Chronic fatigue syndrome: Symptoms, diet, and treatment
Chronic fatigue syndrome (CFS) is a complex condition characterised by an unshakeable exhaustion that persists for at least six months. Its symptoms worsen with mental and physical activity but don’t improve with any amount of rest.
The exact cause of CFS remains largely unknown. Some experts believe it may arise from psychological stress, viral and bacterial infection, hormonal imbalances, or compromised immune function.
Extreme tiredness can make it challenging to carry out basic, everyday tasks. As a result, CFS often affects your mental and emotional health, too.
Unfortunately, there’s no single treatment for chronic fatigue. However, there are many ways to manage the symptoms, as we outline below.
What are the symptoms of chronic fatigue syndrome?
Although the characteristic symptom of CFS is an extreme fatigue severe enough to affect your daily life, you may also experience the following symptoms1.
Post-exertion malaise: intense lethargy after physical or mental activity that’s often described as having your ‘internal batteries’ drained.
Cognitive impairment: impaired memory, problem-solving, and concentration.
Orthostatic intolerance: feeling lightheaded, dizzy, or faint when moving from lying down to sitting or standing.
Pain: cramps and muscle aches that are often described as shooting, burning, tingling, throbbing, or stabbing .
Flu-like symptoms: headaches, sore throat, swollen glands, and joint pain.
How do you test for chronic fatigue syndrome?
There isn’t a specific test available for chronic fatigue syndrome. Doctors generally diagnose CFS based on symptoms alone. Most importantly, your fatigue must be chronic – lasting upwards of six months – and it can’t improve with any amount of rest.
Doctors will also rule out any other conditions that could be causing your ill health before making their diagnosis.
How to manage chronic fatigue syndrome
Listen to your body
Your fatigue will vary in severity depending on the day. Some days you’ll feel depleted; others, you’ll feel better.
Even on your good days, you need to strike a healthy balance between activity and rest. Overexerting yourself will only tire you and may trigger your symptoms.
Be intuitive and listen to your body. As soon as you detect the first signs of pain, discomfort, or fatigue, stop and rest.
Despite feeling drained and exhausted, it’s important to keep moving, even if it’s gentle activity. Evidence consistently highlights that regular exercise keeps you both physically healthy and mentally well, as well as helping prepare the body for sleep at night2.
Just remember to pace yourself; moving too much could make you feel worse. Exercise must always be moderate and within your limits.
Try to start with a small amount of exertion and work up to a level that feels suitable for you. You could begin with a few yoga poses, a short walk, or simply picking up and grasping objects. Over time, you may want to progress to light aerobic exercises, such as walking, swimming, and dancing.
Chronic fatigue treatment diet
Optimising your nutrition is another important component of chronic fatigue treatment. With the correct dietary changes, you can improve your energy levels, address any nutrient deficiencies, and feel better overall.
Choose anti-inflammatory foods
Research suggests individuals with CFS exhibit higher levels of two types of cytokines – compounds known to cause inflammation in the body3. As such, experts often recommend avoiding pro-inflammatory foods – heavily processed meat, fried foods, and sugar – and eating more anti-inflammatory foods, like olive oil, avocados, oily fish, and anti-oxidant-rich vegetables.
Add more low GI foods
Eating foods with slow-releasing energy – also known as low glycaemic index (GI) foods – will help prevent the energy dips that may exacerbate your symptoms. Porridge, brown rice, quinoa, sweet potatoes, and wholegrain pasta and bread are excellent choices to keep your energy levels stable throughout the day.
Eat little and often
If you have chronic fatigue, you may feel too tired to prepare or eat food. But this can perpetuate a vicious cycle and drain your energy further. With this in mind, try eating smaller portions more frequently throughout the day. It might also be an idea to prepare meals at the weekend – or enlist the help of a partner or friend – so you don’t have to think about cooking and exerting yourself during the week.
Drink enough water
Even mild dehydration can lead to fatigue, so it’s important to stay hydrated to manage your symptoms. Aim for 1.5-2 litres of water every day.
Be careful with caffeine
On the surface, drinking caffeine may seem like a quick fix to increase your energy levels. But it can trick you into feeling more energised than you are and could lead to you overdoing it. Caffeine is also known to inhibit sleep. A small amount of caffeine before midday might be fine; just be careful not to push yourself when you drink it.
Following a bespoke supplement regime is another helpful way to support your energy levels. Magnesium, iron, the B vitamins – folic acid, niacin, riboflavin, vitamin B6, and vitamin B12 – and vitamin C contribute to a reduction of tiredness and fatigue, so you may wish to start taking these nutrients.
Treatment for chronic fatigue
Cognitive Behavioural Therapy (CBT)
Cognitive Behavioural Therapy (CBT) is widely touted as one of the most effective ways to manage CFS. CBT is a short-term psychological treatment that aims to change your thoughts and behaviours towards certain things. It’s often used to improve physiological and psychological conditions, providing the necessary mechanisms to break bad habits that perpetuate symptoms.
A team of researchers at Queen Mary, University of London, conducted a large-scale five-year study on a potential treatment for chronic fatigue4. They discovered that a combination of CBT and exercise therapy led to significant improvements in CFS symptoms.
In fact, 22% of patients ‘recovered’ from CFS in this trial.Although the results couldn’t predict whether the participants’ symptoms will re-appear, this was a promising outcome for the future of chronic fatigue treatment.
The physiological and psychological implications of CFS can make the condition extremely challenging to live with. And while there’s no single treatment for chronic fatigue, we hope you can still feel empowered to manage the condition with many of the recommendations outlined above.
For more guidance on improving your sleep hygiene, explore the articles via our dedicated sleep health hub.
- NHS.UK. Chronic fatigue syndrome (CFS/ME).. (2021). Available online: https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs
- Larun. L., Brurberg. K.G., Odgaard-Jensen. J. & Price. J.R. (2017). Exercise therapy for chronic fatigue syndrome. The Cochrane database of systematic reviews. (2010 Apr-Jun). 4(4), CD003200.
- Maes. M., Twisk. F. & Johnson. C. (2012). Myalgic Encephalomyelitis (ME), Chronic Fatigue Syndrome (CFS), and Chronic Fatigue (CF) are distinguished accurately: Results of supervised learning techniques applied on clinical and inflammatory data. Psychiatry Research. 200(2-3), 754-760.>
- PhD. C. (2021). Chronic Fatigue Treatments Lead To Recovery In Trial. Medical News Today. Available online: https://www.medicalnewstoday.com/articles/255720.php
Olivia Salter has always been an avid health nut. After graduating from the University of Bristol, she began working for a nutritional consultancy where she discovered her passion for all things wellness-related. There, she executed much of the company’s content marketing strategy and found her niche in health writing, publishing articles in Women’s Health, Mind Body Green, Thrive and Psychologies.