Diagnosing Chronic Fatigue Syndrome

Patient Expert

By Karen Lee Richards, ChronicPainConnection Lead Expert

Chronic fatigue syndrome (also called myalgic encephalopathy or ME/CFS) should be diagnosed by a physician who is familiar with the illness and regularly treats ME/CFS patients.

Because the symptoms of chronic fatigue syndrome closely resemble several other illnesses, it is important that the doctor run tests to rule them out. A few conditions that are similar to and/or may occur along with ME/CFS include:

  • Fibromyalgia
  • Mononucleosis (Epstein-Barr virus)
  • Irritable bowel syndrome
  • Multiple sclerosis
  • Chronic Lyme disease
  • Mercury poisoning
  • Depression
  • Lupus
  • Multiple Chemical Sensitivity
  • Leaky gut syndrome
  • Primary sleep disorders
  • Gulf War syndrome

The Center for Disease Control (CDC) has developed the following criteria for diagnosing chronic fatigue syndrome:

  1. Unexplained, persistent fatigue that's not due to ongoing exertion, isn't substantially relieved by rest, is of new onset (not lifelong) and results in a significant reduction in previous levels of activity.
  2. Four or more of the following symptoms are present for six months or more:
  • Impaired memory or concentration
  • Postexertional malaise (extreme, prolonged exhaustion and sickness following physical or mental activity)
  • Unrefreshing sleep
  • Muscle pain
  • Multi-joint pain without swelling or redness
  • Headaches of a new type or severity
  • Sore throat that's frequent or recurring
  • Tender cervical or axillary lymph nodes

More information on More info on Chronic Fatigue Syndrome Diagnosis


"Chronic Fatigue Syndrome," MayoClinic.com, 2005.

"Diagnosing CFS," Center for Disease Control, 5/3/06.