According to the Mayo Clinic, although doctors don't know the cause of chronic fatigue syndrome, several possible causes have been proposed, including:
- Iron deficiency anemia
- Low blood sugar (hypoglycemia)
- History of allergies
- Virus infection, such as Epstein-Barr virus or human herpesvirus 6
- Dysfunction in the immune system
- Changes in the levels of hormones produced in the hypothalamus, pituitary glands or adrenal glands
- Mild, chronic low blood pressure (hypotension)
[Editor's Note: Immune dysfunction and endocrine disruption, two of the possible causes mentioned in this list, may be related to exposure to chemical toxins. Many people with environmental illness caused by toxic exposure have come down with CFIDS.)

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