Immune System And Fatigue

What is the immune system?

The immune system is the defender and protector that protects us against foreign bodies, viruses, bacteria, and anything that endangers our body. It is made up of complex organs, cells and proteins working together to fight against any infection. Disorders in the immune system include under or overactive immune system, such as allergic diseases. Autoimmune disease is also considered as an immune system disorder where immune responses against normal components of the body cause destruction of the body itself. 

What is fatigue?

Chronic fatigue syndrome (CFS), also known as Myalgic encephalomyelitis (ME) fatigue syndrome, is a complex and severe debilitating condition that is long term and has a diverse range of annoying symptoms. CFS affects women four times more than men, especially between mid 20 and mid 40. More than 250,000 people in the UK live with CFS and it affects 17 million worldwide. 

Symptoms of chronic fatigue syndrome: 

Chronic fatigue syndrome symptoms differ from person to person, and severity of the symptoms may differ from day to day and even in the same day.

  • The most common symptom is feeling extremely tired all the time. Even after taking a rest or sleeping, it dramatically impacts a person's ability to do daily activities
  • Mental fogginess and problems in concentration, memory and thinking
  • Depression
  • Sleeping problems
  • Dizziness and feeling sick
  • Muscle and joint pain
  • Suffering from a headache
  • Irregular heartbeats (palpitations)
  • flu -like symptoms

About 90% of people with the disorder are not diagnosed because there is no specific test to diagnose chronic fatigue syndrome so diagnosis mainly depends on symptoms.  Moreover, diagnosis of CFS is considered a little bit confusing because the symptoms are similar to many conditions such as fibromyalgia so it is important to see a GP for proper diagnosis. 

Treatment of chronic fatigue syndrome:

CFS has no effective drug treatment to cure it, and treatment aims to manage the symptoms, decrease its intensity and improve quality of life. Treatment includes: 

  1. Cognitive behavioral therapy to help deal with the disease
  2. Medicine to manage pain and sleeping disorders, Antidepressants can be useful in people with chronic fatigue syndrome suffering from muscle pain and sleeping disturbance. Amitriptyline is a low-dose tricyclic antidepressant that may be prescribed to help decrease muscle pain
  3. Exercise plan suitable for chronic fatigue patients, as any vigorous activity may worsen the condition 

Understanding the relationship between the immune system and fatigue

Although the cause of chronic fatigue syndrome is still unknown, there is some evidence claiming that CFS is due to biological processes such as immune dysfunction triggered by infection, playing an important role in the onset of the disease. 

According to theories, there are predisposing factors triggering chronic fatigue syndrome such as:

  • Viral infections
  • Bacterial infections
  • Hormonal imbalance
  • Immune system problems
  • Genetics: CFS may be more common in some families

Chronic fatigue syndrome is one of the most frustrating symptoms associated with autoimmune disease. Immune imbalance is a trigger to chronic fatigue syndrome; research indicated that immune molecules that are present in the blood in response to an infection were higher in patients with the severest symptoms than in patients with mild symptoms (Science, 2017)

Chronic fatigue syndrome is due to an overactive immune system, where the immune system of a  patient seems unable to shut down or decrease its response to an infection that has passed. 

Chronic fatigue and persistent pain are the most common complaints that are associated with autoimmune patients, such as systemic lupus erythematosus, multiple sclerosis and rheumatoid arthritis. It is estimated that 98% of autoimmune patients suffer from chronic pain. 

Signs of a weak immune system

A weak immune system has great impacts on our health and life, and signs indicating that our immune system is not working at its best include:

  1. Extreme tiredness

Being constantly tired and having low energy levels even after taking rest and sleeping well indicates a weak immune system. 

  1. Frequent cold and infections 

Having 2 to 3 episodes of infection every year and recovering in a week or 10 days is normal. But more than 3 episodes and taking longer time to recover indicates weakened immune system. 

  1. Digestive system problems 

Weak immune system includes tummy ache and some digestive problems such as constipation, frequent diarrhoea, and bloating. 

  1. Increased stress levels

Stress is directly proportional to a weak immune system. According to the American Psychological association, the response of the immune system gets weaker by long term stress which decreases white blood cells that fight off the infection. We are at high risk for catching colds and infections when white blood cell level is low. 

  1. Poor wound healing 

Usually wounds heal in 3 to 5 days, but if it takes longer to heal, this indicates an altered immune system. 

  1. Muscles and joint pain

As we now know what the signs of a weak immune system are, we have to know immune system boosters to strengthen your immunity:

  •  Stress management

Stress is a major trigger to chronic fatigue syndrome, so decreasing stress level is important for better immunity. Prolonged stress periods lead to an increase in a hormone called cortisol, which suppresses the cells of the immune system, decreasing the body’s ability to fight infections. 

  • Good night sleep is considered an immune system booster
  • Exercising regularly
  • Maintain a healthy diet 

It is essential to include necessary vitamins and minerals in diet: 

  1. Vitamin B6: found in chicken, tuna, banana, salmon
  2. Vitamin C: in citrus fruits as orange, grapefruit
  3. Vitamin E: found in spinach, almond, peanut butter
  4. Magnesium: found in nuts, seeds, and whole wheat products
  5. Zinc: found in beans, dairy products, oysters, red meat


Chronic fatigue syndrome is a mysterious illness of unknown aetiology and can’t be explained by underlying medical conditions, it has neither standard diagnostic tools nor effective treatment, so prevention and managing the symptoms are the key to treatment. The immune system is the defender and the backbone of our body. Any defect or dysfunction in this system will lead to severe symptoms and fatigue. It is necessary to avoid the triggers which weaken the immune system and to strengthen the immune system which is our superhero. 


  1. Kmiecik C. Beyond tired: Fatigue and autoimmune disease [Internet]. Autoimmune Association. 2022 [cited 2022Dec12]. Available from: 
  2. More clues link immune system imbalance with chronic fatigue syndrome [Internet]. Science. [cited 2022Dec12]. Available from: 
  3. Chronic fatigue syndrome 'could be triggered by overactive immune system' [Internet]. The Guardian. Guardian News and Media; 2018 [cited 2022Dec12]. Available from: 
  4. Chronic fatigue immune dysfunction syndrome triggered by infections? [Internet]. Moleculera Labs. [cited 2022Dec12]. Available from:,often%20triggered%20by%20an%20infection.&text=Chronic%20fatigue%20syndrome%20(CFS)%2C,a%20severe%20and%20chronic%20disease
  5. Rohini Radhakrishnan ENT. What are the signs of a weak immune system? 9 signs & 13 tips [Internet]. MedicineNet. MedicineNet; 2022 [cited 2022Dec12]. Available from: 
  6. 10 symptoms of a weak immune system and what to do about it [Internet]. [cited 2022Dec12]. Available from: 
  7. 6 ways to boost your immune system [Internet]. Houston Methodist On Health. [cited 2022Dec12]. Available from: 
  8. Chronic fatigue syndrome: An autoimmune disorder of the neuroendocrine system. [cited 2022Dec12]. Available from: 
  9. Mandal DA. Chronic fatigue syndrome connected with an overactive immune system [Internet]. News. 2019 [cited 2022Dec12]. Available from: 
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Noran Kotaem

Bachelor's degree, Dentistry, The British University in Egypt

Noran is a dentist and a teaching assistant at the Faculty of Dentistry in the British university in Egypt. Passionate about research, reading and writing in the fields of medicine, nutrition and lifestyle. Keen to learn more about evidence based scientific research and writing.

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