What are the causes of Chronic Fatigue Syndrome (Myalgic Encephalomyelitis)?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: March 19, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

Chronic Fatigue Syndrome (Myalgic Encephalomyelitis) is a complex condition with multiple potential causes, including genetic susceptibility, metabolic disturbances, and biopsychosocial factors, and its management requires a tailored, flexible, and holistic approach. The exact causes of Chronic Fatigue Syndrome are not fully understood, but research suggests that it may involve a combination of biological, psychological, and social mechanisms 1. Some of the potential causes and contributing factors include:

  • Genetic susceptibility
  • Metabolic disturbances
  • Physical functioning and physical activity
  • Comorbidities, such as pain, obesity, anxiety, and depression
  • Stress and relationships
  • Work roles
  • Dysregulation in the body's stress response systems, immune function, or energy metabolism

According to the most recent and highest quality study 1, cognitive-behavioral therapy (CBT) has been shown to be effective in improving health function, health-related quality of life, and physical function in patients with Chronic Fatigue Syndrome. CBT should be considered as a first-line treatment for Chronic Fatigue Syndrome, as it has been found to be effective in multiple studies and has a strong evidence base. Additionally, mindfulness-based therapies have also been found to be effective in reducing functional impairment and improving quality of life in patients with Chronic Fatigue Syndrome 1.

It is essential to note that the management of Chronic Fatigue Syndrome requires a comprehensive approach that takes into account the individual's unique needs and circumstances. A multifaceted approach that includes lifestyle modifications, nutritional support, medical evaluation, and psychological therapies, such as CBT and mindfulness-based therapies, is likely to be the most effective way to manage Chronic Fatigue Syndrome and improve quality of life.

From the Research

Causes of Chronic Fatigue Syndrome (Myalgic Encephalomyelitis)

The exact causes of Chronic Fatigue Syndrome (Myalgic Encephalomyelitis) are still unknown, but several factors are thought to contribute to its development. These include:

  • Lifestyle factors, such as work stress and personality traits, which may predispose individuals to develop the illness 2
  • Triggering events, such as viral infections or life events, which may initiate the onset of symptoms 2
  • Perpetuating factors, such as cerebral dysfunction, sleep disorders, depression, and inconsistent activity levels, which may contribute to the persistence of symptoms 2
  • Immunologic, neurologic, and psychiatric factors, which may also play a role in the development of CFS 3, 4
  • Inflammatory, neurologic, immunologic, and metabolic abnormalities, which have been demonstrated in patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) 5

Potential Triggers and Contributing Factors

Some potential triggers and contributing factors for CFS include:

  • Viral infections 2, 3
  • Life events, such as stress or trauma 2
  • Sleep disorders 2, 6
  • Depression and other psychiatric illnesses 2, 3, 4
  • Inconsistent activity levels and lack of exercise 2, 6
  • Poor sleep hygiene and lifestyle habits 6, 5

Complexity of the Condition

CFS is a heterogeneous disorder, and its causes are likely to be complex and multifactorial 3, 4. The condition may involve an interaction of biologic systems, and its symptoms can be similar to those of other conditions, such as fibromyalgia and irritable bowel syndrome 3. As a result, diagnosis and treatment of CFS can be challenging, and a comprehensive and individualized approach is often necessary 2, 3, 4, 6, 5

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Chronic fatigue syndrome: evaluation and treatment.

American family physician, 2002

Research

The chronically fatigued patient.

The Medical clinics of North America, 1995

Research

Fatigue in Adults: Evaluation and Management.

American family physician, 2023

Research

Fatigue: an overview.

American family physician, 2008

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.