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Chronic fatigue seems to be such a modern problem. Yet it has always been with us, and there are many well-tried approaches we can learn from.”

What is this toolkit?
The College of Medicine Self Care Toolkit is a resource for anyone to use.

We aim to provide you with reliable information for your self care that has been independently and expertly assessed. Mainly we choose options that have the evidence, and provide links so you can see that evidence for yourself. We also mention some of the most plausible and widely-used self care options around the world, where these are likely to be safe and so worth a try.

Find out more about how this resource was put together in the About Us link above.

You can choose your self care treatment options from the list below.

How do you use this?
For each treatment options you will see a row with a choice of three symbols at the top. This is what they mean.

Good evidence suggests this is well worth trying.
Some research suggests that this is worth trying.
A little research suggests this might be worth trying.
Not much research or uncertain results - however safe enough and might still be worth a try.
Costs will be from nothing to £15 per month. This category also includes options that might be available on the NHS even though getting them privately may be expensive.
Costs could be up to £50 one off or per month although may be less.
Expect to pay more than £50 per month.
No safety concerns.
Caution if you have certain health problems.


What to watch out for


This site gives you information NOT medical advice. You should consult your medical practitioner if you have any unexplained symptoms of illness or concerns about treatment. Do not stop a prescribed conventional treatment without consulting a doctor. Tell all the practitioners you’re working with, conventional or complementary, about any medicines, remedies, herbs or supplements you are taking or considering using.


Chronic fatigue

What do we mean by chronic fatigue?

Tiredness in your mind or your body is normal after you’ve been working hard. And prolonged stress, whether at work or at home, can lead to unexpected tiredness. Poor sleep will make you feel tired too, of course.

Ordinary tiredness is common. In about 25% of all general practitioner (GP) consultations, patients complain of feeling tired all the time, and it is the main reason for seeing the doctor in 6.5% of consultations. The National Institute for Clinical Excellence (NICE) suggests that perhaps 1 in 250 people in the UK have chronic fatigue syndrome. Of those who visit their doctor because of persistent tiredness, fewer than 30% will have an actual disease. About half will have a mainly psychological cause – tiredness is often a symptom of depression. 

Chronic fatigue syndrome (CFS) is a disorder associated with extreme fatigue. This fatigue is not the kind of tired feeling that goes away after you rest. Instead, it lasts a long time and limits ability to do ordinary daily activities.

CFS is often used for fatigue that has lasted for six months or more. It is generally accompanied by other problems such as muscle pain, memory problems, headaches, pain in multiple joints, sleep problems, sore throat and tender lymph nodes. This pattern is sometimes also called myalgic encephalomyelitis (ME) and has lately become associated with raised inflammatory markers in the body, and even perhaps in the central nervous system (‘neuroinflammation’). CFS sometimes comes on after a viral illness (‘post-viral syndrome’) and there may be a common inflammatory link.  However since other illnesses can cause similar symptoms, CFS remains hard to define.

If you have been feeling exhausted for more than six months, and have been able to do a lot less because of this, you should talk to your doctor and consider having some simple tests done. Your GP will want to find out what is making you feel so exhausted and exclude other illnesses. 

One complication that can be explored is depression. This can lead to similar symptoms of muscle ache, constant tiredness and sleep difficulties. In the past some doctors considered CFS to be a depressive condition, but this is known not to be correct. Although CFS is obviously depressing, not everyone who has CFS is diagnosable with clinical depression.

Many experts believe that CFS comes in many different forms, and so no single treatment will be suitable for everyone. Most doctors would agree that good self-care plays a very important part in recovery.

Other information that might be helpful

Even if you don’t have CFS, but often feel tired, this section may offer you some ideas on how to improve your well-being:

  • If you think that you might be suffering from anxiety (feeling unusually nervous or having worrying thoughts that are keeping you awake a lot), you might find our section on STRESS AND ANXIETY helpful.
  • If you are feeling ‘low’ (particularly if you’re waking early), or if you’re feeling very down about yourself, you might you might find our section on DEPRESSION helpful.
  • If sleepiness or other sleep problems are more of a difficulty than fatigue itself you might find our section on SLEEP PROBLEMS helpful.