Chronic Fatigue Syndrome (ME/CFS)

What Is ME/CFS?

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex, multi-system illness characterized by profound fatigue that isn't improved by rest and worsens with physical or mental exertion.¹

Core Symptoms

• Profound fatigue - New, not lifelong
• Post-exertional malaise (PEM) - Worsening after activity
• Unrefreshing sleep
• Cognitive impairment - "Brain fog"
• Orthostatic intolerance

Other Common Symptoms

• Widespread pain
• Headaches
• Sore throat, swollen lymph nodes
• Sensitivities (light, sound, chemicals)
• Temperature dysregulation
• GI symptoms

Diagnosis²

• Clinical diagnosis based on symptoms
• No specific diagnostic test
• Must rule out other conditions
• Often takes years to diagnose

Management

• Pacing - Stay within "energy envelope"
• Rest - Allow recovery
• Symptom management - Pain, sleep, etc.
• Treat comorbidities
• Avoid pushing through - Can worsen condition

Important Notes³

• GET (graded exercise therapy) controversial; can harm
• This is a physiological illness, not psychological
• Severity varies widely
• Research is ongoing

References

1. Institute of Medicine. Beyond myalgic encephalomyelitis/chronic fatigue syndrome: redefining an illness. Washington: NAP; 2015.
2. Fukuda K, Straus SE, Hickie I, et al. The chronic fatigue syndrome: a comprehensive approach to its definition and study. Ann Intern Med. 1994;121(12):953-959.
3. Bateman L, Bested AC, Bonilla HF, et al. Myalgic encephalomyelitis/chronic fatigue syndrome: essentials of diagnosis and management. Mayo Clin Proc. 2021;96(11):2861-2878.