The Best Way To Deal With Chronic Fatigue And Tiredness


“Exercise, and you will feel more energetic throughout the day.”

That is on of the most used phrases among health practitioners – But is there any substance to this claim? Can you really feel more energetic by exhausting yourself physically on regular basis?

Let me be perfectly honest with you guys: I’m tired. As I’m writing this I feel exhausted in body and mind.  And I am not alone. Every single patient I met today said one of their toughest symptoms were abnormal tiredness. Every single one of my colleagues was talking about how hard it was to get out of bed this morning. The whole goddamn western civilization has turned into sleepwalking robots, practically sleeping with their index finger on the Snooze-button. The speculation of why this might be is topic for another (very long) article, but as one might predict, sooner or later the somewhat controversial question came come to me:

Is it true that exercise can actually make you feel more energetic?

The Research on Chronic Fatigue Syndrome and Exercise

To best answer this question, let’s look at the research done on abnormally tired patients and exercise. Chronic fatigue syndrome (CFS) is a medical condition, characterized by persistent fatigue. Its cause cannot be explained by any other medical condition (cancer, hypothyreosis, insomnia etc.) or logic (lack of sleep, irregular sleeping patterns, grief etc.)  When searching for adequate papers, I came over a Cochrane review – basically the king of scientific evidence with insanely high trustworthiness, looking at this very subject. For a science geek like me, finding a Cochrane review on a topic you’re interested in is as rewarding as eating one whole cheesecake in one sitting.

According to the text books, standard treatment for chronic fatigue syndrome ranges from antidepressants, self-help treatment, and cognitive behavior therapy to dietary intervention such as supplementation with fish oil and folic acid. Exercise is known to improve strength, cardiovascular health and psychological status in the general population but this study was one of the first to look at its efficacy in reducing tiredness in chronically fatigued patients.
The results were mind-blowing.  In this group of patients, exercise therapy was more effective than standard treatment on factors such as:

  • Symptoms of fatigue
  • Symptoms of depression
  • Increasing quality of life
  • Enhancing sleep quality

Interestingly, exercise therapy was more effective than the anti-depressant drug Fluoxetine in reducing fatigue although less effective in reducing symptoms of depression (non-significant results).  However, drop out was more common among groups treated with exercise then Fluoxetine, perhaps stating the obvious: eating pills is easier than exercising if chronically fatigued.

To sum the findings of this review: Physical activity is pretty awesome for helping people suffering from chronic fatigue syndrome.  The question however still remains:

Can this knowledge be applied to the general tired population?

Hell Yes!

It’s as easy as that. I might not have hard scientific evidence at hand to support this claim but I feel pretty confident about recommending increased physical activity to whoever might feel fatigued. If the abnormally tired group of patients we looked at above experienced a decrease in fatigue, had less depressive symptoms and saw an increase their quality of life, then I do not see why this would not apply to the general fatigued population, even if they don’t have the diagnosis in their medical journals.

Worst case scenario, I might be completely wrong and my recommendation could put you at risk for one or more of the known side effects of increased physical activity: strength gains, increased cardiovascular health, increased metabolic rate, muscular hypertrophy, improved well-being, increased sex drive, and less of a likelihood that you’ll sleep alone in the future. My bad.

At least you’ll sleep like a baby.


Edmonds M, McGuire H, Price JR. Exercise therapy for chronic fatigue syndrome. Cochrane Database of Systematic Reviews 2004, Issue 3.

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5 comments on “The Best Way To Deal With Chronic Fatigue And Tiredness
  1. What kind of exercise?

    Typically studies looking at exercise will use low-moderate intensity aerobic exercise, unless otherwise stated.

    I believe in resistance training, but in times of excessive fatigue, is there a possibility that resistance training (especially if it is intense) is counter productive, particularly if you subscribe to a central fatigue theory?

    • Bojan.K says:

      Nick, thanks for commenting! Interesting thoughts.

      Here’s a summary of the type op activity in the studies included in the review:
      As expected, aerobic exercise was the main intervention, raging from 3-5 sessions/week with workouts around 30 minutes at 40-75% VO2max. If the results can be applied to resistance training is, of course, speculative and not something I’ve seen any research on – however, the central fatigue theory is also something I think is much less of an issue to the general training population than many seems to believe. Again, no science – just personal reflections.

  2. abc1234 says:

    Before CFS I’ve used to take martial arts, build muscle and was really pushing myself. Suddenly I have started to notice being much more exhausted than usual. I’ve tried to eat even better (I was eating well before), I’ve tried resting more, none of it worked.  Through the years  the fatigue and other symptoms just increased. None of this prevented nor helped my fatigue. I think that it was partially responsible for it. A candle that burns twice as hard, burns out in half the time…
    The stronger the exertion the more I’ve regressed… I have also tried less intense exercise like walking the dog… But it didn’t work. Maybe I would have been healthier if I didn’t exercise and exhaust myself. This is coming from someone who subscribed to “no pain no gain” gym motto.

  3. abc1234 says:

    Part 2.
    As I was getting more and more sick and home bound, I did try to “exercise-out-of-it” . I worked out 2-3 times per week, 10minutes to 40 minutes. I did managed on Bowflex to pull down 410 pounds and bench press 410 pounds. With two 72 pound kettlebells  I could clean 20 times… And yet none of it helped. I was getting more and more bed ridden. My “well-being” was turning hellish. Even 10 minute workout made me take 1 hour long nap and entire broken day when I felt like I had a flu.  I am now less able to walk the dog for 15 minutes a day than before… So much for exercising out of it. Before CFS I could deadlift 470 pounds, bent over row with 110 dumbells with ease, and used to want to be like Arnold… I also tried simple exercise like walking the dog, but it didn’t help either.
    My fatigue is definitely NOT due to depression. I wish there were studies of real CFS patients rather than some depressed and malnourished people who never had CFS.

  4. Nicky says:

    I suffer with fatigue and I’ve always been told the best medicine is exercise. Well I beg to differ. I find that a gym session, either partially intense or just at speed walking pace I feel great just afterwards and I don’t feel tired for the whole evening, but I flat line with energy for up to 3 days afterwards and all my joints ache like I have flu. So I find it hard to listen to non fatigue sufferers when they preach that exercise is the answer because I can say hand on heart it is not. I’ve tested this theory over and over and through all seasons and the outcome has always been the same, more tiredness, more fatigue and more aching.

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