Myalgic encephalomyelitis/chronic fatigue syndrome

2014: 889: 442: 64: 1889: 2127: 3803: 2161: 1432: 588: 1679: 1978:'s later research highlighted ME's disabling nature, prompting the removal of "benign" from the name and the creation of diagnostic criteria in 1986. These criteria included the tendency of muscles to tire after minor effort and take multiple days to recover, high symptom variability, and chronicity. Despite Ramsay's work and a UK report affirming that ME was not a psychological condition, scepticism persisted within the medical field, leading to limited research. 419:. It is made worse by normal physical, mental, emotional, and social activity, and is not a result of ongoing overexertion. Rest provides limited relief from fatigue. Particularly in the initial period of illness, this fatigue is described as "flu-like". Individuals may feel restless and describe their experience as "wired but tired". When starting an activity, muscle strength may drop rapidly, which can lead to difficulty with coordination, clumsiness or sudden 1415:

least six months, substantially impair activities in all areas of life, and have a clearly defined onset. Symptoms must be present at least half of the time, and be of moderate severity or worse; previous criteria just required symptoms to be present. In 2021, NICE revised its criteria based on the IOM criteria. The updated criteria require fatigue, PEM, non-restorative sleep, and cognitive difficulties persisting for at least three months.

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and immunological). At least one symptom in two of these categories needs to be present. People diagnosed under the CCC have more severe symptoms compared to those diagnosed under the Fukuda criteria. The 2011 International Consensus Criteria defines ME using symptom clusters and has no minimum duration of symptoms. Similarly to the CCC criteria, ICC is stricter than the Fukuda criteria and selects more severely ill people.

8319: 1721:(GET), a proposed treatment for ME/CFS that assumes deconditioning and a fear of activity play important roles in maintaining the illness, is no longer recommended for people with ME/CFS. Reviews of GET either see weak evidence of a small to moderate effect or no evidence of effectiveness. GET can have serious adverse effects. Similarly, a form of 2087:

People with ME/CFS often face stigma in healthcare settings, and the majority of individuals report negative healthcare experiences. They may feel that their doctor inappropriately calls their illness psychological or doubts the severity of their symptoms. They may also feel forced to prove that they

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in the middle of the 1980s. People suffered from "chronic or recurrent fatigue", among a large number of other symptoms. The initial link between elevated antibodies and the Epstein–Barr virus led to the name "chronic Epstein–Barr virus syndrome". The CDC renamed it chronic fatigue syndrome (CFS), as

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An early diagnosis may improve care and prognosis. Factors that may make the disease worse over days, but also over longer periods, are physical and mental exertion, a new infection, sleep deprivation, and emotional stress. Some people who improve need to manage their activities to prevent a relapse.

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and a two-day cardiopulmonary exercise test (CPET) can be helpful to document aspects of the illness, but they may be risky as they can cause severe PEM. They may be warranted to support a disability claim. Orthostatic intolerance can be measured with a tilt table test. If that is unavailable, it can

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Clinicians may be unfamiliar with ME/CFS, as it is often not fully covered in medical school. Due to this unfamiliarity, people may go undiagnosed for years or be misdiagnosed with mental health conditions. As individuals gain knowledge about their illness over time, their relationship with treating

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and gentle massage can sometimes help. In addition, stretching and exercise may help with pain, but a balance must be struck, as they can trigger PEM. While there is lack of evidence on pharmaceutical options for pain management in ME/CFS, medication that works for fibromyalgia may be tried, such as

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Research on pacing and energy envelope theory typically shows positive effects. However, these studies have often had a low number of participants and have rarely included methods to check if study participants implemented pacing well. Pacing is difficult to apply for people with very severe ME/CFS,

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Pacing can involve breaking up large tasks into smaller ones and taking extra breaks, or creating easier ways to do activities. For example, this might include sitting down while doing the laundry. The decision to stop an activity (and rest or change an activity) is determined by self-awareness of a

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There is no approved drug treatment or cure for ME/CFS, although some symptoms can be treated or managed. Care for ME/CFS is multidisciplinary. Usually, the primary care clinician plays an important role in coordinating health care, social care and educational support for those still in school. This

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Separate diagnostic criteria have been developed for children and young people. A diagnosis for children often requires a shorter symptom duration. For example, the CCC definition only requires three months of persistent symptoms in children compared to six months for adults. NICE requires only four

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The 2015 IOM criteria share significant similarities with the CCC but were developed to be easy to use for clinicians. Diagnosis requires fatigue, PEM, non-restorative sleep, and either cognitive issues (such as memory impairment) or orthostatic intolerance. Additionally, fatigue must persist for at

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and a mental and physical examination. No specific lab tests are approved for diagnosis; while physical abnormalities can be found, no single finding is considered sufficient for diagnosis. Blood and urine tests are used to rule out other conditions that could be responsible for the symptoms. People

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People with ME/CFS often have immune system abnormalities. A consistent finding in studies is a decreased function of natural killer cells, a type of immune cell that targets virus-infected and tumour cells. They are also more likely to have active viral infections, correlating with cognitive issues

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are other potential triggers. ME/CFS may further occur after physical trauma, such as an accident or surgery. Pregnancy has been reported in around 3% to 10% of cases as a trigger. ME/CFS can also begin with multiple minor triggering events, followed by a final trigger that leads to a clear onset of

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Symptoms and their severity can widely differ among people with ME/CFS. This poses a challenge for research into the cause and progression of the disease. Dividing people into subtypes may help manage this heterogeneity. The existence of multiple diagnostic criteria and variations in how scientists

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ME/CFS is a contested illness, with debates mainly revolving around the cause of the illness and treatments. Historically, there was a heated discussion about whether the condition was psychological or neurological. Professionals who subscribed to the psychological model had frequent conflicts with

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Those with a stable illness who understand how to "listen to their body" may be able to carefully and flexibly increase their activity levels. The goal of an exercise programme would be to increase stamina, while not interfering with everyday tasks or making the illness more severe. In many chronic

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for ME/CFS, it is not possible to determine which set of criteria is the most accurate. A trade-off must be made between overdiagnosis and missing more diagnoses. The broad Fukuda criteria have a higher risk of overdiagnosis, whereas the strict ICC criteria have a higher risk of missing people. The

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All types of activities that require energy, whether physical, cognitive, social, or emotional, can trigger PEM. Examples include attending a school event, food shopping, or even taking a shower. For some, being in a stimulating environment can be sufficient to trigger PEM. PEM usually starts 12 to

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Historical research funding for ME/CFS has been far below that of comparable diseases. In a 2015 report, the US National Academy of Sciences said that "remarkably little research funding" had been dedicated to causes, mechanisms, and treatment. Lower funding levels have led to a smaller number and

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Research into ME/CFS seeks to find a better understanding of the disease's causes, biomarkers to aid in diagnosis, and treatments to relieve symptoms. The emergence of long COVID has sparked increased interest in ME/CFS, as the two conditions may share pathology and treatment for one may treat the

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of ME/CFS is limited. Complete recovery, partial improvement, and worsening are all possible, but full recovery is uncommon. Symptoms generally fluctuate over days, weeks, or longer periods, and some people may experience periods of remission. Overall, many will have to adjust to life with ME/CFS.

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Some medical conditions have symptoms similar to ME/CFS. Diagnosis often involves clinical evaluation, testing, and specialist referrals to identify the correct condition. During the time other possible diagnoses are explored, advice can be given on symptom management to help prevent the condition

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The Canadian Consensus Criteria, another commonly used criteria set, was developed in 2003. In addition to PEM, fatigue and sleep problems, pain and neurological or cognitive issues are required for diagnosis. Furthermore, three categories of symptoms are defined (orthostatic, thermal instability,

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are diagnosed more frequently than other groups, but the illness is probably at least as prevalent among African Americans and Hispanics. It used to be thought that ME/CFS was more common among those with higher incomes. Instead, people in minority groups or lower income groups may have increased

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Roughly a quarter of those living with ME/CFS fall into the mild category, and half fall into the moderate or moderate-to-severe categories. The final quarter falls into the severe or very severe category. Severity may change over time. Symptoms might get worse, improve or the illness may go into

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ME/CFS can affect people of all ages, ethnicities, and income levels, but it is more common in women than men. People with a history of frequent infections are more likely to develop it. Those with family members who have ME/CFS are also at higher risk, suggesting a genetic factor. In the United

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The cause of ME/CFS is not yet known. Between 60% and 80% of cases start after an infection, usually a viral infection. A genetic factor is believed to contribute, but there is no single gene responsible for increased risk. Instead, many gene variants probably have a small individual effect, but

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in ME/CFS can be as disabling as physical symptoms, leading to difficulties at work or school, as well as in social interactions. People with ME/CFS sometimes describe it as "brain fog", and report a slowdown in information processing. Individuals may have difficulty speaking, struggling to find

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The 1994 CDC criteria, sometimes called the Fukuda criteria, require six months of persistent or relapsing fatigue for diagnosis, as well as the persistent presence of four out of eight other symptoms. While used frequently, the Fukuda criteria have limitations: PEM and cognitive issues are not

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Reported prevalence rates vary widely depending on how ME/CFS is defined and diagnosed. Overall, around 1 in 150 people have ME/CFS. Based on the 1994 CDC diagnostic criteria, the global prevalence rate for CFS is 0.89%. In comparison, estimates using the stricter 1988 CDC criteria or the 2003

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may appear completely normal, particularly if the individual has rested substantially before a doctor's visit. There may be tenderness in the lymph nodes and abdomen or signs of hypermobility. Answers to questions may show a temporary difficulty with finding words or other cognitive problems.

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Those with severe and very severe ME/CFS experience more extreme and diverse symptoms. They may face severe weakness and greatly limited ability to move. They can lose the ability to speak, swallow, or communicate completely due to cognitive issues. They can further experience severe pain and

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Vigorous aerobic exercise can benefit people with many chronic illnesses. But people with ME/CFS do not tolerate such exercise routines. Standard exercise recommendations for healthy people can be harmful for patients with ME/CFS. However, it is important that patients with ME/CFS undertake

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Ahmed SA, Mewes JC, Vrijhoef H (February 2020). "Assessment of the Scientific Rigour of Randomized Controlled Trials on the Effectiveness of Cognitive Behavioural Therapy and Graded Exercise Therapy for Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Systematic Review".

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Various drug treatments for ME/CFS are being explored. Drugs under investigation often target the nervous system, the immune system, autoimmunity, or pain directly. More recently, there has been a growing interest in drugs targeting energy metabolism. In several clinical trials of ME/CFS,

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Many biomarkers for ME/CFS have been proposed. Studies on biomarkers have often been too small to draw robust conclusions. Natural killer cells have been identified as an area of interest for biomarker research as they show consistent abnormalities. Other proposed markers include

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is poorly studied, and the evidence is mixed. One large retrospective study on the topic found no increase in all-cause mortality due to ME/CFS. Death from suicide was, however, significantly higher among those with ME/CFS. In extreme cases, people can die from the illness.

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questionnaire, especially in the domains of physical and social functioning, general health, and vitality. However, their emotional functioning and mental health are not much lower than those of healthy individuals. Functional impairment in ME/CFS can be greater than

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Economic costs due to ME/CFS are significant. In the United States, estimates range from $ 36 to $ 51 billion per year, considering both lost wages and healthcare costs. A 2017 estimate for the annual economic burden in the United Kingdom was £3.3 billion.

904:. People with ME/CFS have lower performance compared to healthy controls on the first test. On the second test, healthy people's scores stay roughly the same or increase slightly, while those with ME/CFS have a clinically significant decrease in work rate at the 491:, symptoms that start or worsen with standing or sitting. Symptoms, which include nausea, lightheadedness, and cognitive impairment, often improve again after lying down. Weakness and vision changes may also be triggered by the upright posture. Some have 2113:

in children, making them more dependent on their family for assistance instead of gaining independence as they age. Caring for somebody with ME/CFS can be a full-time role, and the stress of caregiving is made worse by the lack of effective treatments.

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criteria. The criteria sets were all developed based on expert consensus and differ in the required symptoms and which conditions preclude a diagnosis of ME/CFS. The definitions differ in their conceptualisation of the cause and mechanisms of ME/CFS.

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ME/CFS has a large social and economic impact, and the disease can be socially isolating. About a quarter of those affected are unable to leave their bed or home. People with ME/CFS often face stigma in healthcare settings, and care is complicated by

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may pose a risk over the long term. Symptoms of severe ME/CFS may be misunderstood as neglect or abuse during well-being evaluations, and NICE recommends that professionals with experience in ME/CFS should be involved in any type of assessment for

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48 hours after the activity, but can also follow immediately after. PEM can last hours, days, weeks, or months. Extended periods of PEM, commonly referred to as "crashes" or "flare-ups" by people with the illness, can lead to a prolonged relapse.

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Morris G, Anderson G, Maes M (November 2017). "Hypothalamic-Pituitary-Adrenal Hypofunction in Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) as a Consequence of Activated Immune-Inflammatory And Oxidative and Nitrosative Pathways".

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Children and teenagers are more likely to recover or improve than adults. For instance, a study in Australia among 6- to 18-year-olds found that two-thirds reported recovery after ten years and that the typical duration of illness was five years.

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ME/CFS negatively impacts people's social lives and relationships. Stress can be compounded by disbelief in the illness from the support network, who can be sceptical due to the subjective nature of diagnosis. Many people with the illness feel

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with ME/CFS often face significant delays in obtaining a diagnosis, and diagnoses may be missed altogether. Specialists in ME/CFS may be asked to confirm the diagnosis, as primary care physicians often lack a good understanding of the illness.

2404: 407:). Symptoms significantly reduce the ability to function and typically last for three to six months before a diagnosis can be confirmed. ME/CFS usually starts after an infection. Onset can be sudden or more gradual over weeks to months. 2213:

may also play a role; the NIH spends less on diseases that predominantly affect women in relation to disease burden. Less well-funded research areas may also struggle to compete with more mature areas of medicine for the same grants.

1446:, which assesses the frequency and severity of ME/CFS symptoms. Individuals may struggle to answer questions related to PEM, if they are unfamiliar with the symptom. To find patterns in symptoms, they may be asked to keep a diary. 1573:. Modern definitions of fibromyalgia not only include widespread pain but also fatigue, sleep disturbances, and cognitive issues. This makes it difficult to distinguish ME/CFS from fibromyalgia and the two are often co-diagnosed. 2209:, a severe lung disease often caused by smoking, receives low funding per healthy life year lost. Similarly, for ME/CFS, the historical belief that it is caused by psychological factors may have contributed to lower funding. 2060:, another retrovirus, and national blood supplies were suspected to be tainted with the retrovirus. After several years of study, the XMRV findings were determined to be the result of contamination of the testing materials. 908:. Potential causes include mitochondrial dysfunction, and issues with the transport and use of oxygen. Some of the usual recovery processes following exercise may be lacking, providing an alternative explanation for PEM. 250:

that contribute to ME/CFS have been confirmed. ME/CFS is associated with changes in the nervous and immune systems, as well as in energy production. Diagnosis is based on symptoms because no diagnostic test is available.

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their combined effect can be strong. Other factors may include problems with the nervous and immune systems, as well as energy metabolism. ME/CFS is a biological disease, not a psychological condition, and is not due to

1689:, or activity management, involves balancing periods of rest with periods of activity. The goal of pacing is to stabilize the illness and avoid triggering PEM. This involves staying within an individual's available 7097: 7082: 7067: 7052: 2193:

The US National Institutes of Health (NIH) is the largest biomedical funder worldwide. Using rough estimates of disease burden, a study found NIH funding for ME/CFS was only 3% to 7% of the average disease per

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physicians changes. They may feel on a more equal footing with their doctors and able to work in partnership. At times, relationships may deteriorate instead as the previous asymmetry of knowledge breaks down.

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was initially proposed as a subset of 'chronic fatigue syndrome' with a documented triggering infection, but might also be used as a synonym of ME/CFS or as a broader set of fatigue conditions after infection.

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of the illness. Doctors may be unfamiliar with ME/CFS, as it is often not fully covered in medical school. Historically, research funding for ME/CFS has been far below that of diseases with comparable impact.

