Why Am I Always Tired? Understanding and Managing Chronic Fatigue Syndrome

Chronic fatigue syndrome can drain your energy Why Am I Always So Tired? Understanding Chronic Fatigue Syndrome (CFS)

Many people today feel tired, but some experience a level of exhaustion that is far beyond the usual feeling of being worn out. For individuals like Sarah, a 37-year-old working in a demanding finance role while caring for her family, this tiredness is constant and overwhelming. Even after a full night of sleep, she wakes up feeling unrefreshed and struggles to get through the day. This type of deep, ongoing fatigue may be a sign of Chronic Fatigue Syndrome (CFS), a condition that affects how the body produces and uses energy. Understanding what CFS is, why it happens, and how it can be managed is the first step toward feeling better.

1. What is chronic fatigue syndrome?

Chronic Fatigue Syndrome (CFS), also called ME/CFS, is a long-term condition where a person experiences severe, ongoing tiredness that does not improve with rest. This exhaustion lasts for at least six months and significantly affects daily life, including work, family responsibilities, and simple tasks like cooking or showering. Many people describe the fatigue as sudden “energy loss” that makes their body feel heavy or shut down, even after sleep.(1,2)

2. Why does chronic fatigue syndrome make me so tired?

Research shows that people with CFS may have difficulties with how their cells create energy. The mitochondria, which are responsible for producing energy in the body, may not work as effectively. At the same time, the immune system may stay activated for long periods, creating inflammation that uses up more energy and slows recovery. Hormonal problems and changes in gut bacteria may also play a role, making the body less able to bounce back from everyday activities. This combination of factors results in a constant feeling of low energy.(1,3,4,5)

3. How is chronic fatigue syndrome different from normal tiredness?

Normal tiredness usually gets better with rest, sleep, or taking a break. CFS does not. People with CFS wake up feeling as tired as when they went to bed, and sometimes even more exhausted. Many also experience symptoms like brain fog, difficulty focusing, headaches, muscle aches, and sleep that does not feel refreshing. One of the most challenging parts of CFS is feeling much worse after even light activity, which can trigger a sudden energy crash lasting for days.(2,6)

4. What causes chronic fatigue syndrome?

There is no single cause of CFS. Instead, most researchers believe it develops from several factors working together. Some people first notice symptoms after a viral infection. Others develop CFS during or after long periods of stress, poor sleep, hormonal changes, or illness. Nutrient deficiencies, toxin exposure, and immune system changes may also play a role. Because each person’s situation is different, the root causes often vary, which is why individual assessment is so important.(2,4,7)

5. Can stress make chronic fatigue syndrome worse?

Yes. Stress puts extra pressure on the body’s hormones, immune system, and nervous system. When the body is under stress for long periods, energy levels drop even further. This can make symptoms like fatigue, brain fog, and poor sleep more intense. Many people with CFS notice that stressful events or busy periods lead to stronger symptoms and longer recovery time.(7)

6. Does chronic fatigue syndrome affect the gut?

Many people with CFS have digestive symptoms such as bloating, constipation, diarrhoea, stomach discomfort, or food intolerances. Research shows that gut bacteria can be very different in people with CFS compared to those without the condition. These differences may affect how the immune system works and how the body handles inflammation. Because the gut and brain are closely connected, gut-related issues may also contribute to fatigue, brain fog, and mood changes.(5)

7. Why do I feel worse after exercise?

People with CFS often experience a symptom called post-exertional malaise (PEM). This means that even light activity such as walking, talking for too long, focusing on work, or doing household chores can cause a significant worsening of symptoms. The crash does not always happen immediately; it often appears hours or even a day later. This happens because the body struggles to create enough energy to recover from activity. Managing energy carefully, known as “pacing,” can help reduce the number of crashes.(6)

8. What tests can help understand my fatigue?

Although no test can diagnose CFS directly, health professionals can look for underlying contributors by checking thyroid function, iron levels, vitamin D, B12, folate, hormone balance, sleep quality, and gut health. These tests help rule out other medical conditions and identify factors that may be making fatigue worse. Understanding these areas helps create a more personalised and targeted plan to improve symptoms.(7)

9. Is there a cure for chronic fatigue syndrome?

There is currently no cure for CFS. However, many people find that their symptoms improve when they follow a personalised plan that supports sleep, nutrition, gut health, stress management, and energy pacing. Some people notice gradual improvements in energy levels over time when they receive the right support. Although progress can be slow, even small improvements can make everyday life more manageable.(2,7)

10. What treatments for chronic fatigue syndrome can help?

Some research suggests that supplements like CoQ10, NADH, L-carnitine, selenium, and probiotics may help reduce fatigue in some people. A balanced, anti-inflammatory diet may also support energy and improve symptoms. Sleep improvement strategies, stress reduction, and pacing techniques are important parts of treatment. Because each person with CFS is different, it is important to work with a health professional to find the best combination of strategies for your body.(3,4,5,7)

11. How can FerFit Dietetics & Nutrition help reduce chronic fatigue syndrome?

FerFit Dietetics & Nutrition offers personalised, research-based support to help uncover what might be contributing to your fatigue. This includes examining your diet, sleep habits, gut health, hormones, stress levels, and daily routines. Based on this assessment, we create a tailored nutritional plan to improve energy using nutrition strategies, gut support, supplement guidance, and pacing advice. Our goal is to help you feel more in control of your health and make steady progress toward better energy and quality of life.

12. What should I do next if I think I have chronic fatigue syndrome?

If you suspect you may have CFS, speaking with a health professional who understands fatigue conditions can be very helpful. A full assessment can bring clarity, rule out other causes, and identify the most effective steps for your situation. You do not need to manage this alone. FerFit Dietetics & Nutrition can guide you through a personalised plan to help support your body and work toward better wellbeing.

References

1. Holden S, Maksoud R, Eaton-Fitch N, Cabanas H, Staines D, Marshall-Gradisnik S. A systematic review of mitochondrial abnormalities in ME/CFS. J Transl Med. 2020;18:290.

2. Castro-Marrero J, Saez-Francas N, Santillo D, Alegre J. Treatment and management of chronic fatigue syndrome/myalgic encephalomyelitis. Br J Pharmacol. 2017;174(5):345–369.

3. Maksoud R, Balinas C, Holden S, et al. Nutraceutical interventions for mitochondrial dysfunctions in ME/CFS. J Transl Med. 2021.

4. Morris G, Maes M. A neuro-immune model of ME/CFS. Metab Brain Dis. 2013;28(4):629-652.

5. Proal A, VanElzakker M. Microbial and immune factors in ME/CFS and post-viral fatigue. Front Pediatr. 2021.

6. Nacul LC, et al. Post-exertional malaise in ME/CFS. J Health Psychol. 2020.

7. Jackson ML, Bruck D. Sleep abnormalities in chronic fatigue syndrome. Sleep Med Rev. 2021.