Chronic Fatigue Syndrome Quiz
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Easily tired
Constant fatigue
Headache
Malaise
Fatigue throughout the day
Unrefreshing sleep
Muscle pain
Brain fog
Sore muscles
Insomnia
Feeling depressed for no reason
Not seeing your symptoms? No worries!
What is Chronic Fatigue Syndrome?
A condition in which fatigue and low energy levels last for an extended period (months to years). It can greatly impair patients' daily activities. The physical causes are currently not well understood.
Typical Symptoms of Chronic Fatigue Syndrome
- Stressed over daily life
- Episodes of sudden, overwhelming daytime sleepiness
- Fatigue or low energy that is worse in the morning
- Dizziness
- Difficulty concentrating
- Forehead pain
- Decreased motivation
- Persistent fatigue and lack of motivation
Diagnostic Questions for Chronic Fatigue Syndrome
Your doctor may ask these questions to check for this disease:
- Do you feel stressed or unhappy about going to work or school?
- Do you have episodes of sudden, overwhelming daytime sleepiness?
- Do you experience fatigue or low energy that is worse in the morning?
- Do you feel dizzy?
- Do you have difficulty concentrating?
Treatment of Chronic Fatigue Syndrome
There is no specific cure for this condition. Often, patients find relief with lifestyle changes such as ensuring adequate sleep, spacing out activities, and avoiding alcohol, smoking, and caffeine.
Reviewed By:
Unnati Patel, MD, MSc (Family Medicine)
Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.
Yu Shirai, MD (Psychiatry)
Dr. Shirai works at the Yotsuya Yui Clinic for mental health treatment for English and Portuguese-speaking patients. He treats a wide range of patients from neurodevelopmental disorders to dementia in children and participates in knowledge sharing through the Diversity Clinic.
Content updated on Jan 14, 2025
Following the Medical Content Editorial Policy
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People with similar symptoms also use Ubie's symptom checker to find possible causes
- Dizziness
- Can't focus
- Dizziness multiple times
- Easily distracted
- Off-balance like floating
- I can not concentrate on my work
- Spinning feeling
- Unable to sit for a long time
- A sense of motion or spinning (vertigo)
- Feeling faint
- My brain is not functioning
- Dizzy when standing up
- Less willpower to do things
- Dizzy in the morning
- Making careless mistakes
See full list
Symptoms Related to Chronic Fatigue Syndrome
Diseases Related to Chronic Fatigue Syndrome
FAQs
Q.
Exhausted? Why Your Mitochondria Function Is Failing & Medically Approved Next Steps
A.
Persistent exhaustion can signal impaired mitochondrial function that reduces ATP, leading to fatigue, brain fog, and muscle weakness; key drivers include poor sleep, chronic stress, nutrient gaps, blood sugar swings, chronic inflammation, environmental toxins, aging, and conditions like anemia, thyroid disease, diabetes, or sleep apnea. Medically approved next steps include seeing your doctor to rule out reversible causes, prioritizing 7 to 9 hours of restorative sleep, gentle regular activity, blood sugar stabilization, clinician-guided correction of deficiencies and possible use of CoQ10, magnesium, and B vitamins, stress reduction, and targeted treatment of inflammation while watching for urgent red flags such as chest pain, fainting, or sudden weakness. There are several factors to consider. See below for specific tests, symptom-check tools, and decision points that can change which next steps are right for you.
References:
* Morris G, Maes M. Mitochondrial dysfunction in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Rev Neurosci. 2022;33(2):161-177. doi: 10.1515/revneuro-2021-0089. PMID: 35197825.
* Filler K, Singh K, Gorlyn A, Feustel P, Blasi-Libera D, Medow MS, Deluca J, Cunningham-Rundles S, Vernon SD, Komaroff AL, Natelson BH. Targeting mitochondrial dysfunction in chronic fatigue syndrome: a therapeutic approach. BMC Neurol. 2020 Jul 17;20(1):275. doi: 10.1186/s12883-020-01851-x. PMID: 32675038.
