Understanding Fatigue and Chronic Fatigue Syndrome (CFS)

Fatigue and Chronic Fatigue Syndrome (CFS)If there is one thing that can frustrate humanity, it should be fatigue. It makes you feel weak in all parts of your body, daily, and nothing seems to fix it. At this point, you may be even tired of medications.

Fatigue isn’t the same as merely feeling tired or sleepy. When you’re suffering fatigue, you have no motivation and no energy. However, despite several clinical trials and studies to determine the underlying causes of fatigue no medical evidence were revealed. On the other hand, being sleepy, mood, and depression are common symptoms associated with fatigue.

When you’re fatigued, and it didn’t resolve with proper rest and nutrition, it is a symptom of physical or mental health condition which ranges in severity from severe to mild. Fatigue can also be a natural result of some lifestyle choices such as smoking, lack of exercise, malnutrition and many more.

What is fatigue?

There is no one generally accepted definition of fatigue. According to Oxford advanced learns dictionary, fatigue is defined as extreme tiredness resulting from physical or mental exertion or illness.

Fatigue is a daily lack of energy; it is identified by an unusual or excessive whole-body exhaustion that can’t be resolved by sleep. Fatigue is said to be acute when its effects are prolonged for one month or less-Also, it is supposed to be chronic when its effects are continued for more than six months. The words malaise and lethargy is sometimes used interchangeably to describe fatigue.

One study on patients released in the United States, 24 percent of primary care patients agree that fatigue is a significant problem and 10 percent of the patients were found to have a medical cause for their fatigue.

What types of fatigue exist?

There are two different types of fatigue: physical fatigue and mental fatigue.

Physical Fatigue

When you no longer function normally and finds it physically hard to do the things you used to do. Physical fatigue is associated with total body weakness. Diagnosis may involve a strength test.

Mental Fatigue

When you find it so hard to stay focused. You may feel sleepy, or have difficulty staying awake while working. Fatigue is a common symptom of anxiety and depression, as well as seasonal affective disorder.

In many cases, both physical and mental fatigue occurs together.

What causes fatigue?

There are many potential causes of fatigue. They can be divided into three main general groups:
lifestyle: physical health conditions, mental health issues and lifestyle.

If you’re experiencing fatigue, your lifestyle choices may be the root cause. For example, fatigue can result from:

  • Physical exertion
  • Lack of physical activity
  • Lack of sleep
  • Being overweight or obese
  • Periods of emotional stress/boredom
  • Certain medications, such as antidepressants or Sedatives
  • Drinking too much or too often alcohol
  • Using street drugs, such as cocaine
  • Consuming too much caffeine
  • Not eating a nutritious diet
  • Physical health conditions
  • Medical Health

Many medical conditions can also cause fatigue. Examples include:

  • Anemia/arthritis
  • Chronic fatigue syndrome (CFS)
  • Infections, such as cold and flu,
  • Sleep disorders, such as insomnia
  • Congestive heart failure
  • Cancer
  • Diabetes/ fibromyalgia
  • Kidney disease/liver disease

Mental health conditions can also cause fatigue. For example:

  • Anxiety
  • Depression
  • Seasonal affective disorder.
  • Common Causes of Fatigue
  • Lack of Sleep

While a lack of quality sleep may be an apparent cause of chronic fatigue, it is a common reason for feeling tired. Many people go through life feeling too busy to slow down and get all of the sleep that they need to feel good. It helps to determine your individual sleep needs. Adults need around eight to ten hours sleep per day. You may have accumulated a sleeping debt, and this requires extra rest to catch up.


Depression is a psychological condition believed to cause abnormalities in the mood. People with depression tend to have issues with sleep, motivation, and energy level. People suffering from depression may also have trouble waking up in the morning and sleep too long.
Losing interest in activities that you once enjoyed, feeling worthless, loss of weight due to lack of feeding, and even having recurring thoughts of death or suicide are other symptoms of depression.


