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Myalgic Encephalitis/Chronic Fatigue Syndrome


It is a multi-system disorder that affects about 1.3 million Americans. It is associated with severe body fatigue. The pathogenesis is not clearly understood, but it affects many systems and has many manifestations. It usually presents as widespread inflammation in the body of persons who were otherwise initially healthy.

There are 4 systems mostly affected by the widespread inflammation;

  • Brain

  • Gut

  • Cardiovascular system

  • Immune System


Predisposing Factors

  • Genetic predisposition

  • A triggering infection particularly viruses, e.g. Coxsackie virus, Herpes Simplex Virus, Epstein Barr Viruses

  • Exposure to toxins



  1. Extreme Fatigue that hinders normal daily activities

  2. Post exertion malaise after a small amount of physical exercise (usually 24-48 hours post-activity)

  3. Brain Fog

  4. Sleep disturbances and unrefreshing sleep

  5. Temperature dysregulation

  6. Symptoms of POTS (postural orthostatic tachycardia syndrome)

    • Postural hypotension,

    • dizziness,

    • palpitations,

    • loss of consciousness/syncope

  7. Food, chemical, and noise sensitivities

  8. Frequent infections, low grade fever, lymph node enlargement 



There is no definitive diagnosis, but the following tests can help make a diagnosis;

  • Cardiopulmonary exercise test

  • Autonomic function testing

  • Laboratory blood tests



The treatment of ME/CFS is mostly supportive. The following are practices that help improve their standard of living.

  • Pacing (of daily activities to meet their energy levels)

  • Avoiding common triggers

  • Maintaining fluid and electrolyte balance

  • Maintaining good sleep hygiene

  • Medications


It is essential to differentiate this from Chronic fatigue. A high index of suspicion is required to identify the symptoms, and supportive treatment must be offered to affected persons as they tend to deteriorate swiftly if unattended to.

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