Materiały źródłowe

• #1 Manage Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | ME/CFS | CDC

  https://www.cdc.gov/me-cfs/management/index.html

  There is no cure or approved treatment for myalgic encephalomyelitis/chronic fatigue syndrome. […] However, some symptoms can be treated or managed. […] Taking these actions may provide some relief for people’s worst symptoms and improve quality of life. […] Unfortunately, these strategies may not be effective for everyone who has ME/CFS. […] ME/CFS is a particularly difficult disease to treat or manage because its cause remains unknown. Treatment is also complicated by the fact that the disease affects people differently. So, there is no one-size-fits-all solution to managing the disease. […] Before starting a management plan, people with ME/CFS, their families, and healthcare providers should also discuss the treatment. This discussion should include the possible benefits and harms of any treatment plans, including medicines and other therapies.

• #2 Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-fatigue-syndrome/diagnosis-treatment/drc-20360510

  There is no cure for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Treatment focuses on symptom relief. The most disruptive or disabling symptoms should be addressed first. […] Some problems associated with ME/CFS can be improved with certain medicines. Examples include: […] If medicines such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) don’t help enough, prescription drugs sometimes used to treat fibromyalgia might be options for you. […] Many people with long-term health problems, such as ME/CFS, are also depressed. Treating your depression can make it easier for you to cope with the problems associated with having a chronic disease. […] People with ME/CFS have a worsening of their symptoms after physical, mental or emotional effort. This is called post-exertional malaise.

• #3 Advancing Research and Treatment: An Overview of Clinical Trials in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Future Perspectives

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10816159/

  There is currently no cure or FDA-recommended treatment for ME/CFS. Consequently, fewer than 5% of patients return to their pre-morbid activity levels. […] In the past, cognitive behavioural therapy (CBT) and graded exercise therapy (GET) were recommended by health agencies for the treatment of ME/CFS. […] Consequently, treatment guidelines have undergone revisions, removing GET as a recommended therapy, while CBT is now provided as a supplementary approach to alleviate the distress related to chronic illness. […] Health agencies recommend a multidisciplinary, individualised approach to treat or manage the symptoms patients experience, utilising both pharmacological and non-pharmacological treatments. […] Treatment and management of comorbid illnesses need to be considered carefully, due to some recommended treatments for the comorbid illnesses having detrimental effects on ME/CFS symptoms.

• #4 Advancing Research and Treatment: An Overview of Clinical Trials in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Future Perspectives

  https://www.mdpi.com/2077-0383/13/2/325

  There is currently no cure or FDA-recommended treatment for ME/CFS. Consequently, fewer than 5% of patients return to their pre-morbid activity levels. […] In the past, cognitive behavioural therapy (CBT) and graded exercise therapy (GET) were recommended by health agencies for the treatment of ME/CFS. Reanalysis of the 2011 PACE (pacing, graded activity, and cognitive behaviour therapy; a randomised evaluation) trial refuted original claims of the safety and efficacy of GET and CBT. Consequently, treatment guidelines have undergone revisions, removing GET as a recommended therapy, while CBT is now provided as a supplementary approach to alleviate the distress related to chronic illness. Health agencies recommend a multidisciplinary, individualised approach to treat or manage the symptoms patients experience, utilising both pharmacological and non-pharmacological treatments. […] This review evaluates past clinical trials (CTs) in ME/CFS, identifying gaps requiring further investigation and providing recommendations for planning and designing robust future CTs into ME/CFS.

• #5 About the Disease – Solve ME/CFS Initiative

  https://solvecfs.org/me-cfs-long-covid/about-the-disease/

  There is currently no FDA-approved treatment or drug for ME/CFS. As neither a cause nor cure for ME/CFS has been identified, treatment is directed at relieving symptoms. However, there are interventions and symptom-reduction strategies that you can use to significantly improve patients quality of life. […] Providing compassionate and effective care for patients with ME/CFS can be challenging, like many other multisystemic chronic conditions. Patients and their providers must be partners with open lines of communication in order to effectively manage this illness. […] Studies show that less than 9-16 percent of ME/CFS patients in the United States have been properly diagnosed. Diagnosing ME/CFS is a challenging process because there is still not one diagnostic test or biomarker thats conclusive. Getting a definitive diagnosis often takes months or even years.

• #6

  https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/treatment/

  Treatments for myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS) aim to help relieve your symptoms. […] There’s no single way of managing ME/CFS that works for everyone, but there are a number of treatment options. […] The National Institute for Health and Care Excellence (NICE) says you should be offered a treatment plan tailored to your symptoms. […] Your doctor should discuss all of the options with you and explain the benefits and risks of any treatment. […] They should work with you to develop a treatment plan that suits you and takes into account your circumstances and preferences. […] You may need advice about making lifestyle changes, specialist treatments, or a combination of both. […] If your symptoms are severe, your doctor should ask a specialist for advice.

• #7 ME/CFS Basics | ME/CFS | CDC

  https://www.cdc.gov/me-cfs/about/index.html

  There is no cure or approved treatment for ME/CFS. But some symptoms can be treated or managed. Treating these symptoms might provide relief for some people with ME/CFS but not others. Other strategies, like learning new ways to manage activity, can also help. […] People with ME/CFS, their families, and healthcare providers need to work together to decide which symptom causes the most problems. This should be treated first after discussing possible benefits and harms of any treatment plans, including medicines and other therapies. […] Healthcare providers need to support their patients’ families as they come to understand how to live with this illness. Providers and families should remember that this process is likely to be hard on people with ME/CFS.

• #8

  https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/treatment/

  Your treatment plan should be reviewed regularly. […] There are a number of specialist treatments for ME/CFS. […] Energy management is a treatment that aims to teach you how to make best use of your energy levels in your day-to-day life, without making your symptoms worse. […] Some people with ME/CFS have found that exercise programmes can make their symptoms better. But some also found it made no difference or actually made symptoms worse. […] If you think you would benefit from increased levels of exercise you should be offered a personalised plan with support from a healthcare professional (such as a physiotherapist) with experience in working with people with ME/CFS. […] Graded exercise therapy (GET), which aims to gradually increase physical activity levels, is not recommended for people with ME/CFS.

• #9

  https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/

  While there’s currently no cure for ME/CFS, there are treatments that may help you manage the condition and relieve the symptoms. […] Treatments include: energy management where you’re given advice about how to make best use of the energy you have without making your symptoms worse […] cognitive behavioural therapy (CBT) […] medicine to control symptoms such as pain and sleeping problems. […] People with ME/CFS will need to adapt their daily routine and pattern of activities on a long-term basis.

