Chronic Fatigue Syndrome Diagnosis

Different Criteria for Chronic Fatigue Syndrome Diagnosis

Chronic Fatigue Syndrome diagnosis is confused by the fact that there are several diagnositc criteria as follows:

  • The Oxford criteria for Chronic Fatigue Syndrome (aka CFS)
  • The Centers for Disease Control (CDC) criteria for CFS
  • The National Institute for Clinical Excellence (NICE) criteria for CFS
  • The Canadian consensus criteria for CFS

In February 2014 an additional set of diagnostic criteria was put forward.
The USA organisation,
the Institute of Medicine (IOM), suggested that the following 3 core symptoms should be required for a Chronic Fatigue Syndrome diagnosis.
(They also suggested that CFS be renamed as Systemic Exertion Intolerance Disease, with use of the abbreviation SEID).

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Symptoms required for diagnosis of SEID or CFS, suggested by IOM (in the USA)

  • Fatigue and reduced activity which has lasted more than six months
  • Fatigue that is worse after exertion
  • Unrefreshing sleep

According to the Institute of Medicine (IOM) one of the following two symptoms should also be required for a diagnosis of CFS or SEID

  • Cognitive impairment, also known as 'brain fog'
  • Orthostatic intolerance - patients find it hard to stay upright for long

These diagnostic criteria suggested by the IOM do not differ greatly from the other CFS criteria listed above.

If you are asking "Do I have CFS?", please consider if your symptoms meet these criteria.

The matching of your symptoms with one of the sets of these criteria are the basis on which Chronic Fatigue Syndrome is diagnosed.

For my personal take on other Chronic Fatigue Syndrome symptoms I experience please keep reading.

(Click through for a list of simple steps to live with a CFS diagnosis, manage the symptoms and assist the possibility of recovery.)

Katherine comments on the IOM criteria for Chronic Fatigue Syndrome Diagnosis

  • It is puzzling to me that muscle pain is not included in the IOM criteria for CFS diagnosis, since this is such a common symptom of CFS and ME.
  • Also, when talking about CFS/ME symptoms I find it is important to distinguish muscle fatigue from general fatigue. Muscle fatigue is not mentioned in these criteria.

    Many people with CFS do not take repeated movement of any muscle group without subsequent muscle fatigue and muscle pain. Persisting in the movement leads to a reduction in the amount of exertion that muscle will take before fatigue and pain set in. For myself post exertional muscle fatigue is the most limiting of the CFS symptoms.

    As a result of this symptom of muscle fatigue and pain following movement, I experience the most pain and the most restricted movement in those parts of my body which I use the most - my eyes and my fingers. Historically I had extreme muscle fatigue in my arms, leading me to rely on carers to feed me for 14 years.
  • I agree with the Institute of Medicine (IOM) that a Chronic Fatigue Syndrome diagnosis should not be given before 6 months. It is difficult to be ill so long without a diagnosis, but chronic fatigue is  symptom of many different chronic illnesses.
    I hope that the 6 month guideline encourages doctors to investigate other possible causes before giving the Chronic Fatigue Syndrome (or SEID or ME) diagnosis.

This article has been written by Katherine T Owen

Katherine is the webmaster at She is author of Be Loved, Beloved (available on or kindle). She was diagnosed with Myalgic Encephalomyelitis in 1993.

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Relevant articles

  • What is Chronic Fatigue Syndrome? And what are the symptoms of CFS? Read more here.
  • There are illnesses with overlapping symptoms to CFS. To avoid a CFS misdiagnosis these conditions need to be excluded.  There are also chronic illnesses which may coexist with Chronic Fatigue Syndrome.

Click through for tips on what to say in reply to the question: "What is the cause of CFS?"

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Disclaimer: I am not a medical practitioner. The articles on this website are not to be taken as medical advice. Please consult a medical practitioner as necessary.