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Those with severe ME/CFS are homebound and can do only limited activities of daily living, for instance brushing their teeth. They may be wheelchair-dependent and spend the majority of their time in bed.

1772:, such as CBT may help manage the stress of being ill and teach self-management strategies. Family sessions may be useful to educate people close to those with ME/CFS about the severity of the illness. 3639: 2148:

takes place on 12 May. The goal of the day is to raise awareness among the public and health care workers about the diagnosis and treatment of ME/CFS. The date was chosen because it is the birthday of

5203:[Interdisciplinary, collaborative D-A-CH (Germany, Austria and Switzerland) consensus statement concerning the diagnostic and treatment of myalgic encephalomyelitis/chronic fatigue syndrome]. 1915:

Women are diagnosed about 1.5 to 4 times more often with ME/CFS than men. The prevalence in children and adolescents is slightly lower than in adults, and children have it less than adolescents. The

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The possible role of chronic viral infection in ME/CFS has been a subject of disagreement. One study caused considerable controversy by establishing a causal relationship between ME/CFS and a

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People with mild ME/CFS can usually still work and care for themselves, but they will need their free time to recover from these activities rather than engage in social and leisure activities.

4802:"A Unifying Hypothesis of the Pathophysiology of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Recognitions from the Finding of Autoantibodies Against Β2-Adrenergic Receptors" 2858: 1737:

can be offered. Avoiding naps during the day can further improve sleep, but there may be a trade-off with needed rest during the day. Drugs that help with insomnia in fibromyalgia, such as

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The illness can improve or worsen over time, but full recovery is uncommon. No therapies or medications are approved to treat the condition, and management is aimed at relieving symptoms.

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O'Leary D (December 2020). "A Concerning Display of Medical Indifference: Reply to 'Chronic Fatigue Syndrome and an Illness-Focused Approach to Care: Controversy, Morality and Paradox'".

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patients, who believed their illness to be organic. While ME/CFS is now generally believed to be a multisystem neuroimmune condition, a subset of professionals still see the condition as

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Treatments based on behavioural and psychological models of the illness have also been the subject of much contention. The largest clinical trial on behavioural interventions, the 2011

423:. Mental fatigue may make cognitive efforts difficult. The fatigue experienced in ME/CFS is of a longer duration and greater severity than in other conditions characterized by fatigue. 7850: 6643: 5602: 5414: 2306:

Committee on the Diagnostic Criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, Board on the Health of Select Populations, Institute of Medicine (10 February 2015).

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from getting worse. Before a diagnosis of ME/CFS is confirmed, a waiting period is used to exclude acute medical conditions or symptoms which may resolve within that time frame.

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words and names. They may have trouble concentrating or multitasking, or may have difficulties with short-term memory. Tests often show problems with short-term visual memory,

5162: 1670:, or other psychological problems, which can be treated. People with ME/CFS may be unusually sensitive to medications, especially ones that affect the central nervous system. 1443: 747:

ME/CFS is associated with changes in several areas, including the nervous and immune systems, as well as disturbances in energy metabolism. Neurological differences include

352:. They consider the term simplistic and trivialising, which in turn prevents the illness from being taken seriously. At the same time, there are also issues with the use of 297:. The classification of ME/CFS as a neurological disease is based on symptoms, which indicate a central role of the nervous system. Alternatively, based on abnormalities in 3233: 8236: 8231: 2870: 8339: 8248: 8226: 7008: 779:

and the use of additional brain areas for cognitive tasks. Other consistent findings, based on a smaller number of studies, are low metabolism in some areas, reduced

4894:"Repeated Maximal Exercise Tests of Peak Oxygen Consumption in People with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Systematic Review and Meta-Analysis" 3944: 1776:

can be useful, but there may be more side effects than in the general population. For instance, it may be difficult to stop weight gain due to exercise intolerance.

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weeks of symptoms to suspect ME/CFS in children, compared to six weeks in adults. Exclusionary diagnoses also differ; for instance, children and teenagers may have

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or altered medical perception as potential causes. This theory, though challenged, sparked controversy and cast doubt on ME's legitimacy in the medical community.

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Multiple reasons have been proposed for the low funding levels. Diseases for which society "blames the victim" are frequently underfunded. This may explain why

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Unrefreshing sleep is a further core symptom. People wake up exhausted and stiff rather than restored after a night's sleep. This can be caused by a pattern of

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A range of structural, biochemical, and functional abnormalities are found in brain imaging studies of people with ME/CFS. Common findings are changes in the

6606: 519:(an abnormally increased sensitivity to pain) are common in ME/CFS. The pain is not accompanied by swelling or redness. The pain can be present in muscles ( 5201:"Interdisziplinäres, kollaboratives D-A-CH Konsensus-Statement zur Diagnostik und Behandlung von Myalgischer Enzephalomyelitis/Chronischem Fatigue-Syndrom" 2088:

are legitimately ill. Some may be given outdated treatments that provoke symptoms or assume their illness is due to unhelpful thoughts and deconditioning.

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Viral infections have long been suspected to cause ME/CFS, based on the observation that ME/CFS sometimes occurs in outbreaks and is possibly connected to

266:. ME/CFS occurs more often in women than in men. It most commonly affects adults between ages 40 and 60 but can occur at other ages, including childhood. 5364:"A Scoping Review of 'Pacing' for Management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Lessons Learned for the Long COVID Pandemic" 5127: 1648:, or medication if required, may be beneficial. Chronic pain is common in ME/CFS, and the CDC recommends consulting with a pain management specialist if 6330:"Children's Experiences of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME): A Systematic Review and Meta-Ethnography Of Qualitative Studies" 4097:"Female Reproductive Health Impacts of Long COVID and Associated Illnesses Including ME/CFS, POTS, And Connective Tissue Disorders: A Literature Review" 3888:

Identifying and Diagnosing ME/CFS: Myalgic Encephalomyelitis (Or Encephalopathy) / Chronic Fatigue Syndrome: Diagnosis and Management: Evidence Review D

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ME/CFS often leads to serious disability, but the degree varies considerably. ME/CFS is generally classified into four categories of illness severity:

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The first management step for sleep problems in ME/CFS is improving sleep habits. If sleep problems remain after implementing sleep hygiene routines,

262:, ME/CFS affected 2 to 9 out of every 1000 people, depending on the definition. However, many people fit ME/CFS diagnostic criteria after contracting 3377:"Research Priorities for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): The Results of a James Lind Alliance Priority Setting Exercise" 2525: 2400: 1383: 72: 1993:

In the 2010s, ME/CFS began to gain more recognition from health professionals and the public. Two reports proved key in this shift. In 2015, the US

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has been proposed as an underlying mechanism of ME/CFS that could explain a large set of symptoms. Several studies suggest neuroinflammation in the

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of immune cells. Several small studies have investigated the genetics of ME/CFS, but none of their findings have been replicated. A larger study,

336:). Reaching consensus on a name has been challenging because the cause and pathology remain unknown. In the WHO's most recent classification, the 5253:"Energy Envelope Maintenance Among Patients with Myalgic Encephalomyelitis and Chronic Fatigue Syndrome: Implications of Limited Energy Reserves" 1815:. To manage sensitivities to environmental stimuli, these stimuli can be limited. For instance, the surroundings can be made perfume-free, or an 434:. PEM involves increased fatigue and is disabling. It can also include flu-like symptoms, pain, cognitive difficulties, gastrointestinal issues, 5881: 4943:"A Systematic Review of Mitochondrial Abnormalities in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome/Systemic Exertion Intolerance Disease" 7590: 6914: 4658:"Evidence of Altered Cardiac Autonomic Regulation in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Systematic Review and Meta-Analysis" 1997:

produced a report with new diagnostic criteria that described ME/CFS as a "serious, chronic, complex systemic disease". Following this, the US

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showed a small reduction in symptoms, but improvements were not sustained after discontinuation. Rintatolimod has been approved in Argentina.

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may also co-occur with ME/CFS. However, many diagnostic criteria require ruling out sleep disorders before confirming a diagnosis of ME/CFS.

379:) and suggested new diagnostic criteria. While the new name was not widely adopted, the diagnostic criteria were taken over by the CDC. Like 1961:. While its infectious nature was suspected, the exact cause remained elusive. The syndrome appeared in sporadic as well as epidemic cases. 7392: 5673: 947:, less change in cortisol levels throughout the day, and a weaker reaction to stress and stimuli. Other proposed abnormalities are reduced 2264:

apply them complicate comparisons between studies. Definitions also vary in which co-occurring conditions preclude a diagnosis of ME/CFS.

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means brain and spinal cord inflammation), as there is only limited evidence of brain inflammation implied by the name. The umbrella term

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Sotzny F, Blanco J, Capelli E, Castro-Marrero J, Steiner S, Murovska M, et al. (European Network on ME/CFS (EUROMENE)) (June 2018).

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that may interact with and worsen ME/CFS symptoms are common, and treating these may help manage ME/CFS. Commonly diagnosed ones include

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Standard laboratory findings are usually normal. Standard tests when suspecting ME/CFS include an HIV test, and blood tests to determine

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remission for a period. People who feel better for a period may overextend their activities, triggering PEM and a worsening of symptoms.

457:, shallow sleep, or broken sleep. However, even a full night's sleep is typically non-restorative. Some individuals experience insomnia, 6636: 6505:"Updating the National Academy of Medicine ME/CFS Prevalence and Economic Impact Figures to Account for Population Growth and Inflation" 5908:

Blease C, Geraghty KJ (September 2018). "Are ME/CFS Patient Organizations 'Militant'? : Patient Protest in a Medical Controversy".

5594: 4070: 3701: 1725:(CBT) that assumed the illness is maintained by unhelpful beliefs about the illness and avoidance of activity is no longer recommended. 6575: 5677: 5598: 5427: 5423: 5166: 5043: 4558:"Neuroinflammation and Cytokines in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): A Critical Review of Research Methods" 4418:

Eriksen W (16 August 2018). "ME/CFS, Case Definition, And Serological Response to Epstein–Barr Virus. A Systematic Literature Review".

4153: 3948: 3237: 2920: 2698: 2443: 1734: 1391: 4458:"A Systematic Review of Neurological Impairments in Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome Using Neuroimaging Techniques" 2202:, which affects fewer people and results in disability no worse than ME/CFS, received 20 times as much funding between 2007 and 2015. 1607:, pain, migraines, and PEM. People with chronic fatigue, which is not due to ME/CFS or other chronic illnesses, may be diagnosed with 8218: 6037: 3424:

Bateman L (2022). "Fibromyalgia and myalgic encephalomyelitis/chronic fatigue syndrome". In Zigmond M, Wiley C, Chesselet MF (eds.).

1634:. Management may start with treating the most disabling symptom first, and tackle symptoms one by one in further health care visits. 492: 5651: 5170: 535:

that were not present before the illness can occur as well. However, chronic daily headaches may indicate an alternative diagnosis.

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during the trial: some participants now met a key criterion for recovery before the trial started. A reanalysis under the original

5999:"The Negative Impact of the Psychiatric Model of Chronic Fatigue Syndrome on Doctors' Understanding and Management of the Illness" 4707:"A Systematic Review of Natural Killer Cells Profile and Cytotoxic Function in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome" 4517:"Brain-Regional Characteristics and Neuroinflammation in ME/CFS Patients from Neuroimaging: A Systematic Review and Meta-Analysis" 844:

when the body is rotated from lying flat to an upright position. This again suggests dysfunction in the autonomic nervous system.

8208: 7385: 3241: 1756:. If this is insufficient, referral to a pain specialist or counselling on pain management can be the next step. Heat treatment, 1407:

mandatory. The large variety of optional symptoms can lead to diagnosis of individuals who differ significantly from each other.

2844: 735:, has also been hypothesised to drive symptoms. EBV is present in about 90% of people, usually in a latent state. The levels of 239:

which starts hours to days after minor physical or mental activity. This "crash" can last from hours or days to several months.

8188: 7861: 7238: 5302:"Pacing as a strategy to improve energy management in myalgic encephalomyelitis/chronic fatigue syndrome: a consensus document" 2924: 1986:

a viral cause could not be confirmed in studies. An initial case definition of CFS was outlined in 1988; the CDC published new

96: 6602: 2522:"Myalgic Encephalomyelitis (Or Encephalopathy)/Chronic Fatigue Syndrome: Diagnosis and Management: Information for the Public" 8213: 7845: 7002: 5767: 5629: 3899: 3437: 2324: 2206: 2134:

Patient organisations have aimed to involve researchers via activism but also by publishing research themselves—similarly to

3976:"Systematic Review and Meta-Analysis Of Cognitive Impairment in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)" 8354: 8051: 8039: 7501: 6986: 3913: 2145: 857:

show less metabolic activity. This may reflect they have reached an exhausted state and cannot respond effectively against

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Joint and muscle pain without swelling or inflammation is a common feature of ME/CFS, but is more closely associated with

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Autoimmunity has been proposed to be a factor in ME/CFS. There is a subset of people with ME/CFS with increased levels of

223:

that does not go away with rest, sleep issues, and problems with memory or concentration. Further common symptoms include

6504: 4149: 1791:, or dairy, can alleviate symptoms. Those with orthostatic intolerance can benefit from increased salt and fluid intake. 368:

without trivialising the disease, but some people object to this name too, as they see CFS and ME as distinct illnesses.

2447: 8270: 8203: 7758: 6579: 558:

and a sore throat. People may also develop allergies or become sensitive to foods, lights, noise, smells or chemicals.

6637:"ME/CFS Research Funding – An Overview Of Activity By Major Institutional Funders Included on the Dimensions Database" 2741:"Systematic Review and Meta-Analysis Of the Prevalence of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME)" 1768:

Like in other chronic illnesses, those with ME/CFS often experience mental health issues like anxiety and depression.

892:

When people with ME/CFS exercise on consecutive days, their performance declines on the second day, unlike those with

708:(EBV), around 8% to 15% develop ME/CFS, depending on criteria. Other viral infections that can trigger ME/CFS are the 7973: 7776: 7231: 5337: 2079:

showed no significant difference in recovery rate between treatment groups and the controls receiving standard care.

1900:

In England and Wales, over 250,000 people are estimated to be affected. These estimates are based on data before the

1471: 915:

abnormalities in cellular energy production, but differences between studies make it hard to draw clear conclusions.

873: 604:

hypersensitivities to touch, light, sound, and smells. Minor day-to-day activities can be sufficient to trigger PEM.

292: 2702: 8344: 5047: 1909: 3458:"Neuroimaging Characteristics of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): A Systematic Review" 2397:"Myalgic Encephalomyelitis (Or Encephalopathy)/Chronic Fatigue Syndrome: Diagnosis and Management: NICE Guideline" 1652:

painkillers are insufficient. For cognitive impairment, adaptations like organisers and calendars may be helpful.

640:

Besides viruses, other reported triggers include stress, traumatic events, and environmental exposures such as to

8349: 8092: 7320: 7268: 6249:

Dumit J (February 2006). "Illnesses You Have to Fight to Get: Facts as Forces in Uncertain, Emergent Illnesses".

2031: 993: 271: 6783: 5416:

Management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): An Updated Systematic Evidence Review

1510:

Possible differential diagnoses span a large set of specialties and depend on the medical history. Examples are

7607: 7583: 7413: 5759: 1534:, and some cancers may also present similar symptoms. Various rheumatological and autoimmune diseases, such as 709: 340:, chronic fatigue syndrome and myalgic encephalomyelitis are named under post-viral fatigue syndrome. The term 2474:"Management of chronic fatigue syndrome/myalgic encephalomyelitis in a pediatric population: A scoping review" 8286: 8171: 8087: 8029: 7799: 7578: 7366: 6779: 4389: 3327:"Healthcare System Barriers Impacting the Care of Canadians with Myalgic Encephalomyelitis: A Scoping Review" 2195: 1998: 1663: 672: 306: 3825:

Jason LA, Johnson M (2 April 2020). "Solving the ME/CFS Criteria and Name Conundrum: The Aftermath of IOM".

1949:

led to the term "benign myalgic encephalomyelitis" (ME). Those affected displayed symptoms such as malaise,

8255: 7629: 6116:

Geraghty KJ (August 2017). "Further Commentary on the PACE Trial: Biased Methods and Unreliable Outcomes".

