Intro
Chronic fatigue is persistent, often disabling tiredness that does not improve with rest and significantly limits day-to-day life. It is a symptom that can arise from many different conditions, including infections, mood disorders, hormonal problems, and chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME).
Key Points
- Fatigue is common and usually short-lived; chronic fatigue lasts ≥3–6 months.
- Many medical and psychological conditions can cause chronic fatigue.
- Evaluation looks for reversible causes (sleep, anaemia, thyroid, mood, medications, infection, etc.).
- Specific criteria apply for chronic fatigue syndrome/ME.
- Management focuses on treating underlying causes, pacing, sleep, and mental health support.
Background
Fatigue sits on a spectrum from “a bit tired” to “cannot get out of bed.” Persistent fatigue deserves a structured assessment, especially if it interferes with work, relationships, or basic self-care.
Causes or Mechanisms
Common contributors include:
- Sleep problems (insomnia, sleep apnoea)
- Mood disorders (depression, anxiety)
- Endocrine and metabolic problems (thyroid disease, diabetes)
- Anaemia, chronic infection, inflammatory conditions
- Medications, alcohol, and drugs
- Post-infectious states (including long COVID and PTLDS in some patients)
Diagnosis / Treatment / Options
Assessment usually includes:
- History, examination, basic blood tests
- Screening for sleep, mood, medications, and substance use
- Considering red flags (weight loss, fever, night sweats, etc.)
Treatment is tailored: correct reversible causes, address sleep, gently rebuild activity, treat mood disorders, and provide psychological support.
Risks / Benefits / Prognosis
Many causes of fatigue improve with treatment, but some post-infectious and chronic conditions can be prolonged. A supportive clinician, realistic pacing, and avoiding boom–bust cycles help long-term outcomes.
FAQ
Q: Is chronic fatigue the same as CFS/ME?
A: No. CFS/ME is a specific diagnosis with defined criteria. Chronic fatigue is a broader symptom category.
Q: Can infections like Lyme or COVID lead to long-term fatigue?
A: Yes, post-infectious fatigue is recognised after several infections, including Lyme disease and COVID-19.