22:
57:
509:" (PENE), which encompasses fatigability, symptoms worsening after exertion, exhaustion after exertion, a prolonged recovery from activity, and reduction of activities due to symptoms. The ICC definition describes severity levels: Mild ME is described as roughly a 50% in functioning compared to before the illness, moderate ME makes one mostly housebound, severe refers to mostly bed-bound, and a very severe being completely bed-bound and requiring care from others.
1289:
Carruthers BM, van de Sande MI, De
Meirleir KL, Klimas NG, Broderick G, Mitchell T, Staines D, Powles AC, Speight N, Vallings R, Bateman L, Baumgarten-Austrheim B, Bell DS, Carlo-Stella N, Chia J, Darragh A, Jo D, Lewis D, Light AR, Marshall-Gradisbik S, Mena I, Mikovits JA, Miwa K, Murovska M, Pall
636:
The
National Institute for Health and Clinical Excellence (NICE) in England and Wales that in the absence of a biomarker, it is difficult to say one set of criteria is more valid than another. The quality can be assessed based on how the case definition was created. In particular, to what extend it
344:
The Oxford criteria differ from the Fukuda criteria in that mental fatigue is required and that symptoms that could be psychiatric in origin can count toward a diagnosis. Likewise, the Oxford criteria differs from the
Canadian consensus criteria by not excluding patients who may have a psychiatric
649:
An examination of the CDC 1994 criteria applied to several hundred patients found that the diagnosis could be strengthened by adding two new symptoms (anorexia and nausea) and eliminating three others (muscle weakness, joint pain, sleep disturbance). Other suggested improvements to the diagnostic
222:
A mental status examination to identify abnormalities in mood, intellectual function, memory, and personality. Particular attention should be directed toward current symptoms of depression or anxiety, self-destructive thoughts, and observable signs such as psychomotor retardation. Evidence of a
47:
is poorly understood, and it can be a difficult condition to diagnose because there is no standard test, many symptoms are non-specific, and because doctors and patients may be unfamiliar with post-exertional malaise. Subgroup analysis suggests that, depending on the applied definition, CFS may
394:
Unlike some criteria, the
Canadian consensus criteria exclude patients with symptoms of mental illness. This definition was updated in 2010 to provide greater specification to the original. Functional impairment must be below defined thresholds in two of the three designated subscales of the
229:
A minimum battery of laboratory screening tests, including complete blood count with leukocyte differential; erythrocyte sedimentation rate; serum levels of alanine aminotransferase, total protein, albumin, globulin, alkaline phosphatase, calcium, phosphorus, glucose, blood urea nitrogen,
218:
A thorough history that covers medical and psychosocial circumstances at the onset of fatigue; depression or other psychiatric disorders; episodes of medically unexplained symptoms; alcohol or other substance abuse; and current use of prescription and over-the-counter medications and food
546:
The CDC states that diagnostic tests should be directed to confirm or exclude other causes for fatigue and other symptoms. Further tests may be individually necessary to identify underlying or contributing conditions that require treatment. The following routine tests are recommended:
425:
These symptoms must have lasted at least 6 months. The London criteria also mention that other symptoms, including autonomic and immune symptoms, are common and may help confirm a diagnosis. In light of the advances in understanding of ME and CFS, the criteria for ME as described by
645:
A 2003 international CFS study group for the CDC found ambiguities in the CDC 1994 CFS research case definition which contribute to inconsistent case identification. Different self-reported causes of CFS are associated with significant differences in clinical measures and outcomes.
317:
The Oxford criteria were published in 1991 and include both CFS of unknown etiology and a subtype of CFS called post-infectious fatigue syndrome (PIFS), which "either follows an infection or is associated with a current infection." The Oxford criteria defines CFS as follows:
439:
The
International Consensus Criteria were based on the Canadian consensus criteria and developed by a group of 26 individuals from 13 countries and consisting of clinicians, researchers, teaching faculty, and an independent patient advocate. The ICC define the illness as:
517:
Several countries, including
Australia and the United Kingdom, have authored clinical guidelines that define ME/CFS based on some or all of the available diagnostic criteria. The 2021 UK NICE guideline requires all of the following symptoms:
1493:
Kennedy G, Abbot NC, Spence V, Underwood C, Belch JJ (February 2004). "The specificity of the CDC-1994 criteria for chronic fatigue syndrome: comparison of health status in three groups of patients who fulfill the criteria".
