EDP column by Professor Ketan Dhatariya
“I feel tired all the time and my GP has told me I have ‘ME’. I have looked this up on the internet and it makes me sound like I am a fraud. Who is correct?”
ME, or ‘myalgic encephalomyelitis’, is also known by several other terms. These include Chronic Fatigue Syndrome and used to be called ‘Yuppie Flu’. By the way this term has been described you may be able to tell that the medical profession has yet to get to terms with what this condition really is.
The reason for the difficulty in getting to the bottom of this condition is because there are no abnormal findings to any tests that your doctor can do. Thus, the condition is really what is known as a ‘diagnosis of exclusion’. Let me give you an example. Your main symptom is tiredness. However, up to 25% of all the people who go and see their GP may say they are tired all the time. There are several hundred separate causes of tiredness. Most of these causes can be determined by the ways that you may be familiar with – those are by your GP asking you specific questions about the symptoms, then examining you and finally sending you for various tests. As a result of these they may then be able to tell what is going on. Some causes may require you to be seen by a specialist. If, after all of the tests have been done, no cause for the tiredness is found – that is all other possible diagnose have been excluded – then it may be possible to say that you have got ME.
Common symptoms include an inability to think properly (‘foggy thinking’), including a poor memory or concentration, tiredness or worsening of all symptoms after exertion that lasts for more than 24 hours, waking unrefreshed after sleep, generalised joint pains without any associated redness or swelling, persistent muscle pain, sore throat, tender lymph nodes, headaches of a new pattern, irritable bowel, abdominal pain, nausea, diarrhea or bloating, psychological problems (depression, irritability, mood swings, anxiety, panic attacks). The list goes on. The diagnosis is often made if you have at least four of these symptoms lasting for at least six months with no other causes being found.
The course of the condition is often relapsing. This means that it can get better for a while and then get worse again. No one knows how long the condition lasts for because it is different for everyone. There are no specific drug treatments for ME. Avoiding things that worsen symptoms is important. Some drugs can help with specific symptoms. Often psychological help with cognitive behavior therapy can be useful, but is not easily available on the NHS.
For more information about ME/Myalgic Encephalomyelitis click these links: