Diagnostic Criteria For Me/cfs
Because there is no single, diagnostic biomarker for myalgic encephalomyelitis/chronic fatigue syndrome, and medical education on the condition is sparse, diagnoses can be challenging to access. Physicians often begin with ruling out other potential underlying conditions before looking at ME/CFS. With that in mind, a diagnosis of ME/CFS requires a patient to meet certain conditions. These include:
The Case For Neuroglial Dysfunction In Myalgic Encephalomyelitis/chronic Fatigue Syndrome
To advance this quest, we have non-systematically reviewed the literature on the clinical and pathobiological features of ME/CFS . From the material gathered, we hypothesize that a common mechanism underlying the pathobiological basis of ME/CFS may indeed be a regulatory CNS failure due to dysfunctional or pathologically reactive neuroglia, resulting in the typical multilevel clinical manifestations of ME/CFS.
Here we test the validity of this hypothesis by an in-depth analysis of the two core features of ME/CFS to determine whether and how they might be explained by neuroglial dysfunction.
Multivariate Analysis Of Me/cfs
ME/CFS is affected by a variety of related factors, and the analysis of a single factor cannot control the influence of confounding factors. Therefore, multivariate logistic regression analysis was used to explore the influencing factors of ME/CFS in university students. With ME/CFS detection or not as the dependent variable and eight factors as independent variables, the relevant variables were assigned . After multi-factor logistic regression analysis, the results showed that study, overnights, diet, anxiety, and sleep quality were associated factors for ME/CFS, with overnights, overeating, anxiety, and sleep quality as independent risk factors and study as a protective factor. The differences in the prevalence of ME/CFS by exercise and alcohol consumption were not statistically significant .
Table 4. Multi-factor logistic regression analysis of CFS.
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How Is Myalgic Encephalomyelitis/chronic Fatigue Syndrome Treated
There is no cure for ME/CFS. Treatment goals include managing symptoms and returning you to a higher quality of life. Some people arenât able to regain the level of health and function they had before their diagnosis.
First, your doctor works with you to determine which symptoms cause the most difficulty. Together, you will address those symptoms immediately.
Counseling is helpful for many people with ME/CFS. This type of treatment helps people better tolerate symptoms by changing thoughts and behaviors. Your doctor may prescribe medications, like antidepressants or sleep aids, if your symptoms are especially severe. These medications can relieve symptoms like unrestful sleep for some people living with ME/CFS.
Before prescribing sleep aids, however, your doctor may provide suggestions for improving sleep without drugs. For instance, he or she might suggest that you visit a sleep specialist. Other tips include:
- Develop a regular bedtime routineâgo to bed and wake up at the same time each day.
- Do not nap for more than 30 minutes total during the day.
- Use your bed and bedroom only for sleeping and sex. Take out all electronics.
- Avoid eating large meals before you go to bed also avoid alcohol and caffeine.
- Do your exercising at least 4 hours before you go to sleep.
How Can I Care For Myself With Chronic Fatigue Syndrome
In addition to the treatments above, there are things you can do to help manage this condition, such as:
- reducing your stress
- getting plenty of rest
- making sleep a priority if you are having trouble sleeping, check out these tips to improve your sleeping habits
- eating a healthy diet to make sure your body is getting the nutrients it needs
- having plenty of salt if you have low blood pressure and a tendency to feel dizzy or even faint on standing
- learning to prioritise the things you need to get done, and then pacing yourself by dividing them into short times of activity with rest breaks in between
- learning mindfulness, meditation or creative visualisation
- getting out into nature regularly, listening to music and enjoying your pets
- developing a support network of understanding friends and family/whnau for when you need help
- joining a support group if there is one in your area
- talking to your doctor about whether there are any medications or supplements that may help you.
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What Are The Symptoms Of Me/cfs
The key symptom or feature of ME/CFS is called post-exertional malaise . This means that your symptoms get worse after exercise or mental effort and dont improve after sleep or rest. PEM can be very disabling and can reduce your ability to function during regular daily activities. PEM is also common if you have long COVID.
ME/CFS may start suddenly or gradually over months or years. The level of activity that triggers your PEM will vary from person to person and can depend on how severe your condition is. For example, if your ME/CFS is relatively mild, you may experience PEM after going for a walk or a jog, but if your ME/CFS is severe, just reading a book or brushing your teeth could bring on your PEM. Your PEM may appear immediately after activity or may sometimes be delayed by up to 3 days. It can last for 24 hours or for a few days. A more serious relapse can last for weeks or months.
A common misconception is that people with ME/CFS have ‘chronic fatigue and are just very tired. Persistent and profound fatigue is just one symptom of ME/CFS.
Other common symptoms of ME/CFS, that may also increase with PEM include:
- thinking problems, loss of memory or poor concentration
- gastrointestinal changes such as nausea, constipation or diarrhoea
- sensitivities to light or noise, food, medicines or chemicals
- problems with temperature regulation
Everyone is different, so you might experience only mild symptoms, or you might develop more severe symptoms.
