These include:
• Adrenal insufficiency caused by excessive stress and/or the overuse of stimulants (tea, coffee, chocolate, cola, alcohol, tobacco, drugs)
• Anemia (low levels of iron or vitamin B12 in the blood result in anemia; a blood test can verify this diagnosis)
• Candidiasis (often misdiagnosed as CFS in women)
• Cardiovascular causes (if breathless-ness and/or chest pain on exertion accompanies fatigue, the heart may be involved)
• Chronic ill-health (many chronic diseases have fatigue as a symptom)
• Depression
• Diabetes
• Headaches
• Hypoglycemia (low blood sugar)
• Obesity
• Premenstrual syndrome (PMS) (the connection will be obvious if fatigue occurs at the same time in the monthly cycle)
• Sleep disturbance or inadequate
• Stress
A number of the causes listed above are also symptoms of chronic fatigue syndrome. This highlights the circularity of symptoms and illness. Depression is both a symptom and a cause of fatigue, as are headaches, candidiasis, PMS, poor stress-coping skills, and sleep disorders. The presence of these factors can produce a downward spiral of illness and it becomes difficult to tell which came first, the fatigue or the other exhibited symptoms.
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