• #10 Chronic Fatigue Syndrome (Myalgic Encephalomyelitis) Treatment & Management: Activity, Exercise Therapy

  https://emedicine.medscape.com/article/235980-treatment

  Post-Exertional Malaise (PEM) in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a hallmark symptom characterized by a exacerbation of symptoms following physical or mental exertion that would have been tolerated previously. This delayed response typically occurs 12-48 hours after the activity and can last for an extended period, often days or even weeks. Managing PEM involves carefully balancing activity and rest to prevent symptom flare-ups and relapse. Patients are advised to identify their individual limits for mental and physical activity, known as their „energy envelope”, to avoid exceeding their capacities and triggering PEM. […] Researchers Wormgoor and Rodenburg conducted a study focusing on the importance and effects of addressing PEM in rehabilitation stays, consultations, and hospital interventions. Their analysis, based on data from patient surveys, revealed varying rates of addressing PEM in different healthcare settings. Patients who received tailored PEM-focused care reported higher satisfaction and beneficial outcomes. Addressing PEM was associated with positive perceptions about healthcare providers’ knowledge and understanding of ME/CFS, symptom acknowledgment, and treatment approaches. This emphasizes the importance of considering PEM in managing ME/CFS within healthcare settings.

• #11 Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-fatigue-syndrome/diagnosis-treatment/drc-20360510

  The goal of pacing is to reduce post-exertional malaise, rather than getting back to the same activity level you had when you were healthy. […] Lack of sleep can make other symptoms more difficult to deal with. Your health care team might suggest avoiding caffeine or changing your bedtime routine. […] Many alternative therapies have been promoted for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), but very few have evidence that they work. […] Emotional support and counseling may help you and your loved ones deal with the uncertainties and restrictions of this disorder.

• #12 Chronic fatigue syndrome (CFS) | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/chronic-fatigue-syndrome-cfs

  Find a doctor who understands ME/CFS. […] Managing symptoms with your trusted healthcare professional can help to stabilise your ME/CFS and improve your quality of life. […] Pacing and rest are two self-management strategies commonly used with ME/CFS. The main goal of pacing is to reduce the intensity and frequency of PEM by limiting activity to the energy available. A key component of pacing is rest. […] While there is currently no cure and no evidence-based treatments, it is important to find a doctor who is not only sympathetic to ME/CFS, but can work with you to help manage your symptoms. […] Pacing, or keeping within your available energy, is a self-management strategy to help people with ME/CFS make sure that they dont overdo activity or exercise. It reduces the likelihood of triggering PEM and can help reduce symptoms. Pacing is not a cure for ME/CFS and does not treat the underlying, physical cause of the disease.

• #13 Chronic Fatigue Syndrome: Causes, Symptoms, and Treatment

  https://www.healthline.com/health/chronic-fatigue-syndrome

  The extreme and persistent fatigue from CFS lasts for at least 6 months and doesnt go away with bed rest. Medications along with diet and lifestyle changes may help you manage symptoms. […] CFS can affect anyone, though its most common among women in their 40s and 50s. Theres currently no cure, but treatment can relieve symptoms. […] Each person has different symptoms and therefore may require different types of treatment to manage the disorder and relieve their symptoms. […] Work with your team of healthcare providers to create the best treatment plan for you. They can go over the possible benefits and side effects of the therapies with you. […] Activity management, also called pacing, can help balance rest and activity to avoid PEM flare-ups. […] Its important to note that while vigorous aerobic exercise is good for most chronic conditions, people with CFS dont tolerate such exercise routines.

• #14 Chronic fatigue syndrome (CFS) | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/chronic-fatigue-syndrome-cfs

  Find a doctor who understands ME/CFS. […] Managing symptoms with your trusted healthcare professional can help to stabilise your ME/CFS and improve your quality of life. […] Pacing and rest are two self-management strategies commonly used with ME/CFS. The main goal of pacing is to reduce the intensity and frequency of PEM by limiting activity to the energy available. A key component of pacing is rest. […] While there is currently no cure and no evidence-based treatments, it is important to find a doctor who is not only sympathetic to ME/CFS, but can work with you to help manage your symptoms. […] Pacing, or keeping within your available energy, is a self-management strategy to help people with ME/CFS make sure that they dont overdo activity or exercise. It reduces the likelihood of triggering PEM and can help reduce symptoms. Pacing is not a cure for ME/CFS and does not treat the underlying, physical cause of the disease.

• #15

  https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/treatment/

  Your doctor may discuss with you whether cognitive behavioural therapy (CBT) is a suitable option. […] CBT aims to help you live with your symptoms. It does not directly treat the symptoms of ME/CFS. […] There’s no specific medicine for treating ME/CFS, but medicine can be used to relieve some of the symptoms. […] Painkillers you buy from a pharmacy or supermarket can help ease headaches, as well as muscle and joint pain. […] Antidepressants can be useful for people with ME/CFS who are in pain or having trouble sleeping. […] As well as specialist treatments for ME/CFS, making lifestyle changes can also help. […] It’s important you eat regularly and have a healthy, balanced diet. […] You may be referred to a dietitian who has experience of working with people with ME/CFS. […] Diets that exclude certain food types are not recommended for people with ME/CFS.

• #16 Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-fatigue-syndrome/diagnosis-treatment/drc-20360510

  There is no cure for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Treatment focuses on symptom relief. The most disruptive or disabling symptoms should be addressed first. […] Some problems associated with ME/CFS can be improved with certain medicines. Examples include: […] If medicines such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) don’t help enough, prescription drugs sometimes used to treat fibromyalgia might be options for you. […] Many people with long-term health problems, such as ME/CFS, are also depressed. Treating your depression can make it easier for you to cope with the problems associated with having a chronic disease. […] People with ME/CFS have a worsening of their symptoms after physical, mental or emotional effort. This is called post-exertional malaise.

• #17 Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/myalgic-encephalomyelitischronic-fatigue-syndrome-mecfs

  There is no cure for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Treatment focuses on symptom relief. The most disruptive or disabling symptoms should be addressed first. […] Some problems associated with ME/CFS can be improved with certain medicines. Examples include: […] If medicines such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) don’t help enough, prescription drugs sometimes used to treat fibromyalgia might be options for you. These include pregabalin (Lyrica), duloxetine (Cymbalta), amitriptyline or gabapentin (Neurontin). […] Many people with long-term health problems, such as ME/CFS, are also depressed. Treating your depression can make it easier for you to cope with the problems associated with having a chronic disease. Low doses of some antidepressants also can help improve sleep and relieve pain.

• #18 Manage Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | ME/CFS | CDC

  https://www.cdc.gov/me-cfs/management/index.html

  Rehabilitation specialists or exercise physiologists who understand ME/CFS may help people with ME/CFS adjust to living with the disease. […] Exercise is not a cure for ME/CFS. […] Standard exercise recommendations for healthy people can be harmful for patients with ME/CFS. However, it is important that patients with ME/CFS undertake activities that they can tolerate, as described above. […] If people are still not sleeping well after using these tips, they might want to try over-the-counter sleep medicines. […] People with ME/CFS should always talk to their healthcare provider before trying any medication. […] Other pain management methods include stretching and movement therapies, gentle massage, heat, toning exercises, and water therapy. […] If people with ME/CFS have depression or anxiety, they should be treated.

