Chronic fatigue syndrome (CFS), also called myalgic encephalomyelitis, is a condition about which we have very little information because no biological marker can be used to diagnose it. Yet it affects between 17 and 24 million people worldwide, including nearly 280,000 in France, and can have severely disabling consequences in daily life. In this article, we take a closer look at this still little-known condition.
What is chronic fatigue syndrome?
Chronic fatigue syndrome (CFS) is a complex, multisystem condition characterized by intense, persistent fatigue that is not relieved by rest and is severe enough to significantly reduce a person's level of activity. Unlike ordinary fatigue, fatigue associated with CFS does not disappear with sleep or rest and may be worsened by physical or mental exertion (a phenomenon known as “post-exertional malaise”).
To be diagnosed, CFS must have been present for at least 6 months and be accompanied by at least one of the following criteria:
- Cognitive impairment (difficulty concentrating, memory loss, “brain fog”)
- Unrefreshing sleep
- Orthostatic intolerance (feeling unwell when standing)
What causes chronic fatigue syndrome?
The causes of CFS are still poorly understood, but several factors appear to be involved:
- Viral infections: in many cases, CFS develops following a viral infection (flu, infectious mononucleosis, COVID-19). Long COVID shares many characteristics with CFS.
- Immune system dysfunction: some studies have identified abnormalities in the immune system of patients with CFS, including chronic activation of immune cells.
- Disruptions to the gut microbiota: recent research suggests that the gut microbiota of patients with CFS has significant imbalances compared with that of healthy people.
- Abnormalities in energy metabolism: some studies have identified mitochondrial dysfunction in patients with CFS, which could explain their inability to produce enough energy.
- Psychological factors: although CFS is not a purely psychosomatic illness, psychological factors (stress, trauma, anxiety) may play a role in triggering or worsening it.
What are the symptoms of chronic fatigue syndrome?
The symptoms of CFS vary and may differ from one person to another:
- Intense, persistent fatigue that is not relieved by rest
- Post-exertional malaise (worsening of symptoms after physical or mental exertion)
- Sleep disturbances (insomnia, unrefreshing sleep)
- Cognitive impairment (difficulty concentrating, memory loss, “brain fog”)
- Muscle and joint pain
- Headaches
- Sensitivity to light and noise
- Digestive problems
- Orthostatic intolerance
How is chronic fatigue syndrome treated?
There is no curative treatment for CFS. Management is therefore symptomatic and aims to improve patients' quality of life. It may include:
- Energy management (“pacing”): a technique that involves adapting one's level of activity to one's current energy capacity in order to avoid post-exertional malaise.
- Cognitive behavioral therapy (CBT): may help manage certain symptoms such as anxiety or sleep disturbances, but its effectiveness in CFS is debated.
- Medications: certain medications may be prescribed to treat specific symptoms, such as painkillers for muscle pain or sleeping pills for sleep disturbances.
- Dietary supplements: certain supplements may help support energy metabolism (CoQ10, L-carnitine, B vitamins), immunity (vitamin D, zinc), or reduce inflammation (omega-3, curcumin).
- Lifestyle adjustments: sufficient rest, a balanced diet, stress management, and avoiding triggers.
In conclusion, chronic fatigue syndrome is a complex and still poorly understood condition that can have severely disabling consequences in daily life. If you think you may have CFS, it is important to consult a doctor for a diagnosis and appropriate care. Patient associations can also be a valuable source of support and information.
