Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

Referrals to the ME/CFS Service

The ME/CFS service is accessed by GP referral. As part of the referral process, we ask GPs to do a range of blood tests in order to exclude any underlying condition that could be contributing to your symptoms.

Currently there is no diagnostic test for ME/CFS and it is recognised on clinical grounds alone.

The NICE guidelines indicate that ME/CFS may be suspected if:

The symptoms are not explained by another condition and

• the person's ability to engage in occupational, educational, social or personal activities is significantly reduced from pre‑illness levels and
• the person has had all of the following persistent symptoms (see below) for a minimum of 6 weeks in adults and 4 weeks in children and young people

All of these symptoms should be present:

• Debilitating fatigue that is worsened by activity, is not caused by excessive cognitive, physical, emotional or social exertion, and is not significantly relieved by rest.
• Post-exertional malaise after activity in which the worsening of symptoms:
• is often delayed in onset by hours or days
• is disproportionate to the activity
• has a prolonged recovery time that may last hours, days, weeks or longer.
• Unrefreshing sleep or sleep disturbance (or both), which may include:
• feeling exhausted, feeling flu-like and stiff on waking
• broken or shallow sleep, altered sleep pattern or hypersomnia
• Cognitive difficulties (sometimes described as 'brain fog'), which may include problems finding words or numbers, difficulty in speaking, slowed responsiveness, short-term memory problems, and difficulty concentrating or multitasking.

A diagnosis of ME/CFS can be made if the symptoms above have persisted for 3 months and are not explained by another condition.

Be aware that the following symptoms may also be associated with, but are not exclusive to, ME/CFS:

• orthostatic intolerance and autonomic dysfunction, including dizziness, palpitations, fainting, nausea on standing or sitting upright from a reclining position
• temperature hypersensitivity resulting in profuse sweating, chills, hot flushes, or feeling very cold
• neuromuscular symptoms, including twitching and myoclonic jerks
• flu-like symptoms, including sore throat, tender glands, nausea, chills or muscle aches
• intolerance to alcohol, or to certain foods and chemicals
• heightened sensory sensitivities, including to light, sound, touch, taste and smell
• pain, including pain on touch, myalgia, headaches, eye pain, abdominal pain or joint pain without acute redness, swelling or effusion.