Graded Exercise Therapy Controversy
The PACE TRIAL
In 2005, patient recruitment began for the PACE Trial – Pacing, Graded Activity, Cognitive Behavioral Therapy, and randomized Evaluation, which was conducted in the UK under the auspices of the UK Medical Research Council, Depart of Health and Social Care for England, Scottish Chief Scientist Office, and Department for Work and Pensions. The investigators were Peter White, a psychiatrist, Trudie Chalder, a professor of cognitive behavioral therapy, and Michael Sharpe, a professor of psychological medicine.
This study, which is the most well-funded single piece of ME/CFS research ever conducted, was designed to compare three different approaches to treatment:
1) Specialist Medical Care , which included the use of medications for symptoms management and instruction in avoidance of extreme activity or inactivity to SMC plus Adaptive Pacing Therapy , which is activity engagement limited by symptoms of PEM on one extreme and complete inactivity on the other
2) Informing the group that they were not ill, but rather deconditioned and should gradually return to activities and that there was nothing preventing their recovery and
3) CBT and GET with the premise that deconditioning, dysfunctional cognition, and false ideas were the source of their symptoms and functional limitations. The GET was to be advanced in a structured manner with the ultimate goal of the patients participating in regular aerobic exercise.
The consequences of the PACE Trial were:
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How Is Me/cfs Diagnosed
There is no single test to diagnose ME/CFS. Your doctor will ask you about your symptoms, and how long you have had them, and might do some tests to rule out other possible causes.
You can only receive a diagnosis of ME/CFS after you have had symptoms for 6 months or more.
Long Covid/ Long Haulers
Following the outbreak of COVID-19 in late 2019 in Wuhan Province, China, and its rapid spread into other parts of the world, researchers, scientists, and patients familiar with post-viral syndromes began to become concerned not only about the acute danger of this particular virus but the potential long-term sequelae. Following SARS-1, West Nile Virus, H1N1 influenza virus, and other reports claim, that up to 11% of patients who had severe infections from Epstein-Barr virus , Q fever , or Ross River virus , and others, develop ME/CFS. Other studies following SARS and MERS suggest an even higher proportion develop ME/CFS or Fibromyalgia.”
Given that some estimates suggest as much as 75% of all ME/CFS patients developed their illness following a post-viral or post-bacterial illness, there has been considerable frustration in the ME/CFS community-researchers and patients alike-that had ME/CFS patients been taken more seriously all along, then research into what causes this debilitating outcome in some patients and not in others would have been identified and potentially remedied by now.
Additionally, there is great frustration in the ME/CFS community as they watch these new cases as they are now being officially diagnosed as they pass the six-month mark required for official ME/CFS diagnosis.
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Chronic Fatigue Syndrome/myalgic Encephalomyelitis In Adolescents: Practical Guidance And Management Challenges
Abstract:
This paper reviews the current understanding of myalgic encephalomyelitis/chronic fatigue syndrome , and whether any treatment strategies have been effective. ME/CFS is a condition of as yet unknown etiology that commonly follows an infective process. It includes a new onset of fatigue , post-exertional malaise, cognitive difficulties and unrefreshing sleep, and frequently orthostatic intolerance, somatic symptoms and pain. Long COVID has renewed interest in the condition and stimulated research with findings suggestive of a multisystem neuroimmune disease. There are no definitively effective treatments. Despite earlier recommendations regarding graded exercise therapy and cognitive behavior therapy, the current recommendations are managing symptoms, with lifestyle management and supportive care.
This paper provides an outline of strategies that young people and their families have reported as helpful in managing a chronic illness that impacts their life socially, physically, emotionally, cognitively and educationally. As the illness frequently occurs at a time of rapid developmental changes, reducing these impacts is reported to be as important as managing the physical symptoms. Young people face a mean duration of 5 years illness with a likely residual 20% having significant restrictions after 10 years.
What Is It Like Living With Me/cfs
The severity of ME/CFS varies greatly from patient to patient, with some people able to maintain fairly active lives. For others, ME/CFS has a profound impact. About 25 percent of people with ME/CFS are housebound or bedbound as a result of their illness. For many, there is often a pattern of relapse and remission. Most symptoms are invisible to others, which makes it difficult for family members, friends, and the public to understand the challenges of the disease.
We know its so important to share personal experiences to increase understanding of ME/CFS. Visit our Humans of M.E. story archive to read and share your stories of ME/CFS.Solve M.E. is also producing Long Haul Voices, a mini-series that amplifies the experiences of individuals with Long Covid and ME/CFS, the experts devoted to improving their care, and the challenges surrounding these largely invisible, poorly-understood diseases that affect a rapidly growing population.
It feels like I always have the flu, only much worse. It feels like the world is always moving, and I cant find my bearings.Rob P.