3886: 2307: 2210: 2068: 1994: 1941:

From 1934 onwards, there were multiple outbreaks globally of an unfamiliar illness, initially mistaken for

1722: 1686: 1637: 1387: 836:

have also been found, together suggesting a role of the autonomic nervous system. Individuals often have a

810: 685:

or via a "hit and run" mechanism, in which infections dysregulate the immune system or cause autoimmunity.

577:(self-care activities, such as making a meal). People are usually unable to work and require frequent rest. 255: 3265:"The Lonely, Isolating, and Alienating Implications of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome" 3131:"Unravelling Shared Mechanisms: Insights from Recent ME/CFS Research to Illuminate Long COVID Pathologies" 7765: 2018: 1693:

to reduce the PEM "payback" caused by overexertion. The technique was developed for ME/CFS in the 1980s.

1479: 4332:"Epstein-Barr Virus-Acquired Immunodeficiency in Myalgic encephalomyelitis-Is It Present in Long COVID?" 2842: 8309: 8243: 7793: 7465: 7325: 6994: 5797:"Case Definitions for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME): A Systematic Review" 4843:"The Prospects of the Two-Day Cardiopulmonary Exercise Test (CPET) in ME/CFS Patients: A Meta-Analysis" 1608: 1559: 1390:(IOM) criteria, the International Consensus Criteria (ICC), the Canadian Consensus Criteria (CCC), and 893: 574: 35: 5846:"Legitimizing Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Indications of Change over a Decade" 4609:"Objective Sleep Measures in Chronic Fatigue Syndrome Patients: A Systematic Review and Meta-Analysis" 3894:. NICE Evidence Reviews Collection. London: National Institute for Health and Care Excellence (NICE). 8193: 8161: 8135: 8113: 7962: 7541: 7223: 5998: 5845: 3974:

Aoun Sebaiti M, Hainselin M, Gounden Y, Sirbu CA, Sekulic S, Lorusso L, et al. (February 2022).

3635: 837: 288: 6906: 2013: 877: 624:. Fewer than half of people with ME/CFS are employed, and roughly one in five have a full-time job. 8260: 8034: 7448: 7356: 7115: 6378: 5362:

Sanal-Hayes NE, Mclaughlin M, Hayes LD, Mair JL, Ormerod J, Carless D, et al. (October 2023).

2316: 1982: 1916: 1803:

People with moderate to severe ME/CFS may benefit from home adaptations and mobility aids, such as

748: 701: 539: 258:

can help avoid worsening symptoms, and counselling may help in coping with the illness. Before the

243: 1535: 8265: 8198: 7954: 7772: 7624: 7614: 7458: 7361: 7278: 6670:"The European ME/CFS Biomarker Landscape Project: An Initiative of the European Network EUROMENE" 6603:"Dr. Nancy Lee on International Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Awareness Day" 3512:

Marshall-Gradisnik S, Eaton-Fitch N (September 2022). "Understanding myalgic encephalomyelitis".

3426:

Neurobiology of Brain Disorders : Biological Basis of Neurological and Psychiatric Disorders

2634:"Biomarkers for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): a systematic review" 2076: 1718: 1641: 1577: 1455: 504: 488: 427: 400: 396: 236: 125: 88: 7377: 6668:

Scheibenbogen C, Freitag H, Blanco J, Capelli E, Lacerda E, Authier J, et al. (July 2017).

6379:"Unpaid Carers Are the Missing Piece in Treatment Guidelines and Research Priorities for ME/CFS" 6328:

Parslow RM, Harris S, Broughton J, Alattas A, Crawley E, Haywood K, et al. (January 2017).

5681: 2142:, for example, helped start discussions about weaknesses in trials of psychological treatments. 1709:

illnesses, intense exercise is beneficial, but in ME/CFS it is not recommended. The CDC states:

1705:

as the activities that trigger PEM in this group, such as eating, cannot be avoided completely.

688:

Different types of viral infection have been implicated in ME/CFS, including airway infections,

8130: 8122: 8077: 7753: 7725: 7573: 4607:

Mohamed AZ, Andersen T, Radovic S, Del Fante P, Kwiatek R, Calhoun V, et al. (June 2023).

4230:

Rasa S, Nora-Krukle Z, Henning N, Eliassen E, Shikova E, Harrer T, et al. (October 2018).

4181:"Evaluation of Viral Infection as an Etiology of ME/CFS: A Systematic Review and Meta-Analysis" 2038: 1596: 1581: 1547: 1483: 952: 916: 784: 713: 705: 17: 7166: 6728:"Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Where Will the Drugs Come From?" 5753: 2521: 8145: 8019: 7837: 7815: 7730: 7653: 7563: 7550: 7475: 7061: 6859:"Research Update: The Relation Between ME/CFS Disease Burden and Research Funding in the USA" 4456:

Maksoud R, du Preez S, Eaton-Fitch N, Thapaliya K, Barnden L, Cabanas H, et al. (2020).

4037: 1832: 1792: 1604: 944: 780: 464: 188: 5076:"Review of Case Definitions for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)" 4941:

Holden S, Maksoud R, Eaton-Fitch N, Cabanas H, Staines D, Marshall-Gradisnik S (July 2020).

3665: 2999:"Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Essentials of Diagnosis and Management" 2997:

Bateman L, Bested AC, Bonilla HF, Chheda BV, Chu L, Curtin JM, et al. (November 2021).

527:. Individuals with ME/CFS may have chronic pain behind the eyes and in the neck, as well as 8082: 7899: 7788: 6452:

Pheby DF, Araja D, Berkis U, Brenna E, Cullinan J, de Korwin JD, et al. (April 2020).

5503:"The 'Cognitive Behavioural Model' of Chronic Fatigue Syndrome: Critique of a Flawed Model" 5199:

Hoffmann K, Hainzl A, Stingl M, Kurz K, Biesenbach B, Bammer C, et al. (August 2024).

4469: 3987: 3521: 3375:

Tyson S, Stanley K, Gronlund TA, Leary S, Emmans Dean M, Dransfield C, et al. (2022).

2224: 2149: 1919:

rate (the onset of ME/CFS) has two peaks, one at 10–19 and another at 30–39 years, and the

1824: 1779:

Bowel issues are a common symptom of ME/CFS. For some, eliminating specific foods, such as

1627: 1620: 284: 7091: 6069:"Xenotropic Murine Leukemia Virus-Related Virus (XMRV) and the Safety of the Blood Supply" 2843:

Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG) (17 April 2023).

2126: 1981:

In the United States, Nevada and New York State saw outbreaks of what appeared similar to

1542:, may have overlapping symptoms with ME/CFS. Furthermore, it may be necessary to evaluate 739:

to EBV are commonly higher in people with ME/CFS, indicating possible viral reactivation.

399:(PEM, overall symptoms getting worse after mild activity). In addition, cognitive issues, 387:

only focuses on a single symptom, and opinion from those affected was generally negative.

8: 8011: 7658: 7513: 7453: 7101: 6938:"Pharmaceutical Interventions in Chronic Fatigue Syndrome: A Literature-Based Commentary" 5625: 4761:"Myalgic Encephalomyelitis/Chronic Fatigue Syndrome – Evidence for an Autoimmune Disease" 4232:"Chronic Viral Infections in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)" 4095:

Pollack B, von Saltza E, McCorkell L, Santos L, Hultman A, Cohen AK, et al. (2023).

4036:

Unger ER, Lin JS, Brimmer DJ, Lapp CW, Komaroff AL, Nath A, et al. (December 2016).

2846:

Myalgische Enzephalomyelitis / Chronic Fatigue Syndrome (ME/CFS): Aktueller Kenntnisstand

2053: 1987: 1946: 1527: 963:

is reduced compared to healthy controls. Women with ME/CFS are more likely to experience

948: 905: 760: 732: 547: 441: 6202:"Dismissing Chronic Illness: A Qualitative Analysis of Negative Health Care Experiences" 6153:"Rethinking the Standard of Care for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome" 5390: 5363: 5225: 5200: 4633: 4608: 4473: 4358: 4331: 4207: 4180: 4123: 4096: 4038:"CDC Grand Rounds: Chronic Fatigue Syndrome – Advancing Research and Clinical Education" 3991: 3525: 3325:

Hussein S, Eiriksson L, MacQuarrie M, Merriam S, Dalton M, Stein E, et al. (2024).

2660: 2633: 8181: 8166: 8154: 7904: 7855: 7692: 7555: 7443: 7109: 6962: 6937: 6888: 6834: 6810:"Gender Disparity in the Funding of Diseases by the U.S. National Institutes of Health" 6809: 6757: 6696: 6669: 6535: 6480: 6453: 6419: 6354: 6329: 6226: 6201: 6177: 6152: 6093: 6068: 5979: 5933: 5873: 5821: 5796: 5729: 5704: 5576: 5527: 5502: 5478: 5453: 5329: 5277: 5252: 5102: 5018: 4969: 4923: 4869: 4842: 4733: 4706: 4705:

Eaton-Fitch N, du Preez S, Cabanas H, Staines D, Marshall-Gradisnik S (November 2019).

4682: 4657: 4584: 4557: 4492: 4435: 4312: 4258: 4231: 4008: 3975: 3850: 3693: 3609: 3555: 3484: 3457: 3406: 3299: 3264: 3205: 3180: 3081: 3056: 3028: 2851:

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): current state of knowledge

2767: 2605: 2498: 2473: 2199: 2190:

size of studies. In addition, drug companies have invested very little in the disease.

1784: 1698: 1555: 1475: 678: 613: 500: 469: 403:(dizziness or nausea when upright) or other physical symptoms may be present (see also 120: 7106: 5720: 5626:

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in Adults: United States, 2021–2022

1823:

can be used. Those with severe ME/CFS may have significant trouble getting nutrition.

595:

of individuals with ME/CFS, showing it to be lower than in 20 other chronic conditions

7944: 7910: 7882: 7873: 7805: 7781: 7648: 7496: 7315: 7126: 6998: 6987:"Chapter 14: Synthetic agonists of Toll-like receptors and therapeutic applications." 6967: 6892: 6880: 6839: 6761: 6749: 6701: 6539: 6527: 6485: 6423: 6411: 6359: 6310: 6266: 6231: 6182: 6133: 6098: 6018: 5983: 5971: 5925: 5877: 5865: 5826: 5763: 5734: 5643: 5580: 5568: 5532: 5483: 5395: 5321: 5282: 5230: 5107: 5010: 4974: 4927: 4915: 4874: 4823: 4782: 4738: 4687: 4638: 4589: 4538: 4497: 4363: 4316: 4304: 4263: 4212: 4128: 4062: 4013: 3905: 3895: 3854: 3842: 3697: 3685: 3613: 3601: 3559: 3547: 3489: 3456:

Shan ZY, Barnden LR, Kwiatek RA, Bhuta S, Hermens DF, Lagopoulos J (September 2020).

3433: 3410: 3398: 3352: 3344: 3304: 3286: 3210: 3152: 3086: 3032: 3020: 2862: 2772: 2665: 2609: 2597: 2503: 2330: 2320: 2135: 2110: 2106: 2072: 1958: 1936: 1901: 1592: 888: 869: 790: 259: 242:

The cause of the disease is unknown. ME/CFS often starts after an infection, such as

216: 199: 175: 79: 6953: 6610: 6262: 5937: 5333: 4439: 2916: 2251:, was studied and found to be ineffective. Another option targeting autoimmunity is 1640:, or managing one's activities to stay within energy limits, can reduce episodes of 1603:, loss of interest, and/or guilt, and the absence of ME/CFS bodily symptoms such as 1382:

Multiple research and clinical criteria exist to diagnose ME/CFS. These include the

8067: 7938: 7933: 7718: 7713: 7273: 7177: 6957: 6949: 6936:

Richman S, Morris MC, Broderick G, Craddock TJ, Klimas NG, Fletcher MA (May 2019).

6870: 6829: 6821: 6739: 6691: 6681: 6519: 6475: 6465: 6401: 6393: 6349: 6341: 6300: 6258: 6221: 6213: 6172: 6164: 6125: 6088: 6080: 6010: 5963: 5917: 5857: 5816: 5808: 5724: 5716: 5633: 5560: 5522: 5514: 5473: 5469: 5465: 5385: 5375: 5313: 5272: 5264: 5251:

O'Connor K, Sunnquist M, Nicholson L, Jason LA, Newton JL, Strand EB (March 2019).

5220: 5212: 5097: 5087: 5022: 5002: 4964: 4954: 4905: 4864: 4854: 4813: 4772: 4728: 4718: 4677: 4669: 4628: 4620: 4579: 4569: 4528: 4487: 4477: 4427: 4353: 4343: 4294: 4253: 4243: 4202: 4192: 4118: 4108: 4052: 4003: 3995: 3834: 3677: 3591: 3537: 3529: 3479: 3469: 3388: 3334: 3294: 3276: 3200: 3192: 3142: 3076: 3068: 3010: 2762: 2752: 2655: 2645: 2587: 2493: 2485: 2252: 2228: 2109:

are high, especially in those without a supportive care network. ME/CFS interrupts

2102: 1912:

found that 1.3% of adults in the United States, or 3.3 million, had ME/CFS.

1649: 1580:(EDS). Unlike ME/CFS, EDS is present from birth. People with ME/CFS are more often 1467: 821: 663:

risks due to poorer nutrition, lower healthcare access, and increased work stress.

583:

With very severe ME/CFS, people are mostly bedbound and cannot care for themselves.

528: 426:

The hallmark feature of ME/CFS is a worsening of symptoms after exertion, known as

371:

A 2015 report from the US Institute of Medicine recommended the illness be renamed

108: 6523: 6305: 6288: 6217: 6014: 5861: 4910: 4893: 4431: 3838: 3393: 3376: 2632:

Maksoud R, Magawa C, Eaton-Fitch N, Thapaliya K, Marshall-Gradisnik S (May 2023).

1486:

may come back positive, but below the levels that suggest the individual may have

809:

levels, which are signs of neuroinflammation. More direct evidence from two small

8323: 7989: 7680: 7120: 5501:

Geraghty K, Jason L, Sunnquist M, Tuller D, Blease C, Adeniji C (23 April 2019).

5317: 4818: 4801: 4777: 4760: 4533: 4516: 4482: 4457: 3147: 3130: 3015: 2998: 2592: 2575: 2139: 1897:

Canadian Consensus Criteria for ME/CFS produced a prevalence rate of only 0.17%.

1876: 1563: 1543: 980: 968: 841: 693: 659: 592: 454: 302: 6345: 5812: 4673: 3792: 3666:"Using Data Mining and Time Series to Investigate ME and CFS Naming Preferences" 2576:"Diagnosis and Management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome" 2309:

Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness

57:

Post-viral fatigue syndrome (PVFS), systemic exertion intolerance disease (SEID)

8046: 7995: 7823: 7532: 7409: 7351: 7346: 7180: 6744: 6727: 6168: 5967: 5380: 5216: 5092: 5075: 4959: 4942: 4624: 4348: 4299: 4282: 4197: 4113: 3999: 3596: 3579: 3474: 3196: 2757: 2740: 2650: 1888: 1842:. Regular repositioning is important to keep their joints flexible and prevent 1839: 1808: 1773: 1631: 1523: 1420: 960: 956: 919:, the primary energy carrier in cells, is likely more frequently produced from 801:

regions of the brain. Individuals with ME/CFS, for instance, have higher brain

634: 7131: 7076: 6686: 6470: 5921: 5006: 4723: 4248: 4157: 3681: 3281: 971:, and other menstrual irregularities compared to women without the condition. 8333: 8072: 8024: 7894: 7663: 7619: 7470: 7341: 6531: 6314: 6129: 6022: 5869: 5564: 5518: 5268: 4919: 4574: 4281:

Altmann DM, Whettlock EM, Liu S, Arachchillage DJ, Boyton RJ (October 2023).

4057: 3846: 3799: 3689: 3402: 3348: 3290: 2866: 2489: 2439: 1975: 1969: 1769: 1645: 1450: 964: 912: 833: 825: 798: 756: 721: 682: 617: 607:

Individuals with ME/CFS have decreased quality of life when evaluated by the

481: 473: 232: 92: 6571: 3533: 2071:

are moderately effective. The trial drew heavy criticism. The study authors

1595:, depression and anxiety co-occur frequently with ME/CFS. Depression may be 317:

share many symptoms with ME/CFS and are suspected to have a similar cause.

7568: 7438: 7421: 6971: 6884: 6843: 6753: 6705: 6489: 6415: 6363: 6270: 6235: 6186: 6137: 6102: 5975: 5929: 5830: 5738: 5647: 5572: 5536: 5487: 5399: 5325: 5286: 5234: 5111: 5014: 4978: 4878: 4827: 4786: 4742: 4691: 4642: 4593: 4542: 4501: 4367: 4308: 4267: 4216: 4132: 4066: 4017: 3909: 3605: 3551: 3493: 3356: 3308: 3214: 3156: 3090: 3024: 2776: 2669: 2601: 2507: 2334: 2240: 1965: 1904:. It is likely that numbers have increased as a large share of people with 1852: 1847: 1828: 1757: 1678: 1659: 1570: 1515: 928: 865: 794: 764: 543: 516: 445:

Typical timeframes of post-exertional malaise after normal daily activities

357: 298: 84: 6825: 5638: 5301: 3072: 320:

Many names have been proposed for the illness. The most commonly used are

7527: 7488: 7430: 7202: 7197: 7161: 6377:

O'Dwyer S, Boothby S, Smith G, Biddle L, Muirhead N, Khot S (July 2022).

6200:

McManimen S, McClellan D, Stoothoff J, Gleason K, Jason LA (March 2019).

6084: 5795:

Brurberg KG, Fønhus MS, Larun L, Flottorp S, Malterud K (February 2014).

3129:

Annesley SJ, Missailidis D, Heng B, Josev EK, Armstrong CW (March 2024).

2694: 1950: 1843: 1753: 1748:

Pain is initially managed with over-the-counter pain medication, such as

1585: 1576:

Another common condition that often co-occurs with ME/CFS is hypermobile

802: 621: 458: 161: 129: 112: 31: 6406: 6289:"A Systematic Scoping Review of How People with ME/CFS Use the Internet" 5039: 3542: 2160: 1431: 587: 63: 7638: 7508: 7283: 7186: 6875: 6858: 4859: 3794:

BMJ Best Practice: Myalgic Encephalomyelitis (Chronic Fatigue Syndrome)

2064: 2045: 1924: 1920: 1905: 1816: 1812: 1804: 1762: 1742: 1551: 924: 901: 752: 736: 725: 717: 697: 689: 555: 551: 524: 496: 310: 263: 104: 7253: 7044: 6397: 6038:"Retrovirus No Longer Thought to Be Cause of Chronic Fatigue Syndrome" 4656:

Nelson MJ, Bahl JS, Buckley JD, Thomson RL, Davison K (October 2019).

3339: 3326: 7748: 7699: 7687: 7670: 7602: 7172: 7137: 7086: 6775: 3789: 2244: 1864: 1749: 1738: 1600: 1539: 1511: 1399: 829: 814: 776: 696:, or an acute "flu-like illness". Between 15% and 50% of people with 477: 224: 100: 5755:

Emerging Illnesses and Society: Negotiating the Public Health Agenda

1964:

In 1970, two UK psychiatrists proposed that these ME outbreaks were

8223:

Spinal muscular atrophy with lower extremity predominance (SMALED)

7928: 7920: 7886: 7740: 7643: 7299: 7211: 5250: 4754: 4752: 4455: 3429: 2232: 2138:

in the 1980s, which also sought to combat underfunding and stigma.

2057: 1780: 1655: 1626:

coordinator can help provide access to community resources such as

1519: 1491: 858: 832:, a phase of sleep characterised by rapid eye movement. Changes to 817:, a type of immune cell in the brain, were contradictory, however. 532: 420: 167: 6199: 7407: 7142: 6667: 5452:

Larun L, Brurberg KG, Odgaard-Jensen J, Price JR (October 2019).

4758: 4704: 3973: 3790:

Baraniuk JN, Marshall-Gradisnik S, Eaton-Fitch N (January 2024).

3324: 3050: 3048: 3046: 3044: 3042: 2739:

Lim EJ, Ahn YC, Jang ES, Lee SW, Lee SH, Son CG (February 2020).

2631: 1820: 1667: 1531: 1490:. C-reactive protein levels are often at the high end of normal. 880:. Problems with these receptors can lead to impaired blood flow. 806: 645: 520: 416: 309:(PAIS) or an infection-associated chronic illness. PAISs such as 220: 5451: 4749: 4280: 4179:

Hwang JH, Lee JS, Oh HM, Lee EJ, Lim EJ, Son CG (October 2023).

4094: 2859:

Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen

2440:"Symptoms of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome" 2255:, which removes a large set of (auto)antibodies from the blood. 1838:

Patients who cannot move easily in bed may need help to prevent

700:

also meet the diagnostic criteria for ME/CFS. Of people who get

681:. How viral infections cause ME/CFS is unclear; it could be via 7967: 7708: 7675: 7071: 7056: 4940: 4606: 2248: 1788: 1495: 979:

Diagnosis of ME/CFS is based on symptoms and involves taking a

854: 435: 337: 228: 6935: 5361: 5300:

Goudsmit EM, Nijs J, Jason LA, Wallman KE (19 December 2011).

4555: 4383:

Report of the ME/CFS Research Roadmap Working Group of Council

4229: 3884: 3039: 1438:

handout from the US Centers for Disease Control and Prevention

6376: 6327: 5624:

Vahratian A, Lin JS, Bertolli J, Unger ER (8 December 2023).

3511: 1942: 1566:, and side effects of medications may also explain symptoms. 1487: 920: 608: 247: 34:, a symptom experienced in many chronic illnesses, including 5500: 4793: 3181:"Long COVID: Major Findings, Mechanisms and Recommendations" 3128: 531:(related to disorders of the nervous system). Headaches and 5794: 5412: 3577: 2695:"Manage Myalgic Encephalomyelitis/Chronic Fatigue Syndrome" 2005:

report, which gave recommendations on research priorities.

1954: 1892:

Incidence rates by age and sex, from a 2014 study in Norway

641: 6630: 6628: 6286: 3507: 3505: 3503: 2996: 1682:

A heart rate monitor can be helpful for energy management.

1666:. The debilitating nature of ME/CFS can cause depression, 951:

under orthostatic stress (as found in a tilt table test),

6725: 6287:

Shortland D, Fazil Q, Lavis A, Hallett N (4 April 2024).

5623: 3374: 6726:

Toogood PL, Clauw DJ, Phadke S, Hoffman D (March 2021).

5299: 5198: 4655: 4329: 3179:

Davis HE, McCorkell L, Vogel JM, Topol EJ (March 2023).

3178: 395:

ME/CFS causes debilitating fatigue, sleep problems, and

6857:

Mirin AA, Dimmock ME, Jason LA (2020). Mooney A (ed.).

6625: 6150: 3500: 3455: 2574:

Grach SL, Seltzer J, Chon TY, Ganesh R (October 2023).

820:

ME/CFS affects sleep. Individuals experience decreased

6451: 3578:

Choutka J, Jansari V, Hornig M, Iwasaki A (May 2022).

2573: 999:

ME/CFS symptoms according to five diagnostic criteria

731:

Reactivation of latent viruses, in particular EBV and

415:

People with ME/CFS experience persistent debilitating

8307: 6642:. UK CFS/ME Research Collaborative and ÜberResearch. 5595:"ME/CFS Clinical Care for Severely Affected Patients" 4330:

Ruiz-Pablos M, Paiva B, Zabaleta A (September 2023).

3939: 3937: 3935: 3933: 3931: 3785: 3783: 3781: 3779: 3777: 3775: 3773: 3771: 3769: 3767: 3765: 3763: 3761: 3759: 3757: 3755: 3753: 3751: 3749: 3747: 3745: 3743: 3741: 3739: 2152:, who had an unidentified illness similar to ME/CFS. 71:

The four primary symptoms of ME/CFS according to the

7034: 6907:"Experts Launch World's Largest Genetic Study of ME" 5129:

Myalgic Encephalomyelitis (Chronic Fatigue Syndrome)

4556:

VanElzakker MB, Brumfield SA, Lara Mejia PS (2019).

3737: 3735: 3733: 3731: 3729: 3727: 3725: 3723: 3721: 3719: 3055:

Dibble JJ, McGrath SJ, Ponting CP (September 2020).

3054: 2911: 1908:

meet the diagnostic criteria of ME/CFS. A 2021–2022

939:

Some people with ME/CFS have abnormalities in their

305:

