There can be several reasons as you said. I remember when I was in my 30s my internist tested me for Epstein-Barr which is a chronic fatigue syndrome. So there are some that can be "tested" for. Also you can have nutritional deficiencies that leave you tired and hormone imbalances. A good place to start is a full checkup with blood work. Sometimes a gyn is better at detecting hormone problems and not to be sexist but often female doctors are more sympathetic than males.

Meds...ugh what helps you hurts you. Not a single thing we take is free of side effects. Sometimes there are better options and sometimes we need to decide if the benefit is worth the side effects.

I know some people who swear by exercise to feel better. I know most of us feel that exercise is impossible with our conditions but we also know the endorphins make you feel better. So maybe research some things you can do. A few sessions with a good personal trainer might be worth the investment.

I just had to stop one med I was taking that really helped my vision because I was always tired and not motivated. It was a hard choice. I think what we really need is a magic wand to make this all go away :)

Unfortunately, anyone who has ever been exposed to mono (even if they didn't have a clinical case) will show up with a positive Epstein-barr titre. be sure they do a lyme disease test and an ANA to be sure you don't have an auto-immune disorder.
Also, a lot of people who are diagnosed with CFS are eventually diagnosed with fibromyalgia, which has similar symptoms but with more muscle pain and fatigue. There's no definitive test for fibro; it's diagnosed on symptomatology and presentation. With fibro,you have specific pain trigger points and I believe you have to have 12 or 18 trigger points to be dx.with fibro. When I was diagnosed,i had 22 trigger points which is a bit high.

Tigg is right- exercise is one of the best things for CFS or fibro. Even the slightest exercise (walking or swimming in a warm water pool) will help the pain and fatigue. That's easier said than done. I did find when I did warm water PT 3x a week I felt the best. I have a script for it now but am waiting to have my gb surgery before I start. i'm not sure how the RSD will respond to it but I do know my fibro and lupus pain improved dramatically when I did it

Just don't get trapped in the depression diagnosis that so many CFS patients get. CFS is not depression. it's a physiological disorder not a psychiatric condition.

Sandy

Hello Deleted_user. I too have chronic fatigue. No, it will not show in bloodwork explicitly, for CFS. But, in my case, I have low testosterone, which in turn, which will show in bloodwork, or a deficiency elsewhere, thusly fatugue. I hate being drained, mentally a physically and always sluggish. Having sleep apnea and T2 diabetes does not help. I struggle with daily exercise, and force myself. There can be many fascits with CFS. What may work for you may not help someone else. You are not alone. It's more common than you think. I do not know if there, here in Canada, any specialists with CFS. Swimming is low impact and high resistance. Listen to your body. I feel it's an uphill battle. Keep a diary with any progress. Hope this makes sence. Good luck.

CaptainM..........Ask your doctor to put you on testosterone replacement therapy.

Are you an overweight person? If so, you can often reverse diabetes with weight loss and a change in your eating habits like cutting out processed foods and sugar and salt.

If you can work your way up to walking two miles a day, you will see a huge difference in how you feel. If you can get someone to go with you, that would be a big help but. I often walk with a neighbor but if not, then I will bring my smartphone which has an audio book on it and I will listen to that.

Lifestyle changes are difficult to stick to and I waited until my late sixties thinking I hope it's not too late however, it's never too late to begin the work toward a more fulfilling life!

God Bless