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ME/chronic fatigue syndrome

Encephalomyelitis myalgica (syndroma fatigationis chronicae) · ME/syndrom chronické únavy

What it is

Disabling fatigue with post-exertional crash, often after infection.

Symptoms & signs

  • Crash 24–72 h after exertion
  • unrefreshing sleep
  • brain fog
  • orthostatic intolerance
  • pain

🚩 Get help if…

  • call 112 / 911 now Thoughts of suicide
  • see a doctor soon Weight loss, fever or night sweats — look for another cause
  • see a doctor soon Cannot eat, drink or get out of bed
  • see a doctor soon New breathlessness, chest pain or joint swelling

Where it strikes

Medical treatment

  • Pacing (not graded exercise)
  • treat orthostatic intolerance (fludrocortisone, salt)
  • sleep and pain management
  • Low-dose naltrexone — small studies early / small studies

Natural & lifestyle

  • Energy envelope management
  • compression garments
  • salt and fluids
  • rest scheduling
  • gentle mobility within limits

Emerging & experimental

  • Long-COVID overlap trials
  • BC007 autoantibody removal
  • immunoadsorption
  • mitochondrial support studies

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Graded exercise therapy — trials such as PACE reported modest gains, disputed over their methods; patient surveys report harm, and NICE dropped it in 2021 mixed evidence
  • CoQ10 with NADH, D-ribose — small trials of less fatigue early / small studies
  • The Lightning Process — one trial claimed benefit and was heavily criticised anecdotal / traditional

ICD codes