Dr Dulcy Rakumakoe
3 minute read
24 Jun 2019
10:54 am

What you need to know about chronic fatigue syndrome

Dr Dulcy Rakumakoe

Cognitive behavioural therapy can be useful in helping patients pace themselves and avoid the push-crash cycle.

Picture: iStock

Chronic fatigue syndrome (CFS) is a complicated disorder characterised by extreme fatigue that can’t be explained by any underlying medical condition.

This fatigue is not the kind of tired feeling that goes away after you rest. Instead, it limits your ability to do ordinary daily activities. The fatigue may worsen with physical or mental activity.

The cause of chronic fatigue syndrome is unknown, although there are many theories ranging from viral infections to psychological stress. Some experts believe chronic fatigue syndrome might be triggered by a combination of factors.

There’s no single test to confirm a diagnosis of chronic fatigue syndrome. You may need a variety of medical tests to rule out other health problems that have similar symptoms.

Treatment focuses on symptom relief.


  • Fatigue that lasts six months or more;
  • Loss of memory or concentration;
  • Sore throat;
  • Enlarged lymph nodes in your neck or armpits;
  • Unexplained muscle pain;
  • Pain that moves from one joint to another without swelling or redness;
  • Headache of a new type;
  • Unrefreshing sleep
  • Extreme exhaustion lasting more than 24 hours after physical or mental exercise.


Some of the factors that have been studied include:

  • Viral infections.
  • Immune system problems.
  • Hormonal imbalances.

Factors that may increase your risk include:

  • Age: It most commonly affects people in their 40s and 50s.
  • Sex: women are diagnosed with CFS much more often than men, but it may be that women are simply more likely to report their symptoms to a doctor.
  • Stress.


  • Depression
  • Social isolation
  • Lifestyle restrictions
  • Increased work absenteeism


The symptoms can mimic so many other health problems therefore there is no single test to confirm a diagnosis. Consult your doctor if you suspect you might be suffering from CFS in order to rule out a number of other illnesses.

These conditions may include:

Sleep disorders. A sleep study can determine if your rest is being disturbed.

Medical problems, such as anaemia, diabetes, systemic lupus erythematosus, fybromyalgia and underactive thyroid (hypothyroidism). Lab tests can check your blood for evidence of some of the top suspects.

Mental health issues, such as depression, anxiety, bipolar disorder and schizophrenia.

The side effects of certain drugs, such as antihistamines and alcohol.


Tailor treatment to your specific set of symptoms. Symptom relief may include certain medications:


Sleeping pills. There’s evidence that a multi-pronged approach may be helpful:

Be kind to yourself. Keep your activity on an even level.

Develop a plan to avoid or limit overexertion and emotional stress.

Improve sleep habits. Go to bed and get up at the same time each day.

Pain may be helped by acupuncture, massage, yoga or tai chi.

Previous studies suggest that graded exercise is an effective and safe treatment.

Psychological counselling can help you figure out options to work around some of the limitations.

Cognitive behavioural therapy (CBT) and self-management strategies are among the most helpful. CBT is often prescribed to help patients with chronic illness cope better with illness and develop strategies that relieve the symptoms of their illness.

It has been successful in helping patients with cardiovascular disease, diabetes, and cancer. For CFS patients, CBT can be useful in helping them pace themselves and avoid the push-crash cycle.

Dietary changes that have been shown to work: add flaxseed oil to your food, stop coffee, stop consuming junk food, limit dairy intake and eat more greens.

Not everyone who has severe CFS responds to treatment in the same way. People who have a better chance of treatment success tend to have less impairment, focus less on symptoms, comply with counselling programmes and pace themselves to avoid overexertion and underexertion.

Emotional support and counselling may help you and your loved ones deal with the uncertainties and restrictions of chronic fatigue syndrome.

You may find it therapeutic to join a support group and meet other people with chronic fatigue syndrome. Support groups aren’t for everyone, and you may find that a support group adds to your stress rather than relieves it.

Experiment and use your own judgment to determine what’s best for you.

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