When my symptoms first occurred, I was diagnosed with the flu during June, July, and August during off-flu season. Doctors suspected that I was a hypochondriac.Conella B.
Sometimes it feels as if my body is shutting down on me. Every time I ever have gone to the emergency room for my invisible illnesses, they have never once been able to help me in any way.Kelly S.
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Recommended Reading: What Can I Do For Chronic Fatigue Syndrome
About Myalgic Encephalomyelitis/chronic Fatigue Syndrome
ME/CFS is a complex illness and symptoms of ME/CFS may seem similar to many other illnesses. ME/CFS requires three symptoms:Not being able to participate in routine activities that were possible before becoming ill, such as work, school, social life, and/or personal life, that:
- Lasts for more than 6 months
- Is accompanied by fatigue that is:
- Not the result of ongoing activities
- Not from more than usual effort
- Not made better by rest
Post-exertional malaise . Worsening of symptoms after physical, mental, or emotional effort that would not have caused a problem before the illness. Symptom onset can be immediate or delayed for hours or days. This is sometimes referred to as crashing by people with ME/CFS.
Unrefreshing sleep. People with ME/CFS may not feel better even after a full night of sleep .
In addition, at least one of the following symptoms is also required: Impaired memory or ability to concentrate. People with ME/CFS may have trouble remembering, learning new things, concentrating, or making decisions.
Orthostatic intolerance . People with ME/CFS may feel lightheaded or dizzy when standing upright and may even faint.
- Pain in the joints without swelling or redness
- Headaches of a new type, pattern, or severity
- Swollen or tender lymph nodes in the neck or armpit
- A sore throat that is frequent or recurring
- Gastrointestinal symptoms
- Sensitivity to light, sound, touch, and smell
- Chills and night sweats
- Allergies or sensitivities to foods, odors, chemicals, or medications
Tips For Exercising Safely With Me/cfs
If you feel you can tolerate some exercise, be guided by your doctor or specialist, but general suggestions include:
- Experiment to find the type of exercise that works best for you. Choose from a range of gentle activities such as stretching, yoga, tai chi, walking and light weight training. Often, people find exercises lying down use less energy.
- Keep an activity diary so you have a long-term picture of your performance levels and factors that might impact on your symptoms. Some people with ME/CFS find they feel good straight after exercise, but then crash later on, so make sure you monitor how you feel, hours to days after exercise.
- Stop the physical activity well before you feel any symptom flare. Pacing yourself is very important.
- Remember that the amount of exercise you can do will change from one day to the next.
- Listen to your body if you dont feel up to exercising on a particular day, dont.
- Find out as much as you can about your ME/CFS. Make sure you consult with health professionals who fully understand ME/CFS as a biomedical disease
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Physiological Findings And Physical Therapy
As most physical therapy treatments are ultimately focused on exercise and movement, physical therapists need to review the aerobic and anaerobic respiratory cycles as they relate to ME/CFS patients.
Physical therapists must recognize that research indicates the aerobic metabolism system in those with ME/CFS is broken and according to Dr. Mark Van Ness of the University of the Pacific, Classic exercise training produces little improvement and may result in PEM. He also states, Aerobic conditioning does not appear to improve or repair broken aerobic metabolism.
‘”’Dialogues for ME/CFS” is made possible with a reward from the Wellcome Public Engagement Fund. Click https://www.dialogues-mecfs.co.uk/ for access to additional scientifically-based videos on ME/CFS.”’
Cdc And Webmd Collaboration
CDC partnered with WebMD to publish an informational article, titled Myalgic Encephalomyelitis/Chronic Fatigue Syndrome : The Need to Raise Awareness. Together, WebMD and CDC also produced a video that addresses the misconceptions around ME/CFS.
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Availability Of Data And Materials
The quantitative data that support the findings of this study are available from NPS MedicineWise but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. The deidentified qualitative data are not publicly available due to confidentiality and the sensitive nature of these data, but are available from the corresponding author on reasonable request.
What Are The Symptoms Of Myalgic Encephalomyelitis/chronic Fatigue Syndrome
For many people, the symptoms of ME/CFS resemble other diseases, like influenza. Symptoms may come and go over time and may increase or decrease in severity. ME/CFS symptoms vary widely from person to person.
Many of the symptoms of ME/CFS make daily life difficult. These symptoms include:
- Severe fatigue lasting at least 6 months that does not improve with rest or sleep
- Difficulty sleeping
- Flu-like symptoms, including swollen lymph nodes , headaches, and joint pain
- Cognitive difficulties, including attention and memory problems
Less common symptoms of ME/CFS include:
- Problems with vision
- Irritable bowel, an intestinal condition causing painful bloating, gas, constipation and diarrhea
- Psychological issues, including mood swings, irritability and anxiety
- Tingling or numbness in the feet, hands or face
For many people, ME/CFS symptoms get worse following physical exercise or strenuous mental exertion. In some cases, orthostatic intolerance causes dizziness, weakness, and fainting.
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