Chronic Fatigue Syndrome

There are several complications that have been associated with mononucleosis. One such complication linked to infectious mononucleosis is chronic fatigue syndrome.

A lesser-known complication of mono, chronic fatigue syndrome can have adverse effects on an individual's health. However, there is contention with regard to the nature of the relationship between mononucleosis and chronic fatigue syndrome.

What is Chronic Fatigue Syndrome (CFS)?

Chronic fatigue syndrome is characterized by unexplained fatigue that is persistent and severe in nature. The onset of this condition can be gradual or sudden. Fatigue associated with this disease lasts for at least six months or longer and is not minimized by rest.

Women are twice as likely as men to develop CFS while Caucasians are more likely than other ethnic groups to develop this disease.

CFS Symptoms

In addition to severe fatigue, there are other symptoms of chronic fatigue syndrome include:

  • sore throat
  • difficulty concentrating or forgetfulness
  • tender lymph nodes (neck, armpit)
  • muscle pain or multi-joint pain but lack of swelling
  • severe or unusual headaches
  • lack of refreshing sleep
  • feelings of illness or depression after exerting oneself, which last more than 24 hours following exertion
  • fatigue that lasts for a period longer than 24 hours

These symptoms should last for a period of six consecutive months or more. At least four of them must be experienced concurrently with extreme fatigue in order for CFS to be diagnosed.

Diagnosing CFS

The diagnosis of CFS can be difficult because many of the symptoms of this disease are non-specific symptoms, meaning that they can be attributed to several other diseases.

One study found that of 1,000 patients, only 8.5% had major fatigue with no apparent cause that lasted for a period of at least six months. Only 15% of these individuals met the medical definition of CFS.

Causes of CFS: Does Mononucleosis Lead to CFS?

There are conflicting results with regard to whether or not infectious mononucleosis in fact leads to chronic fatigue syndrome.

In the past, it was believed that the virus which causes mono, the Epstein-Barr virus, also caused mononucleosis, as well as chronic fatigue syndrome.

However, recent studies have suggested that there is no link between these two conditions. Despite this, other reports conflict with this finding.

In fact, one study found that in about one-third of every case of infectious mononucleosis in which the onset of mono was abrupt, individuals promptly experienced the onset of respiratory, gastronomical or other acute infections with flu-like symptoms, including mono.

Other studies indicate that CFS occurs following an emotional traumatic experience, such as a death in the family.

Some experts believe that CFS is not caused by mono, but is still caused by a viral infection, as CFS symptoms generally mimic those of mononucleosis.

Also known as post-viral fatigue syndrome, CFS has also been linked to a potential immune system or central nervous system disorder.


There is no cure for CFS; however, like mono treatment, there are a variety of ways in which to manage the effects of CFS on an individual, including:

  • healthy diet
  • stress management and reduction
  • regular, carefully monitored exercise
  • yoga, tai chi and/or meditation

In addition, cognitive behavioral therapy and anti-depressant medication may also be prescribed.

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