CFS; Fatigue - chronic; Immune dysfeature syndrome; Myalgic encephalomyelitis (ME); Myalgic encephalopathy chronic tiredness syndrome (ME-CFS); Systemic exertion intolerance condition (SEID)


Myalgic encephalomyelitis / chronic exhaustion syndrome (ME/CFS) is a long-term condition that affects many type of body systems. People with this condition are not able to execute their usual activities. Sometimes, they may be confined to bed. The condition deserve to additionally be called systemic exertional intolerance illness (SEID).

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One prevalent symptom is significant exhaustion. It does not acquire better via remainder and is not straight caused by various other clinical problems. Other symptoms can incorporate problems through thinking and concentrating, pain, and also dizziness.


The precise cause of ME/CFS is unwell-known. It may have actually even more than one reason. For example, two or even more possible reasons may work together to trigger the disease.

Researchers are looking into these possible causes:

Infection -- About 1 out of 10 world that construct specific infections, such as Epstein-Barr virus and also Q fever before, go on to build ME/CFS. Other infections have actually additionally been stupassed away, however no one reason has actually been found.Immune system changes -- ME/CFS might be motivated by changes in the means a person"s immune device responds to anxiety or disease.Mental or physical stress -- Many type of human being with ME/CFS have been under significant psychological or physical stress and anxiety before becoming ill.Energy production -- The way that cells within the body acquire power is different in people via ME/CFS than in people without the condition. It"s unclear how this is attached to developing the disease.

Genetics or ecological determinants might also play a role in the breakthrough of ME/CFS:

Anyone deserve to gain ME/CFS.While a lot of widespread in people between 40 and also 60 years old, the condition affects kids, teens, and also adults of all ages.Among adults, womales are affected more regularly than males.White human being are diagnosed more than various other races and also ethnic backgrounds. But many human being with ME/CFS have not been diagnosed, specifically among minorities.

Tright here are three main, or "core," symptoms in people with ME/CFS:

Prouncovered fatigueWorsening symptoms after physical or psychological activitySleep problems

People with ME/CFS have persistent and also profound exhaustion and are unable to carry out activities they were able to do before the illness. This excessive exhaustion is:

NewLasts at least 6 monthsNot because of unusual or intense activityNot relieved by sleep or bed restSevere enough to save you from participating in specific activities

ME/CFS symptoms have the right to end up being worse after physical or psychological task. This is referred to as post-exertional malaise (PEM), additionally known as a crash, relapse, or collapse.

For instance, you may suffer a crash after shopping at the grocery keep and also have to take a nap prior to driving house. Or you may require someone to come pick you up.There is no method to predict what will cause a crash or recognize exactly how lengthy it will take to recuperate. It can take days, weeks, or much longer to recoup.

Sleep problems might include difficulties falling or remaining asleep. A full-night"s remainder does not relieve exhaustion and also other symptoms.

People via ME/CFS likewise regularly endure at leastern among the two adhering to symptoms:

Forgetfulness, concentration difficulties, troubles complying with details (additionally dubbed "brain fog")Worsening symptoms as soon as standing or sitting upbest. This is dubbed orthostatic intolerance. You might feel dizzy, lightheaded, or faint as soon as standing or sitting up. You also might have actually vision changes or view spots.

Other common symptoms include:

Sore throat, sore lymph nodes in the neck or under the arms, chills and also night sweatsDigestive difficulties, such as irritable bowel syndromeAllergiesSensitivity to noise, food, odors, or chemicals

The Centers for Disease Control (CDC) defines ME/CFS as a distinct disorder via specific symptoms and also physical indicators. Diagnosis is based upon ruling out various other possible causes.

Your wellness treatment provider will certainly try to rule out various other feasible causes of fatigue, including:

Drug dependenceInfectionsOther illnesses (such as heart, kidney, or liver diseases)Psychiatric or mental illnesses, especially depressionTumors

A diagnosis of ME/CFS must include:

Absence of various other causes of permanent (chronic) fatigueAt least 4 ME/CFS-certain symptomsExtreme, long-term fatigue

Tright here are no certain tests to confirm the diagnosis of ME/CFS. However, there have actually been reports of human being via ME/CFS having actually abnormal outcomes on the following tests:

White blood cell count

There is presently no cure for ME/CFS. The goal of treatment is to relieve symptoms.