• #19 Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/myalgic-encephalomyelitischronic-fatigue-syndrome-mecfs

  There is no cure for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Treatment focuses on symptom relief. The most disruptive or disabling symptoms should be addressed first. […] Some problems associated with ME/CFS can be improved with certain medicines. Examples include: […] If medicines such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) don’t help enough, prescription drugs sometimes used to treat fibromyalgia might be options for you. These include pregabalin (Lyrica), duloxetine (Cymbalta), amitriptyline or gabapentin (Neurontin). […] Many people with long-term health problems, such as ME/CFS, are also depressed. Treating your depression can make it easier for you to cope with the problems associated with having a chronic disease. Low doses of some antidepressants also can help improve sleep and relieve pain.

• #20 Manage Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | ME/CFS | CDC

  https://www.cdc.gov/me-cfs/management/index.html

  Rehabilitation specialists or exercise physiologists who understand ME/CFS may help people with ME/CFS adjust to living with the disease. […] Exercise is not a cure for ME/CFS. […] Standard exercise recommendations for healthy people can be harmful for patients with ME/CFS. However, it is important that patients with ME/CFS undertake activities that they can tolerate, as described above. […] If people are still not sleeping well after using these tips, they might want to try over-the-counter sleep medicines. […] People with ME/CFS should always talk to their healthcare provider before trying any medication. […] Other pain management methods include stretching and movement therapies, gentle massage, heat, toning exercises, and water therapy. […] If people with ME/CFS have depression or anxiety, they should be treated.

• #21 Chronic Fatigue Syndrome – Harvard Health

  https://www.health.harvard.edu/a_to_z/chronic-fatigue-syndrome-a-to-z

  There is no FDA proven treatment for ME/CFS. However, clinician acknowledgement of the patients condition as ME/CFS and symptom guided approaches can improve quality of life. […] In general, doctors use a combination of the following: […] Patients are often initially encouraged to slow down, minimize physical exertion and try to avoid psychological stress. They learn to save their energy for essential activities at home or work and to cut back on less-important activities. […] Patients must first recognize the level of physical exertion that will trigger post-exertional malaise (PEM) symptoms and avoid reaching that level. […] Staying well hydrated, adding salt, wearing compression stockings, and avoiding prolonged standing can help prevent lightheadedness and extreme fatigue. […] This starts with sleep hygiene. Your doctor may suggest low dose trazadone or a tricyclic antidepressant before bed. […] Aspirin, acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) are used to treat headaches, muscle pain and joint pain. Antidepressant medications also may help to reduce chronic pain.

• #22 Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Information & Treatment

  https://www.columbiadoctors.org/health-library/condition/myalgic-encephalomyelitis-chronic-fatigue-syndrome/

  Your doctor may have you wear pressure stockings, put your legs up while sitting, or increase your salt intake. […] Different kinds of pain can be treated in different ways. […] Work with your doctor to watch for signs of depression. […] An ME/CFS support group can be a good source of information and tips for managing your illness. […] Get specialized care if you need it. […] Medicines don’t cure ME/CFS. But they can help relieve your symptoms. […] You might take over-the-counter pain relievers and anti-inflammatory drugs. […] These include: Anticonvulsants, also called antiseizure medicines. […] Antidepressants. […] Other medicines, such as fludrocortisone or midodrine. […] There are safe nontraditional treatments that can relieve pain and stress, ease muscle tension, and help you feel better and healthier. […] Some popular complementary treatments include: Acupuncture, Massage therapy, Mind-body techniques like mindfulness, meditation, and yoga. […] Talk with your doctor before you try a new diet, vitamin, or supplement.

• #23 Myalgic encephalomyelitis/chronic fatigue syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Myalgic_encephalomyelitis/chronic_fatigue_syndrome

  Addressing sleep problems with good sleep hygiene, 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 over-the-counter painkillers are insufficient. […] For cognitive impairment, adaptations like organisers and calendars may be helpful. […] Co-occurring conditions that may interact with and worsen ME/CFS symptoms are common, and treating these may help manage ME/CFS. […] The debilitating nature of ME/CFS can cause depression, anxiety, 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.

• #24 Chronic Fatigue Syndrome: Causes, Symptoms, and Treatment

  https://patient.info/signs-symptoms/tiredness-fatigue/chronic-fatigue-syndrome-myalgic-encephalomyelitis

  People with chronic fatigue syndrome may be more intolerant of drug treatment. Therefore, medicines might need to be started at a lower dose than usual and then gradually increased. […] Adequate fluid intake and a well-balanced diet are essential. A dietician with a special interest in CFS might be involved if someone is: Losing weight and at risk of malnutrition. Gaining weight. Following a restrictive diet. […] Adults with CFS should be seen for a review of their care and support plan in primary care at least once a year. Children and young people with CFS should have a review of their care and support plan at least every six months. These should be carried out or overseen by a paediatrician with expertise in CFS.

• #25 Chronic Fatigue Syndrome (Myalgic Encephalomyelitis) Treatment & Management: Activity, Exercise Therapy

  https://emedicine.medscape.com/article/235980-treatment

  Patients with ME/CFS often experience non-restorative sleep, waking up feeling less refreshed than before the onset of illness. […] While good sleep hygiene practices are recommended, patients may still wake unrefreshed, prompting consideration of sleep medication, starting with over-the-counter options. […] Initial management options include over-the-counter pain medications like acetaminophen, aspirin, or ibuprofen, with a pain specialist consultation recommended if these remedies are insufficient. […] Non-pharmacological methods, such as stretching, manual therapy, massage, heat therapy, toning exercises, and hydrotherapy, may also aid in managing pain for patients with ME/CFS. […] Memory issues in patients with ME/CFS can be managed using memory aids such as organizers, notebooks, smartphones, and tablets for tasks, appointments, and reminders.

• #26 Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-fatigue-syndrome/diagnosis-treatment/drc-20360510

  There is no cure for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Treatment focuses on symptom relief. The most disruptive or disabling symptoms should be addressed first. […] Some problems associated with ME/CFS can be improved with certain medicines. Examples include: […] If medicines such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) don’t help enough, prescription drugs sometimes used to treat fibromyalgia might be options for you. […] Many people with long-term health problems, such as ME/CFS, are also depressed. Treating your depression can make it easier for you to cope with the problems associated with having a chronic disease. […] People with ME/CFS have a worsening of their symptoms after physical, mental or emotional effort. This is called post-exertional malaise.

