What Is ME/CFS?
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex, chronic illness characterised by profound, disabling fatigue that is not relieved by rest. It is not psychological — emerging research points to immune dysregulation, autonomic dysfunction and energy metabolism problems.
Core Symptoms
- Profound fatigue lasting more than 6 months
- Post-exertional malaise (PEM) — worsening of symptoms after physical or mental activity (hallmark symptom)
- Unrefreshing sleep
- Cognitive impairment (brain fog, word-finding difficulties)
- Orthostatic intolerance (symptoms worsen when upright)
Blood Tests — Ruling Out Other Causes
| Test | Condition Ruled Out |
|---|---|
| TSH, Free T4 | Hypothyroidism or hyperthyroidism |
| Full Blood Count | Anaemia, infection, blood disorders |
| ESR & CRP | Inflammatory conditions |
| ANA | Lupus |
| Vitamin B12 & Folate | Deficiency states |
| Vitamin D | Deficiency (very common in fatigue) |
| Fasting Glucose + HbA1c | Diabetes |
| Liver & Kidney function | Organ disease |
| Calcium | Hyperparathyroidism |
| Cortisol (9am) | Adrenal insufficiency |
Post-COVID and ME/CFS
Long COVID shares significant overlap with ME/CFS — particularly PEM, fatigue, brain fog and autonomic dysfunction. Many long COVID patients meet criteria for ME/CFS.
Management
- Energy management (pacing) — staying within your energy envelope; avoiding boom-and-bust
- Sleep hygiene
- Symptomatic treatment: pain, sleep, orthostatic symptoms
- Low-dose naltrexone, beta-blockers for orthostatic intolerance
- Avoid graded exercise therapy (GET) — can worsen PEM in ME/CFS
FAQs
Is ME/CFS treatable?
There is no cure, but management can significantly reduce symptom burden. Pacing is the most evidence-supported approach for preventing deterioration.
Why does exercise make ME/CFS worse?
PEM — post-exertional malaise — is a hallmark feature. Aerobic exercise appropriate for deconditioning can be harmful in ME/CFS; pacing is recommended instead.
Is ME/CFS recognised by major health bodies?
Yes — the WHO, NHS, CDC and NIH all recognise ME/CFS as a serious chronic disease with ongoing research into its mechanisms.
Medical Disclaimer: ME/CFS diagnosis requires exclusion of other treatable conditions. Management should be with a doctor familiar with the condition.