Chronic fatigue syndrome

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People with CFS often report a feeling of being unwell and suffering from malaise that can wax and wane.[1]Chronic fatigue and post-exertional malaise[2] are just two symptoms they experience
Roger Cicero was a famous German jazz singer. A few years prior to his death he was diagnosed with CFS. A number of health issues followed which led to an acute case of myocarditis. He died of a sudden stroke at age 45
Emma Blackery is a British singer-songwriter and YouTube vlogger. Emma had symptoms for six years before getting a diagnosis of CFS. The trigger most likely was glandular fever, also known as mononucleosis

Chronic fatigue syndrome (CFS) was a name coined by the Centers for Disease Control (CDC) in response to an outbreak of "chronic flu-like illness" in Incline Village, Lake Tahoe in 1984-1985[3] and several outbreaks and sporadic cases in the United States during the 1980s.

Prior to Incline Village, chronic fatigue syndrome was known as myalgic encephalomyelitis (ME). The "chronic fatigue syndrome" outbreaks of the 1980s and 1990s were likely ME outbreaks, although they differed in some respects from the 1930s-1960s outbreaks. With the development of the 1991 Oxford criteria and the 1994 Fukuda criteria for CFS, which differed in significant respects from historic descriptions of ME, CFS became a basket diagnosis that included patients with ME along with those suffering from a wide range of undefined or misdiagnosed fatiguing illnesses.[citation needed]

There have been media reports of athletes diagnosed with ME or CFS who have recovered in a relatively short period of time after rest, supplementation, and diet changes,[4][5][6] but may have had overtraining syndrome.[citation needed]

Although a diagnosis of CFS is valid and in the US the Fukuda criteria was used, diagnostic criterion such as SEID (ME/CFS), the Canadian Consensus Criteria (ME/CFS), and International Consensus Criteria (ME) offer a more accurate diagnosis of ME/CFS and ME.[citation needed]

Name controversy

The name "chronic fatigue syndrome" is controversial, as many consider it stigmatizing and focusing on a single symptom, chronic fatigue (CF), and despite the fact that post-exertional malaise is regarded as the hallmark symptom rather than chronic fatigue. For decades, patient advocates have been lobbying the CDC to instead use the name myalgic encephalomyelitis (ME).[7] Most patients and patient organizations prefer the name ME, or the hybrid ME/CFS. The names are often used interchangeably or together (ME/CFS).[8]

  • February 2016, Dr Anthony Komaroff, who was part of the CDC group of clinicians who coined the name chronic fatigue syndrome, said: "I think that was a big mistake because the name, in my opinion, and the opinion of a lot of people, it both trivializes and stigmatizes the illness. It makes it seem unimportant, maybe not even real".[10]
  • December 2016, Unger et al. CDC Grand Rounds: Chronic Fatigue Syndrome - Advancing Research and Clinical Education[11]. abstract notes:
Chronic fatigue syndrome (CFS) is a complex and serious illness that is often misunderstood. Experts have noted that the terminology "chronic fatigue syndrome" can trivialize this illness and stigmatize persons who experience its symptoms (1). The name was coined by a group of clinicians convened by CDC in the late 1980s to develop a research case definition for the illness, which, at the time, was called chronic Epstein-Barr virus syndrome. The name CFS was suggested because of the characteristic persistent fatigue experienced by all those affected and the evidence that acute or reactivated Epstein-Barr virus infection was not associated with many cases (2). However, the fatigue in this illness is striking and quite distinct from the common fatigue everyone experiences. A variety of other names have been used, including myalgic encephalomyelitis (ME), ME/CFS, chronic fatigue immune dysfunction, and most recently, systemic exertion intolerance disease (3). The lack of agreement about nomenclature need not be an impediment for advancing critically needed research and education. The term ME/CFS will be used in this article.[11]
  • Jul 2017, the CDC changed its website for Chronic Fatigue Syndrome to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).[8]

The Oxford criteria and Fukuda criteria are used in Australia, South Africa, Canada, and parts of Europe; they use the name CFS. The UK will sometimes use the name chronic fatigue syndrome or CFS/ME although they also use the name ME.[citation needed] The United States CDC now uses the acronym ME/CFS.[8]


Graph comparing the unadjusted quality of life EQ-5D-3L HRQoL score for ME/CFS with other chronic illnesses
ME/CFS patients have the lowest, unadjusted EQ-5D-3L measured HRQoL (quality of life) of 20 conditions, including multiple sclerosis and stroke. Overall, the same results are found after controlling for gender, age, education, and co-morbidity, including mental illness.
Unadjusted average quality of life in CFS compared to different illnesses. Source: PLoS One. 2015; 10(7): e0132421.

Chronic fatigue syndrome is a highly disabling illness, with only around 5% of patients achieving a full recovery. Quality of life, physical and work limitations, and pain are consistently found to be worse in CFS patients than in other chronic illnesses.[12]

Notable studies

Source: Chronic fatigue syndrome: A review (Balachander et al.) 2014.[13]