• #27 Manage Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | ME/CFS | CDC

  https://www.cdc.gov/me-cfs/management/index.html

  Rehabilitation specialists or exercise physiologists who understand ME/CFS may help people with ME/CFS adjust to living with the disease. […] Exercise is not a cure for ME/CFS. […] Standard exercise recommendations for healthy people can be harmful for patients with ME/CFS. However, it is important that patients with ME/CFS undertake activities that they can tolerate, as described above. […] If people are still not sleeping well after using these tips, they might want to try over-the-counter sleep medicines. […] People with ME/CFS should always talk to their healthcare provider before trying any medication. […] Other pain management methods include stretching and movement therapies, gentle massage, heat, toning exercises, and water therapy. […] If people with ME/CFS have depression or anxiety, they should be treated.

• #28 Treatment | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) | CDC

  http://medbox.iiab.me/modules/en-cdc/www.cdc.gov/me-cfs/treatment/index.html

  Patients should always talk to their healthcare provider before trying any medication. […] Other pain management methods include stretching and movement therapies, gentle massage, heat, toning exercises, and water therapy for healing. Acupuncture, when done by a licensed practitioner, might help with pain for some patients. […] Although treating depression or anxiety can be helpful, it is not a cure for ME/CFS. […] Some people with ME/CFS might benefit from trying techniques like deep breathing and muscle relaxation, massage, and movement therapies (such as stretching, yoga, and tai chi). These can reduce stress and anxiety, and promote a sense of well-being. […] For people with ME/CFS who do not have heart or blood vessel disease, doctor might suggest patients increase daily fluid and salt intake and use support stockings. If symptoms do not improve, prescription medication can be considered.

• #29 Treatment | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) | CDC

  http://medbox.iiab.me/modules/en-cdc/www.cdc.gov/me-cfs/treatment/index.html

  Patients should always talk to their healthcare provider before trying any medication. […] Other pain management methods include stretching and movement therapies, gentle massage, heat, toning exercises, and water therapy for healing. Acupuncture, when done by a licensed practitioner, might help with pain for some patients. […] Although treating depression or anxiety can be helpful, it is not a cure for ME/CFS. […] Some people with ME/CFS might benefit from trying techniques like deep breathing and muscle relaxation, massage, and movement therapies (such as stretching, yoga, and tai chi). These can reduce stress and anxiety, and promote a sense of well-being. […] For people with ME/CFS who do not have heart or blood vessel disease, doctor might suggest patients increase daily fluid and salt intake and use support stockings. If symptoms do not improve, prescription medication can be considered.

• #30 Chronic Fatigue Syndrome | Arthritis Foundation

  https://www.arthritis.org/diseases/chronic-fatigue-syndrome

  Consider traditional Chinese medicine. Herbs, acupuncture and other traditional Chinese therapies have been shown in randomized controlled trials to achieve excellent results for ME/CFS, often outperforming conventional approaches. Many private insurers cover acupuncture for various indications. Medicare covers it for back pain only and limits the number of treatments.

• #31 Myalgic encephalomyelitis/chronic fatigue syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Myalgic_encephalomyelitis/chronic_fatigue_syndrome

  Addressing sleep problems with good sleep hygiene, 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 over-the-counter painkillers are insufficient. […] For cognitive impairment, adaptations like organisers and calendars may be helpful. […] Co-occurring conditions that may interact with and worsen ME/CFS symptoms are common, and treating these may help manage ME/CFS. […] The debilitating nature of ME/CFS can cause depression, anxiety, 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.

• #32 Chronic Fatigue Syndrome (Myalgic Encephalomyelitis) Treatment & Management: Activity, Exercise Therapy

  https://emedicine.medscape.com/article/235980-treatment

  Patients with ME/CFS often experience non-restorative sleep, waking up feeling less refreshed than before the onset of illness. […] While good sleep hygiene practices are recommended, patients may still wake unrefreshed, prompting consideration of sleep medication, starting with over-the-counter options. […] Initial management options include over-the-counter pain medications like acetaminophen, aspirin, or ibuprofen, with a pain specialist consultation recommended if these remedies are insufficient. […] Non-pharmacological methods, such as stretching, manual therapy, massage, heat therapy, toning exercises, and hydrotherapy, may also aid in managing pain for patients with ME/CFS. […] Memory issues in patients with ME/CFS can be managed using memory aids such as organizers, notebooks, smartphones, and tablets for tasks, appointments, and reminders.

• #33 Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-fatigue-syndrome/diagnosis-treatment/drc-20360510

  The goal of pacing is to reduce post-exertional malaise, rather than getting back to the same activity level you had when you were healthy. […] Lack of sleep can make other symptoms more difficult to deal with. Your health care team might suggest avoiding caffeine or changing your bedtime routine. […] Many alternative therapies have been promoted for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), but very few have evidence that they work. […] Emotional support and counseling may help you and your loved ones deal with the uncertainties and restrictions of this disorder.

• #34

  https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/treatment/

  You should be given advice about how to establish a normal sleeping pattern. […] Having too much sleep does not usually improve the symptoms of ME/CFS, and sleeping during the day can stop you sleeping at night. […] If you have severe ME/CFS and need to spend much of your time in bed, it can cause problems, including pressure sores and blood clots. […] You should not take up vigorous unsupervised exercise, such as going to the gym or for a run as this may make your symptoms worse.

• #35 Manage Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | ME/CFS | CDC

  https://www.cdc.gov/me-cfs/management/index.html

  Rehabilitation specialists or exercise physiologists who understand ME/CFS may help people with ME/CFS adjust to living with the disease. […] Exercise is not a cure for ME/CFS. […] Standard exercise recommendations for healthy people can be harmful for patients with ME/CFS. However, it is important that patients with ME/CFS undertake activities that they can tolerate, as described above. […] If people are still not sleeping well after using these tips, they might want to try over-the-counter sleep medicines. […] People with ME/CFS should always talk to their healthcare provider before trying any medication. […] Other pain management methods include stretching and movement therapies, gentle massage, heat, toning exercises, and water therapy. […] If people with ME/CFS have depression or anxiety, they should be treated.

• #36 Chronic Fatigue Syndrome (Myalgic Encephalomyelitis) Treatment & Management: Activity, Exercise Therapy

  https://emedicine.medscape.com/article/235980-treatment

  Patients with ME/CFS often experience non-restorative sleep, waking up feeling less refreshed than before the onset of illness. […] While good sleep hygiene practices are recommended, patients may still wake unrefreshed, prompting consideration of sleep medication, starting with over-the-counter options. […] Initial management options include over-the-counter pain medications like acetaminophen, aspirin, or ibuprofen, with a pain specialist consultation recommended if these remedies are insufficient. […] Non-pharmacological methods, such as stretching, manual therapy, massage, heat therapy, toning exercises, and hydrotherapy, may also aid in managing pain for patients with ME/CFS. […] Memory issues in patients with ME/CFS can be managed using memory aids such as organizers, notebooks, smartphones, and tablets for tasks, appointments, and reminders.

