Chronic fatigue syndrome/ myalgic encephalomyelitis

chronic fatigue syndrome

What is chronic fatigue syndrome/ myalgic encephalomyelitis?

Tiredness and fatigue are commonplace effects of modern life. However, chronic fatigue syndrome (CFS), also known by other names including myalgic encephalomyelitis (ME) and post viral fatigue syndrome, is defined by severe and sustained fatigue with disabling consequences. What differentiates CFS/ME from other conditions associated with severe chronic fatigue is the apparent absence of a psychological or physical illness to medically explain CFS/ME symptoms.

How common is chronic fatigue syndrome?

CFS/ME is a common condition, estimated to effect 0.2-0.4% of the population.

CFS/ME can affect people of all ages and is more common in women than men.

What are the causes of CFS/ME?

The causes of CFS/ME are not fully understood and more research is needed.

There is a diverse list of possible causes or triggers of CFS/ME involving:
  • Infections (viral, parasitic and bacterial)
  • Immune system
  • Hormones
  • Genetics
  • Mental disorders
  • Emotional and physical stress
  • Toxic substances
  • Environmental exposures

What are the symptoms?

Although these will vary from person to person and in severity, symptoms associated with CFS/ME include:
  • Severe and overburdening fatigue
  • Poor recovery following small amounts of exertion
  • Muscle and joint pains
  • Impaired physical function
  • Sleep disturbances
  • Gut and digestive problems
  • Poor concentration and memory
Some people with CFS/ME make a full recovery. Many people with CFS/ME experience cycles of improvements and worsening of symptoms. A minority have consistently severe and debilitating symptoms.

What is the treatment for CFS/ME?

Presently there are no drugs or therapies proven to cure CFS/MS. Current medical management of CFS/ME focuses on supporting symptoms and providing strategies to support sleep, relaxation and rest. Cognitive behavioural therapy and graded exercise therapy are considered evidence-based treatments. Many people with CFS/MS also use complementary therapies and make changes to their diets.

What can you do to help manage CFS/ME?

As with many chronic diseases, poor sleep, infection and stress may contribute to setbacks and relapse. It is therefore important to rectify poor sleep habits, adopt a balanced diet and include some form of relaxation to support general health and wellbeing.

The debilitating symptoms of CFS/ME can make shopping and preparing meals difficult. Added to this, people with CFS/ME may experience poor appetite, nausea, cravings and difficulties eating and swallowing, which can result in eating little and poor dietary choices. Such patterns of eating can make it difficult to meet the body’s nutritional needs. Conversely some people with CFS/ME may gain weight due to low physical activity levels coinciding with unhealthy changes in eating habits.

Strategies to ensure you are getting a healthy balanced diet include:
  • Schedule times to eat small regular meals if large meals are not well tolerated.
  • Eat a large variety of fruit and vegetables
  • Puree and mash food if you have problems swallowing food
  • Choose wholegrain and high fibre versions of starchy food
  • Eat mainly low glycaemic index (GI) carbohydrates (e.g. porridge oats, sweet potato, pumpernickel bread), which slowly release energy
  • Limit high sugar and refined foods
  • Include meat, fish, eggs or a plant-based protein (e.g. lentils, tofu, beans) with 2-3 meals per day
  • Monitor your weight once a week if weight gain/ loss is a concern
Vitamin D: people with ME/CFS may be more at risk of vitamin D deficiency if they have little outdoor exposure to sunlight. Symptoms of vitamin D deficiency include muscle pain and weakness, which could be present simultaneously with CFS/MS symptoms1, thus possibly accentuating them.

Elimination diets: restrictive diets are not routinely recommended for CFS/MS, however, supervised dietary manipulation may be appropriate for people with co-existing medical conditions, e.g. food allergy and intolerances or irritable bowel syndrome.

Manage sleep-related problems: get advice on ‘sleep hygiene’ and look at making changes to your current routine to support a good night’s sleep.

1. Berkovtiz, S., Ambler, G., Jenkins, M., Thurgood, S., (2009). Serum 25-hydroxy vitamin D levels in chronic fatigue syndrome: a retrospective study. International Journal for Vitamin and Nutrition Research. 79, 250-254.