100:
They also note that for all symptoms except orthostatic intolerance, "frequency and severity of symptoms should be assessed," and that these symptoms should be present at least half the time with at least moderate severity.
924:
Fukuda K, Straus S, Hickie I, Sharpe M, Dobbins J, Komaroff A (15 December 1994). "The chronic fatigue syndrome: a comprehensive approach to its definition and study. International
Chronic Fatigue Syndrome Study Group".
658:
A new "empirical definition" of the CDC 1994 criteria was published in 2005. A 2009 evaluation of the 2005 empirical definition compared 27 patients with a prior diagnosis of CFS with 37 patients diagnosed with a
430:
and others were updated in 2009. These have been cited in articles and are being evaluated as of 2011, for example, in studies to ascertain differences between patients selected using different case definitions.
147:
The concurrent occurrence of four or more of the following symptoms, all of which must have persisted or recurred during six or more consecutive months of illness and must not have predated the fatigue:
411:
in all studies they funded until the mid-1990s. An incomplete version edited by Nick
Anderson (CEO of AFME) was published in a 1994 report. The London criteria require the following:
808:
Jason LA, Taylor RR, Kennedy CL, Song S, Johnson D, Torres S (September 2000). "Chronic fatigue syndrome: occupation, medical utilization, and subtypes in a community-based sample".
113:. The criteria were described as the most widely used diagnostic criteria for CFS in 2007. These criteria are sometimes called the "Fukuda definition" after the first author (
1617:
Reeves, William; Dieter Wagner; Rosane
Nisenbaum; James Jones; Brian Gurbaxani; Laura Solomon; Dimitris Papanicolaou; Elizabeth Unger; Suzanne Vernon; Christine Heim (2005).
1676:
Jason, Leonard A; Najar, Natasha; Porter, Nicole; Reh, Christy (2009). "Evaluating the
Centers for Disease Control's Empirical Chronic Fatigue Syndrome Case Definition".
1880:
211:
All other known causes of chronic fatigue must have been ruled out, specifically clinical depression, side effects of medication, eating disorders and substance abuse.
44:
663:. The researchers reported that "38% of those with a diagnosis of a Major Depressive Disorder were misclassified as having CFS using the new CDC definition."
505:
Compared to the Canadian criteria, chronic fatigue is not required, and there is no requirement for symptoms to occur for 6 months. The main symptom is "
1398:
Identifying and diagnosing ME/CFS: Myalgic encephalomyelitis (or encephalopathy) / chronic fatigue syndrome: diagnosis and management: Evidence review D
1747:
1738:
246:
The initial chronic fatigue syndrome definition was published in 1988. It is also called the "Holmes definition", after the manuscript's first author.
33:
36:) vary. Different groups have produced sets of diagnostic criteria that share many similarities. The biggest differences between criteria are whether
73:
criteria come from the IOM's 2015 report on CFS, and the CDC currently uses this definition. The IOM criteria require the following three symptoms:
683:"Understanding History of Case Definitions and Criteria | Healthcare Providers | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) | CDC"
234:
Other diagnostic tests have no recognized value unless indicated on an individual basis to confirm or exclude a differential diagnosis, such as
543:
As there is no generally accepted test for chronic fatigue syndrome, diagnosis is based on symptoms, history, and ruling out other conditions.
1529:
Komaroff AL; Fagioli LR; Geiger AM; et al. (January 1996). "An examination of the working case definition of chronic fatigue syndrome".
1239:"Contrasting case definitions for chronic fatigue syndrome, myalgic encephalomyelitis/chronic fatigue syndrome and myalgic encephalomyelitis"
309:
To make a diagnosis, a patient must meet either 8 of the 11 symptom criteria, or 6 of the 11 symptom criteria and 2 of 3 physical criteria.
535:
Additionally, the symptoms must be present for at least 6 weeks in adults and 4 weeks in children, and not explained by another condition.