• #37 Chronic Fatigue Syndrome – Harvard Health

  https://www.health.harvard.edu/a_to_z/chronic-fatigue-syndrome-a-to-z

  There is no FDA proven treatment for ME/CFS. However, clinician acknowledgement of the patients condition as ME/CFS and symptom guided approaches can improve quality of life. […] In general, doctors use a combination of the following: […] Patients are often initially encouraged to slow down, minimize physical exertion and try to avoid psychological stress. They learn to save their energy for essential activities at home or work and to cut back on less-important activities. […] Patients must first recognize the level of physical exertion that will trigger post-exertional malaise (PEM) symptoms and avoid reaching that level. […] Staying well hydrated, adding salt, wearing compression stockings, and avoiding prolonged standing can help prevent lightheadedness and extreme fatigue. […] This starts with sleep hygiene. Your doctor may suggest low dose trazadone or a tricyclic antidepressant before bed. […] Aspirin, acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) are used to treat headaches, muscle pain and joint pain. Antidepressant medications also may help to reduce chronic pain.

• #38

  https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/treatment/

  You should be given advice about how to establish a normal sleeping pattern. […] Having too much sleep does not usually improve the symptoms of ME/CFS, and sleeping during the day can stop you sleeping at night. […] If you have severe ME/CFS and need to spend much of your time in bed, it can cause problems, including pressure sores and blood clots. […] You should not take up vigorous unsupervised exercise, such as going to the gym or for a run as this may make your symptoms worse.

• #39 Chronic Fatigue Syndrome (Myalgic Encephalomyelitis) Treatment & Management: Activity, Exercise Therapy

  https://emedicine.medscape.com/article/235980-treatment

  Managing ME/CFS in pediatric patients involves addressing the impact of activities of daily living, education, and social engagement, which can trigger post-exertional malaise (PEM) in some cases. […] Although some young patients may require careful planning to accommodate these activities, others may navigate them with ease. […] Ensuring continuity in schooling and social connections is vital in managing the condition in children. Healthcare providers can collaborate with young patients and school authorities, potentially implementing study plans or Individualized Educational Plans (IEP) to support their educational needs. […] Many individuals with ME/CFS also endure symptoms that worsen when standing upright, a condition called orthostatic intolerance. […] Strategies to manage orthostatic issues involve avoiding triggers like heat or prolonged standing, utilizing postural maneuvers, compression garments, or increased salt/fluid intake where appropriate. If non-pharmacological methods prove ineffective, medications tailored for conditions like POTS and neurally mediated hypotension may be necessary, along with support stockings to alleviate symptoms.

• #40 Chronic Fatigue Syndrome – Harvard Health

  https://www.health.harvard.edu/a_to_z/chronic-fatigue-syndrome-a-to-z

  There is no FDA proven treatment for ME/CFS. However, clinician acknowledgement of the patients condition as ME/CFS and symptom guided approaches can improve quality of life. […] In general, doctors use a combination of the following: […] Patients are often initially encouraged to slow down, minimize physical exertion and try to avoid psychological stress. They learn to save their energy for essential activities at home or work and to cut back on less-important activities. […] Patients must first recognize the level of physical exertion that will trigger post-exertional malaise (PEM) symptoms and avoid reaching that level. […] Staying well hydrated, adding salt, wearing compression stockings, and avoiding prolonged standing can help prevent lightheadedness and extreme fatigue. […] This starts with sleep hygiene. Your doctor may suggest low dose trazadone or a tricyclic antidepressant before bed. […] Aspirin, acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) are used to treat headaches, muscle pain and joint pain. Antidepressant medications also may help to reduce chronic pain.

• #41 Chronic Fatigue Syndrome | Arthritis Foundation

  https://www.arthritis.org/diseases/chronic-fatigue-syndrome

  Manage orthostatic symptoms. Adding more salt to the diet, drinking plenty of water and wearing compression hose can help stabilize blood pressure. […] Improve sleep. Do you toss and turn even when you follow all the rules of sleep hygiene cool, dark bedroom, no large meals, alcohol or screens before bed? Then consider meditation, free sleep apps like Calm, or cognitive behavioral therapy for insomnia (CBT-i), which is also available on various evidence-based apps. […] Avoid trigger foods. Stay away from foods that aggravate symptoms, especially sugar, alcohol and caffeine. People with ME/CFS often have food sensitivities; a food diary can help you track the most troublesome. […] Try unsaturated fatty acids. Evidence suggests that fish oil supplements or foods rich in unsaturated fatty acids such as wild salmon, olive oil and nuts may reduce inflammation in ME/CFS.

• #42 Myalgic Encephalomyelitis/Chronic Fatigue Syndrome – Boris Bentsianov, MD

  https://www.brooklynentdoc.com/patient-education/health-library?DOCHWID=hw33387

  The most common ME/CFS symptoms can also be the most treatable. […] Learning how to manage your activity can help you be as active as possible without causing your symptoms to get worse. […] Good sleep habits can help improve the quality of your sleep. […] Your doctor may have you wear pressure stockings, put your legs up while sitting, or increase your salt intake. […] Different kinds of pain can be treated in different ways. […] Work with your doctor to watch for signs of depression. […] An ME/CFS support group can be a good source of information and tips for managing your illness. […] Get specialized care if you need it.

• #43 Chronic Fatigue Syndrome (Myalgic Encephalomyelitis) Treatment & Management: Activity, Exercise Therapy

  https://emedicine.medscape.com/article/235980-treatment

  Managing ME/CFS in pediatric patients involves addressing the impact of activities of daily living, education, and social engagement, which can trigger post-exertional malaise (PEM) in some cases. […] Although some young patients may require careful planning to accommodate these activities, others may navigate them with ease. […] Ensuring continuity in schooling and social connections is vital in managing the condition in children. Healthcare providers can collaborate with young patients and school authorities, potentially implementing study plans or Individualized Educational Plans (IEP) to support their educational needs. […] Many individuals with ME/CFS also endure symptoms that worsen when standing upright, a condition called orthostatic intolerance. […] Strategies to manage orthostatic issues involve avoiding triggers like heat or prolonged standing, utilizing postural maneuvers, compression garments, or increased salt/fluid intake where appropriate. If non-pharmacological methods prove ineffective, medications tailored for conditions like POTS and neurally mediated hypotension may be necessary, along with support stockings to alleviate symptoms.

• #44 Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Information & Treatment

  https://www.columbiadoctors.org/health-library/condition/myalgic-encephalomyelitis-chronic-fatigue-syndrome/

  Your doctor may have you wear pressure stockings, put your legs up while sitting, or increase your salt intake. […] Different kinds of pain can be treated in different ways. […] Work with your doctor to watch for signs of depression. […] An ME/CFS support group can be a good source of information and tips for managing your illness. […] Get specialized care if you need it. […] Medicines don’t cure ME/CFS. But they can help relieve your symptoms. […] You might take over-the-counter pain relievers and anti-inflammatory drugs. […] These include: Anticonvulsants, also called antiseizure medicines. […] Antidepressants. […] Other medicines, such as fludrocortisone or midodrine. […] There are safe nontraditional treatments that can relieve pain and stress, ease muscle tension, and help you feel better and healthier. […] Some popular complementary treatments include: Acupuncture, Massage therapy, Mind-body techniques like mindfulness, meditation, and yoga. […] Talk with your doctor before you try a new diet, vitamin, or supplement.

• #45 Manage Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | ME/CFS | CDC

  https://www.cdc.gov/me-cfs/management/index.html

  Some people with ME/CFS might benefit from antidepressants and anti-anxiety medications. […] Healthcare providers will often check the person’s heart rate and blood pressure to make sure nothing else is wrong. […] If symptoms continue but the person doesn’t have heart or blood vessel disease, healthcare providers may suggest additional measures. […] Tools like organizers and calendars can help people manage memory problems.

• #46 Myalgic encephalomyelitis/chronic fatigue syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Myalgic_encephalomyelitis/chronic_fatigue_syndrome

  Addressing sleep problems with good sleep hygiene, 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 over-the-counter painkillers are insufficient. […] For cognitive impairment, adaptations like organisers and calendars may be helpful. […] Co-occurring conditions that may interact with and worsen ME/CFS symptoms are common, and treating these may help manage ME/CFS. […] The debilitating nature of ME/CFS can cause depression, anxiety, 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.

• #47 Chronic Fatigue Syndrome (Myalgic Encephalomyelitis) Treatment & Management: Activity, Exercise Therapy

  https://emedicine.medscape.com/article/235980-treatment

  Patients with ME/CFS often experience non-restorative sleep, waking up feeling less refreshed than before the onset of illness. […] While good sleep hygiene practices are recommended, patients may still wake unrefreshed, prompting consideration of sleep medication, starting with over-the-counter options. […] Initial management options include over-the-counter pain medications like acetaminophen, aspirin, or ibuprofen, with a pain specialist consultation recommended if these remedies are insufficient. […] Non-pharmacological methods, such as stretching, manual therapy, massage, heat therapy, toning exercises, and hydrotherapy, may also aid in managing pain for patients with ME/CFS. […] Memory issues in patients with ME/CFS can be managed using memory aids such as organizers, notebooks, smartphones, and tablets for tasks, appointments, and reminders.

• #48 Chronic Fatigue Syndrome | Arthritis Foundation

  https://www.arthritis.org/diseases/chronic-fatigue-syndrome

  Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex illness marked by profound exhaustion that lasts at least six months. […] There is no cure or specific treatment for ME/CFS. Doctors are likely to recommend certain lifestyle changes to reduce symptoms and help maintain and build strength. […] Physical pacing. This is one of the most important but also most challenging aspects of treating ME/CFS. Patients first must figure out what level of activity triggers post-exertional symptoms. Then, working with a physical therapist or personal trainer experienced in ME/CFS, they can begin a gentle exercise program that aims to increase in intensity while preventing PEM. Research shows that ME/CFS patients feel and sleep better and have more energy with exercise. […] Mental pacing. As with physical pacing, its important to avoid intense mental work that might trigger a reaction. Many people need to scale back what they once did on the job or in school.

• #49 Chronic Fatigue Syndrome (Myalgic Encephalomyelitis) Treatment & Management: Activity, Exercise Therapy

  https://emedicine.medscape.com/article/235980-treatment

  When addressing cognitive problems, caution is advised when considering stimulant medications. […] Patients with chronic illnesses sometimes develop depression and/or anxiety as a co-morbid condition with their chronic illnesses. […] As many as half of patients with ME/CFS develop depression at some time during their illness. […] Although treating these comorbid conditions can be helpful, treatment for such conditions does not cure ME/CFS. […] Some patients with ME/CFS who are clinically depressed may benefit from antidepressants. However, healthcare providers should use caution in prescribing these medications. […] Patients with less severe ME/CFS may benefit from non-medication techniques that reduce stress and anxiety and promote a sense of well-being. […] Smakowski et al examined the effectiveness of graded exercise therapy provided to patients with chronic fatigue syndrome/myalgic encephalomyelitis (ME/CFS) in a specialist clinic by collecting patient-reported outcome data at multiple time points during therapy. […] Fatigue scores were significantly reduced by session 4 and at follow-up. Work and social adjustment and physical functioning progressively improved over the course of therapy, reaching significance at discharge and maintained at follow-up.

• #50 Chronic Fatigue Syndrome Medications: What Works and Why

  https://www.webmd.com/chronic-fatigue-syndrome/medicines-treat-chronic-fatigue-syndrome

  There’s no cure for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), sometimes called systemic exertion intolerance disease (SEID). Also, there are no FDA-approved medications to treat it. But some over-the-counter and prescription medications may help ease your symptoms. […] Many people with ME/CFS have some kind of sleep disorder. Getting a good (or at least better) night’s sleep could help you feel less tired during the day. […] If over-the-counter sleeping pills don’t work, your doctor might suggest a prescription sleeping pill. […] For some people, doctors prescribe stimulants, such as the ones used to treat ADHD. They help ease fatigue and problems with memory and concentration. […] Pain often goes hand in hand with ME/CFS. Up to 59% of people with CFS report having headaches, for example.

• #51 Chronic Fatigue Syndrome (Myalgic Encephalomyelitis) Treatment & Management: Activity, Exercise Therapy

  https://emedicine.medscape.com/article/235980-treatment

  When addressing cognitive problems, caution is advised when considering stimulant medications. […] Patients with chronic illnesses sometimes develop depression and/or anxiety as a co-morbid condition with their chronic illnesses. […] As many as half of patients with ME/CFS develop depression at some time during their illness. […] Although treating these comorbid conditions can be helpful, treatment for such conditions does not cure ME/CFS. […] Some patients with ME/CFS who are clinically depressed may benefit from antidepressants. However, healthcare providers should use caution in prescribing these medications. […] Patients with less severe ME/CFS may benefit from non-medication techniques that reduce stress and anxiety and promote a sense of well-being. […] Smakowski et al examined the effectiveness of graded exercise therapy provided to patients with chronic fatigue syndrome/myalgic encephalomyelitis (ME/CFS) in a specialist clinic by collecting patient-reported outcome data at multiple time points during therapy. […] Fatigue scores were significantly reduced by session 4 and at follow-up. Work and social adjustment and physical functioning progressively improved over the course of therapy, reaching significance at discharge and maintained at follow-up.

• #52 Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-fatigue-syndrome/diagnosis-treatment/drc-20360510

  There is no cure for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Treatment focuses on symptom relief. The most disruptive or disabling symptoms should be addressed first. […] Some problems associated with ME/CFS can be improved with certain medicines. Examples include: […] If medicines such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) don’t help enough, prescription drugs sometimes used to treat fibromyalgia might be options for you. […] Many people with long-term health problems, such as ME/CFS, are also depressed. Treating your depression can make it easier for you to cope with the problems associated with having a chronic disease. […] People with ME/CFS have a worsening of their symptoms after physical, mental or emotional effort. This is called post-exertional malaise.

