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Chronic Fatigue Syndrome: All You Need to Know

Chronic Fatigue Syndrome: All You Need to Know


  • Sensitivities: Adverse or unpleasant reaction to light, noise, and certain foods or odours have been observed in some cases.
  • Pain: There have been instances of muscle and joint pain, often described as myalgia. Typically, this kind of pain is without any swelling or redness.
  • Headaches: Recurrent headaches, including migraines, is a common symptom.

Chronic fatigue syndrome (CFS), also known as Myalgic Encephalomyelitis (ME), is a complex and often misunderstood medical condition characterized by extreme fatigue that has no apparent link to any underlying disease within the patient. The debilitating fatigue or tiredness may worsen with physical or mental activity and doesn’t get better with rest. This condition is very hard to explain and reduces the quality of life of the person as well as limiting their ability to carry out daily activities.

In this comprehensive blog, we will help you understand the various aspects of CFS, including its symptoms, potential causes, diagnosis, treatment, and the challenges faced by individuals living with this debilitating condition.

What is chronic fatigue syndrome?

CFS can be defined as a systemic exertion intolerance disease. Myalgic Encephalomyelitis is a term preferred by some individuals and advocacy groups who believe it better reflects the neurological and immune system aspects of the illness. Its profound impact on an individual’s life often leads to significant disability and reduced quality of life.

Symptoms of chronic fatigue syndrome

Although the hallmark symptom of CFS is persistent and unexplained fatigue, strangely, it cannot be relieved by simple rest. Instead, this fatigue substantially impairs a person’s ability to function. 

Aside from the main symptom of fatigue, CFS has eight official symptoms that are central to its classification. These include:

  • Cognitive Impairment: This may include problems with memory, concentration, and word-finding.
  • Immune Dysfunction: Dysregulation of the immune system has been observed in some cases.
  • Sleep Disturbances: These can include Insomnia, unrefreshing sleep, and disturbances in the sleep-wake cycle.
  • Post-Exertional Malaise: Physical or mental exertion can lead to a worsening of symptoms and a prolonged recovery period.
  • Presence of Lymph Nodes: Enlarged and tender neck and armpit lymph nodes are also typical of CFS.

The symptoms of CFS vary in each individual but for proper classification as CFS, fatigue and at least four of the above symptoms must exist in the patient for at least six months. Since CFS follows a cycle of remission and relapse, it becomes difficult to treat these patients.

Causes of chronic fatigue syndrome

Seen more commonly in women as compared to men, CFS typically manifests in individuals between the ages of 40 and 50 years.

The exact cause of CFS remains unknown, and it is likely a complex interplay of multiple factors. Some potential triggers and contributors that have been explored include:

  • Viral Infections: CFS is sometimes preceded by a viral illness, leading to the theory that viral infections might trigger the condition. It has been observed that about 10-12% of people with Epstein-Barr virus, Ross River virus and Coxiella burnetti infections go on to develop symptoms that resemble the criteria needed for a diagnosis of CFS.
  • Immune System Dysfunction: Abnormalities in the immune system have been observed, but it is unclear whether they are a cause or an effect of CFS.
  • Family History: There may be a genetic predisposition to CFS, as it sometimes clusters in families.
  • Environmental Factors: These include exposure to toxins and stress.
  • Hormonal Imbalance: Hormonal abnormalities, particularly involving the hypothalamic-pituitary-adrenal (HPA) axis are being studied as possible contributors.
  • Psychological Factors: While CFS is not a psychological condition, the experience of living with chronic illness can lead to psychological challenges.

Diagnosing chronic fatigue syndrome

Diagnosing CFS is challenging due to the absence of specific biomarkers. Instead, a diagnosis is typically based on a process of exclusion. The diagnostic process involves ruling out other medical conditions that could explain the symptoms, such as thyroid disorders, sleep disorders, and autoimmune diseases.

Complications of chronic fatigue syndrome

Owing to its chronic nature and rather debilitating symptoms, CFS can have the following complications:

  • Reduced quality of life
  • Social isolation
  • Mental health issues
  • Employment and financial difficulties
  • Lack of understanding and social stigma
  • Loss of independence

Each of the above is a cause for concern and calls for urgent medical attention which usually focuses on relieving symptoms only. Antidepressants and sleeping pills are the main medications used to relieve the patient. The patient is also advised about self-care measures to reduce stress, restrict use of stimulants, have a paced routine and undergo physical and psychological therapy.


