Chronic Fatigue Syndrome (ME/CFS)


What is Chronic Fatigue Syndrome (ME/CFS)?

Myalgic encephalomyeltis/chronic fatigue syndrome (ME/CFS) is an illness that affects nearly 0.5% of the general population. The history of chronic fatigue syndrome is interesting and the illness wasn’t identified or named until fairly recently, but similar symptoms presented as early as the 1860s. It is characterized by profound fatigue lasting at least six months and accompanied by numerous somatic symptoms. Although multiple biological and psychological mechanisms for ME/CFS have been investigated, a unifying disease concept is still lacking. In particular, little is known about the underlying neural mechanisms which initiate and chronically sustain fatigue.

Chronic fatigue has been linked to aberrant autonomic nervous system activity involving the hypothalamic-pituitary-adrenal axis, pain-related pathways, and abnormal brain activity. Brain areas commonly associated with mental fatigue include the parietal, cingulate, inferior frontal and superior temporal cortices, and the cerebellum and have been reported in patients with ME/CFS as well as multiple sclerosis, Parkinson’s disease, and cancer.  These brain regions are known to contribute to cognitive function, including working memory.

Although abnormal neural mechanisms are critically important for this disabling syndrome, many different factors can initiate and perpetuate ME/CFS. Some of the epidemiological data strongly suggest that acute or chronic infections may be responsible, but chronic fatigue has also been reported in patients with cancer, auto-immune diseases, metabolic diseases, congestive heart failure, pulmonary diseases, etc. Our lab is focused on the neural mechanisms of fatigue because better understanding these abnormalities may help improve or abolish ME/CFS related fatigue in the future. Here is a video with some of our recent research findings related to brain connectivity in individuals with ME/CFS.

Below are some treatment recommendations that my be effective for your fatigue:

Sleep Improvements

Good sleep habits are important for all people, especially people with ME/CFS.

For more information about methods to improve sleeping, please see the following pages:

Stress Reduction

Many patients with ME/CFS suffer from depression, stress and anxiety. Some people with ME/CFS may benefit from relaxation techniques to reduce their stress and anxiety. For more information about methods to improve stress, see the Stress Reduction (PDF) information sheet.

Memory Improvements

Memory and concentration problems are associated with ME/CFS. There are many helpful tools you can use to combat this, like organizers and calendars. For more information about methods to enhance your memory, see the Memory Improvement (PDF) information sheet.

Gradual Exercise

Exercise recommendations for people with ME/CFS differ from general guidelines. Exercise is important, but it needs to be performed with caution as overexertion can trigger relapses in some people with ME/CFS. Graded exercise, or a slow gradual increase in activity is often recommended for patients with ME/CFS. Exercise can be broken up into several brief sessions a day to help you stay active. Before beginning any new exercise routine, you should consult with your doctor.

Diet Recommendations

Current recommendations for individuals with ME/CFS are to eat a balanced diet and a variety of nutritious foods. Eating a balanced diet is important for all people (even those without ME/CFS), but it can be especially challenging to do when you’re struggling with fatigue. Many individuals with ME/CFS report that several smaller meals throughout the day help keep their energy levels up and help them avoid nausea. Caffeine may seem helpful, but research has shown that it’s best to avoid it whenever possible. For more information on how to build a healthier eating style, visit MyPlate.