condition. The disease can further be regarded as a

5357: 5355: 4035: 3057:"Genetic Risk Factors of ME/CFS: A Critical Review" 2909: 2907: 2905: 2903: 2901: 2899: 2897: 2895: 2893: 2891: 872:. Some may have higher levels of autoantibodies to 8340:Myalgic encephalomyelitis/chronic fatigue syndrome 7255:Myalgic encephalomyelitis/chronic fatigue syndrome 7192:Myalgic encephalomyelitis/chronic fatigue syndrome 5549: 5413:Chou R, McDonagh M, Griffins J, Grusing S (2022). 5126: 4991: 4841:Lim EJ, Kang EB, Jang ES, Son CG (December 2020). 4799: 3928: 3791: 1599:by the presence of feelings of worthlessness, the 1463:, which tests the response to prolonged standing. 330:myalgic encephalomyelitis/chronic fatigue syndrome 209:Myalgic encephalomyelitis/chronic fatigue syndrome 49:Myalgic encephalomyelitis/chronic fatigue syndrome 6984: 6856: 6282: 6280: 5163:"Monitoring the Use of Medicines and Supplements" 3716: 2526:National Institute for Health and Care Excellence 2401:National Institute for Health and Care Excellence 278: 73:National Institute for Health and Care Excellence 8331: 6634: 6566: 6564: 6151:Friedberg F, Sunnquist M, Nacul L (March 2020). 5352: 5194: 5192: 5190: 5188: 5118: 3451: 3449: 3262: 3124: 3122: 3120: 2992: 2990: 2988: 2986: 2984: 2982: 2980: 2978: 2976: 2974: 2972: 2970: 2968: 2966: 2964: 2962: 2888: 900:Objective signs of PEM have been found with the 751:dysfunction and a change in brain structure and 455:sleeping during the day and being awake at night 348:Many individuals with ME/CFS object to the term 6721: 6719: 6717: 6715: 5949: 5947: 5903: 5901: 5899: 5788: 5454:"Exercise Therapy for Chronic Fatigue Syndrome" 4031: 4029: 4027: 3573: 3571: 3569: 3320: 3318: 3228: 3226: 3224: 3118: 3116: 3114: 3112: 3110: 3108: 3106: 3104: 3102: 3100: 2960: 2958: 2956: 2954: 2952: 2950: 2948: 2946: 2944: 2942: 2689: 2687: 2685: 2683: 2681: 2679: 2569: 2567: 2235:, is currently underway in the United Kingdom. 1831:may be necessary to address this or to address 1673: 6277: 6193: 5907: 5034: 5032: 4891: 4840: 4451: 4449: 3880: 3878: 3876: 3874: 3872: 3870: 3868: 3866: 3864: 3659: 3657: 3256: 2838: 2836: 2834: 2832: 2830: 2828: 2826: 2824: 2822: 2820: 2818: 2816: 2814: 2812: 2810: 2808: 2806: 2627: 2625: 2623: 2621: 2619: 2565: 2563: 2561: 2559: 2557: 2555: 2553: 2551: 2549: 2547: 2467: 2465: 7393: 7239: 6803: 6801: 6594: 6561: 5494: 5185: 4985: 4885: 4380: 4178: 3945:"Strategies to Prevent Worsening of Symptoms" 3446: 3370: 3368: 3366: 3174: 3172: 3170: 3168: 3166: 2804: 2802: 2800: 2798: 2796: 2794: 2792: 2790: 2788: 2786: 2738: 2471: 2130:The blue ribbon is used for ME/CFS awareness. 2095: 2067:, concluded that graded exercise therapy and 1550:, as well as neurological disorders, such as 542:or other problems with digestion, chills and 461:(excessive sleepiness), or vivid nightmares. 272:controversies around the cause and treatments 6712: 6321: 6242: 6144: 6109: 6060: 5944: 5896: 5745: 5293: 5246: 5244: 4834: 4698: 4649: 4600: 4508: 4323: 4274: 4223: 4172: 4088: 4024: 3967: 3824: 3580:"Unexplained Post-Acute Infection Syndromes" 3566: 3315: 3221: 3097: 2939: 2676: 2434: 2432: 2430: 2428: 2426: 2424: 2422: 1494:levels may be useful to test, as borderline 8112: 6978: 6929: 6512:Fatigue: Biomedicine, Health & Behavior 6293:Fatigue: Biomedicine, Health & Behavior 6066: 6003:Fatigue: Biomedicine, Health & Behavior 5953: 5850:Fatigue: Biomedicine, Health & Behavior 5458:The Cochrane Database of Systematic Reviews 5069: 5067: 5065: 5029: 4898:Fatigue: Biomedicine, Health & Behavior 4446: 4420:Fatigue: Biomedicine, Health & Behavior 4045:MMWR. Morbidity and Mortality Weekly Report 3861: 3827:Fatigue: Biomedicine, Health & Behavior 3663: 3654: 3632:ICD-11 – Mortality and Morbidity Statistics 3381:Fatigue: Biomedicine, Health & Behavior 2616: 2544: 2462: 2391: 2389: 2387: 2385: 2383: 2381: 2379: 2082: 507:, a drop in blood pressure after standing. 503:. Additionally, individuals may experience 291:(WHO) since 1969, initially under the name 7400: 7386: 7246: 7232: 6985:Agrawal S, Kandimalla ER (February 2019). 6798: 6607:US Department of Health and Human Services 6576:Centers for Disease Control and Prevention 6502: 5678:Centers for Disease Control and Prevention 5599:Centers for Disease Control and Prevention 5543: 5424:Centers for Disease Control and Prevention 5167:Centers for Disease Control and Prevention 5044:Centers for Disease Control and Prevention 4934: 4514: 4154:Centers for Disease Control and Prevention 3949:Centers for Disease Control and Prevention 3363: 3331:Journal of Evaluation in Clinical Practice 3238:Centers for Disease Control and Prevention 3163: 2921:Centers for Disease Control and Prevention 2783: 2699:Centers for Disease Control and Prevention 2444:Centers for Disease Control and Prevention 2377: 2375: 2373: 2371: 2369: 2367: 2365: 2363: 2361: 2359: 2301: 2299: 2297: 2021:relating to ME support in South East Wales 1735:cognitive behavioural therapy for insomnia 1662:, irritable bowel syndrome, migraines and 1518:, and neuroendocrine disorders, including 1403:IOM and NICE criteria fall in the middle. 62: 6961: 6874: 6833: 6743: 6695: 6685: 6479: 6469: 6405: 6353: 6304: 6225: 6176: 6092: 5843: 5820: 5728: 5637: 5526: 5477: 5406: 5389: 5379: 5276: 5241: 5224: 5101: 5091: 4968: 4958: 4909: 4868: 4858: 4817: 4776: 4732: 4722: 4681: 4632: 4583: 4573: 4532: 4491: 4481: 4357: 4347: 4298: 4257: 4247: 4206: 4196: 4122: 4112: 4056: 4007: 3595: 3541: 3483: 3473: 3392: 3338: 3298: 3280: 3204: 3146: 3080: 3014: 2766: 2756: 2734: 2732: 2730: 2728: 2726: 2724: 2722: 2720: 2659: 2649: 2591: 2497: 2419: 2295: 2293: 2291: 2289: 2287: 2285: 2283: 2281: 2279: 2277: 2164:Graph of ME/CFS papers published by year: 1990:in 1994, which became widely referenced. 1501: 493:postural orthostatic tachycardia syndrome 219:. People with ME/CFS experience profound 6115: 5996: 5445: 5124: 5062: 4515:Lee JS, Sato W, Son CG (November 2023). 2175: Papers whose title mentions ME/CFS 2159: 2125: 2012: 1887: 1677: 1609:idiopathic (unexplained) chronic fatigue 1430: 887: 586: 510: 440: 404: 5751: 4417: 4411: 3885:National Guideline Centre (UK) (2021). 3664:Bhatia S, Jason LA (24 February 2023). 3423: 3263:Boulazreg, S, Rokach A (17 July 2020). 2472:Collard SS, Murphy J (September 2020). 2356: 1795:can help with orthostatic intolerance. 1701:may help some individuals with pacing. 838:blunted heart rate response to exercise 499:after standing up, which can result in 14: 8332: 8189:Distal hereditary motor neuronopathies 7862:Template:Demyelinating diseases of CNS 6035: 5073: 4800:Wirth K, Scheibenbogen C (June 2020). 2717: 2274: 2008: 1644:. Addressing sleep problems with good 1426: 987: 7381: 7227: 6991:Advances in Nucleic Acid Therapeutics 6807: 6786:from the original on 28 November 2023 6248: 6048:from the original on 22 February 2024 5702: 5654:from the original on 17 February 2024 5630:National Center for Health Statistics 4892:Franklin JD, Graham M (3 July 2022). 4144: 4142: 3916:from the original on 19 February 2024 3806:from the original on 19 February 2024 3620: 2073:weakened their definition of recovery 2052:. Some with the illness began taking 1498:can make some ME/CFS symptoms worse. 959:entering the blood. The diversity of 390: 373:systemic exertion intolerance disease 364:would retain the better-known phrase 8040:Idiopathic intracranial hypertension 7429: 6917:from the original on 20 January 2023 6649:from the original on 4 February 2024 6157:Journal of General Internal Medicine 6067:Johnson AD, Cohn CS (October 2016). 5884:from the original on 4 February 2024 4101:Frontiers in Rehabilitation Sciences 3704:from the original on 6 November 2023 3670:Journal of Disability Policy Studies 3240:(CDC). 21 March 2023. Archived from 2876:from the original on 2 November 2023 2407:from the original on 8 February 2024 2344:from the original on 20 January 2017 1584:compared to the general population. 1421:anxiety related to school attendance 487:People with ME/CFS often experience 432:post-exertional symptom exacerbation 315:post-treatment Lyme disease syndrome 6600: 6503:Jason LA, Mirin AA (January 2021). 6206:Health Care for Women International 5143:from the original on 9 October 2023 4381:Bateman L, Hanson M (15 May 2024). 4076:from the original on 6 January 2017 2041:, or an "illness-without-disease". 955:, and an increase in the amount of 941:hypothalamic–pituitary–adrenal axis 902:2-day cardiopulmonary exercise test 840:, but a higher heart rate during a 666: 561: 538:Additional common symptoms include 126:Worsening of symptoms with activity 24: 8271:Infantile progressive bulbar palsy 6549:from the original on 15 March 2023 5680:(CDC). 31 May 2024. Archived from 5169:(CDC). 10 May 2024. Archived from 4156:(CDC). 10 May 2024. Archived from 4139: 3642:from the original on 1 August 2018 2198:between 2015 and 2019. Worldwide, 2146:ME/CFS International Awareness Day 2017:Presentation of a petition to the 1714:activities that they can tolerate. 1459:also be assessed with the simpler 874:muscarinic acetylcholine receptors 742: 476:. There may also be problems with 140:Peaks at 10–19 and 30–39 years old 25: 8366: 7974:Template:Cerebrovascular diseases 7777:Frontotemporal lobar degeneration 7030: 6674:Journal of Translational Medicine 6433:from the original on 6 March 2024 5368:Journal of Translational Medicine 5340:from the original on 28 July 2020 5080:Journal of Translational Medicine 4947:Journal of Translational Medicine 4336:Journal of Translational Medicine 4236:Journal of Translational Medicine 4185:Journal of Translational Medicine 3628:"8E49 Postviral Fatigue Syndrome" 3462:Journal of Translational Medicine 2745:Journal of Translational Medicine 2532:from the original on 4 April 2024 2169: Papers mentioning ME or CFS 1728: 1514:, such as Epstein–Barr virus and 1472:red blood cell sedimentation rate 495:(POTS), an excessive increase in 301:, ME/CFS is sometimes labelled a 246:. It can run in families, but no 8317: 7994:For more detailed coverage, see 7972:For more detailed coverage, see 7943:For more detailed coverage, see 7909:For more detailed coverage, see 7860:For more detailed coverage, see 7011:from the original on 14 May 2022 6989:. In Agrawal S, Gait MJ (eds.). 6582:from the original on 17 May 2024 5776:from the original on 18 May 2023 5605:from the original on 28 May 2024 5050:from the original on 17 May 2024 4399:from the original on 22 May 2024 3955:from the original on 18 May 2024 2927:from the original on 17 May 2024 2705:from the original on 18 May 2024 2450:from the original on 17 May 2024 1798: 1697:worsening of symptoms. Use of a 1442:Screening can be done using the 1423:, which could explain symptoms. 847: 410: 342:post-infectious fatigue syndrome 294:benign myalgic encephalomyelitis 283:ME/CFS has been classified as a 6954:10.1016/j.clinthera.2019.02.011 6899: 6850: 6768: 6661: 6635:Radford G, Chowdhury S (2016). 6496: 6445: 6370: 6263:10.1016/j.socscimed.2005.06.018 6029: 5990: 5837: 5696: 5666: 5617: 5587: 5155: 4549: 4374: 3818: 3417: 2032:Controversies related to ME/CFS 1945:. A 1950s outbreak at London's 1883: 994:Clinical descriptions of ME/CFS 770: 652: 644:. Bacterial infections such as 356:(myalgia means muscle pain and 5844:Friedberg F (2 January 2020). 5760:Johns Hopkins University Press 5470:10.1002/14651858.CD003200.pub8 5205:Wiener Klinische Wochenschrift 4283:"The Immunology of Long COVID" 2514: 2025: 279:Classification and terminology 13: 1: 8287:Amyotrophic lateral sclerosis 8172:Hereditary spastic paraplegia 8030:Normal pressure hydrocephalus 7367:Whittemore Peterson Institute 6780:National Institutes of Health 6524:10.1080/21641846.2021.1878716 6306:10.1080/21641846.2024.2303887 6251:Social Science & Medicine 6218:10.1080/07399332.2018.1521811 6073:Clinical Microbiology Reviews 6015:10.1080/21641846.2020.1834295 5910:Journal of Bioethical Inquiry 5862:10.1080/21641846.2020.1718292 5721:10.1016/s0140-6736(61)92893-8 5306:Disability and Rehabilitation 4911:10.1080/21641846.2022.2108628 4432:10.1080/21641846.2018.1503125 4390:National Institutes of Health 3839:10.1080/21641846.2020.1757809 3394:10.1080/21641846.2022.2124775 2917:"Clinical Overview of ME/CFS" 2267: 2258: 2217: 1999:National Institutes of Health 1723:cognitive behavioural therapy 1664:mast cell activation syndrome 1614: 828:, and take longer to achieve 763:function and, in some cases, 673:Post-acute infection syndrome 307:post-acute infection syndrome 115:, other specialists in ME/CFS 8256:Progressive muscular atrophy 6118:Journal of Health Psychology 5553:Journal of Health Psychology 5318:10.3109/09638288.2011.635746 5125:Baraniuk JN (January 2022). 5074:Lim EJ, Son CG (July 2020). 