Managing chronic fatigue syndrome

At Plexus, our management strategies for CFS focus on symptom relief and improving the patient’s quality of life. We use a combination of the following approaches:

  • Stem cell therapy
  • Activity pacing
  • Cognitive behavioral therapy (CBT)
  • Graded exercise therapy (GET)
  • Dietary and lifestyle changes
  • Supportive therapies: Complementary therapies like acupuncture, massage, and mindfulness techniques may provide some relief.

Stem cell therapy for chronic fatigue syndrome at Plexus

At Plexus, we use autologous (from the patient’s own body) mesenchymal stem cells to manage CFS and provide long-term relief from symptoms. Stem cells help modulate the immune system, reduce inflammation, and promote tissue repair and regeneration, all of which are critical for managing CFS.

Fatigue disorders and CFS comorbidities

Post-Stroke Fatigue Syndrome (PSFS)

Post-Stroke Fatigue Syndrome, is a condition characterized by extreme and persistent fatigue that occurs after a stroke. It is also referred to as post-stroke fatigue or post-stroke asthenia, PSFS is marked by disproportionate and debilitating exhaustion that can significantly impact a person’s quality of life.

PSFS and CFS share some commonalities, such as severe fatigue, which can be debilitating. Additionally, cognitive impairment, sleep disturbances, and physical limitations. However, their main difference lies in the onset. CFS may develop all of a sudden or just gradually without any specific cause. PSFS, on the other hand, typically occurs as a result of stroke.

PSFS is more commonly associated with neurological damage (due to a stroke). It can impact the brain’s ability to regulate energy levels, thereby leading to fatigue. In the case of CFS, since its exact cause is unclear, but typically attributed to family history, viral infections, and immune dysfunction among other causes mentioned earlier in this blog.

PSFS can be managed through Plexus’ post-stroke rehabilitation

Management of CFS follows a combination of symptom management, lifestyle adjustments, as well as experimental therapies such as stem cell treatment.

Fatigue in Epilepsy

Fatigue is a common symptom of epilepsy. It is often attributed to the frequent occurrence of seizures, side effects of antiepileptic medications, and the emotional and psychological burden of living with a chronic condition. It is important to understand that fatigue in epilepsy can be both physical and mental in nature.

It is absolutely vital to differentiate between epilepsy-related fatigue and CFS. A thorough medical evaluation, including neurological and psychological assessments, can help clarify the source of fatigue.

Managing both conditions requires a holistic approach that includes optimizing seizure control, addressing medication side effects, and implementing lifestyle and psychological strategies to manage fatigue effectively.

If you or your loved one is suffering from chronic fatigue syndrome, we urge you to visit us at our centres in Bangalore and Hyderabad. To book a consultation, reach out to us today.

WhatsApp +91 89048 42087

Call +91 78159 64668 (Hyderabad) | +91 82299 99888 (Bangalore)


What is acute fatigue?

Acute fatigue is extreme tiredness and exhaustion that lasts up to one month or less.

How do you fix chronic fatigue?

Chronic fatigue is not fixable, per se. But it can be managed with a combination of physical therapy, occupational therapy, and experimental therapies, such as stem cell therapy. Additionally, implementation of certain lifestyle changes like keeping up your intake of essential fatty acids, vitamin B12, folic acid, and other nutrients can help reduce symptoms of chronic fatigue syndrome.

What are the 7 symptoms of chronic fatigue syndrome?

The following are the major symptoms of chronic fatigue syndrome:

  • Cognitive impairment
  • Immune dysfunction
  • Sleep disturbances
  • Post-exertional fatigue and pain
  • Adverse or unpleasant reaction to light, noise, and certain foods or odour
  • Pain without swelling and redness
  • Headaches
  • Presence of lymph nodes

What does chronic fatigue feel like?

Fatigue over a long period of time, typically lasting longer than 6 months, is characteristic of chronic fatigue syndrome. Many patients experience brain fog, which appears like confusion, forgetfulness, as well as a lack of focus.

Is chronic fatigue a mental illness?

No. Chronic fatigue syndrome is not a mental illness.

What vitamins help with fatigue?

Vitamins B12 and D are known to help manage fatigue. However, if you experience fatigue on a regular basis, please be sure to check with your doctor.

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