Chronic Fatigue Syndrome Explained

by Yuri Elkaim, BPHE, CK, RHN
Author, Eating for Energy


Chronic fatigue syndrome (CFS) is a poorly understood, variably debilitating disorder of uncertain causation. It is characterized by long-standing marked fatigue in the absence of physical or psychological causes.  

CFS is thought to occur in 4 adults per 1,000 in North America and for unknown reasons it tends to afflict more women than men, as well as people in their 40s and 50s. Unfortunately, it remains a diagnosis of exclusion based largely on patient history and evaluation of symptoms and, thus, is difficult to accurately diagnose.

Nonetheless, some of the potential triggers of chronic fatigue syndrome may include persistent viral infections, excessive stress, low adrenal function, a weakened immune system, pre-existing physical condition (ie. cardiovascular disease, multiple sclerosis, diabetes, cancer, etc…), depression, and/or impaired liver function.


What Are the Symptoms?

Symptoms of CFS can include flu-like symptoms like mild fever, sore throat, painful lymph nodes, widespread muscle and joint pain, and others including headaches, poor memory and concentration, insomnia, and chronic mental and physical exhaustion after a bout of physical activity in a previously healthy and active person.   Overall fatigue is one the most prevalent symptoms of CFS, affecting almost all of the vital systems in the body.


How is it Diagnosed?

Diagnosis requires a number of features, the most common being severe mental and physical exhaustion, which is not relieved by rest and is worsened by exertion (in a previously healthy and able person) and is present for at least six months.

Because chronic fatigue syndrome is a “condition of exclusion”, diagnosis requires that the symptoms must not be caused by other medical conditions. The most commonly used diagnostic criteria and definition of CFS was defined by the United States Centers for Disease Control and Prevention (CDC). The CDC definition of CFS requires two criteria be fulfilled:

  1. A new onset of unexplained, persistent fatigue unrelated to exertion and is not substantially relieved by rest, that causes a significant reduction in previous activity levels.
  2. Four or more of the following symptoms that last six months or longer:
    1. Impaired memory or concentration
    2. Post-exertional malaise, where physical or mental exertions bring on "extreme, prolonged exhaustion and sickness".
    3. Unrefreshing sleep
    4. Muscle pain
    5. Joint pain across multiple joints
    6. Headaches of a new kind or greater severity
    7. Frequent or recurring sore throat
    8. Tender lymph nodes

When symptoms are attributable to other conditions, the diagnosis of CFS is excluded.   In such cases, other illnesses may be more applicable, including mononucleosis, Lyme disease, lupus, multiple sclerosis, fibromyalgia, primary sleep disorders, severe obesity or   major depressive disorders.


Can it be Treated?

Yes, chronic fatigue can be treated but since the true root cause of CFS is obscure, so too is its treatment, meaning that full resolution occurs in only 5-10% of cases.   Nonetheless, many cases have been greatly improved through dietary and nutritional measures.

From a holistic point of view, you want to do your best to identify (and then remove or rectify) anything that could be creating an imbalance in your body (ie. stress, diet, allergies, candida, etc…) as this will only exacerbate the problem.  

In general, following a nutrient-rich raw alkaline diet – one that is rich in vegetables and fruit – and minimizing the intake of refined sugars, alcohol, coffee, and processed foods may be the most powerful step you can take towards healing your body.

Supporting your liver, nutritionally, will be of prime importance since CFS sufferers tend to have compromised liver function.   Green leafy vegetables (kale, swiss chard, collards), cruciferous veggies (broccoli, Brussels sprouts), and berries and pomegranate are all great liver-supporting foods.  

Although a healthy whole foods diet is your first priority, you may also wish to consider some helpful supplements. They include vitamins (A, B complex, C, and E), flax seed or fish oil (for their omega-3 content), green superfoods such as wheat grass or barley grass, and a digestive enzyme and probiotic for improved digestion and intestinal function.

Lifestyle changes may also be recommended. Modest exercise, such as walking, can be a means of restoring some of the loss of energy and stamina; however, this should be monitored to avoid overexertion.   Learning ways to manage energy levels is important since overexertion during periods of good health can lead to a return of symptoms.   For instance, finding ways to cope and deal with physical and emotional stresses (ie. deep breathing, meditation, tai chi) will be helpful in preventing a return of CFS symptoms.



Chronic Fatigue Syndrome Basic Facts". Centers for Disease Control and Prevention. May 9, 2006.

Stadler-Mitrea, L. Pathology and Nutrition: A Guide for Professionals. CSNN Publishing. 2005.




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