Diagnosis

1. Persistent tiredness or fatigability, whcih persists or shows relapsing course for 6 months or more

2. four or more of following >6mo

   1. impaired memory or concentration

   2. sore throat

   3. Tender cervical or axillary lymph nodes

   4. Muscle pain

   5. Multi-joint pain

   6. New headaches

   7. Unrefreshing sleep

   8. Malaise after exertion lasting >24hrs

3. Fatigue that cannot be fully explained by any active medical condition

   1. untreated hypothyroidsim

   2. sleep apnoea

   3. iatrogenic causes

   4. unresolved medical condition (hepatitis B)

   5. alcohol or substance misuse within 2 years before or at any time after onset of fatigue

   6. severe obesity

   7. severe mental illness