Chronic fatigue syndrome

The central symptom of chronic fatigue syndrome is fatigue. We know fatigue that arises from exertion and that ultimately means that you have to stop when you are tired. This disappears again with rest. With depression we experience fatigue, but exercise is possible and running improves the symptoms.

Chronic fatigue

However, CFS is a different form of fatigue, which is not caused by exertion and does not disappear with (bed) rest, which is always present and which hinders the patient in daily functioning. Exertion causes exhaustion, which sometimes takes days or weeks to disappear. Such fatigue occurs in serious illnesses, where it is often experienced as more burdensome than pain. If the fatigue still exists after 6 months, it is called chronic, as in chronic fatigue syndrome.


  • Ever-present fatigue. Also when waking up.
  • Concentration or memory disorder.
  • Pain in the joints without visible abnormality.
  • Pain in the muscles.
  • Pain in the head, other than before the fatigue.
  • A sore throat.
  • Swollen sensitive glands in the neck and/or armpits.
  • It takes more than 24 hours to recover from extra effort.


What is going on?

We already know a lot more about CFS than we did a few years ago. For example, two studies have shown that fewer gray cells are seen in the brains of people with CFS. The decrease in cells corresponded to the decrease in physical fitness and activity. Not with the severity of the fatigue and that is logical, because the fatigue is a signal that something is wrong, it is not the problem itself. The decrease in gray cells is probably caused by damage at the time the CFS started. The duration of the disease did not affect the reduction in gray cells. It was also found that people with CFS have more difficulty with complex assignments, they have to use more parts of the brain than normal. During exercise, the body reacts differently than in healthy individuals, different signals are found in the genes and clear indications of adaptations to illness have been found in the blood.


Our knowledge of CFS has increased since the criteria of Fukuda et al. were drawn up, and a number of centers have also been established in the Netherlands where research is taking place. These centers have outpatient clinics where the acquired knowledge is applied in patient care. The chance of recovery from CFS is reasonable in the beginning, but decreases as the disease continues. Ultimately, improvement may occur, and less than 10% of patients are completely cured. The prospects may be somewhat better in children. In small studies, 28 of 84 patients recovered completely. Achieving improvement is therefore usually the goal of treatment for the time being.


For a disease like CFS with symptoms that can be caused by multiple causes and therefore by multiple diseases, of which we know very little, the therapy is of course unknown. Claims that there is a scientifically proven treatment for CFS therefore indicate certainty, which is based on a lack of knowledge. That does not mean that we are completely empty-handed, but we must make a distinction between experiments and science.

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