9 Causes of Chronic Fatigue

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9 Causes of Chronic Fatigue

Last updated: Thursday, September 8, 2022 | 4 min reading time

Chronic fatigue is a complex long-term condition that is sometimes difficult to diagnose. What are some of its possible causes?

We've all had days when we felt exhausted. Perhaps you've gotten home from a long day at work with little sleep from the night before and had to burn the midnight oil to get more work done – all while having to wake up early the next day. If it was a busy period at work, perhaps this cycle might've carried on for a few days. Fortunately, the weekend would've eventually arrived, bringing with it respite.

But imagine if feeling rested wasn't possible – no matter how much sleep or rest you had. What if the feeling of always being exhausted became a new normal?

That's what individuals experiencing chronic fatigue syndrome (CFS) face. Also known as myalgic encephalomyelitis (ME), this condition is typically characterised by severe fatigue lasting for a minimum of 6 months. It often brings about extreme tiredness, and can hurt the sufferer's mental, emotional, and physical health. Daily activities become an uphill battle, relationships get affected, and unwanted, significant, lifestyle changes result.

There are several theories as to why chronic fatigue can occur in individuals. Here are 9 possible direct or indirect causes of CFS/ME in individuals.

1. Viral and bacterial infections

Viral and bacterial infections

There are cases where individuals develop CFS/ME after having a viral or bacterial infection. Several infections are suspected to be able to cause chronic fatigue:

  • COVID-19
  • HIV
  • Hepatitis
  • Mononucleosis
  • Cytomegalovirus
  • Flu
  • Pneumonia

There are no conclusive links between specific viruses and chronic fatigue, but viruses like the Epstein-Barr virus and the human herpesvirus-6 have come under question.

2. Weak immune systems

There are cases of people with CFS/ME who have weakened immune systems, although results aren't conclusive as to whether this is a direct cause. Having a weaker immune system is also known as being immunocompromised – which can cause a higher likelihood of someone catching viruses and bacterial infections.

3. Hormonal imbalances

Individuals experiencing CFS/ME may, in some cases, experience abnormal levels of hormones in their blood. Significant areas this is found in include the hypothalamus, pituitary, and adrenal glands. More research is being done to draw conclusions on the significance of these connections.

4. Rheumatoid arthritis

Rheumatoid arthritis

Rheumatoid arthritis, a type of inflammatory arthritis, is characterised by joint stiffness in the morning, and having joint pain and inflamed joints. The pain experienced can affect a person's sleep, contributing to CFS/ME. Rheumatoid arthritis should always be looked at and treated by a doctor as soon as possible because waiting can result in disability.

5. Stress

According to the Archives of General Psychiatry, childhood trauma, stress, and/or emotional instability may cause CFS/ME to develop. The brain's inability to process and deal with difficult experiences is at the crux of this. Stress and trauma can affect a person's sleep, and if experienced over a prolonged period of time, can result in CFS/ME.

6. Allergic rhinitis

Allergic rhinitis happens to be commonly found in cases of CFS/ME. Allergic rhinitis is also known as hay fever, an allergic reaction that causes a sore throat, congestion, sneezing, and an itchy nose. Dust mites, mould, pollen, pet dander, and insects like cockroaches (due to their saliva and waste) are thought to be culprits of allergic rhinitis.

It's worth noting that nose and throat inflammation can also occur due to food allergies, which can be life-threatening and require immediate medical attention.

7. Anaemia


The primary reason anaemia can contribute to CFS/ME is low oxygen levels in the bloodstream. The body relies on a constant flow of oxygen from red blood cells, but people with anaemia lack enough healthy red blood cells to carry this out.

8. Fibromyalgia

Fibromyalgia is thought to be one of the more common causes of CFS/ME. It's a condition that can cause widespread pain all over the body. In some cases, it also causes the individual experiencing it to become more sensitive to pain. Fibromyalgia can also disrupt REM sleep and result in prolonged periods of unrest in individuals, thereby contributing to CFS/ME.

9. Heart disease

Heart disease can make simple daily activities like walking up a short flight of stairs challenging. Feeling constantly tired from carrying out simple daily tasks with no respite (unless the heart disease is treated directly) can eventually result in CFS/ME.

If you suspect you might be experiencing chronic fatigue, it's important for you to consult a doctor. When it comes to diagnosing this long-term condition, your doctor would likely have to rule out a variety of other conditions, since chronic fatigue is often a symptom of other conditions.

The sooner you get treatment for chronic fatigue, the better it is for your overall health and quality of life.

Biggers, A. (2020, March 12). CFS (Chronic Fatigue Syndrome). Retrieved from https://www.healthline.com/health/chronic-fatigue-syndrome#treatment

Carey, E. (2021, December 9). Immunodeficiency Disorders. Retrieved from https://www.healthline.com/health/immunodeficiency-disorders

CDC. (2020, January 6). Fibromyalgia. Retrieved from https://www.cdc.gov/arthritis/basics/fibromyalgia.htm

Cleveland Clinic. (2020, July 30). Allergic Rhinitis (Hay Fever). Retrieved from https://my.clevelandclinic.org/health/diseases/8622-allergic-rhinitis-hay-fever

JAMA and Archives Journals. (2006, November 7). Stress, Childhood Trauma Linked To Chronic Fatigue Syndrome In Adults. ScienceDaily. Retrieved from www.sciencedaily.com/releases/2006/11/061107082833.htm

Mayo Clinic Staff. (2022, July 6). Chronic Fatigue Syndrome. Retrieved from https://www.mayoclinic.org/diseases-conditions/chronic-fatigue-syndrome/symptoms-causes/syc-20360490

Nazario, B. (2021, April 21). Causes of Extreme Fatigue and Exhaustion. Retrieved from https://www.webmd.com/balance/how-tired-is-too-tired

NHS. (2021, October 29). Myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS). Retrieved from https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/
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