110:
1354:"Recommendations | Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management | Guidance | NICE"
1062:
844:"IOM 2015 Diagnostic Criteria | Diagnosis | Healthcare Providers | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) | CDC"
1444:"Identification of ambiguities in the 1994 chronic fatigue syndrome research case definition and recommendations for resolution"
1731:
506:
1215:
843:
502:
The ICC definition also notes that children may have somewhat different symptoms, and that symptoms tend to be more variable.
1406:
882:
223:
psychiatric or neurologic disorder requires that an appropriate psychiatric, psychological, or neurologic evaluation be done;
160:
severe enough to cause substantial reduction in previous levels of occupational, educational, social, or personal activities;
898:
1420:
1148:
1724:
1149:"Myalgic encephalomyalitis/chronic fatigue syndrome: Clinical working definition, diagnostic and treatment protocols"
464:
Immune, gastrointestinal and genitourinary symptoms: patients must have at least one symptom in three of five areas:
1564:
King C, Jason LA (February 2005). "Improving the diagnostic criteria and procedures for chronic fatigue syndrome".
109:
The 1994 research guidelines were proposed by the "International Chronic Fatigue Syndrome Study Group", led by the
1353:
1813:
1025:
Holmes GP; Kaplan JE; Gantz NM; et al. (March 1988). "Chronic fatigue syndrome: a working case definition".
682:
138:
results in substantial reduction in previous levels of occupational, educational, social, or personal activities.
580:
1859:
357:
and published by an international group of researchers in 2003. The requirements are summarized as follows:
869:
70:
1818:
1401:. NICE Evidence Reviews Collection. London: National Institute for Health and Care Excellence (NICE).
1716:
1338:
660:
637:
represented a consensus process and involved stakeholders such as patients, doctors and researchers.
1690:
1578:
1849:
1854:
1771:
1059:
94:
37:
1189:
1685:
1573:
1381:
484:
Energy production symptom: patients must have at least one symptom from any of the four lists
938:
625:
575:
1124:
331:
The fatigue must have lasted for 6 months or longer, and be present at least 50% of the time
551:
447:
Neurological symptoms: patients must have at least one symptom from one of the four lists:
230:
electrolytes, and creatinine; determination of thyroid-stimulating hormone; and urinalysis.
117:) of the publication. The 1994 CDC criteria specify the following conditions must be met:
8:
606:
21:
1619:"Chronic Fatigue Syndrome – A clinically empirical approach to its definition and study"
337:
Conditions known to cause severe fatigue and some mental conditions exclude a diagnosis.
1703:
1653:
1618:
1599:
1316:
1291:
1263:
1238:
1107:
1082:
1050:
1004:
950:
790:
744:
709:
584:
235:
1542:
1470:
1443:
253:
Debilitating fatigue of new onset which interferes with the patient's daily activities
1808:
1658:
1640:
1591:
1546:
1511:
1475:
1412:
1402:
1321:
1307:
1268:
1112:
1042:
996:
991:
974:
942:
878:
825:
821:
782:
731:
334:
Other symptoms are possible, such as muscle pain, mood problems, or sleep disturbance
153:
1707:
1603:
1587:
1507:
1054:
1008:
125:
Clinically evaluated, unexplained, persistent or relapsing chronic fatigue that is:
1766:
1695:
1648:
1630:
1583:
1538:
1503:
1465:
1455:
1311:
1303:
1258:
1250:
1223:
1163:
1102:
1094:
1034:
986:
934:
817:
794:
772:
739:
721:
954:
1066:
902:
592:
1038:
871:
Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness
1844:
1839:
1396:
1098:
726:
565:
1616:
777:
760:
708:
Davis, Hannah E.; McCorkell, Lisa; Vogel, Julia Moore; Topol, Eric J. (2023).
341:
Post-infectious fatigue syndrome also requires evidence of a prior infection.
1874:
1834:
1699:
1644:
1254:
735:
427:
408:
354:
157:
1237:
Jason, LA; Brown AA; Clyne E; Bartgis L; Evans M; Brown M. (December 2011).
1662:
1635:
1595:
1515:
1479:
1460:
1416:
1325:
1272:
1171:
1000:
829:
786:
569:
114:
1550:
1167:
1116:
1080:
1046:
946:
618:
610:
557:
176:
170:
163:
56:
1776:
1528:
1288:
1216:"Myalgic Encephalomyelitis (ME). Criteria and clinical guidelines 2014"
1129:
759:
Jason LA, Corradi K, Torres-Harding S, Taylor RR, King C (March 2005).
605:
In addition to the CDC's recommendation, the NICE guideline recommends
598:
183:
48:
represent a variety of conditions rather than a single disease entity.
1746:
631:
614:
189:
1146:
407:
The London Criteria were designed for research purposes and used by
295:
And three physical criteria that must be documented by a physician:
1792:
1081:
Sharpe MC; Archard LC; Banatvala JE; et al. (February 1991).
1024:
561:
376:
At least one symptom from the lists for two of these categories:
758:
1441:
1394:
1384:. Centers of Disease Control and Prevention. 27 January 2021.
1292:"Myalgic encephalomyelitis: International Consensus Criteria"
1236:
1083:"A report--chronic fatigue syndrome: guidelines for research"
396:
196:
1442:
Reeves WC; Lloyd A; Vernon SD; et al. (December 2003).
710:"Long COVID: major findings, mechanisms and recommendations"
653:
1492:
1125:"Oxford criteria for the diagnosis of chronic fatigue syn"
923:
707:
40:(PEM) is required, and the number of symptoms needed.
807:
399:
i.e. Vitality, Social Functioning, and Role-Physical.
421:
Fluctuating symptoms, usually in response to exertion
1675:
1190:"London Criteria for M.E. – for website discussion"
877:. National Academy of Medicine. 2015. p. 210.
632:
Diagnostic complications and suggested improvements
434:
202:
post-exertional malaise lasting more than 24 hours.
1881:Myalgic encephalomyelitis/chronic fatigue syndrome
1748:Myalgic encephalomyelitis/chronic fatigue syndrome
1123:
613:tests, and mentions that blood tests for vitamins
353:The Canadian consensus criteria were initiated by
34:myalgic encephalomyelitis/chronic fatigue syndrome
1279:
761:"Chronic fatigue syndrome: the need for subtypes"
459:"Neurosensory, perceptual and motor disturbances"
129:of new or definite onset (has not been lifelong);
87:Also, at least one of the following is required:
1872:
1284:
1282:
1213:
279:Fatigue after exercise lasting at least 24 hours
25:Chart comparing the different definitions of CFS
901:. National Institutes of Health. Archived from
444:"Postexertional neuroimmune exhaustion" or PENE
1376:
1374:
899:"About CFS: What is Chronic Fatigue Syndrome?"
650:criteria include the use of severity ratings.
390:Symptoms must be present for at least 6 months
373:Two or more neurological or cognitive symptoms
348:
60:Chart from the CDC explaining the IOM criteria
1732:
1020:
1018:
256:Other fatiguing conditions must be eliminated
249:The Homes criteria require these two points:
479:Sensitivity to food, medicines, or chemicals
418:Impaired short-term memory and concentration
135:is not substantially alleviated by rest; and
1388:
1371:
979:Acta Neurologica Scandinavica. Supplementum
1739:
1725:
1015:
975:"The chronic fatigue syndrome – an update"
111:Centers for Disease Control and Prevention
1689:
1652:
1634:
1577:
1563:
1469:
1459:
1315:
1262:
1106:
1076:
1074:
990:
972:
776:
743:
725:
1187:
968:
966:
964:
939:10.7326/0003-4819-121-12-199412150-00009
364:"Post-Exertional Malaise and/or Fatigue"
214:The clinical evaluation should include:
55:
20:
1395:National Guideline Centre (UK) (2021).
1243:Evaluation & the Health Professions
1142:
1140:
891:
312:
1873:
1188:Shepherd, Charles (21 February 2011).
1071:
917:
512:
507:post-exertional neuroimmune exhaustion
291:A rapid onset over a few hours or days
132:is not the result of ongoing exertion;
77:Severe, disabling fatigue of new onset
1720:
1423:from the original on 19 February 2024
1348:
1346:
961:
1678:Journal of Disability Policy Studies
1137:
677:
675:
601:for blood cells, protein and glucose
241:
192:of a new type, pattern, or severity;
104:
64:
1214:Howes, S; Goudsmit, E; Shepard, C.
1156:Journal of Chronic Fatigue Syndrome
1147:Carruthers BM; et al. (2003).
528:Unrefreshing and/or disturbed sleep
13:
1343:
402:
186:without joint swelling or redness;
14:
1892:
801:
752:
672:
260:They define 11 symptom criteria:
1308:10.1111/j.1365-2796.2011.02428.x
992:10.1111/j.1600-0404.2007.00840.x
822:10.1097/00005053-200009000-00002
435:International Consensus Criteria
328:The fatigue must be debilitating
322:Fatigue must be the main symptom
226:A thorough physical examination;
1669:
1610:
1588:10.1016/j.biopsycho.2004.03.015
1557:
1522:
1508:10.1016/j.annepidem.2003.10.004
1486:
1435:
1332:
1230:
1207:
1181:
654:CDC "Empirical definition" 2005
30:Clinical descriptions of ME/CFS
16:Case definitions of the illness
1290:ML, Stevens S (October 2011).
862:
836:
701:
581:Erythrocyte sedimentation rate
325:There must be a definite onset
51:
1:
1860:Whittemore Peterson Institute
1543:10.1016/S0002-9343(96)90012-1
666:
470:Gets sick from viruses easily
415:Fatigue triggered by exercise
80:Post-exertional malaise (PEM)
1339:Australian Guidelines (2002)
276:Muscle discomfort or myalgia
169:tender cervical or axillary
152:self-reported impairment in
7:
1039:10.7326/0003-4819-108-3-387
714:Nature Reviews Microbiology
640:
624:, infectious diseases, and
496:Intolerance of heat or cold
397:Short Form 36 Health Survey
349:Canadian consensus criteria
10:
1897:
1099:10.1177/014107689108400224
727:10.1038/s41579-022-00846-2
538:
473:Gastro-intestinal symptoms
450:Neurocognitive impairments
1827:
1801:
1785:
1754:
778:10.1007/s11065-005-3588-2
661:Major Depressive Disorder
493:Temperature dysregulation
1850:Open Medicine Foundation
1700:10.1177/1044207308325995
1255:10.1177/0163278711424281
1065:29 November 2009 at the
302:Nonexudative pharyngitis
1855:Solve ME/CFS Initiative
1772:Post-exertional malaise
525:Post-exertional malaise
487:Cardiovascular symptoms
382:Neuroendocrine symptoms
288:Hypersomnia or insomnia
143:Additional requirements
95:Orthostatic intolerance
38:post-exertional malaise
1636:10.1186/1741-7015-3-19
1461:10.1186/1472-6963-3-25
576:Thyroid function tests
572:, and protein levels).
531:Cognitive difficulties
476:Genitourinary symptoms
61:
26:
1762:Clinical descriptions
1382:"Diagnosis of ME/CFS"
1168:10.1300/J092v11n01_02
626:adrenal insufficiency
59:
24:
1177:on 16 December 2008.
552:Complete blood count
522:Debilitating fatigue
490:Respiratory symptoms
313:Oxford 1991 criteria
264:Mild fever or chills
91:Cognitive impairment
1802:Society and history
1448:BMC Health Serv Res
905:on 16 February 2013
628:may be warranted.
513:National guidelines
83:Unrefreshing sleep.
45:pathology of ME/CFS
1194:The ME Association
973:Wyller VB (2007).
810:J. Nerv. Ment. Dis
689:. 19 November 2019
585:C-Reactive protein
379:Autonomic symptoms
305:Tender lymph nodes
236:multiple sclerosis
62:
27:
1868:
1867:
1408:978-1-4731-4221-3
884:978-0-309-31689-7
556:Blood chemistry (
467:Flu-like symptoms
456:Sleep disturbance
367:Sleep dysfunction
242:CDC 1988 criteria
207:Final requirement
154:short-term memory
105:CDC 1994 criteria
65:2015 IOM criteria
1888:
1819:Notable patients
1741:
1734:
1727:
1718:
1717:
1712:
1711:
1693:
1673:
1667:
1666:
1656:
1638:
1614:
1608:
1607:
1581:
1561:
1555:
1554:
1526:
1520:
1519:
1490:
1484:
1483:
1473:
1463:
1439:
1433:
1432:
1430:
1428:
1392:
1386:
1385:
1378:
1369:
1368:
1366:
1364:
1350:
1341:
1336:
1330:
1329:
1319:
1286:
1277:
1276:
1266:
1234:
1228:
1227:
1226:on 14 July 2014.
1222:. Archived from
1211:
1205:
1204:
1202:
1200:
1185:
1179:
1178:
1176:
1170:. Archived from
1153:
1144:
1135:
1133:
1127:
1120:
1110:
1078:
1069:
1058:
1027:Ann. Intern. Med
1022:
1013:
1012:
994:
970:
959:
958:
921:
915:
914:
912:
910:
895:
889:
888:
876:
866:
860:
859:
857:
855:
840:
834:
833:
805:
799:
798:
780:
765:Neuropsychol Rev
756:
750:
749:
747:
729:
705:
699:
698:
696:
694:
679:
270:Sore lymph nodes
121:Primary symptoms
1896:
1895:
1891:
1890:
1889:
1887:
1886:
1885:
1871:
1870:
1869:
1864:
1823:
1797:
1781:
1750:
1745:
1715:
1691:10.1.1.508.1082
1674:
1670:
1615:
1611:
1579:10.1.1.595.4767
1562:
1558:
1527:
1523:
1491:
1487:
1440:
1436:
1426:
1424:
1409:
1393:
1389:
1380:
1379:
1372:
1362:
1360:
1358:www.nice.org.uk
1352:
1351:
1344:
1337:
1333:
1287:
1280:
1235:
1231:
1212:
1208:
1198:
1196:
1186:
1182:
1174:
1151:
1145:
1138:
1122:
1079:
1072:
1067:Wayback Machine
1023:
1016:
971:
962:
922:
918:
908:
906:
897:
896:
892:
885:
874:
868:
867:
863:
853:
851:
850:. 27 April 2021
842:
841:
837:
806:
802:
757:
753:
706:
702:
692:
690:
681:
680:
673:
669:
656:
643:
634:
622:
611:creatine kinase
541:
515:
437:
405:
403:London criteria
385:Immune symptoms
351:
315:
299:Low-grade fever
273:Muscle weakness
244:
107:
67:
54:
17:
12:
11:
5:
1894:
1884:
1883:
1866:
1865:
1863:
1862:
1857:
1852:
1847:
1845:ME Research UK
1842:
1840:ME Association
1837:
1831:
1829:
1825:
1824:
1822:
1821:
1816:
1811:
1805:
1803:
1799:
1798:
1796:
1795:
1789:
1787:
1783:
1782:
1780:
1779:
1774:
1769:
1764:
1758:
1756:
1755:Medical issues
1752:
1751:
1744:
1743:
1736:
1729:
1721:
1714:
1713:
1668:
1609:
1556:
1521:
1485:
1434:
1407:
1387:
1370:
1342:
1331:
1278:
1249:(3): 280–304.
1229:
1220:Axford's Abode
1206:
1180:
1136:
1070:
1014:
960:
933:(12): 953–59.
927:Ann Intern Med
916:
890:
883:
861:
835:
800:
751:
720:(3): 133–146.
700:
670:
668:
665:
655:
652:
642:
639:
633:
630:
620:
603:
602:
596:
593:Celiac disease
590:
587:
578:
573:
566:renal function
554:
540:
537:
533:
532:
529:
526:
523:
514:
511:
500:
499:
498:
497:
494:
491:
488:
482:
481:
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477:
474:
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468:
462:
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387:
386:
383:
380:
374:
371:
368:
365:
362:
361:Severe fatigue
350:
347:
339:
338:
335:
332:
329:
326:
323:
314:
311:
307:
306:
303:
300:
293:
292:
289:
286:
283:
280:
277:
274:
271:
268:
265:
258:
257:
254:
243:
240:
232:
231:
227:
224:
220:
209:
208:
204:
203:
200:
193:
187:
180:
174:
167:
161:
145:
144:
140:
139:
136:
133:
130:
123:
122:
106:
103:
98:
97:
92:
85:
84:
81:
78:
66:
63:
53:
50:
15:
9:
6:
4:
3:
2:
1893:
1882:
1879:
1878:
1876:
1861:
1858:
1856:
1853:
1851:
1848:
1846:
1843:
1841:
1838:
1836:
1835:Action for ME
1833:
1832:
1830:
1828:Organizations
1826:
1820:
1817:
1815:
1814:Controversies
1812:
1810:
1807:
1806:
1804:
1800:
1794:
1791:
1790:
1788:
1784:
1778:
1775:
1773:
1770:
1768:
1765:
1763:
1760:
1759:
1757:
1753:
1749:
1742:
1737:
1735:
1730:
1728:
1723:
1722:
1719:
1709:
1705:
1701:
1697:
1692:
1687:
1684:(2): 93–100.
1683:
1679:
1672:
1664:
1660:
1655:
1650:
1646:
1642:
1637:
1632:
1628:
1624:
1620:
1613:
1605:
1601:
1597:
1593:
1589:
1585:
1580:
1575:
1572:(2): 87–106.
1571:
1567:
1560:
1552:
1548:
1544:
1540:
1536:
1532:
1525:
1517:
1513:
1509:
1505:
1502:(2): 95–100.
1501:
1497:
1496:Ann Epidemiol
1489:
1481:
1477:
1472:
1467:
1462:
1457:
1453:
1449:
1445:
1438:
1422:
1418:
1414:
1410:
1404:
1400:
1399:
1391:
1383:
1377:
1375:
1359:
1355:
1349:
1347:
1340:
1335:
1327:
1323:
1318:
1313:
1309:
1305:
1302:(4): 327–38.
1301:
1297:
1293:
1285:
1283:
1274:
1270:
1265:
1260:
1256:
1252:
1248:
1244:
1240:
1233:
1225:
1221:
1217:
1210:
1195:
1191:
1184:
1173:
1169:
1165:
1161:
1157:
1150:
1143:
1141:
1131:
1126:
1118:
1114:
1109:
1104:
1100:
1096:
1093:(2): 118–21.
1092:
1088:
1084:
1077:
1075:
1068:
1064:
1061:
1056:
1052:
1048:
1044:
1040:
1036:
1033:(3): 387–89.
1032:
1028:
1021:
1019:
1010:
1006:
1002:
998:
993:
988:
984:
980:
976:
969:
967:
965:
956:
952:
948:
944:
940:
936:
932:
928:
920:
904:
900:
894:
886:
880:
873:
872:
865:
849:
845:
839:
831:
827:
823:
819:
816:(9): 568–76.
815:
811:
804:
796:
792:
788:
784:
779:
774:
770:
766:
762:
755:
746:
741:
737:
733:
728:
723:
719:
715:
711:
704:
688:
684:
678:
676:
671:
664:
662:
651:
647:
638:
629:
627:
623:
616:
612:
608:
600:
597:
594:
591:
588:
586:
582:
579:
577:
574:
571:
570:liver enzymes
567:
563:
559:
555:
553:
550:
549:
548:
544:
536:
530:
527:
524:
521:
520:
519:
510:
508:
503:
495:
492:
489:
486:
485:
483:
478:
475:
472:
469:
466:
465:
463:
458:
455:
452:
449:
448:
446:
443:
442:
441:
432:
429:
420:
417:
414:
413:
412:
410:
409:Action for ME
400:
398:
389:
384:
381:
378:
377:
375:
372:
369:
366:
363:
360:
359:
358:
356:
355:Health Canada
346:
342:
336:
333:
330:
327:
324:
321:
320:
319:
310:
304:
301:
298:
297:
296:
290:
287:
284:
281:
278:
275:
272:
269:
266:
263:
262:
261:
255:
252:
251:
250:
247:
239:
237:
228:
225:
221:
217:
216:
215:
212:
206:
205:
201:
198:
195:unrefreshing
194:
191:
188:
185:
181:
178:
175:
172:
168:
165:
162:
159:
158:concentration
155:
151:
150:
149:
142:
141:
137:
134:
131:
128:
127:
126:
120:
119:
118:
116:
112:
102:
96:
93:
90:
89:
88:
82:
79:
76:
75:
74:
72:
58:
49:
46:
41:
39:
35:
31:
23:
19:
1761:
1681:
1677:
1671:
1626:
1623:BMC Medicine
1622:
1612:
1569:
1566:Biol Psychol
1565:
1559:
1537:(1): 56–64.
1534:
1530:
1524:
1499:
1495:
1488:
1451:
1447:
1437:
1427:23 September
1425:. Retrieved
1397:
1390:
1361:. Retrieved
1357:
1334:
1299:
1296:J Intern Med
1295:
1246:
1242:
1232:
1224:the original
1219:
1209:
1197:. Retrieved
1193:
1183:
1172:the original
1159:
1155:
1121:Synopsis by
1090:
1086:
1030:
1026:
982:
978:
930:
926:
919:
907:. Retrieved
903:the original
893:
870:
864:
852:. Retrieved
847:
838:
813:
809:
803:
771:(1): 29–58.
768:
764:
754:
717:
713:
703:
691:. Retrieved
686:
657:
648:
644:
635:
604:
558:electrolytes
545:
542:
534:
516:
504:
501:
438:
424:
406:
393:
352:
343:
340:
316:
308:
294:
259:
248:
245:
233:
219:supplements;
213:
210:
146:
124:
115:Keiji Fukuda
108:
99:
86:
68:
42:
29:
28:
18:
1162:(1): 7–36.
1087:J R Soc Med
848:www.cdc.gov
687:www.cdc.gov
345:condition.
267:Sore throat
177:muscle pain
171:lymph nodes
164:sore throat
52:Definitions
1777:2-day CPET
1531:Am. J. Med
1130:GPnotebook
667:References
599:Urinalysis
589:Iron tests
583:(ESR) and
285:Joint pain
184:joint pain
1767:Treatment
1686:CiteSeerX
1645:1741-7015
1574:CiteSeerX
1454:(1): 25.
736:1740-1534
595:screening
282:Headaches
190:headaches
1875:Category
1793:DecodeME
1786:Research
1708:71852821
1663:16356178
1604:12601890
1596:15450690
1516:15018881
1480:14702202
1421:Archived
1417:35438857
1326:21777306
1273:22158691
1063:Archived
1055:42395288
1009:11247547
1001:17419822
985:: 7–14.
830:11009329
787:15929497
641:CDC 1994
1809:History
1654:1334212
1551:8579088
1317:3427890
1264:3658447
1117:1999813
1108:1293107
1060:Details
1047:2829679
947:7978722
909:27 June
795:8153255
745:9839201
562:glucose
539:Testing
370:Myalgia
1706:
1688:
1661:
1651:
1643:
1629:: 19.
1602:
1594:
1576:
1549:
1514:
1478:
1471:317472
1468:
1415:
1405:
1363:3 July
1324:
1314:
1271:
1261:
1199:4 July
1115:
1105:
1053:
1045:
1007:
999:
955:510735
953:
945:
881:
854:3 July
828:
793:
785:
742:
734:
693:3 July
428:Ramsay
182:multi-
1704:S2CID
1600:S2CID
1175:(PDF)
1152:(PDF)
1051:S2CID
1005:S2CID
951:S2CID
875:(PDF)
791:S2CID
607:HbA1c
197:sleep
1659:PMID
1641:ISSN
1592:PMID
1547:PMID
1512:PMID
1476:PMID
1429:2023
1413:PMID
1403:ISBN
1365:2022
1322:PMID
1269:PMID
1201:2022
1113:PMID
1043:PMID
997:PMID
943:PMID
911:2009
879:ISBN
856:2022
826:PMID
783:PMID
732:ISSN
695:2022
617:and
609:and
453:Pain
69:The
43:The
1696:doi
1649:PMC
1631:doi
1584:doi
1539:doi
1535:100
1504:doi
1466:PMC
1456:doi
1312:PMC
1304:doi
1300:270
1259:PMC
1251:doi
1164:doi
1103:PMC
1095:doi
1035:doi
1031:108
987:doi
983:187
935:doi
931:121
818:doi
814:188
773:doi
740:PMC
722:doi
156:or
71:IOM
1877::
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Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