* Jain S, Kumar V, Bhardwaj A, Devi U, Kaur T, Kaur J, Mittal S, Singh AK, Kaur H, Kaur P. Nutritional and Metabolic Interventions for Enhancing Mitochondrial Health and Reducing Fatigue. Curr Issues Mol Biol. 2023 Feb 8;45(2):932-951. doi: 10.3390/cimb45020061. PMID: 36773347.
* Morris G, Maes M. Mitochondrial targeted therapies for chronic fatigue syndrome. Expert Opin Investig Drugs. 2021 May;30(5):441-456. doi: 10.1080/13543784.2021.1906914. Epub 2021 Mar 26. PMID: 33769970.
* Morris G, Maes M. Mitochondrial dysfunction and chronic fatigue syndrome: Cause or consequence? Rev Neurosci. 2018 May 26;29(4):441-455. doi: 10.1515/revneuro-2017-0071. PMID: 29778738.
Q.
Always Exhausted? Why Chronic Fatigue Syndrome Stops Your Body + Medically Approved Next Steps
A.
Chronic fatigue syndrome is a real, medically recognized illness where severe fatigue lasting 6 months or more, unrefreshing sleep, and post exertional malaise can stem from disruptions in cellular energy, autonomic regulation, immune activity, and brain processing. There are several factors to consider; start with a medical evaluation to rule out other causes, then use pacing, optimize sleep, treat coexisting conditions, and consider only gentle, supervised activity plus cognitive supports. For urgent red flags and a step by step plan, see below.
References:
* Campitelli, A., De Jesus, T. C., Furlan, R., Gilhus, N. E., Gude, T., Habicht, J., Joosten, I., Kristiansen, R. A., Laustsen, L., Lunn, M. P., Mattozzi, S., Midtgard, U., Mor, N., Mygland, Å., Naess, H., Nacul, L., Østgård, R. D., Roer, H. D., Schetters, T., … Skjelbred, C. F. (2023). Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: An International Collaborative Perspective on an Emerging Postinfectious Disease. *Current Rheumatology Reports*, *25*(12), 657–671.
* Ribeiro, M., Barbosa, D., Nacul, L., & Lacerda, E. M. (2023). Updates in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) for Clinicians. *Medicina (Kaunas)*, *59*(2), 373.
* Sheng, S., Chen, S., Sun, Y., Feng, Y., Sun, X., Lu, Z., Cao, K., & Zhao, Y. (2023). Pathophysiology of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Dysregulation of the Immune System and the Gut Microbiome. *Brain Sciences*, *13*(11), 1532.
* Athanasiou, A., & Nacul, L. (2023). ME/CFS: Current State of Diagnosis and Potential for Biomarkers. *International Journal of Molecular Sciences*, *24*(21), 15989.
* Nacul, L., Ribeiro, M., & Barbosa, D. (2023). Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Following COVID-19: What Do We Know and What Can We Learn? *Vaccines*, *11*(12), 1790.
Q.
Constant Fatigue? Why Cells Need NAD & Medically Approved Next Steps
A.
Persistent fatigue can reflect problems in cellular energy production where NAD helps make ATP, yet low NAD is usually just one part of the puzzle. There are several factors to consider; see below to understand more. Recommended next steps are to get medical evaluation for common causes, optimize sleep, nutrition, and gentle activity, and only then consider NAD precursors like NR, NMN, or niacin with your doctor's guidance, since evidence for treating general fatigue is limited and side effects or red flags may change what you should do right away.
References:
* Covarrubias AJ, Perrone R, Grozio A, Verdin E. Nicotinamide adenine dinucleotide (NAD+) in aging, metabolism, and neurodegeneration. Cell Mol Life Sci. 2020 Jul;77(14):2755-2766. doi: 10.1007/s00018-020-03488-8. Epub 2020 Apr 18. PMID: 32305591; PMCID: PMC7164993.
* Yang J, Lin Z, Morita M, Han K, Chen C, Gao R, Lu Z. NAD+ and Mitochondrial Homeostasis: The Yin and Yang of Cell Metabolism. Trends Cell Biol. 2020 Jul;30(7):577-593. doi: 10.1016/j.tcb.2020.03.003. Epub 2020 Apr 3. PMID: 32247260; PMCID: PMC7157778.