See also

Generally accepted criteria for diagnosing ME/CFS and ME

Learn more


  1. "Is CFS a Real Disease? — Watchtower ONLINE LIBRARY". August 22, 1992. What if CFS Is a Real Disease?. Retrieved February 8, 2019. Symptoms come and go, wax and wane
  2. "Is CFS a Real Disease? — Watchtower ONLINE LIBRARY". August 22, 1992. Could CFS Be Depression?. Retrieved February 8, 2019. especially a peculiar malaise and muscle soreness that may occur after even moderate exercise
  3. Boffey, Philip M. (1987). "Fatigue 'Virus' Has Experts More Baffled And Skeptical Than Ever". Retrieved August 11, 2018.
  4. Marathon runner forced to quit work after developing ME claims diet change gave him his life back by Claudia Tanner - iNews
  5. Muslim fighter with ME who left an arranged marriage to win world title by Rick Broadbent - The Times
  6. Video Mark 6:18 - Committee reviews 'potentially harmful and old fashioned' chronic fatigue treatments - by Andy Park and Clare O'Halloran - ABC 7.30
  7. "A Disease in Search of a Name: The History of CFS and the Efforts to Change Its Name - Prohealth". Prohealth. January 3, 2007. Retrieved August 11, 2018.
  8. "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)". Centers for Disease Control. July 3, 2017. Retrieved August 11, 2018.
  9. Klimas, Nancy (June 21, 2014). "ME/CFS Diagnosis and Name with Dr. Nancy Klimas". YouTube. ME/CFS Community.
  10. Komaroff, Anthony; Iskander, John (February 17, 2016), "Interview with Dr Anthony Komaroff", CDC Public Health Ground Rounds - Beyond the Data - Chronic Fatigue Syndrome: Advancing Research and Clinical Education
  11. 11.011.1 Unger, Elizabeth R.; Lin, Jin-Mann Sally; Brimmer, Dana J.; Lapp, Charles W.; Komaroff, Anthony L.; Nath, Avindra; Laird, Susan; Iskander, John (December 30, 2016). "CDC Grand Rounds: Chronic Fatigue Syndrome - Advancing Research and Clinical Education". MMWR. Morbidity and mortality weekly report. 65 (50–51): 1434–1438. doi:10.15585/mmwr.mm655051a4. ISSN 1545-861X. PMID 28033311.
  13. 13.013.1 Singh, Shubh Mohan; Sarkar, Siddharth; Rao, Pradyumna; Balachander, Srinivas (July 1, 2014). "Chronic fatigue syndrome: A review". Medical Journal of Dr. D.Y. Patil University. 7 (4): 415. doi:10.4103/0975-2870.135252. ISSN 0975-2870.
  14. Carruthers, Bruce M.; Jain, Anil Kumar; De Meirleir, Kenny L.; Peterson, Daniel L.; Klimas, Nancy G.; Lerner, A. Martin; Bested, Alison C.; Flor-Henry, Pierre; Joshi, Pradip; Powles, A C Peter; Sherkey, Jeffrey A.; van de Sande, Marjorie I. (2003), "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols" (PDF), Journal of Chronic Fatigue Syndrome, 11 (2): 7-115, doi:10.1300/J092v11n01_02
  15. Carruthers, Bruce M.; van de Sande, Marjorie I.; De Meirleir, Kenny L.; Klimas, Nancy G.; Broderick, Gordon; Mitchell, Terry; Staines, Donald; Powles, A. C. Peter; Speight, Nigel; Vallings, Rosamund; Bateman, Lucinda; Baumgarten-Austrheim, Barbara; Bell, David; Carlo-Stella, Nicoletta; Chia, John; Darragh, Austin; Jo, Daehyun; Lewis, Donald; Light, Alan; Marshall-Gradisnik, Sonya; Mena, Ismael; Mikovits, Judy; Miwa, Kunihisa; Murovska, Modra; Pall, Martin; Stevens, Staci (August 22, 2011). "Myalgic encephalomyelitis: International Consensus Criteria". Journal of Internal Medicine. 270 (4): 327–338. doi:10.1111/j.1365-2796.2011.02428.x. ISSN 0954-6820. PMC 3427890. PMID 21777306.
  16. Clayton, Ellen Wright; Alegria, Margarita; Bateman, Lucinda; Chu, Lily; Cleeland, Charles; Davis, Ronald; Diamond, Betty; Ganiats, Theodore; Keller, Betsy; Klimas, Nancy; Lerner, A Martin; Mulrow, Cynthia; Natelson, Benjamin; Rowe, Peter; Shelanski, Michael (2015). "Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome - Redefining an Illness" (PDF).
  17. Dambelli, Milena (October 16, 2018). "Chronic Fatigue Syndrome (1 hr. News Segment)". SBS Australia (Video). Retrieved October 17, 2018.
  18. "Brain studies show chronic fatigue syndrome and Gulf War illness are distinct conditions". Retrieved December 13, 2019.

Centers for Disease Control and Prevention (CDC) - The Centers for Disease Control and Prevention is a U.S. government agency dedicated to epidemiology and public health. It operates under the auspices of the Department of Health and Human Services.

chronic fatigue (CF) - Persistent and abnormal fatigue is a symptom, not an illness. It may be caused by depression, multiple sclerosis, fibromyalgia, chronic fatigue syndrome or many other illnesses. The term "chronic fatigue" should never be confused with the disease chronic fatigue syndrome.

myalgic encephalomyelitis (M.E.) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

Canadian Consensus Criteria (CCC) - A set of diagnostic criteria used to diagnose ME/CFS, developed by a group of practicing ME/CFS clinicians in 2003. The CCC is often considered to be the most complex criteria, but possibly the most accurate, with the lowest number of patients meeting the criteria. Led to the development of the International Consensus Criteria (ICC) in 2011.

International Consensus Criteria (ICC) - A set of diagnostic criteria, based on the Canadian Consensus Criteria, that argued for the abandonment of the term "chronic fatigue syndrome" and encouraged the sole use of the term "myalgic encephalomyelitis".

systemic exertion intolerance disease (SEID) - A term for ME/CFS that aims to avoid the stigma associated with the term "chronic fatigue syndrome", while emphasizing the defining characteristic of post-exertional malaise (PEM). SEID was defined as part of the diagnostic criteria put together by the Institute of Medicine (IOM) report of 10 February 2015.

The information provided at this site is not intended to diagnose or treat any illness.
From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history.