Chronic fatigue syndrome (CFS) causes extreme fatigue that continues over a period of at least six months. Some people may also experience persistent fatigue following viral infection (post-viral fatigue).
The defining characteristic of CFS is unexplainable fatigue that persists for at least six months, and that is accompanied by cognitive problems such as concentration difficulties and poor short-term memory.
Before a diagnosis of CFS is confirmed, all other explanations for the persistent fatigue need to be ruled out, and at least four of the following symptoms must have been present consistently or repeatedly since its onset:
The fatigue of CFS interferes with the sufferer's ability to continue with their normal work, study, social or personal activities. It persists despite sleep or rest, and is not caused by excessive exertion.
In fact, even minor physical or mental exertion can leave patients feeling exhausted and extremely unwell, sometimes causing them to 'crash' for 24 hours or more afterwards.
A wide variety of additional symptoms may also occur, including lowered resistance to infection, low-grade fever, muscle pains and weakness, dryness of the mouth and/or throat, gastrointestinal issues (including diarrhoea, bloating, nausea and stomach pain), low blood pressure (sometimes causing dizziness or fainting) and respiratory symptoms such as coughing and shortness of breath.
Many sufferers become highly sensitive to light, noise and smells and/or develop intolerances to alcohol, chemicals and/or particular foods.
Mood problems often arise as a result of the frustration and despair at being unable to engage in normal day-to-day activities.
Although CFS can persist for many months or even years, most people with it have periods of feeling relatively well, followed by episodes of relapse and debilitation.
The symptoms of post-viral fatigue are similar to those of CFS, but differ in that they can be directly traced to a viral infection, and do not include cognitive problems. In this situation, the fatigue and tiredness that are common symptoms of viral infections continue after the other symptoms have been resolved.
The causes of CFS and post-viral fatigue have not been determined, but they are believed to have their origins in infection, perhaps in combination with abnormal responses to it due to underlying immune system dysfunction.
Post-viral fatigue occurs after infection with the Epstein-Barr virus (EBV, which is responsible for glandular fever), or by any of a number of other viruses that affect the respiratory and gastrointestinal tracts.
Infection with EBV and numerous other viruses are also common triggers for the onset of CFS, but do not actually cause the condition. A period of intense physical or mental stress is also a trigger for some people, but in others no initiating event can be determined.
Other factors that have been hypothesised to contribute to CFS and/or aggravate its symptoms include:
From the perspective of traditional Chinese medicine (TCM), characteristics of CFS and post-viral fatigue such as impaired production of cellular energy and abnormal muscle responses to exercise are broadly suggestive of deficiencies of Qi (life force energy), and Yang (the energy responsible for stimulation, movement and activity).
Other symptoms are suggestive of deficient Yin (the energy that nourishes the body, mind and spirit), including the impairment of immune function and the presence of low-grade fever, sweating, and dryness of the mouth, throat and mucous membranes.
Depending on the specific symptoms experienced, suitable Chinese herbs to aid the management of CFS and post-viral fatigue may include those that invigorate the Qi (including Astragalus, Codonopsis, Atractylodes, Chinese Licorice and Schisandra), often in combination with Yin-nourishing tonics such as Ligustrum.
Of these, Chinese Licorice have additional benefits thanks to its effects on adrenal gland function, and Astragalus is specifically indicated to promote convalescence and recovery after illness, for which purposes it is often taken with Siberian Ginseng.
CFS relapses are often triggered by infections such as colds and flu, so support your resistance to infection by taking herbs like Andrographis, Echinacea and Olive Leaf, along with key nutrients for healthy immune function, such as zinc and vitamin C.
Coenzyme Q10 is crucial to the functioning of the mitochondria, which are responsible for the cellular production of energy, so may have a role to play in the management of CFS.
In addition to helping to maintain and improve general wellbeing, it supports muscle activity, exercise tolerance and healthy immune function.
Research suggests that symptoms of low CoQ10 levels may include fatigue, reduced stamina and endurance, and muscle aches and pains.
Chronic fatigue syndrome is a complicated and debilitating condition that’s not suitable for self-diagnosis or self-management. If you’re concerned you may be affected, it’s important to see your doctor or healthcare professional because there are many causes of long-term fatigue, ranging from poor diet and lifestyle right through to serious health problems, and all of these need to be ruled out before a diagnosis of CFS is determined.