What is the first treatment tried for chronic fatigue syndrome?

Chronic fatigue syndrome, also called myalgic encephalomyelitis, can involve disabling fatigue, unrefreshing sleep, problems with concentration and worsening symptoms after exertion. There is no single test that confirms it. A GP reviews the pattern, examines you and considers other explanations such as anaemia, thyroid disease, infection, sleep disorders or medication effects. Blood tests may help check for some of these conditions.

Arrange a GP consultation and describe what happens after physical, mental or social activity, including delayed worsening and recovery time. Keep a simple diary of sleep, energy, symptoms and activity without forcing yourself to increase exertion. Pacing means balancing activity with rest, staying within your available energy and avoiding repeated boom-and-bust cycles. Protect sleep, eat regularly and discuss practical support for work, study or personal care.

Seek prompt medical review for new or rapidly worsening fatigue, fainting, chest pain, severe breathlessness, neurological changes, persistent fever, unexplained bleeding or inability to manage basic needs. Urgent help is needed for confusion, collapse or thoughts of self-harm. A sudden change should not be assumed to be chronic fatigue syndrome.

Ask which symptoms support the diagnosis, which other conditions should be checked, whether blood tests are appropriate, how to pace safely, and what follow-up plan will monitor changes without overexertion.