Chronic Fatigue Syndrome Diagnosis

Chronic fatigue syndrome (CFS) is often misdiagnosed because its symptoms are shared by other disorders, including mononucleosis, fibromyalgia (for more common questions and expert answers on Fibromyalgia, visit, Lyme disease, post-polio syndrome and autoimmune diseases such as lupus and multiple sclerosis. There also are no specific tests for chronic fatigue syndrome that a health care professional can use to diagnose the illness.

Criteria for establishing a diagnosis of chronic fatigue syndrome include:

Clinically evaluated, unexplained persistent or relapsing chronic fatigue that is new (i.e., not lifelong), is not the result of ongoing exertion, is not substantially alleviated by rest and necessitates substantial reduction in previous levels of occupational, educational, social or personal activities.

The concurrent occurrence of four or more of the following symptoms:

  • substantial impairment in short-term memory or concentration
  • sore throat; tender lymph nodes
  • muscle pain
  • multi-joint pain without joint swelling or redness
  • headaches of a new type, pattern or severity
  • unrefreshing sleep
  • post-exertional malaise lasting more than 24 hours

These symptoms must have persisted or recurred during six or more consecutive months of illness and must not have pre-dated the fatigue.

A thorough medical history, physical and mental status examinations, and laboratory tests also are critical to establishing a diagnosis of chronic fatigue syndrome and to identify possible underlying conditions that may require treatment. Conditions that share the same or similar symptoms with chronic fatigue syndrome are:

  • hypothyroidism
  • sleep apnea
  • narcolepsy
  • unresolved hepatitis B or C
  • alcohol or substance abuse
  • severe obesity
  • lupus
  • multiple sclerosis
  • cancer
  • depression
  • anorexia nervosa
  • bulimia nervosa
  • schizophrenia
  • bipolar disorder
  • dementia

Copyright 2003 National Women's Health Resource Center Inc. (NWHRC)