When you have anemia, the red blood cells in your system reduces, or it doesn’t have enough hemoglobin. Hemoglobin is the substance that carries oxygen throughout your body.
When the hemoglobin level in your system reduces, or you don’t have enough red blood cells, your body will be deficient of oxygen, and you feel tired or weak as a result. Other symptoms of anemia are pale skin, shortness of breath, dizziness, or headaches. Iron deficiency alone has been found to cause chronic fatigue.


This disease occurs when the thyroid gland does not produce enough hormones called thyroid hormone. Thyroid disease is common in women and affects 27 out of 60 million people in the United States.

Thyroid hormones control your body metabolism. So when the thyroid hormone levels are low, you may experience symptoms such as tiredness, weight gain, and feeling cold. Also, hypothyroidism can imitate depression symptoms.

Heart Disease

Heart failure is a type of heart disease that can cause you to feel tired always. With heart failure, the heart is less active in pumping oxygenated blood to your muscles and other organs in the body. Even your regular activities, like walking, may be challenging.

Sleep Apnea

Sleep apnea is a chronic condition which can lead to shallow breathing, lasting anywhere from 15 seconds to one minute while the person is sleeping. These shallow breaths can occur as many as 30 times a minute. And, as you sleep each time you breathe it usually often accompanies a snort or a choking sound, it can be very unruly to your sleep.

This unruly and poor sleeping routine is a common cause of daytime sleepiness. It’s important to point out that untreated sleep apnea not only causes tiredness but can lead to heart disease or even sudden death.


Hepatitis is an inflammation of the liver caused by either infection or obesity. The liver functions to break down toxins and manufacture proteins that control blood clotting. When the liver is inflamed, these vital processes stop. In addition to being tired, you might experience abdominal pain, jaundice, nausea, dark yellow urine, and light-colored stools.

Vitamin D deficiency

One study confirmed a link between low levels of this vitamin, low energy, and depression.
Vitamin D is synthesized in our skin with the help of sunlight and is one of the few vitamins not available in food. If you live in an area with low levels of sunlight, talk to your doctor about vitamin D supplements.


Diabetes is an ailment human suffer when the body doesn’t produce enough insulin, or it doesn’t use it effectively. Insulin helps glucose get into the body’s cells to be used for energy production. This why diabetes might be causing you feeling tired all the time. Other symptoms of diabetes include extreme thirst, frequent urination, weight loss, and much more.


Fatigue is one of the most troubling symptoms for people with cancer. Fatigue is often even overshadowing pain, nausea, and vomiting as one of the most feared symptoms of cancer and cancer treatment. The disease itself may cause cancer-related fatigue. Cancer-fatigue may also be related to other factors such as anemia, anxiety, depression, and side effects of treatment.

Drug-induced fatigue

Fatigue is often associated with alcohol and excessive use of drugs. More so, the side effect of several different medications such as Blood pressure medications, Benzodiazepines, Proton pump inhibitors, Antihistamines Antipsychotics, bipolar disorder, Antibiotics, Diuretics, Narcotic pain medications and many more.

What are the symptoms of chronic fatigue syndrome (CFS)Psychologic causes of fatigue

Anxiety and Depression

Fear, anxiety, and depression are the most common psychological causes of fatigue. A majority of patients with chronic fatigue also experience mood or anxiety issues, according to medichealth.com. Clinical trials have confirmed that chronic fatigue is a typical form of anxiety or depressive states, meaning that chronic fatigue might be just another form of anxiety or depression. Some people with depression may also experience a total lack of energy sometimes called ‘anergia.’

Somatization Disorder

Patients with somatization disorder are preoccupied with numerous physical symptoms. The symptoms often cause significant distress such as pain or fatigue. However, the person’s complaints cannot be explained by an underlying medical disorder.

It is essential to understand that the patient is not faking; his or her complaints are real. Somatization disorder is more common in women than men. Erectile dysfunction is a common complaint in men. Women may experience menstrual irregularities. Patients with somatization problem often undergo numerous clinical examinations before the psychological cause of their distress is identified.

What is chronic fatigue syndrome (CFS)?

