• Genetic predisposition – there is some evidence ME/CFS can run in families (Buchwald et al., 2001, Albright et al., 2011, Schlauch et al., 2016);
• Acute or chronic infection (including viral, bacterial and/or parasitic infections – for example glandular fever, Q fever and Ross River fever are all known possible triggers of ME/CFS (Hickie et al., 2006));
• A flu-like illness – this is what occurs in most cases of ME/CFS (Sairenji and Nagata, 2007);
• Exposure to toxic chemicals, environmental pollutants or heavy metals – this may indicate that Multiple Chemical Sensitivities (MCS) or Idiopathic Environmental Intolerance (IEI) and Gulf War Illness/Syndrome have an overlap with ME/CFS (Khaiboullina et al., 2015);
• Immunisation – there have been some reports of ME/CFS onset following certain vaccinations (Lloyd et al., 1988, Appel et al., 2007, Ortega-Hernandez and Shoenfeld, 2009);
• Severe physical or emotional trauma (Afari et al., 2014).

In some cases ME/CFS may not have an obvious precipitating event but be the result of a gradual onset (DeLuca et al., 1997, Mawle, 1997). ME/CFS frequently appears with other medical conditions.

Quick Links:

What is ME/CFS?

Symptoms

Severity

Who gets ME/CFS?

Further reading

References

Nguyen, T., et al. “Novel identification and characterisation of Transient receptor potential melastatin 3 ion channels on Natural Killer cells and B lymphocytes: effects on cell signalling in Chronic fatigue syndrome/Myalgic encephalomyelitis patients.” Biol Res, 2016, 49(1): 27.

Schlauch, K. A., et al. “Genome-wide association analysis identifies genetic variations in subjects with myalgic encephalomyelitis/chronic fatigue syndrome.” Transl Psychiatry, 2016, 6: e730.

Khaiboullina, S. F., et al. “Cytokine expression provides clues to the pathophysiology of Gulf War illness and myalgic encephalomyelitis.” Cytokine, 2015, 72(1): 1-8.

Bested, A. C. and L. M. Marshall. “Review of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: an evidence-based approach to diagnosis and management by clinicians.” Rev Environ Health, 2015, 30(4): 223-249.

Afari, N., et al. “Psychological trauma and functional somatic syndromes: a systematic review and meta-analysis.” Psychosom Med, 2014, 76(1): 2-11.

Papadopoulos, A. S. and A. J. Cleare. “Hypothalamic-pituitary-adrenal axis dysfunction in chronic fatigue syndrome.” Nat. Rev. Endocrinol. 2012, 8(1): 22-32.

Albright, F., et al. “Evidence for a heritable predisposition to Chronic Fatigue Syndrome.” BMC Neurol, 2011, 11: 62.

Lemle, M. D. “Hypothesis: chronic fatigue syndrome is caused by dysregulation of hydrogen sulfide metabolism.” Med Hypotheses, 2009, 72(1): 108-109.

Ortega-Hernandez, O.-D. and Y. Shoenfeld. “Infection, vaccination, and autoantibodies in chronic fatigue syndrome, cause or coincidence?” Ann. N. Y. Acad. Sci., 2009, 1173(Contemporary Challenges in Autoimmunity): 600-609.

Ortega-Hernandez, O.-D. and Y. Shoenfeld. “Infection, vaccination, and autoantibodies in chronic fatigue syndrome, cause or coincidence?” Ann. N. Y. Acad. Sci., 2009, 1173(Contemporary Challenges in Autoimmunity): 600-609.

Appel, S., et al. “Infection and vaccination in chronic fatigue syndrome: myth or reality?” Autoimmunity, 2007, 40(1): 48-53.

Sairenji, T. and K. Nagata. “Viral infections in chronic fatigue syndrome.” Nihon Rinsho, 2007, 65(6): 991-996.

Hickie, I., et al. “Post-infective and chronic fatigue syndromes precipitated by viral and non-viral pathogens: prospective cohort study.” Bmj, 2006, 333(7568): 575.

Buchwald, D., et al. “A twin study of chronic fatigue.” Psychosom Med, 2001, 63(6): 936-943.

DeLuca, J., et al. “Sudden vs gradual onset of chronic fatigue syndrome differentiates individuals on cognitive and psychiatric measures.” J Psychiatr Res, 1997, 31(1): 83-90.

Mawle, A. C. “Chronic fatigue syndrome.” Immunol Invest, 1997, 26(1-2): 269-273.

Lloyd, A. R., et al. “What is myalgic encephalomyelitis?” Lancet, 1988, 1(8597): 1286-1287.