* Chini EN, Hogikyan ND, Kashyap S. NAD+ metabolism in health and disease: a therapeutic target for aging and age-related diseases. Sci Transl Med. 2019 Mar 13;11(482):eaau6948. doi: 10.1126/scitranslmed.aau6948. PMID: 30878518; PMCID: PMC6425977.
* D'Acunto CW, Piazzi L, Ciafrè S, Valaperta R, Lapi M, Cappelletti G, Milani P. NAD+ precursors: a new frontier in human health and therapeutic interventions. Mol Cell Biochem. 2022 Sep;477(9):2155-2172. doi: 10.1007/s11010-022-04374-9. Epub 2022 Feb 13. PMID: 35165975; PMCID: PMC8831969.
* Dollerup OL, Stokholm K, Møller N, Krogh-Madsen R. Nicotinamide riboside and nicotinamide mononucleotide: a review of their safety and efficacy in human and animal studies. J Physiol. 2020 Jul;598(13):2903-2917. doi: 10.1113/JP279124. Epub 2020 May 15. PMID: 32412891; PMCID: PMC7216965.
Q.
Fatigued? Why Your Metabolism Is Crashing: Medically Approved Healthy Breakfast Ideas & Next Steps
A.
Feeling drained with a "crashing metabolism" is often due to blood sugar spikes from sugary breakfasts, poor sleep, chronic stress, thyroid issues, or low iron, B12, or vitamin D, and it often improves with balanced, protein-rich breakfasts like eggs with greens, Greek yogurt with berries and seeds, or oats plus added protein while skipping pastries and sweet drinks. There are several factors to consider; key tests, red flags, and step-by-step next actions are outlined below, so review the complete guidance below to choose the right healthcare next steps.
References:
* Morris G, Anderson G, Berk M. Mitochondrial dysfunction and fatigue. J Intern Med. 2020 Feb;287(2):161-173. doi: 10.1111/joim.12992. Epub 2019 Dec 19. PMID: 31858597.
* Ma X, Chen Q, Pu Y, Du M, Zhang Y, Yu J. The Importance of Breakfast in Metabolic and Weight Regulation. Nutrients. 2022 Jun 10;14(12):2400. doi: 10.3390/nu14122400. PMID: 35745070; PMCID: PMC9228531.
* Maki KC, Phillips-Eakley AK, Smith SA. The impact of breakfast on energy regulation and metabolism. Endocrinol Metab Clin North Am. 2014 Dec;43(4):857-71. doi: 10.1016/j.ecl.2014.08.003. Epub 2014 Sep 17. PMID: 25434199.
* Gibson C, Guthrie N, Philpott JD, Power G. Dietary Patterns and Fatigue: A Review of the Evidence. Nutrients. 2018 Sep 20;10(9):1314. doi: 10.3390/nu10091314. PMID: 30235839; PMCID: PMC6163777.
* Castro-Marrero J, Sáez-Francàs N, Santpere G, Pujol AM, Fernández-Solà J. The Role of Nutrition in Chronic Fatigue Syndrome and Myalgic Encephalomyelitis: A Systematic Review. Nutrients. 2018 Sep 12;10(9):1244. doi: 10.3390/nu10091244. PMID: 30209351; PMCID: PMC6163156.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Yancey JR, Thomas SM. Chronic fatigue syndrome: diagnosis and treatment. Am Fam Physician. 2012 Oct 15;86(8):741-6. PMID: 23062157.
https://www.aafp.org/pubs/afp/issues/2012/1015/p741.htmlTurner-Stokes L, Wade DT. Updated NICE guidance on chronic fatigue syndrome. BMJ. 2020 Dec 16;371:m4774. doi: 10.1136/bmj.m4774. PMID: 33328173.
https://www.bmj.com/content/371/bmj.m4774Bested AC, Marshall LM. Review of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: an evidence-based approach to diagnosis and management by clinicians. Rev Environ Health. 2015;30(4):223-49. doi: 10.1515/reveh-2015-0026. PMID: 26613325.
https://www.degruyter.com/document/doi/10.1515/reveh-2015-0026/html