Chronic fatigue syndrome (CFS) is a debilitating disorder associated with extreme fatigue or tiredness that doesn’t go away with quality sleep or nutrition and can’t be explained by an underlying medical condition. Sometimes CFS can also be referred to as myalgic encephalomyelitis (ME) or systemic exertion intolerance disease (SEID).

CFS may be challenging to diagnose and cure because the causes of CFS are not known yet and other deceases have similar symptoms. Some studies include viral infection, psychological stress, or a combination of factors. In the past, CFS has been a controversial diagnosis, but nowadays it is widely accepted as a medical condition.

Anyone can suffer CFS, though it’s most common among women in their 40s and 50s. There’s currently no complete cure of CFS, so therapy for CFS focuses on addressing the symptoms. There are no specific tests for chronic fatigue syndrome available, so to figure out your diagnosis your doctor needs to rule out other causes for your fatigue.

What causes chronic fatigue syndrome (CFS)?

The cause of CFS is yet to be known. Researchers make guesses that contributing factors may include:

  • Viruses
  • A weakened immune system
  • Stress
  • Hormonal imbalances

It’s also possible that some people may naturally develop CFS. We are yet to know if CFS is hereditary and contagious. Though CFS can most times develop after a viral infection, no single type of disease has been found to cause CFS, not even speculation. Here are some viral infections that have been studied about CFS include:

  • Epstein-Barr virus (EBV)
  • Human herpesvirus 6
  • Ross River virus (RRV)
  • Rubella

Infections caused by bacteria, including mycoplasma and pneumonia, have also been studied about CFS.

What are risk factors for chronic fatigue syndrome (CFS)?

CFS is most commonly seen among individuals in their 40s and 50s. Gender is also a determining factor as women are two to four times more likely to be diagnosed with CFS than men. Genetic, allergies, stress, and environmental factors may also increase or worsen the severity of CFS.

A recent study had suggested that around 10% of the people with Epstein-Barr virus, Ross River virus, and Coxiella burnetii show symptoms that meet the criteria for a CFS diagnosis. Additionally, people with CFS sometimes have weakened immune systems, but doctors don’t know whether this is enough to cause the disease.

What are the symptoms of chronic fatigue syndrome (CFS)?

The symptoms of CFS differ based on the individual affected and the severity (serious or mild). The most common symptom is strong fatigue that’s severe enough to make you tired and expressly interfere with your daily activities. For CFS to be diagnosed, the patient must have prolonged fatigue which is not curable with bed rest or proper nutrition.

Other symptoms of CFS may include

  • Post-exertional malaise (PEM), where the symptoms get worse after any physical or mental activity
  • Loss of memory or concentration
  • Not feeling fresh after a night’s sleep
  • Swollen lymph nodes in your neck and armpits

The symptoms of CFS might show up in cycles, with periods where affected people sometimes feel worse and then better again.

What to do when diagnosed with chronic fatigue syndrome (CFS)?

What to do when diagnosed with chronic fatigue syndrome (CFS)Of course, it strongly depends on what symptoms you are experiencing and how severe they are, but there is no doubt that you are going to face significant lifestyle changes in order to deal with chronic fatigue.

First of all, you should closely work with your doctor to develop the right treatment plan, including possibly necessary medicines and other therapies. This often works in a way, that together with your doctor you identify the symptoms which cause the most problems first and then start from there.

Complementary therapies such as relaxation therapy or any form of meditation might be helpful. However, important is that you discuss all types of therapy with your doctor or therapist first to exclude potential risks.

If possible also involve your family so that they become familiar with potential (positive or negative) effects of the treatment. The better yourself and the people around you understand the disease the more effectively it can be treated.

Social isolation is by far the worst condition you could be in when diagnosed with CFS, especially if you experience anxiety or depression. Therefore, if you do not have anybody around you who can support you, talk to your doctor or therapist and do not hesitate to join a support group. Also, organizations like the Solve ME/CFS Initiative (SMCI) are providing helpful resources, and the CDC advises on how to manage and live with CFS.

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