4847:Journal of Clinical Medicine 4819:10.1016/j.autrev.2020.102527 4778:10.1016/j.autrev.2018.01.009 4534:10.1016/j.autrev.2023.103484 4483:10.1371/journal.pone.0232475 3185:Nature Reviews. Microbiology 3148:10.1016/j.molmed.2024.02.003 3135:Trends in Molecular Medicine 3016:10.1016/j.mayocp.2021.07.004 2593:10.1016/j.mayocp.2023.07.032 2478:Journal of Child Health Care 1858: 1674:Pacing and energy management 1562:. Finally, sleep disorders, 1444:DePaul Symptom Questionnaire 1363:Susceptibility to infection 974: 7: 8355:Syndromes of unknown causes 7766:Primary progressive aphasia 6346:10.1136/bmjopen-2016-012633 5813:10.1136/bmjopen-2013-003973 5705:"Myalgic Encephalomyelitis" 4674:10.1097/MD.0000000000017600 2155: 2121: 2019:National Assembly for Wales 1959:nervous system inflammation 1480:thyroid-stimulating hormone 943:hormones. This can include 894:unexplained chronic fatigue 10: 8371: 8088:Hashimoto's encephalopathy 7794:Posterior cortical atrophy 7615:Striatonigral degeneration 7466:Cavernous sinus thrombosis 6997:. pp. 306–338 (310). 6995:Royal Society of Chemistry 6745:10.1016/j.phrs.2021.105465 6169:10.1007/s11606-019-05375-y 5997:Geraghty K (2 July 2020). 5968:10.1136/medhum-2019-011743 5381:10.1186/s12967-023-04587-5 5217:10.1007/s00508-024-02372-y 5093:10.1186/s12967-020-02455-0 4960:10.1186/s12967-020-02452-3 4625:10.1016/j.smrv.2023.101771 4349:10.1186/s12967-023-04515-7 4300:10.1038/s41577-023-00904-7 4287:Nature Reviews. Immunology 4198:10.1186/s12967-023-04635-0 4114:10.3389/fresc.2023.1122673 4000:10.1038/s41598-021-04764-w 3597:10.1038/s41591-022-01810-6 3475:10.1186/s12967-020-02506-6 3197:10.1038/s41579-022-00846-2 2758:10.1186/s12967-020-02269-0 2651:10.1186/s12916-023-02893-9 2184: 2096:Economic and social impact 2056:targeted specifically for 2029: 1934: 1930: 1745:, may help in ME/CFS too. 1618: 1601:inability to feel pleasure 1560:craniocervical instability 991: 868:, possibly as a result of 826:take longer to fall asleep 755:. Observed changes in the 670: 591:Results of a study on the 575:activities of daily living 573:Moderate severity impedes 405:§ Diagnostic criteria 198:About 0.17% to 0.89% (pre- 36:idiopathic chronic fatigue 29: 8194:Spinal muscular atrophies 8162:Primary lateral sclerosis 8144: 8121: 8105: 8060: 8020:Intracranial hypertension 8010: 7982: 7953: 7919: 7881: 7870: 7836: 7814: 7800:Creutzfeldt–Jakob disease 7739: 7549: 7540: 7526: 7486: 7420: 7334: 7308: 7292: 7261: 7152: 7038: 6814:Journal of Women's Health 6687:10.1186/s12967-017-1263-z 6471:10.3390/healthcare8020088 5922:10.1007/s11673-018-9866-5 5007:10.1007/s12035-016-0170-2 4724:10.1186/s13643-019-1202-6 4249:10.1186/s12967-018-1644-y 3682:10.1177/10442073231154027 3636:World Health Organization 3282:10.3390/healthcare8040413 2528:(NICE). 29 October 2021. 2403:(NICE). 29 October 2021. 883: 704:, which is caused by the 627: 354:myalgic encephalomyelitis 326:myalgic encephalomyelitis 289:World Health Organization 194: 184: 174: 160: 152: 144: 136: 119: 78: 70: 61: 53: 48: 27:Chronic medical condition 8261:Progressive bulbar palsy 8052:Intracranial hypotension 8035:Choroid plexus papilloma 7449:Herpesviral encephalitis 7357:Open Medicine Foundation 6732:Pharmacological Research 6130:10.1177/1359105317714486 5565:10.1177/1359105319847261 5519:10.1177/2055102919838907 5269:10.1177/1742395317746470 4575:10.3389/fneur.2018.01033 4058:10.15585/mmwr.mm655051a4 3061:Human Molecular Genetics 2490:10.1177/1367493519864747 2317:National Academies Press 2083:Doctor–patient relations 1875:The effect of ME/CFS on 1597:differentially diagnosed 1546:, such as depression or 1461:NASA 10-minute lean test 1321:Cardiovascular problems 1252:Orthostatic intolerance 934: 749:autonomic nervous system 702:infectious mononucleosis 540:irritable bowel syndrome 438:, and sleep problems. 350:chronic fatigue syndrome 328:, and the umbrella term 322:chronic fatigue syndrome 237:worsening of the illness 132:, sleep problems, others 30:Not to be confused with 8345:Immune system disorders 7773:Frontotemporal dementia 7459:Encephalitis lethargica 7362:Solve ME/CFS Initiative 7279:Post-exertional malaise 5703:Price JL (April 1961). 5513:(1): 2055102919838907. 3534:10.1126/science.abo1261 3003:Mayo Clinic Proceedings 2580:Mayo Clinic Proceedings 2247:, a drug that depletes 2225:electrical measurements 2077:clinical trial protocol 1719:Graded exercise therapy 1656:Co-occurring conditions 949:blood flow to the brain 878:β2 adrenergic receptors 716:(the virus that causes 554:. Some experience sore 505:orthostatic hypotension 489:orthostatic intolerance 428:post-exertional malaise 401:orthostatic intolerance 397:post-exertional malaise 89:rehabilitation medicine 8350:Neurological disorders 8078:Hepatic encephalopathy 7021:14.2: Agonists of TLR3 6808:Mirin AA (July 2021). 6776:"Grants & Funding" 6572:"ME/CFS Awareness Day" 6036:Westly E (June 2011). 5507:Health Psychology Open 4995:Molecular Neurobiology 4613:Sleep Medicine Reviews 4562:Frontiers in Neurology 2196:healthy life year lost 2177: 2131: 2022: 2003:Pathways to Prevention 1968:phenomena, suggesting 1893: 1833:electrolyte imbalances 1807:, disability parking, 1716: 1683: 1578:Ehlers–Danlos syndrome 1548:substance use disorder 1502:Differential diagnosis 1484:antinuclear antibodies 1439: 1436:Could You Have ME/CFS? 1080:Functional impairment 953:small-fibre neuropathy 911:Studies have observed 897: 785:neurovascular coupling 781:serotonin transporters 596: 446: 8136:Ataxia–telangiectasia 8093:Static encephalopathy 7816:Mitochondrial disease 7654:Spasmodic torticollis 7564:Basal ganglia disease 7269:Clinical descriptions 6942:Clinical Therapeutics 6913:. 12 September 2022. 6826:10.1089/jwh.2020.8682 6601:Lee N (12 May 2012). 5136:. BMJ Best Practice. 2163: 2129: 2016: 1995:Institute of Medicine 1891: 1793:Compression stockings 1711: 1681: 1605:autonomic dysfunction 1434: 1388:Institute of Medicine 1276:Flu or cold symptoms 945:lower cortisol levels 891: 590: 511:Other common symptoms 465:Cognitive dysfunction 444: 8083:Toxic encephalopathy 7789:Lewy bodies dementia 6085:10.1128/CMR.00086-15 5674:"Fast Facts: ME/CFS" 5601:(CDC). 13 May 2024. 5211:(Suppl 5): 103–123. 5046:(CDC). 13 May 2024. 4806:Autoimmunity Reviews 4765:Autoimmunity Reviews 4521:Autoimmunity Reviews 4051:(50–51): 1434–1438. 3951:(CDC). 10 May 2024. 3800:BMJ Publishing Group 2923:(CDC). 10 May 2024. 2701:(CDC). 10 May 2024. 2446:(CDC). 10 May 2024. 2150:Florence Nightingale 2054:antiretroviral drugs 1628:occupational therapy 1621:Management of ME/CFS 1544:psychiatric diseases 1478:, blood glucose and 783:, and problems with 710:H1N1 influenza virus 285:neurological disease 256:Pacing of activities 8131:Friedreich's ataxia 7514:Meningoencephalitis 7454:Limbic encephalitis 7309:Society and history 6042:Scientific American 5752:Packard RM (2004). 5650:. NCHS Data Brief. 5639:10.15620/cdc:134504 5433:on 14 February 2024 5040:"Diagnosing ME/CFS" 4474:2020PLoSO..1532475M 3992:2022NatSR..12.2157A 3526:2022Sci...377.1150M 3520:(6611): 1150–1151. 3073:10.1093/hmg/ddaa169 2227:of blood cells and 2107:thoughts of suicide 2009:Society and culture 1988:diagnostic criteria 1947:Royal Free Hospital 1863:Information on the 1825:Intravenous feeding 1512:infectious diseases 1427:Clinical assessment 1342:Hypersensitivities 1000: 988:Diagnostic criteria 906:anaerobic threshold 761:natural killer cell 733:human herpesvirus 6 679:autoimmune diseases 552:irregular heartbeat 548:shortness of breath 8167:Pseudobulbar palsy 7905:Status epilepticus 7856:Multiple sclerosis 7693:Myoclonic epilepsy 7556:movement disorders 7502:Acute disseminated 7444:Viral encephalitis 7153:External resources 6876:10.3233/WOR-203173 5956:Medical Humanities 4860:10.3390/jcm9124040 4711:Systematic Reviews 3980:Scientific Reports 2200:multiple sclerosis 2178: 2140:Citizen scientists 2132: 2111:normal development 2023: 1894: 1699:heart rate monitor 1684: 1556:multiple sclerosis 1536:Sjögren's syndrome 1476:C-reactive protein 1440: 1226:Pain or headaches 998: 898: 759:include decreased 706:Epstein–Barr virus 614:multiple sclerosis 597: 447: 391:Signs and symptoms 170:, viral infections 97:infectious disease 8305: 8304: 8301: 8300: 8297: 8296: 8101: 8100: 8006: 8005: 7945:Template:Headache 7911:Template:Epilepsy 7832: 7831: 7806:Vascular dementia 7649:Status dystonicus 7522: 7521: 7497:Encephalomyelitis 7375: 7374: 7221: 7220: 7004:978-1-78801-732-9 6398:10.1136/bmj.o1691 5769:978-0-8018-7942-5 5715:(7180): 737–738. 5312:(13): 1140–1147. 3901:978-1-4731-4221-3 3439:978-0-323-85654-6 3340:10.1111/jep.14047 3067:(R1): R117–R124. 3009:(11): 2861–2878. 2586:(10): 1544–1551. 2326:978-0-309-31689-7 2253:immune adsorption 2103:socially isolated 1937:History of ME/CFS 1902:COVID-19 pandemic 1593:chronic illnesses 1380: 1379: 1194:Cognitive issues 791:Neuroinflammation 683:viral persistence 358:encephalomyelitis 260:COVID-19 pandemic 215:) is a disabling 206: 205: 200:COVID-19 pandemic 180:Based on symptoms 176:Diagnostic method 130:long-term fatigue 43:Medical condition 16:(Redirected from 8362: 8322: 8321: 8320: 8313: 8119: 8118: 8110: 8109: 8068:Brain herniation 7879: 7878: 7719:Intention tremor 7714:Essential tremor 7579:Postencephalitic 7547: 7546: 7538: 7537: 7427: 7426: 7408:Diseases of the 7402: 7395: 7388: 7379: 7378: 7326:Notable patients 7248: 7241: 7234: 7225: 7224: 7036: 7035: 7024: 7023: 7018: 7016: 6982: 6976: 6975: 6965: 6933: 6927: 6926: 6924: 6922: 6903: 6897: 6896: 6878: 6854: 6848: 6847: 6837: 6805: 6796: 6795: 6793: 6791: 6772: 6766: 6765: 6747: 6723: 6710: 6709: 6699: 6689: 6665: 6659: 6658: 6656: 6654: 6648: 6641: 6632: 6623: 6622: 6620: 6618: 6609:. Archived from 6598: 6592: 6591: 6589: 6587: 6568: 6559: 6558: 6556: 6554: 6548: 6509: 6500: 6494: 6493: 6483: 6473: 6449: 6443: 6442: 6440: 6438: 6432: 6409: 6383: 6374: 6368: 6367: 6357: 6325: 6319: 6318: 6308: 6284: 6275: 6274: 6246: 6240: 6239: 6229: 6197: 6191: 6190: 6180: 6148: 6142: 6141: 6124:(9): 1209–1216. 6113: 6107: 6106: 6096: 6064: 6058: 6057: 6055: 6053: 6033: 6027: 6026: 5994: 5988: 5987: 5951: 5942: 5941: 5905: 5894: 5893: 5891: 5889: 5841: 5835: 5834: 5824: 5792: 5786: 5785: 5783: 5781: 5749: 5743: 5742: 5732: 5700: 5694: 5693: 5691: 5689: 5670: 5664: 5663: 5661: 5659: 5641: 5632:. pp. 1–8. 5621: 5615: 5614: 5612: 5610: 5591: 5585: 5584: 5547: 5541: 5540: 5530: 5498: 5492: 5491: 5481: 5464:(10): CD003200. 5449: 5443: 5442: 5440: 5438: 5432: 5426:. Archived from 5421: 5410: 5404: 5403: 5393: 5383: 5359: 5350: 5349: 5347: 5345: 5297: 5291: 5290: 5280: 5248: 5239: 5238: 5228: 5196: 5183: 5182: 5180: 5178: 5159: 5153: 5152: 5150: 5148: 5142: 5135: 5132: 5122: 5116: 5115: 5105: 5095: 5071: 5060: 5059: 5057: 5055: 5036: 5027: 5026: 5001:(9): 6806–6819. 4989: 4983: 4982: 4972: 4962: 4938: 4932: 4931: 4913: 4889: 4883: 4882: 4872: 4862: 4838: 4832: 4831: 4821: 4797: 4791: 4790: 4780: 4756: 4747: 4746: 4736: 4726: 4702: 4696: 4695: 4685: 4653: 4647: 4646: 4636: 4604: 4598: 4597: 4587: 4577: 4553: 4547: 4546: 4536: 4512: 4506: 4505: 4495: 4485: 4453: 4444: 4443: 4415: 4409: 4408: 4406: 4404: 4398: 4387: 4378: 4372: 4371: 4361: 4351: 4327: 4321: 4320: 4302: 4278: 4272: 4271: 4261: 4251: 4227: 4221: 4220: 4210: 4200: 4176: 4170: 4169: 4167: 4165: 4146: 4137: 4136: 4126: 4116: 4092: 4086: 4085: 4083: 4081: 4075: 4060: 4042: 4033: 4022: 4021: 4011: 3971: 3965: 3964: 3962: 3960: 3941: 3926: 3925: 3923: 3921: 3893: 3882: 3859: 3858: 3822: 3816: 3815: 3813: 3811: 3797: 3787: 3714: 3713: 3711: 3709: 3661: 3652: 3651: 3649: 3647: 3624: 3618: 3617: 3599: 3575: 3564: 3563: 3545: 3509: 3498: 3497: 3487: 3477: 3453: 3444: 3443: 3428:(2nd ed.). 3421: 3415: 3414: 3396: 3372: 3361: 3360: 3342: 3322: 3313: 3312: 3302: 3284: 3260: 3254: 3253: 3251: 3249: 3230: 3219: 3218: 3208: 3176: 3161: 3160: 3150: 3126: 3095: 3094: 3084: 3052: 3037: 3036: 3018: 2994: 2937: 2936: 2934: 2932: 2913: 2886: 2885: 2883: 2881: 2875: 2856: 2840: 2781: 2780: 2770: 2760: 2736: 2715: 2714: 2712: 2710: 2691: 2674: 2673: 2663: 2653: 2629: 2614: 2613: 2595: 2571: 2542: 2541: 2539: 2537: 2518: 2512: 2511: 2501: 2469: 2460: 2459: 2457: 2455: 2436: 2417: 2416: 2414: 2412: 2393: 2354: 2353: 2351: 2349: 2343: 2314: 2303: 2229:Raman microscopy 2174: 2168: 2001:published their 1650:over-the-counter 1632:district nursing 1591:Like with other 1468:full blood count 1238: 1221: 1189: 1182: 1170: 1153: 1146: 1139: 1132: 1115: 1108: 1101: 1094: 1087: 1075: 1068: 1061: 1054: 1047: 1001: 997: 822:sleep efficiency 714:varicella zoster 667:Viral infections 562:Illness severity 529:neuropathic pain 109:general practice 66: 46: 45: 21: 8370: 8369: 8365: 8364: 8363: 8361: 8360: 8359: 8330: 8329: 8328: 8318: 8316: 8308: 8306: 8293: 8219:Congenital DSMA 8140: 8097: 8056: 8002: 7990:Sleep disorders 7978: 7955:Cerebrovascular 7949: 7915: 7872: 7866: 7828: 7810: 7735: 7681:Choreoathetosis 7554: 7531: 7518: 7482: 7416: 7406: 7376: 7371: 7330: 7304: 7288: 7257: 7252: 7222: 7217: 7216: 7148: 7147: 7047: 7033: 7028: 7027: 7014: 7012: 7005: 6983: 6979: 6934: 6930: 6920: 6918: 6905: 6904: 6900: 6855: 6851: 6806: 6799: 6789: 6787: 6774: 6773: 6769: 6724: 6713: 6666: 6662: 6652: 6650: 6646: 6639: 6633: 6626: 6616: 6614: 6599: 6595: 6585: 6583: 6578:. 