van de Sande (2006). “Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Clinical Case Definition and Guidelines for Medical Practitioners. An Overview of the Canadian Consensus Document,” Carruthers and van de Sande, https://www.canada.ca/en/public-health/services/chronic-diseases/chronic-fatique-syndrome-myaligic-encephalomyelitis.html.
- Canadian Institutes for Health Research. “Working with patients and their families to improve health outcomes for people living with ME/CFS,” https://cihr-irsc.gc.ca/e/51074.html [accessed on February 28, 2022].
- Stephen J. Gluckman (2021). “Clinical features and diagnosis of myalgic encephalomyelitis/chronic fatigue syndrome,” UpToDate, https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-myalgic-encephalomyelitis-chronic-fatigue-syndrome.
- Fred Friedberg et al. (2012). “Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Primer for Clinical Practitioners,” International Association for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis, https://aqem.org/wp-content/uploads/2014/06/Primer-IACFSME-en-fran%C3%A7ais.pdf.
- E. Nepotchatykh, W. Elremaly, I. Caraus I. et al. (2020). “Profile of Circulating MicroRNAs in Myalgic Encephalomyelitis and Their Relation to Symptom Severity, and Disease Pathophysiology,” Nature Scientific Reports, 10(19620), https://www.nature.com/articles/s41598-020-76438-y.epdf.
- Stephen J. Gluckman (2020). “Patient education: Myalgic encephalomyelitis/chronic fatigue syndrome (Beyond the Basics),” UpToDate, https://www.uptodate.com/contents/myalgic-encephalomyelitis-chronic-fatigue-syndrome-beyond-the-basics?topicRef=2742&source=see_link.