Treatment has a combination of the following:

Sleep monitoring techniquesMedicines to minimize pain, discomfort, and also feverMedicines to treat stress and anxiety (anti-tension drugs)Medicines to treat depression (antidepressant drugs)Healthy diet

Some drugs have the right to cause reactions or side effects that are worse than the original symptoms of the condition.

People via ME/CFS are urged to maintain an active social life. Mild physical exercise might likewise be beneficial. Your wellness treatment team will certainly aid you number out just how much activity you have the right to carry out, and also just how to progressively rise your activity. Tips include:

Avoid doing as well much on days when you feel tiredBalance your time in between task, rest, and sleepBreak big work into smaller, even more controlled onesSpread out your even more difficult work via the week

Relaxation and stress-reduction techniques deserve to help control chronic (long-term) pain and also fatigue. They are not supplied as the primary therapy for ME/CFS. Relaxation techniques include:

BiofeedbackDeep breapoint exercisesHypnosisMassage therapyMeditationMuscle relaxation techniquesYoga

It also may be helpful to job-related with a therapist to aid you resolve your feelings and the impact of the illness on your life.

Newer medication philosophies are being researched.


Support Groups


Some people might benefit from taking part in an ME/CFS support team.


Outlook (Prognosis)


The irreversible outlook for world via ME/CFS varies. It is hard to predict as soon as symptoms first start. Some civilization totally recover after 6 months to a year.

About 1 in 4 civilization via ME/CFS are so severely disabled that they can"t get out of bed or leave their house. Symptoms have the right to come and go in cycles, and even as soon as world feel much better, they may suffer a relapse triggered by exertion or an unrecognized reason.

Some world never before feel prefer they did before they emerged ME/CFS. Studies indicate that you are more most likely to acquire much better if you receive substantial rehabilitation.


Complications might include:

DepressionIncapability to take component in occupational and also social activities, which have the right to lead to isolationSide effects from medicines or therapies

Call your provider if you have actually serious fatigue, through or without other symptoms of this disorder. Other more severe disorders deserve to reason similar symptoms and also have to be ruled out.


Centers for Disease Control and also Prevention webwebsite. Myalgic encephalomyelitis/chronic exhaustion syndrome: therapy. www.cdc.gov/me-cfs/treatment/index.html. Updated November 19, 2019. Accessed July 17, 2020.

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Committee on the Diagnostic Criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome; Board on the Health of Select Populations; Institute of Medicine. Beyond myalgic encephalomyelitis/chronic fatigue syndrome: respecifying a disease. Washington, DC: National Academies Press; 2015. PMID: 25695122 pubmed.ncbi.nlm.nih.gov/25695122/.

Ebenbichler GR. Chronic exhaustion syndrome. In: Frontera, WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation. fourth ed. Philadelphia, PA: Elsevier; 2019:chap 126.

Engleberg NC. Chronic exhaustion syndrome (systemic exertion intolerance disease). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett"s Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 130.

Smith MEB, Haney E, McDonagh M, et al. Treatment of myalgic encephalomyelitis/chronic fatigue syndrome: a methodical review for a National Institutes of Health Pathmeans to Prevention Workshop. Ann Intern Med. 2015;162(12):841-850. PMID: 26075755 pubmed.ncbi.nlm.nih.gov/26075755/.

van der Meer JWM, Bleijenberg G. Chronic exhaustion syndrome. In: Cohen J, Powderly WG, Opal SM, eds. Infectious Diseases. 4th ed. Philadelphia, PA: Elsevier; 2017:chap 70.

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Reviewed by: Diane M. Horowitz, MD, Rheumatology and Internal Medicine, Northwell Health, Great Neck, NY. Rewatch gave by VeriMed Healthtreatment Network. Also reregarded by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and also the A.D.A.M. Editorial team.