Chronic fatigue syndrome: symptoms and signs

Chronic fatigue is a group of symptoms that make it difficult for a person to function normally. This ailment is characterized by extreme tiredness and fatigue, which does not disappear even after sleep and rest, and can also worsen with certain physical or mental activity. This condition can occur at any age, but it is most common in people between the ages of forty and fifty.

Diseases and conditions that lead to this ailment

Chronic fatigue can be the result of one or more diseases. The most common cause is found to be a dysfunction of the endocrine system, as well as hormonal imbalance. They also include the adrenal glands (Addison’s disease), the thyroid gland (hypothyroidism and hyperthyroidism), and diabetes.

Other diseases and conditions that can cause this syndrome:

  • anemia;
  • electrolyte disturbances;
  • drugs (diuretics, beta blockers, and drug abuse);
  • psychological disorders (depression and chronic stress);
  • heart failure, renal and hepatic failure;
  • chronic infectious diseases (tuberculosis and HIV);
  • malignant diseases;
  • neurological ailments (multiple sclerosis and myasthenia gravis).

There is also a special type of chronic fatigue, the cause of which is unknown and different from the above.

What are the symptoms and signs?

The main symptom is fatigue, which is present for more than 4 months and does not go away after a period of rest and sleep.

  • Decreased memory and concentration.
  • Myalgia (muscle pain).
  • Pain in certain parts of the body and head.
  • Tachycardia (rapid heart rate).
  • Low blood pressure.
  • Dizziness.
  • Increased sensitivity to noise and light.

Adrenal disease and the pituitary-hypothalamus-adrenal axis

Adrenal insufficiency can lead to chronic fatigue. This is all due to a decrease in the production of the hormone cortisol from the spleen. In addition, a disorder of the pituitary-hypothalamus-adrenal axis, which work together to regulate human hormone levels, may be the cause. Disruption of any part of this axis can lead to hormonal imbalances and a lack of hormones such as cortisol, aldosterone, estrogens, progesterone, testosterone, and other hormones.


A decrease and increase in the action of the thyroid gland is one of the causes of chronic fatigue. It can manifest as lethargy, mood changes, joint and muscle pain, memory loss, tachycardia, headache, dizziness, and the like. With an accurate diagnosis and adequate treatment, symptoms disappear.

Insulin-resistant diabetes

Chronic fatigue is common in patients with type 1 and type 2 diabetes (insulin resistance). Fatigue symptoms also occur with high blood sugar (hyperglycemia) and low blood sugar (hypoglycemia).

Electrolyte disturbances

In some patients, chronic fatigue syndrome is a consequence of an electrolyte imbalance in the blood:

  • Hypokalemia is a low blood potassium threshold that is associated with kidney and adrenal disease.
  • Hypercalcemia – a high threshold of calcium in the blood as a result of increased function of the parathyroid glands.
  • Low sodium content in the blood due to adrenal and kidney malfunction.


Treatment depends on the exact diagnosis. The first step is to see an endocrinologist.

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