Hakim, Alan, De Wandele, Inge, O'Callaghan, Chris et al. · American journal of medical genetics. Part C, Seminars in medical genetics · 2017 · DOI
Chronic fatigue is common in people with Ehlers-Danlos syndrome (EDS), a connective tissue disorder, and can significantly reduce quality of life. This review explains that EDS and ME/CFS share similar symptoms, and some people diagnosed with ME/CFS may actually have undiagnosed EDS. Treatment requires ruling out common causes of fatigue like anemia and thyroid problems, then addressing EDS-specific issues like sleep problems, pain, heart rhythm problems, and physical deconditioning through a combination of symptom management, physical therapy, and supportive care.
This work is important because it highlights significant symptom overlap between EDS and ME/CFS, suggesting that some ME/CFS patients may have unrecognized connective tissue disease. Understanding the multifactorial nature of fatigue in EDS provides a framework for evaluating ME/CFS patients and may inform treatment strategies that address autonomic dysfunction, deconditioning, and sleep disturbance—key features in both conditions.
This review does not establish causal relationships between specific EDS pathophysiology and fatigue, nor does it quantify the proportion of ME/CFS cases that represent undiagnosed EDS. It provides no new epidemiological data, diagnostic validation studies, or randomized controlled trials of proposed treatments. The recommendations are clinical consensus rather than evidence-based findings from primary research.
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Primary citation
Hakim, Alan, De Wandele, Inge, O'Callaghan, Chris, Pocinki, Alan, & Rowe, Peter (2017). Chronic fatigue in Ehlers-Danlos syndrome-Hypermobile type.. American journal of medical genetics. Part C, Seminars in medical genetics. https://doi.org/10.1002/ajmg.c.31542
BibTeX
@article{mecfsatlas-hakim-2017-chronic-fatigue,
author = {Hakim, Alan and De Wandele, Inge and O'Callaghan, Chris and Pocinki, Alan and Rowe, Peter},
title = {Chronic fatigue in Ehlers-Danlos syndrome-Hypermobile type.},
journal = {American journal of medical genetics. Part C, Seminars in medical genetics},
year = {2017},
doi = {10.1002/ajmg.c.31542},
note = {PubMed: 28186393},
url = {https://www.mecfsatlas.com/evidence/hakim-2017-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/hakim-2017-chronic-fatigue
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