10 May 2024. 6570: 6569: 6562: 6552: 6550: 6546: 6507: 6501: 6497: 6450: 6446: 6436: 6434: 6430: 6381: 6375: 6371: 6326: 6322: 6285: 6278: 6247: 6243: 6198: 6194: 6149: 6145: 6114: 6110: 6065: 6061: 6051: 6049: 6034: 6030: 5995: 5991: 5952: 5945: 5906: 5897: 5887: 5885: 5842: 5838: 5793: 5789: 5779: 5777: 5770: 5750: 5746: 5701: 5697: 5687: 5685: 5672: 5671: 5667: 5657: 5655: 5622: 5618: 5608: 5606: 5593: 5592: 5588: 5548: 5544: 5499: 5495: 5450: 5446: 5436: 5434: 5430: 5419: 5411: 5407: 5360: 5353: 5343: 5341: 5298: 5294: 5257:Chronic Illness 5249: 5242: 5197: 5186: 5176: 5174: 5161: 5160: 5156: 5146: 5144: 5140: 5133: 5123: 5119: 5072: 5063: 5053: 5051: 5038: 5037: 5030: 4990: 4986: 4939: 4935: 4890: 4886: 4839: 4835: 4798: 4794: 4757: 4750: 4703: 4699: 4654: 4650: 4605: 4601: 4554: 4550: 4513: 4509: 4468:(4): e0232475. 4454: 4447: 4416: 4412: 4402: 4400: 4396: 4385: 4379: 4375: 4328: 4324: 4293:(10): 618–634. 4279: 4275: 4228: 4224: 4177: 4173: 4163: 4161: 4150:"ME/CFS Basics" 4148: 4147: 4140: 4093: 4089: 4079: 4077: 4073: 4040: 4034: 4025: 3972: 3968: 3958: 3956: 3943: 3942: 3929: 3919: 3917: 3902: 3891: 3883: 3862: 3823: 3819: 3809: 3807: 3788: 3717: 3707: 3705: 3662: 3655: 3645: 3643: 3626: 3625: 3621: 3584:Nature Medicine 3576: 3567: 3510: 3501: 3454: 3447: 3440: 3422: 3418: 3373: 3364: 3323: 3316: 3261: 3257: 3247: 3245: 3244:on 6 March 2024 3232: 3231: 3222: 3177: 3164: 3127: 3098: 3053: 3040: 2995: 2940: 2930: 2928: 2915: 2914: 2889: 2879: 2877: 2873: 2854: 2841: 2784: 2737: 2718: 2708: 2706: 2693: 2692: 2677: 2630: 2617: 2572: 2545: 2535: 2533: 2520: 2519: 2515: 2470: 2463: 2453: 2451: 2438: 2437: 2420: 2410: 2408: 2395: 2394: 2357: 2347: 2345: 2341: 2327: 2312: 2304: 2275: 2270: 2261: 2220: 2187: 2176: 2172: 2170: 2166: 2158: 2124: 2098: 2085: 2034: 2028: 2011: 1957:, and signs of 1939: 1933: 1886: 1877:life expectancy 1861: 1846:and stiffness. 1827:(via blood) or 1801: 1774:Antidepressants 1731: 1691:energy envelope 1676: 1623: 1617: 1564:coeliac disease 1528:Blood disorders 1504: 1456:Cognitive tests 1429: 1398:As there is no 1234: 1217: 1185: 1178: 1166: 1158:Sleep problems 1149: 1142: 1135: 1128: 1111: 1104: 1097: 1090: 1083: 1071: 1064: 1057: 1050: 1043: 1035: 1030: 1025: 1020: 1015: 1009: 1007: 996: 990: 981:medical history 977: 969:early menopause 937: 886: 850: 842:tilt table test 773: 745: 743:Pathophysiology 694:gastroenteritis 675: 669: 660:white Americans 655: 630: 593:quality of life 564: 513: 413: 393: 281: 217:chronic illness 44: 39: 32:chronic fatigue 28: 23: 22: 15: 12: 11: 5: 8368: 8358: 8357: 8352: 8347: 8342: 8327: 8326: 8303: 8302: 8299: 8298: 8295: 8294: 8292: 8291: 8290: 8289: 8278: 8277: 8276: 8275: 8274: 8273: 8268: 8258: 8253: 8252: 8251: 8246: 8241: 8240: 8239: 8234: 8229: 8221: 8216: 8211: 8206: 8201: 8191: 8177: 8176: 8175: 8174: 8169: 8164: 8150: 8148: 8142: 8141: 8139: 8138: 8133: 8127: 8125: 8116: 8107: 8103: 8102: 8099: 8098: 8096: 8095: 8090: 8085: 8080: 8075: 8070: 8064: 8062: 8058: 8057: 8055: 8054: 8049: 8047:Cerebral edema 8044: 8043: 8042: 8037: 8032: 8027: 8016: 8014: 8008: 8007: 8004: 8003: 8001: 8000: 7999: 7998: 7996:Template:Sleep 7986: 7984: 7980: 7979: 7977: 7976: 7970: 7965: 7959: 7957: 7951: 7950: 7948: 7947: 7941: 7936: 7931: 7925: 7923: 7917: 7916: 7914: 7913: 7907: 7902: 7897: 7891: 7889: 7876: 7868: 7867: 7865: 7864: 7858: 7853: 7848: 7842: 7840: 7834: 7833: 7830: 7829: 7827: 7826: 7824:Leigh syndrome 7820: 7818: 7812: 7811: 7809: 7808: 7797: 7796: 7791: 7786: 7785: 7784: 7770: 7769: 7768: 7763: 7762: 7761: 7745: 7743: 7737: 7736: 7734: 7733: 7728: 7723: 7722: 7721: 7716: 7705: 7704: 7703: 7702: 7697: 7696: 7695: 7685: 7684: 7683: 7673: 7668: 7667: 7666: 7661: 7656: 7651: 7635: 7634: 7633: 7632: 7627: 7622: 7617: 7612: 7611: 7610: 7600: 7599: 7598: 7588: 7587: 7586: 7581: 7576: 7560: 7558: 7551:Extrapyramidal 7544: 7535: 7533:encephalopathy 7524: 7523: 7520: 7519: 7517: 7516: 7511: 7506: 7505: 7504: 7493: 7491: 7484: 7483: 7481: 7480: 7479: 7478: 7468: 7463: 7462: 7461: 7456: 7451: 7446: 7435: 7433: 7424: 7418: 7417: 7410:nervous system 7405: 7404: 7397: 7390: 7382: 7373: 7372: 7370: 7369: 7364: 7359: 7354: 7352:ME Research UK 7349: 7347:ME Association 7344: 7338: 7336: 7332: 7331: 7329: 7328: 7323: 7318: 7312: 7310: 7306: 7305: 7303: 7302: 7296: 7294: 7290: 7289: 7287: 7286: 7281: 7276: 7271: 7265: 7263: 7262:Medical issues 7259: 7258: 7251: 7250: 7243: 7236: 7228: 7219: 7218: 7215: 7214: 7205: 7194: 7183: 7169: 7157: 7156: 7154: 7150: 7149: 7146: 7145: 7134: 7123: 7112: 7094: 7079: 7064: 7048: 7043: 7042: 7040: 7039:Classification 7032: 7031:External links 7029: 7026: 7025: 7003: 6977: 6948:(5): 798–805. 6928: 6898: 6869:(2): 277–282. 6849: 6820:(7): 956–963. 6797: 6767: 6711: 6660: 6624: 6613:on 8 July 2012 6593: 6560: 6495: 6444: 6369: 6340:(1): e012633. 6320: 6299:(2): 142–176. 6276: 6257:(3): 577–590. 6241: 6212:(3): 241–258. 6192: 6163:(3): 906–909. 6143: 6108: 6059: 6028: 6009:(3): 167–180. 5989: 5943: 5916:(3): 393–401. 5895: 5836: 5807:(2): e003973. 5787: 5768: 5744: 5695: 5684:on 3 June 2024 5665: 5616: 5586: 5559:(2): 240–255. 5542: 5493: 5444: 5405: 5351: 5292: 5240: 5184: 5173:on 25 May 2024 5154: 5117: 5061: 5028: 4984: 4933: 4904:(3): 119–135. 4884: 4833: 4792: 4771:(6): 601–609. 4748: 4697: 4668:(43): e17600. 4648: 4599: 4548: 4507: 4445: 4410: 4373: 4322: 4273: 4222: 4171: 4160:on 23 May 2024 4138: 4087: 4023: 3966: 3927: 3900: 3860: 3817: 3715: 3653: 3619: 3590:(5): 911–923. 3565: 3499: 3445: 3438: 3416: 3387:(4): 200–211. 3362: 3314: 3275:(4): 413–433. 3255: 3234:"Epidemiology" 3220: 3191:(3): 133–146. 3162: 3141:(5): 443–458. 3096: 3038: 2938: 2887: 2782: 2716: 2675: 2615: 2543: 2513: 2484:(3): 411–431. 2461: 2418: 2355: 2325: 2272: 2271: 2269: 2266: 2260: 2257: 2219: 2216: 2186: 2183: 2171: 2165: 2157: 2154: 2123: 2120: 2097: 2094: 2084: 2081: 2030:Main article: 2027: 2024: 2010: 2007: 1935:Main article: 1932: 1929: 1923:is highest in 1885: 1882: 1860: 1857: 1840:pressure sores 1800: 1797: 1730: 1729:Symptom relief 1727: 1675: 1672: 1619:Main article: 1616: 1613: 1524:hypothyroidism 1503: 1500: 1492:Serum ferritin 1428: 1425: 1378: 1377: 1375: 1373: 1368: 1366: 1364: 1360: 1359: 1357: 1355: 1350: 1345: 1343: 1339: 1338: 1336: 1334: 1329: 1324: 1322: 1318: 1317: 1315: 1313: 1308: 1303: 1301: 1297: 1296: 1294: 1292: 1287: 1282: 1277: 1273: 1272: 1270: 1265: 1260: 1255: 1253: 1249: 1248: 1246: 1244: 1239: 1232: 1227: 1223: 1222: 1215: 1210: 1205: 1200: 1195: 1191: 1190: 1183: 1176: 1171: 1164: 1159: 1155: 1154: 1147: 1140: 1133: 1126: 1121: 1117: 1116: 1109: 1102: 1095: 1088: 1081: 1077: 1076: 1069: 1062: 1055: 1048: 1041: 1037: 1036: 1033: 1031: 1028: 1026: 1023: 1021: 1018: 1016: 1013: 1011: 992:Main article: 989: 986: 976: 973: 936: 933: 885: 882: 876:as well as to 866:autoantibodies 849: 846: 772: 769: 744: 741: 671:Main article: 668: 665: 654: 651: 635:deconditioning 629: 626: 585: 584: 581: 578: 571: 563: 560: 512: 509: 412: 409: 392: 389: 280: 277: 231:and pain. The 204: 203: 196: 192: 191: 186: 182: 181: 178: 172: 171: 168:family history 166:Being female, 164: 158: 157: 154: 150: 149: 146: 142: 141: 138: 134: 133: 123: 117: 116: 82: 76: 75: 68: 67: 59: 58: 55: 51: 50: 42: 26: 9: 6: 4: 3: 2: 8367: 8356: 8353: 8351: 8348: 8346: 8343: 8341: 8338: 8337: 8335: 8325: 8315: 8314: 8311: 8288: 8285: 8284: 8283: 8280: 8279: 8272: 8269: 8267: 8264: 8263: 8262: 8259: 8257: 8254: 8250: 8247: 8245: 8242: 8238: 8235: 8233: 8230: 8228: 8225: 8224: 8222: 8220: 8217: 8215: 8212: 8210: 8207: 8205: 8202: 8200: 8197: 8196: 8195: 8192: 8190: 8187: 8186: 8185: 8183: 8179: 8178: 8173: 8170: 8168: 8165: 8163: 8160: 8159: 8158: 8156: 8152: 8151: 8149: 8147: 8143: 8137: 8134: 8132: 8129: 8128: 8126: 8124: 8120: 8117: 8115: 8111: 8108: 8104: 8094: 8091: 8089: 8086: 8084: 8081: 8079: 8076: 8074: 8073:Reye syndrome 8071: 8069: 8066: 8065: 8063: 8059: 8053: 8050: 8048: 8045: 8041: 8038: 8036: 8033: 8031: 8028: 8026: 8025:Hydrocephalus 8023: 8022: 8021: 8018: 8017: 8015: 8013: 8009: 7997: 7993: 7992: 7991: 7988: 7987: 7985: 7981: 7975: 7971: 7969: 7966: 7964: 7961: 7960: 7958: 7956: 7952: 7946: 7942: 7940: 7937: 7935: 7932: 7930: 7927: 7926: 7924: 7922: 7918: 7912: 7908: 7906: 7903: 7901: 7898: 7896: 7893: 7892: 7890: 7888: 7884: 7880: 7877: 7875: 7869: 7863: 7859: 7857: 7854: 7852: 7849: 7847: 7844: 7843: 7841: 7839: 7838:Demyelinating 7835: 7825: 7822: 7821: 7819: 7817: 7813: 7807: 7804: 7803: 7802: 7801: 7795: 7792: 7790: 7787: 7783: 7780: 7779: 7778: 7774: 7771: 7767: 7764: 7760: 7757: 7756: 7755: 7752: 7751: 7750: 7747: 7746: 7744: 7742: 7738: 7732: 7729: 7727: 7726:Restless legs 7724: 7720: 7717: 7715: 7712: 7711: 7710: 7707: 7706: 7701: 7698: 7694: 7691: 7690: 7689: 7686: 7682: 7679: 7678: 7677: 7674: 7672: 7669: 7665: 7664:Blepharospasm 7662: 7660: 7657: 7655: 7652: 7650: 7647: 7646: 7645: 7642: 7641: 7640: 7637: 7636: 7631: 7628: 7626: 7623: 7621: 7620:Hemiballismus 7618: 7616: 7613: 7609: 7606: 7605: 7604: 7601: 7597: 7594: 7593: 7592: 7589: 7585: 7582: 7580: 7577: 7575: 7572: 7571: 7570: 7567: 7566: 7565: 7562: 7561: 7559: 7557: 7552: 7548: 7545: 7543: 7539: 7536: 7534: 7529: 7525: 7515: 7512: 7510: 7507: 7503: 7500: 7499: 7498: 7495: 7494: 7492: 7490: 7485: 7477: 7474: 7473: 7472: 7471:Brain abscess 7469: 7467: 7464: 7460: 7457: 7455: 7452: 7450: 7447: 7445: 7442: 7441: 7440: 7437: 7436: 7434: 7432: 7428: 7425: 7423: 7419: 7415: 7411: 7403: 7398: 7396: 7391: 7389: 7384: 7383: 7380: 7368: 7365: 7363: 7360: 7358: 7355: 7353: 7350: 7348: 7345: 7343: 7342:Action for ME 7340: 7339: 7337: 7335:Organizations 7333: 7327: 7324: 7322: 7321:Controversies 7319: 7317: 7314: 7313: 7311: 7307: 7301: 7298: 7297: 7295: 7291: 7285: 7282: 7280: 7277: 7275: 7272: 7270: 7267: 7266: 7264: 7260: 7256: 7249: 7244: 7242: 7237: 7235: 7230: 7229: 7226: 7213: 7209: 7206: 7204: 7200: 7199: 7195: 7193: 7189: 7188: 7184: 7182: 7179: 7175: 7174: 7170: 7168: 7164: 7163: 7159: 7158: 7155: 7151: 7144: 7140: 7139: 7135: 7133: 7129: 7128: 7124: 7122: 7118: 7117: 7113: 7111: 7108: 7104: 7103: 7099: 7095: 7093: 7089: 7088: 7084: 7080: 7078: 7074: 7073: 7069: 7065: 7063: 7059: 7058: 7054: 7050: 7049: 7046: 7041: 7037: 7022: 7010: 7006: 7000: 6996: 6992: 6988: 6981: 6973: 6969: 6964: 6959: 6955: 6951: 6947: 6943: 6939: 6932: 6916: 6912: 6908: 6902: 6894: 6890: 6886: 6882: 6877: 6872: 6868: 6864: 6860: 6853: 6845: 6841: 6836: 6831: 6827: 6823: 6819: 6815: 6811: 6804: 6802: 6785: 6781: 6777: 6771: 6763: 6759: 6755: 6751: 6746: 6741: 6737: 6733: 6729: 6722: 6720: 6718: 6716: 6707: 6703: 6698: 6693: 6688: 6683: 6679: 6675: 6671: 6664: 6645: 6638: 6631: 6629: 6612: 6608: 6604: 6597: 6581: 6577: 6573: 6567: 6565: 6545: 6541: 6537: 6533: 6529: 6525: 6521: 6517: 6513: 6506: 6499: 6491: 6487: 6482: 6477: 6472: 6467: 6463: 6459: 6455: 6448: 6429: 6425: 6421: 6417: 6413: 6408: 6403: 6399: 6395: 6391: 6387: 6380: 6373: 6365: 6361: 6356: 6351: 6347: 6343: 6339: 6335: 6331: 6324: 6316: 6312: 6307: 6302: 6298: 6294: 6290: 6283: 6281: 6272: 6268: 6264: 6260: 6256: 6252: 6245: 6237: 6233: 6228: 6223: 6219: 6215: 6211: 6207: 6203: 6196: 6188: 6184: 6179: 6174: 6170: 6166: 6162: 6158: 6154: 6147: 6139: 6135: 6131: 6127: 6123: 6119: 6112: 6104: 6100: 6095: 6090: 6086: 6082: 6079:(4): 749–57. 6078: 6074: 6070: 6063: 6047: 6043: 6039: 6032: 6024: 6020: 6016: 6012: 6008: 6004: 6000: 5993: 5985: 5981: 5977: 5973: 5969: 5965: 5961: 5957: 5950: 5948: 5939: 5935: 5931: 5927: 5923: 5919: 5915: 5911: 5904: 5902: 5900: 5883: 5879: 5875: 5871: 5867: 5863: 5859: 5855: 5851: 5847: 5840: 5832: 5828: 5823: 5818: 5814: 5810: 5806: 5802: 5798: 5791: 5775: 5771: 5765: 5761: 5757: 5756: 5748: 5740: 5736: 5731: 5726: 5722: 5718: 5714: 5710: 5706: 5699: 5683: 5679: 5675: 5669: 5653: 5649: 5645: 5640: 5635: 5631: 5627: 5620: 5604: 5600: 5596: 5590: 5582: 5578: 5574: 5570: 5566: 5562: 5558: 5554: 5546: 5538: 5534: 5529: 5524: 5520: 5516: 5512: 5508: 5504: 5497: 5489: 5485: 5480: 5475: 5471: 5467: 5463: 5459: 5455: 5448: 5429: 5425: 5418: 5417: 5409: 5401: 5397: 5392: 5387: 5382: 5377: 5373: 5369: 5365: 5358: 5356: 5339: 5335: 5331: 5327: 5323: 5319: 5315: 5311: 5307: 5303: 5296: 5288: 5284: 5279: 5274: 5270: 5266: 5262: 5258: 5254: 5247: 5245: 5236: 5232: 5227: 5222: 5218: 5214: 5210: 5207:(in German). 5206: 5202: 5195: 5193: 5191: 5189: 5172: 5168: 5164: 5158: 5139: 5131: 5130: 5121: 5113: 5109: 5104: 5099: 5094: 5089: 5085: 5081: 5077: 5070: 5068: 5066: 5049: 5045: 5041: 5035: 5033: 5024: 5020: 5016: 5012: 5008: 5004: 5000: 4996: 4988: 4980: 4976: 4971: 4966: 4961: 4956: 4952: 4948: 4944: 4937: 4929: 4925: 4921: 4917: 4912: 4907: 4903: 4899: 4895: 4888: 4880: 4876: 4871: 4866: 4861: 4856: 4852: 4848: 4844: 4837: 4829: 4825: 4820: 4815: 4812:(6): 102527. 4811: 4807: 4803: 4796: 4788: 4784: 4779: 4774: 4770: 4766: 4762: 4755: 4753: 4744: 4740: 4735: 4730: 4725: 4720: 4716: 4712: 4708: 4701: 4693: 4689: 4684: 4679: 4675: 4671: 4667: 4663: 4659: 4652: 4644: 4640: 4635: 4630: 4626: 4622: 4618: 4614: 4610: 4603: 4595: 4591: 4586: 4581: 4576: 4571: 4567: 4563: 4559: 4552: 4544: 4540: 4535: 4530: 4527:(2): 103484. 