Early symptoms of chronic fatigue syndrome

cfsAmong the early symptoms of chronic fatigue syndrome (CFS), the most noticeable is for obvious reasons the one after which the condition is named. However, there are several other signs that can occur as well. Just like fatigue can be a symptom of several different diseases, the symptoms of CFS can resemble those of other conditions, making diagnosis more difficult that it would seem at first. One telling sign, though, is that chronic fatigue is not the sort that follows a hectic day, a sleepless night, or a stressful event, but a debilitating state that bed rest does not improve and physical or mental activity make worse.

Chronic fatigue syndrome symptoms include:

  • Memory or concentration problems.
  • Sore throat.
  • Swollen or tender lymph nodes in the neck or armpits.
  • Unexplained muscle pain.
  • Pain moving from one joint to another without redness or swelling.
  • Headache of a new type, pattern or severity.
  • Unrefreshing sleep.
  • Severe exhaustion that lasts longer than 24 hours following physical or mental activity.
  • Dizziness when sitting up or standing.

Researchers have not been able to identify a single cause for CFS symptoms. As a matter of fact, this condition may be most likely caused by several different causes, including the following:

  • Viral infections

Epstein-Barr virus.

Human herpesvirus 6.



Candida albicans.



Ross River virus.

Coxiella burnetti.

Human retrovirus.

  • Immune system issues.
  • Allergies.
  • Hypothalamic-Pituitary Adrenal (HPA) Axis.
  • Abnormally Low Blood Pressure and Lightheadedness.
  • Nutritional Deficiency.

People of all ages, genders, and races can develop chronic fatigue syndrome, but CFS is:

  • 4 times more frequent in women than men.
  • Most common in people in 40s and 50s.
  • More common in adults and teenagers than children.
  • As common in African Americans and Latinos as in Caucasians.

Statistics need not be taken at face value, though. For example, women may be more likely to report the early symptoms of chronic fatigue syndrome – which could account for the fact that they are diagnosed more often. And speaking of diagnosis, it can prove challenging for healthcare providers as they have to overcome such challenges as these:

  • There are no laboratory tests or biomarkers for CFS.
  • Fatigue and other symptoms are shared by many conditions.
  • It may not obvious to doctors that some CFS patients are actually sick.
  • CFS has a remission-and-relapse pattern.
  • Symptoms vary in type, number, and severity from one patient to the next.

In light of this, the physician must run a battery of tests to discard other conditions (e.g., sleep disorders, depression, Lyme disease, lupus, MS, fibromyalgia), including but not limited to:

  • Alanine aminotransferase (ALT).
  • Albumin, alkaline phosphatase (ALP).
  • Blood urea nitrogen (BUN).
  • Calcium.
  • Complete blood count with differential.
  • Creatinine.    
  • Electrolytes.
  • Erythrocyte sedimentation rate (ESR).
  • Globulin.
  • Glucose.
  • Phosphorus.
  • Thyroid stimulating hormone (TSH).
  • Total protein.
  • Transferrin saturation.    
  • Urinalysis.

However, that is only a part of a seven-step process for diagnosing CFS.

Steps for diagnosing chronic fatigue syndrome

Step 1

Detailed medical history plus complete physical exam.

Step 2

Mental status examination.

Step 3

Standard series of blood and urine lab tests to identify alternative causes.

Step 4

Additional laboratory testing in case initial tests suggests alternative explanations.

Step 5

The patient is classified as having CFS if they have unexplained, persistent fatigue for six months or longer that interferes with daily activities or work, and at least four of the symptoms mentioned above.

Step 6

The patient is classified as having idiopathic (unknown cause) chronic fatigue if his or her fatigue is not severe enough, or if the symptom criteria for CFS are not met.

Step 7

Scientists compare CFS patients with patients who have other forms of unexplained fatigue by means of grouping them into specific categories in order to search more effectively for clinical markers that may be unique to CFS.


It is important not immediately assume that the early symptoms of chronic fatigue syndrome are in fact CFS without seeking first a professional opinion. One reason for this is that other possible conditions that can cause these symptoms will not necessarily respond well to CFS treatment. Conversely, receiving the proper treatment for CFS is essential prevent complications related to this illness, such as:

  • Depression.
  • Social isolation.
  • Lifestyle restrictions.
  • Work absences.
  • Changing and unpredictable symptoms.
  • Decreasing stamina.
  • Loss of independence, livelihood, and financial security.

Treatment involves medication and therapy and is aimed at accomplishing a variety of goals.

CFS treatment


  • Antidepressants.
  • Sleeping pills.


  • Graded exercise.
  • Psychological counseling.


  • Treating the most disruptive symptoms first.
  • Monitoring the use of all medicines and supplements.
  • Managing activities and exercise.
  • Improving health and quality of life.


In addition to tried-and-true scientifically-backed approaches, people with CFS can also try alternative medicine medical supplies online such as acupuncture, massage, yoga, or tai chi.

Related Read:

- How to treat Chronic Fatigue Syndrome