• #53 Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/myalgic-encephalomyelitischronic-fatigue-syndrome-mecfs

  There is no cure for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Treatment focuses on symptom relief. The most disruptive or disabling symptoms should be addressed first. […] Some problems associated with ME/CFS can be improved with certain medicines. Examples include: […] If medicines such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) don’t help enough, prescription drugs sometimes used to treat fibromyalgia might be options for you. These include pregabalin (Lyrica), duloxetine (Cymbalta), amitriptyline or gabapentin (Neurontin). […] Many people with long-term health problems, such as ME/CFS, are also depressed. Treating your depression can make it easier for you to cope with the problems associated with having a chronic disease. Low doses of some antidepressants also can help improve sleep and relieve pain.

• #54 Diagnosis and Treatment of Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome | Effective Health Care (EHC) Program

  https://effectivehealthcare.ahrq.gov/products/chronic-fatigue/research

  This systematic review summarizes research on methods of diagnosing myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and benefits and harms of multiple medical and nonmedical treatments. It identifies evidence gaps and limitations to inform future research. […] Of the 35 trials of treatment, rintatolimod compared with placebo improved measures of exercise performance; counseling therapies and graded exercise treatment (GET) compared with no treatment, relaxation, or support improved fatigue, function, and quality of life, and counseling therapies also improved employment outcomes. Other treatments either provided no benefit or results were insufficient to draw conclusions. GET was associated with higher numbers of reported adverse events compared with counseling therapies or controls. Harms were generally inadequately reported across trials.

• #55 Treatment | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) | CDC

  http://medbox.iiab.me/modules/en-cdc/www.cdc.gov/me-cfs/treatment/index.html

  Patients should always talk to their healthcare provider before trying any medication. […] Other pain management methods include stretching and movement therapies, gentle massage, heat, toning exercises, and water therapy for healing. Acupuncture, when done by a licensed practitioner, might help with pain for some patients. […] Although treating depression or anxiety can be helpful, it is not a cure for ME/CFS. […] Some people with ME/CFS might benefit from trying techniques like deep breathing and muscle relaxation, massage, and movement therapies (such as stretching, yoga, and tai chi). These can reduce stress and anxiety, and promote a sense of well-being. […] For people with ME/CFS who do not have heart or blood vessel disease, doctor might suggest patients increase daily fluid and salt intake and use support stockings. If symptoms do not improve, prescription medication can be considered.

• #56 Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Information & Treatment

  https://www.columbiadoctors.org/health-library/condition/myalgic-encephalomyelitis-chronic-fatigue-syndrome/

  Your doctor may have you wear pressure stockings, put your legs up while sitting, or increase your salt intake. […] Different kinds of pain can be treated in different ways. […] Work with your doctor to watch for signs of depression. […] An ME/CFS support group can be a good source of information and tips for managing your illness. […] Get specialized care if you need it. […] Medicines don’t cure ME/CFS. But they can help relieve your symptoms. […] You might take over-the-counter pain relievers and anti-inflammatory drugs. […] These include: Anticonvulsants, also called antiseizure medicines. […] Antidepressants. […] Other medicines, such as fludrocortisone or midodrine. […] There are safe nontraditional treatments that can relieve pain and stress, ease muscle tension, and help you feel better and healthier. […] Some popular complementary treatments include: Acupuncture, Massage therapy, Mind-body techniques like mindfulness, meditation, and yoga. […] Talk with your doctor before you try a new diet, vitamin, or supplement.

• #57

  https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/treatment/

  Your doctor may discuss with you whether cognitive behavioural therapy (CBT) is a suitable option. […] CBT aims to help you live with your symptoms. It does not directly treat the symptoms of ME/CFS. […] There’s no specific medicine for treating ME/CFS, but medicine can be used to relieve some of the symptoms. […] Painkillers you buy from a pharmacy or supermarket can help ease headaches, as well as muscle and joint pain. […] Antidepressants can be useful for people with ME/CFS who are in pain or having trouble sleeping. […] As well as specialist treatments for ME/CFS, making lifestyle changes can also help. […] It’s important you eat regularly and have a healthy, balanced diet. […] You may be referred to a dietitian who has experience of working with people with ME/CFS. […] Diets that exclude certain food types are not recommended for people with ME/CFS.

• #58 ME or CFS | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/myalgic-encephalomyelitis-me-or-chronic-fatigue-syndrome-cfs/

  Your illness might make it more difficult for you to eat the right balance of nutrients in your diet due to loss of appetite and food intolerances. […] Balancing periods of activity and rest and noticing what activities demand most from you, can allow you to reduce the number of episodes of PEM. […] Counselling can support you to adjust to the impact ME/CFS can have on your life. […] CBT should only be delivered by a healthcare professional with the right training and experience in CBT for ME/CFS. […] Alternative or holistic therapies may provide some comfort but be cautious of any method that claims to offer a cure for ME/CFS.

• #59 Advancing Research and Treatment: An Overview of Clinical Trials in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Future Perspectives

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10816159/

  This review evaluates past clinical trials (CTs) in ME/CFS, identifying gaps requiring further investigation and providing recommendations for planning and designing robust future CTs into ME/CFS. […] Rintatolimod is the only drug to date that has undergone a Phase III clinical trial with confirmed improvements in ME/CFS patients. It has been approved for use in severe ME/CFS patients in Argentina, but it is still classified as an experimental drug and not approved for use in other countries. […] Future RCTs should not only validate the effectiveness of these treatments in a larger group of patients but should also explore the potential benefits of combining multiple supplements. […] Most CTs are OPT; therefore, RCTs should be undertaken, first confirming efficacy in ME/CFS patients with GI disturbances prior to trialling in other ME/CFS patient cohorts.

• #60 Treatment and management of chronic fatigue syndrome/myalgic encephalomyelitis: all roads lead to Rome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5301046/

  The therapy options available for CFS/ME focus on symptom relief. […] Drugs such as isoprinosine and rintatolimod have been used in experimental studies of the illness but have not been approved for marketing for any condition in the USA. […] A systematic review identified five RCTs evaluating the effect of immunoglobulin in CFS. […] Rintatolimod (Ampligen) has undergone years of clinical trials. […] Despite the latest advances of Rituximab immunotherapy in CFS/ME, the risk of adverse effects is unclear: Reports of adverse events in other contexts such as neutropenia and infections give reason for caution. […] The results further showed that this response was related to an improvement of the clinical outcome due to treatment. […] The authors concluded that the beneficial effects of nutritional supplements are not random, but that their action is due to the removal of one of the causes of the CFS/ME.