4526: 4522: 4518: 4511: 4503: 4499: 4494: 4489: 4484: 4479: 4475: 4471: 4467: 4463: 4459: 4452: 4450: 4441: 4437: 4433: 4429: 4426:(4): 220–34. 4425: 4421: 4414: 4395: 4391: 4384: 4377: 4369: 4365: 4360: 4355: 4350: 4345: 4341: 4337: 4333: 4326: 4318: 4314: 4310: 4306: 4301: 4296: 4292: 4288: 4284: 4277: 4269: 4265: 4260: 4255: 4250: 4245: 4241: 4237: 4233: 4226: 4218: 4214: 4209: 4204: 4199: 4194: 4190: 4186: 4182: 4175: 4159: 4155: 4151: 4145: 4143: 4134: 4130: 4125: 4120: 4115: 4110: 4106: 4102: 4098: 4091: 4072: 4068: 4064: 4059: 4054: 4050: 4046: 4039: 4032: 4030: 4028: 4019: 4015: 4010: 4005: 4001: 3997: 3993: 3989: 3985: 3981: 3977: 3970: 3954: 3950: 3946: 3940: 3938: 3936: 3934: 3932: 3915: 3911: 3907: 3903: 3897: 3890: 3889: 3881: 3879: 3877: 3875: 3873: 3871: 3869: 3867: 3865: 3856: 3852: 3848: 3844: 3840: 3836: 3833:(2): 97–107. 3832: 3828: 3821: 3805: 3801: 3796: 3795: 3786: 3784: 3782: 3780: 3778: 3776: 3774: 3772: 3770: 3768: 3766: 3764: 3762: 3760: 3758: 3756: 3754: 3752: 3750: 3748: 3746: 3744: 3742: 3740: 3738: 3736: 3734: 3732: 3730: 3728: 3726: 3724: 3722: 3720: 3703: 3699: 3695: 3691: 3687: 3683: 3679: 3675: 3671: 3667: 3660: 3658: 3641: 3637: 3633: 3629: 3623: 3615: 3611: 3607: 3603: 3598: 3593: 3589: 3585: 3581: 3574: 3572: 3570: 3561: 3557: 3553: 3549: 3544: 3539: 3535: 3531: 3527: 3523: 3519: 3515: 3508: 3506: 3504: 3495: 3491: 3486: 3481: 3476: 3471: 3467: 3463: 3459: 3452: 3450: 3441: 3435: 3431: 3427: 3420: 3412: 3408: 3404: 3400: 3395: 3390: 3386: 3382: 3378: 3371: 3369: 3367: 3358: 3354: 3350: 3346: 3341: 3336: 3332: 3328: 3321: 3319: 3310: 3306: 3301: 3296: 3292: 3288: 3283: 3278: 3274: 3270: 3266: 3259: 3243: 3239: 3235: 3229: 3227: 3225: 3216: 3212: 3207: 3202: 3198: 3194: 3190: 3186: 3182: 3175: 3173: 3171: 3169: 3167: 3158: 3154: 3149: 3144: 3140: 3136: 3132: 3125: 3123: 3121: 3119: 3117: 3115: 3113: 3111: 3109: 3107: 3105: 3103: 3101: 3092: 3088: 3083: 3078: 3074: 3070: 3066: 3062: 3058: 3051: 3049: 3047: 3045: 3043: 3034: 3030: 3026: 3022: 3017: 3012: 3008: 3004: 3000: 2993: 2991: 2989: 2987: 2985: 2983: 2981: 2979: 2977: 2975: 2973: 2971: 2969: 2967: 2965: 2963: 2961: 2959: 2957: 2955: 2953: 2951: 2949: 2947: 2945: 2943: 2926: 2922: 2918: 2912: 2910: 2908: 2906: 2904: 2902: 2900: 2898: 2896: 2894: 2892: 2872: 2868: 2864: 2860: 2857:(in German). 2852: 2848: 2847: 2839: 2837: 2835: 2833: 2831: 2829: 2827: 2825: 2823: 2821: 2819: 2817: 2815: 2813: 2811: 2809: 2807: 2805: 2803: 2801: 2799: 2797: 2795: 2793: 2791: 2789: 2787: 2778: 2774: 2769: 2764: 2759: 2754: 2750: 2746: 2742: 2735: 2733: 2731: 2729: 2727: 2725: 2723: 2721: 2704: 2700: 2696: 2690: 2688: 2686: 2684: 2682: 2680: 2671: 2667: 2662: 2657: 2652: 2647: 2643: 2639: 2635: 2628: 2626: 2624: 2622: 2620: 2611: 2607: 2603: 2599: 2594: 2589: 2585: 2581: 2577: 2570: 2568: 2566: 2564: 2562: 2560: 2558: 2556: 2554: 2552: 2550: 2548: 2531: 2527: 2523: 2517: 2509: 2505: 2500: 2495: 2491: 2487: 2483: 2479: 2475: 2468: 2466: 2449: 2445: 2441: 2435: 2433: 2431: 2429: 2427: 2425: 2423: 2406: 2402: 2398: 2392: 2390: 2388: 2386: 2384: 2382: 2380: 2378: 2376: 2374: 2372: 2370: 2368: 2366: 2364: 2362: 2360: 2340: 2336: 2332: 2328: 2322: 2318: 2311: 2310: 2302: 2300: 2298: 2296: 2294: 2292: 2290: 2288: 2286: 2284: 2282: 2280: 2278: 2273: 2265: 2256: 2254: 2250: 2246: 2242: 2236: 2234: 2230: 2226: 2215: 2212: 2208: 2203: 2201: 2197: 2191: 2182: 2162: 2153: 2151: 2147: 2143: 2141: 2137: 2136:AIDS activism 2128: 2119: 2115: 2112: 2108: 2104: 2093: 2089: 2080: 2078: 2074: 2070: 2066: 2061: 2059: 2055: 2051: 2047: 2042: 2040: 2039:psychosomatic 2033: 2020: 2015: 2006: 2004: 2000: 1996: 1991: 1989: 1984: 1983:mononucleosis 1979: 1977: 1976:Melvin Ramsay 1973: 1971: 1970:mass hysteria 1967: 1962: 1960: 1956: 1952: 1948: 1944: 1938: 1928: 1926: 1922: 1918: 1913: 1911: 1907: 1903: 1898: 1890: 1881: 1878: 1873: 1869: 1866: 1856: 1854: 1849: 1845: 1841: 1836: 1834: 1830: 1826: 1822: 1818: 1814: 1810: 1809:shower chairs 1806: 1799:Severe ME/CFS 1796: 1794: 1790: 1786: 1782: 1777: 1775: 1771: 1770:Psychotherapy 1766: 1764: 1759: 1755: 1751: 1746: 1744: 1740: 1736: 1726: 1724: 1720: 1715: 1710: 1706: 1702: 1700: 1694: 1692: 1688: 1680: 1671: 1669: 1665: 1661: 1657: 1653: 1651: 1647: 1646:sleep hygiene 1643: 1639: 1635: 1633: 1629: 1622: 1612: 1610: 1606: 1602: 1598: 1594: 1589: 1587: 1583: 1579: 1574: 1572: 1567: 1565: 1561: 1557: 1553: 1549: 1545: 1541: 1538:, lupus, and 1537: 1533: 1529: 1525: 1521: 1517: 1513: 1508: 1499: 1497: 1493: 1489: 1485: 1481: 1477: 1473: 1469: 1464: 1462: 1457: 1452: 1451:physical exam 1447: 1445: 1437: 1433: 1424: 1422: 1416: 1412: 1408: 1404: 1401: 1396: 1393: 1389: 1385: 1376: 1374: 1372: 1369: 1367: 1365: 1362: 1361: 1358: 1356: 1354: 1351: 1349: 1346: 1344: 1341: 1340: 1337: 1335: 1333: 1330: 1328: 1325: 1323: 1320: 1319: 1316: 1314: 1312: 1309: 1307: 1304: 1302: 1299: 1298: 1295: 1293: 1291: 1288: 1286: 1283: 1281: 1278: 1275: 1274: 1271: 1269: 1266: 1264: 1261: 1259: 1256: 1254: 1251: 1250: 1247: 1245: 1243: 1240: 1237: 1233: 1231: 1228: 1225: 1224: 1220: 1216: 1214: 1211: 1209: 1206: 1204: 1201: 1199: 1196: 1193: 1192: 1188: 1184: 1181: 1177: 1175: 1172: 1169: 1165: 1163: 1160: 1157: 1156: 1152: 1148: 1145: 1141: 1138: 1134: 1131: 1127: 1125: 1122: 1119: 1118: 1114: 1110: 1107: 1103: 1100: 1096: 1093: 1089: 1086: 1082: 1079: 1078: 1074: 1070: 1067: 1063: 1060: 1056: 1053: 1049: 1046: 1042: 1039: 1038: 1032: 1027: 1022: 1017: 1012: 1008:M: Mandatory 1006: 1003: 1002: 995: 985: 982: 972: 970: 966: 965:endometriosis 962: 958: 954: 950: 946: 942: 932: 930: 929:carbohydrates 926: 922: 918: 914: 913:mitochondrial 909: 907: 903: 895: 890: 881: 879: 875: 871: 870:viral mimicry 867: 862: 860: 856: 853:and fatigue. 848:Immunological 845: 843: 839: 835: 834:non-REM sleep 831: 827: 823: 818: 816: 812: 808: 804: 800: 796: 792: 788: 786: 782: 778: 768: 766: 762: 758: 757:immune system 754: 750: 740: 738: 734: 729: 727: 723: 719: 715: 711: 707: 703: 699: 695: 691: 686: 684: 680: 674: 664: 661: 650: 647: 643: 638: 636: 625: 623: 619: 618:heart disease 615: 610: 605: 601: 594: 589: 582: 579: 576: 572: 569: 568: 567: 559: 557: 553: 549: 545: 541: 536: 534: 530: 526: 522: 518: 508: 506: 502: 498: 494: 490: 485: 483: 482:verbal memory 479: 475: 474:reading speed 471: 470:reaction time 466: 462: 460: 456: 451: 443: 439: 437: 433: 429: 424: 422: 418: 411:Core symptoms 408: 406: 402: 398: 388: 386: 382: 378: 374: 369: 367: 363: 359: 355: 351: 346: 343: 339: 335: 331: 327: 323: 318: 316: 312: 308: 304: 300: 296: 295: 290: 286: 276: 273: 267: 265: 261: 257: 252: 249: 245: 244:mononucleosis 240: 238: 235:symptom is a 234: 230: 226: 222: 218: 214: 210: 201: 197: 193: 190: 187: 183: 179: 177: 173: 169: 165: 163: 159: 155: 151: 147: 143: 139: 135: 131: 127: 124: 122: 118: 114: 110: 106: 102: 98: 94: 93:endocrinology 90: 86: 83: 81: 77: 74: 69: 65: 60: 56: 52: 47: 41: 37: 33: 19: 8281: 8180: 8153: 8114:Degenerative 7851:Inflammatory 7798: 7731:Stiff-person 7569:Parkinsonism 7542:Degenerative 7439:Encephalitis 7422:Inflammation 7412:, primarily 7254: 7207: 7196: 7185: 7171: 7160: 7136: 7125: 7114: 7096: 7081: 7066: 7051: 7020: 7013:. Retrieved 6990: 6980: 6945: 6941: 6931: 6919:. Retrieved 6910: 6901: 6866: 6862: 6852: 6817: 6813: 6788:. Retrieved 6770: 6735: 6731: 6677: 6673: 6663: 6651:. Retrieved 6615:. Retrieved 6611:the original 6596: 6584:. Retrieved 6551:. Retrieved 6515: 6511: 6498: 6461: 6457: 6447: 6435:. Retrieved 6407:10871/130699 6389: 6385: 6372: 6337: 6333: 6323: 6296: 6292: 6254: 6250: 6244: 6209: 6205: 6195: 6160: 6156: 6146: 6121: 6117: 6111: 6076: 6072: 6062: 6050:. Retrieved 6041: 6031: 6006: 6002: 5992: 5959: 5955: 5913: 5909: 5886:. Retrieved 5856:(1): 24–31. 5853: 5849: 5839: 5804: 5800: 5790: 5778:. Retrieved 5754: 5747: 5712: 5708: 5698: 5686:. Retrieved 5682:the original 5668: 5656:. Retrieved 5619: 5607:. Retrieved 5589: 5556: 5552: 5545: 5510: 5506: 5496: 5461: 5457: 5447: 5435:. Retrieved 5428:the original 5415: 5408: 5371: 5367: 5342:. Retrieved 5309: 5305: 5295: 5263:(1): 51–60. 5260: 5256: 5208: 5204: 5175:. Retrieved 5171:the original 5157: 5147:30 September 5145:. Retrieved 5128: 5120: 5083: 5079: 5052:. Retrieved 4998: 4994: 4987: 4950: 4946: 4936: 4901: 4897: 4887: 4853:(12): 4040. 4850: 4846: 4836: 4809: 4805: 4795: 4768: 4764: 4714: 4710: 4700: 4665: 4661: 4651: 4616: 4612: 4602: 4565: 4561: 4551: 4524: 4520: 4510: 4465: 4461: 4423: 4419: 4413: 4401:. Retrieved 4376: 4339: 4335: 4325: 4290: 4286: 4276: 4239: 4235: 4225: 4188: 4184: 4174: 4162:. Retrieved 4158:the original 4104: 4100: 4090: 4078:. Retrieved 4048: 4044: 3983: 3979: 3969: 3957:. Retrieved 3920:23 September 3918:. Retrieved 3887: 3830: 3826: 3820: 3808:. Retrieved 3793: 3706:. Retrieved 3673: 3669: 3644:. Retrieved 3631: 3622: 3587: 3583: 3543:10072/420658 3517: 3513: 3465: 3461: 3425: 3419: 3384: 3380: 3330: 3272: 3268: 3258: 3246:. Retrieved 3242:the original 3188: 3184: 3138: 3134: 3064: 3060: 3006: 3002: 2929:. Retrieved 2878:. Retrieved 2850: 2845: 2748: 2744: 2707:. Retrieved 2641: 2638:BMC Medicine 2637: 2583: 2579: 2534:. Retrieved 2516: 2481: 2477: 2452:. Retrieved 2409:. Retrieved 2346:. Retrieved 2308: 2262: 2241:rintatolimod 2237: 2221: 2204: 2192: 2188: 2179: 2144: 2133: 2116: 2099: 2090: 2086: 2062: 2043: 2035: 2002: 1992: 1980: 1974: 1966:psychosocial 1963: 1940: 1914: 1899: 1895: 1884:Epidemiology 1874: 1870: 1862: 1853:safeguarding 1848:Osteoporosis 1844:contractures 1837: 1829:tube feeding 1802: 1778: 1767: 1758:hydrotherapy 1747: 1732: 1717: 1712: 1707: 1703: 1695: 1690: 1685: 1660:fibromyalgia 1654: 1636: 1624: 1590: 1586:Sleep apnoea 1575: 1571:fibromyalgia 1568: 1516:Lyme disease 1509: 1505: 1482:. Tests for 1465: 1448: 1441: 1435: 1417: 1413: 1409: 1405: 1397: 1386:guidelines, 1381: 1370: 1352: 1347: 1331: 1326: 1310: 1305: 1289: 1284: 1279: 1267: 1262: 1257: 1241: 1235: 1229: 1218: 1212: 1207: 1202: 1197: 1186: 1179: 1173: 1167: 1161: 1150: 1143: 1136: 1129: 1123: 1112: 1105: 1098: 1091: 1084: 1072: 1065: 1058: 1051: 1044: 1010:O: Optional 1004: 978: 961:gut microbes 957:gut microbes 938: 910: 899: 863: 851: 819: 789: 774: 771:Neurological 765:autoimmunity 746: 730: 687: 676: 656: 653:Risk factors 639: 631: 606: 602: 598: 565: 544:night sweats 537: 517:hyperalgesia 514: 486: 463: 452: 448: 431: 425: 414: 394: 384: 380: 376: 372: 370: 365: 361: 353: 349: 347: 341: 333: 329: 325: 321: 319: 299:immune cells 293: 282: 268: 253: 241: 212: 208: 207: 162:Risk factors 85:Rheumatology 40: 8266:Fazio–Londe 8106:Both/either 7900:Generalised 7759:Early-onset 7754:Alzheimer's 7489:spinal cord 7198:Radiopaedia 7162:MedlinePlus 6790:22 November 6518:(1): 9–13. 6437:21 February 6052:22 February 4107:: 1122673. 3986:(1): 2157. 2211:Gender bias 2026:Controversy 1951:sore throat 1813:stair lifts 1805:wheelchairs 1754:paracetamol 1582:hypermobile 925:amino acids 813:studies of 622:lung cancer 556:lymph nodes 459:hypersomnia 383:, the name 303:neuroimmune 189:Symptomatic 137:Usual onset 113:paediatrics 54:Other names 8334:Categories 7874:paroxysmal 7846:Autoimmune 7639:Dyskinesia 7509:Meningitis 7487:Brain and 7284:2-day CPET 7187:Patient UK 7127:DiseasesDB 7015:20 October 6921:20 January 6738:: 105465. 6680:(1): 162. 6617:12 October 6553:21 January 6458:Healthcare 5888:4 February 5780:6 February 5658:8 December 5628:(Report). 5374:(1): 720. 5086:(1): 289. 4953:(1): 290. 4717:(1): 279. 4619:: 101771. 4388:(Report). 4342:(1): 633. 4242:(1): 268. 4191:(1): 763. 3810:19 January 3708:15 October 3468:(1): 335. 3269:Healthcare 2880:8 November 2751:(1): 100. 2644:(1): 189. 2268:References 2259:Challenges 2218:Directions 2065:PACE trial 2046:retrovirus 1925:middle age 1921:prevalence 1910:CDC survey 1906:long COVID 1763:pregabalin 1743:suvorexant 1615:Management 1552:narcolepsy 1530:, such as 927:than from 753:metabolism 737:antibodies 726:SARS-CoV-1 718:chickenpox 698:long COVID 690:bronchitis 649:symptoms. 497:heart rate 311:long COVID 264:long COVID 195:Prevalence 105:immunology 7871:Episodic/ 7749:Tauopathy 7700:Akathisia 7688:Myoclonus 7671:Athetosis 7603:Tauopathy 7274:Treatment 7173:eMedicine 7138:SNOMED CT 6893:219974997 6762:231787959 6540:233745601 6532:2164-1846 6464:(2): 88. 6424:250533596 6392:: o1691. 6315:2164-1846 6023:2164-1846 5984:220253462 5962:(4): e4. 5878:214434278 5870:2164-1846 5581:149443976 4928:251636593 4920:2164-1846 4317:259831825 4080:5 January 3855:219011696 3847:2164-1846 3698:257198201 3690:1044-2073 3676:: 65–72. 3614:248889597 3560:252159772 3411:252652429 3403:2164-1846 3349:1356-1294 3291:2164-1846 3033:237419583 2867:1864-2500 2610:263665180 2245:Rituximab 1917:incidence 1865:prognosis 1859:Prognosis 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Myalgic encephalomyelitis/chronic fatigue syndrome

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