Chronic fatigue syndrome (ME/CFS) patients experience a fatigue severe enough to cause them to substantially cut down their work, educational and/or social activities. The Centers For Disease Control calls this fatigue ‘severe, incapacitating, and all-encompassing‘. At its most severe it can leave chronic fatigue syndrome patients house or bed-bound.

A recent study also found that chronic fatigue syndrome (ME/CFS) patients experience four kinds of fatigue that healthy people do not.

Hot Point: 

Studies suggest that two problems; greatly increased fatigue and other symptoms after physical and/or mental activity i.e. post-exertional malaise) and problems with memory and concentration are the hallmark symptoms of ME/CFS.

Several types of fatigue have been found in CFS.  (The only kind of fatigue regularly felt in the general population is the last; flu-like fatigue)

  • ‘Post-exertional fatigue (or malaise)’ occurs after physical or mental exertion; it is considered a hallmark symptom of this disease.
  • ‘Brain fog’ – involves having difficulty with words and concentration; it is considered a hallmark symptom of this disease
  • ‘Wired But Tired fatigue’ – is characterized by low energy levels accompanied by a feeling of over stimulation
  • Molasses Fatigue’ – is characterized by a feeling of heaviness in the limbs
  •  Flu-like fatigue

Besides Fatigue ME/CFS Patients Can Also Experience

Problems Getting a Good Nights Sleep

Almost all chronic fatigue syndrome (ME/CFS) patients experience unrefreshing sleep and/or reduced or increased levels of sleep.

Problems ‘Thinking’

Chronic fatigue syndrome (ME/CFS) patients almost universally report more difficulty with thinking including slowed understanding, trouble finding or saying words, trouble with writing, reading and mathematics, inability to keep track of things, short term memory problems and poor concentration. For some CFS patients this is the most disturbing part of CFS.

Problems with Perception

This includes loss of depth perception, inability to follow quickly moving objects, problems while walking.

Problems with Muscle Coordination

such as muscle weakness, muscle twitches, poor coordination, difficulty with everyday activities such as brushing teeth, dialing the telephone, etc.


Many CFS patients report having headaches, shoulder and neck pain and muscle pain. They tend to demonstrate a lower pain threshold (allodynia), have tender points and/or myofascial trigger points in their muscles and joint pain without joint swelling.

Problems with ‘Overload ‘

such as hypersensitivity to light, sound, odors, vibration, speed, reduced multi-tasking ability, difficulty making decisions, motor overload – increased clumsiness, etc. when fatigued, dizziness, numbness, tingling, nausea are often found.

Nervous System Symptoms

such as difficulty standing (orthostatic intolerance), rapid heartbeat and/or reduced blood pressure resulting in dizziness, nausea, fatigue, headaches, sweating, pallor, mottling in lower limbs, etc. particularly during standing, palpitations, breathing dysregulation (breath holding, irregular breathing, exercise induced shortness of breath), irritable bowel syndrome (constipation, diarrhea, cramping, bloating and/or nausea), visual disturbances, burning sensations, chest pain can be found.

Hormonal Type Symptoms

such as increased or reduced body temperature, hot/cold feelings, intolerance of weather extremes, feverishness, sweating episodes, weight gain or weight loss, anxiety or panic attacks, alcohol intolerance often occur.

Immune System Symptoms

such as sore throat, tender lymph nodes, fever, muscle and joint pains, new sensitivities to food, drugs and/or chemicals are common.

Problems With Mood

such as irritability, depression and/or anxiety are common.

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CFIDS Association of America: Symptoms 2007.

Defining and Distinguishing Types of Fatigue. Porter, Nicole. International Association of Chronic Fatigue Syndrome Conference Jan 13-17, 2007, Fort Lauderdale, Fl.

Carruthers, B., Jain, A., De Meirleir, K., Peterson, D., Klimas, N., Lerner, M., Bested, A., Flor-Henry, P., Joshi, P., Powles, A., Sherkey, J., van de Sande, M. Journal of Chronic Fatigue Syndrome 11: 7-37, 2003. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition.


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