Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2023;108(1):online

Related article: Fatigue in Adults: Evaluation and Management

Myalgic encephalomyelitis (my-AL-gic en-SEH-fuhlow-MY-uh-LIE-tus)/chronic fatigue syndrome (ME/CFS) is a chronic, severe, possibly disabling disorder. It can cause inflammatory, neurologic, immune, and metabolic problems that are not well understood.

You may have ME/CFS if you are:

  • Having ongoing severe fatigue for six months or more

  • Not feeling rested after sleep

  • Feeling very tired after an activity that you would have been able to do before you became ill and feeling like you have “crashed” when you overexert yourself

  • Having lightheadedness after standing for a long time

  • Having “brain fog”

What causes ME/CFS?

No one is sure what causes it. Many, but not all, patients report symptoms starting after a viral illness. Researchers are looking for a cause.

How can I help myself?

Knowing your activity limits and pacing yourself are the best ways to feel better. Some of your tasks may use lots of energy and make you feel more fatigued, so choose each day's activities carefully and do your important work earlier in the day. Write down your symptoms to review with your doctor, who can help you build a personal treatment plan.

Lifestyle, Exercise, Diet, Sleep, and Stress

Although there is no cure for ME/CFS, you should do your best to improve your health.

  • Modest exercise may worsen fatigue in many people with ME/CFS. You should work on “pacing” to balance physical efforts with rest.

  • It's important to exercise within your limits. Always stop exercising before you feel tired.

  • Eat a well-balanced diet.

  • If possible, go to bed and get up at the same time every day. Do not watch TV in bed because it makes it harder to fall asleep.

  • Set reasonable limits for yourself. Trying to do too much makes things worse. Instead, plan your day's activities for when you usually feel better.

  • Relaxation techniques, such as deep breathing, meditation, and massage therapy, can help you manage stress and chronic pain.

Where can I get more information?

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