• #61 Diagnosis and Treatment of Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome | Effective Health Care (EHC) Program

  https://effectivehealthcare.ahrq.gov/products/chronic-fatigue/research

  This systematic review summarizes research on methods of diagnosing myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and benefits and harms of multiple medical and nonmedical treatments. It identifies evidence gaps and limitations to inform future research. […] Of the 35 trials of treatment, rintatolimod compared with placebo improved measures of exercise performance; counseling therapies and graded exercise treatment (GET) compared with no treatment, relaxation, or support improved fatigue, function, and quality of life, and counseling therapies also improved employment outcomes. Other treatments either provided no benefit or results were insufficient to draw conclusions. GET was associated with higher numbers of reported adverse events compared with counseling therapies or controls. Harms were generally inadequately reported across trials.

• #62 Systematic review of randomized controlled trials for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) | Journal of Translational Medicine | Full Text

  https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-019-02196-9

  Although medical requirements are urgent, no effective intervention has been proven for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). […] In addition, despite numerous approaches with various interventions, no definitively effective treatment has been approved for patients with CFS/ME. […] A recent trial using a monoclonal antibody, rituximab, also did not show promising results. […] New approaches and randomized controlled trials (RCTs) are now urgently needed with rigorous experimental designs for therapeutic developments combating CFS/ME. […] However, there was no definitely effective intervention with coherence and reproducibility. […] This systematic review provides a comprehensive integration of previous RCTs for CFS/ME. […] Psychological treatments were predominant and had limitations curing CFS/ME. An exploration of the pathophysiology of CFS/ME and better development of treatments are needed.

• #63 Chronic fatigue syndrome: Symptoms, treatment, and causes

  https://www.medicalnewstoday.com/articles/184802

  If these strategies do not help, the doctor may prescribe medication. […] At first, a doctor may recommend over-the-counter (OTC) drugs for headaches and other types of pain. If these do not work, they may prescribe stronger medication. […] Nondrug therapies that may help include: gentle stretching and toning exercises, gentle massage, heat therapy, water therapy. […] Anxiety and depression are common among people with ME/CFS. Antidepressant drugs may help some people, but they can sometimes make symptoms worse. […] Some laboratory research has investigated the potential action of rituximab (Rituxan), a cancer drug that targets certain cells in the immune system, for treating ME/CFS. […] Various strategies can help people manage ME/CFS. […] Gentle stretching, yoga, and tai chi might be helpful in some cases, and at the right time, but vigorous exercise can make symptoms worse. […] The CDC notes that exercise plans that benefit many people with chronic diseases are not usually suitable for people with ME/CFS, and they may be dangerous. […] Until scientists find a specific treatment, coping strategies will play a key role in managing ME/CFS.

• #64 Treatment and management of chronic fatigue syndrome/myalgic encephalomyelitis: all roads lead to Rome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5301046/

  The therapy options available for CFS/ME focus on symptom relief. […] Drugs such as isoprinosine and rintatolimod have been used in experimental studies of the illness but have not been approved for marketing for any condition in the USA. […] A systematic review identified five RCTs evaluating the effect of immunoglobulin in CFS. […] Rintatolimod (Ampligen) has undergone years of clinical trials. […] Despite the latest advances of Rituximab immunotherapy in CFS/ME, the risk of adverse effects is unclear: Reports of adverse events in other contexts such as neutropenia and infections give reason for caution. […] The results further showed that this response was related to an improvement of the clinical outcome due to treatment. […] The authors concluded that the beneficial effects of nutritional supplements are not random, but that their action is due to the removal of one of the causes of the CFS/ME.

• #65 Cyclophosphamide may be an effective treatment for myalgic encephalomyelitis | 2 Minute Medicine

  https://www.2minutemedicine.com/cyclophosphamide-may-be-an-effective-treatment-for-myalgic-encephalomyelitis/

  Cyclophosphamide may be an effective treatment for myalgic encephalomyelitis. […] Six-year follow-up data reveal that ME/CFS patients treated with cyclophosphamide reported greater and more lasting improvements than those treated with rituximab or placebo. […] Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a disease with unknown etiology, no validated biomarker, and no approved effective treatment. […] These observations suggest that ME/CFS may be associated with an autoimmune pathomechanism involving B cells/plasma cells and antibodies. […] Overall, study results support the hypothesis that ME/CFS may be associated with an autoimmune pathomechanism which may be targetable by immunomodulatory drugs. […] Despite encouraging results in the CycloME trial, cyclophosphamide should not be used for ME/CFS patients outside of clinical trials until future research is available as it carries toxicity concerns.

• #66 Cyclophosphamide may be an effective treatment for myalgic encephalomyelitis | 2 Minute Medicine

  https://www.2minutemedicine.com/cyclophosphamide-may-be-an-effective-treatment-for-myalgic-encephalomyelitis/

  Cyclophosphamide may be an effective treatment for myalgic encephalomyelitis. […] Six-year follow-up data reveal that ME/CFS patients treated with cyclophosphamide reported greater and more lasting improvements than those treated with rituximab or placebo. […] Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a disease with unknown etiology, no validated biomarker, and no approved effective treatment. […] These observations suggest that ME/CFS may be associated with an autoimmune pathomechanism involving B cells/plasma cells and antibodies. […] Overall, study results support the hypothesis that ME/CFS may be associated with an autoimmune pathomechanism which may be targetable by immunomodulatory drugs. […] Despite encouraging results in the CycloME trial, cyclophosphamide should not be used for ME/CFS patients outside of clinical trials until future research is available as it carries toxicity concerns.

• #67 Treatment and management of chronic fatigue syndrome/myalgic encephalomyelitis: all roads lead to Rome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5301046/

  In summary, nutritional supplementation is recommended in CFS/ME patients with biochemically proven deficiencies. […] CFS/ME treatment should also be optimized by the use of individualized pacing strategies, customization of CBT and other types of counselling and behavioural therapies so as to help relieve the symptoms. […] Further additional larger interventions should now incorporate personalized integrative medicine approaches for identifying CFS/ME patients most likely to respond to each type of treatment.

• #68

  https://www.eleanorsteinmd.ca/blog/4-step-treatment

  Many of my email correspondents asked me questions such as what vitamins are good for myalgic encephalomyelitis (ME) and what supplements are good for chronic fatigue syndrome (CFS). In this blog post, I will share a new 4-step treatment for the severely ill with ME/CFS. […] This 4-step treatment was created by Dr. Dag Stola and his team at the Rysumtunet Hospital, who I learned about at a conference this year. […] The first of the four steps starts with general supplements and hydration: thiamine 600 1800 mg, oral rehydration salts 20 mg in 1 L of water twice per week, N-acetyl cysteine, multi-vitamin, and multi-mineral including potassium and magnesium. […] When considering what supplements are good for myalgic encephalomyelitis/chronic fatigue syndrome, keep in mind that mitochondrial support is key. The following supplements can support mitochondrial function: NADH 20 mg/day, CoQ10 200 mg/day, Hydroxy B12 10 mg/2 ml subcutaneously twice/week.

• #69

  https://www.eleanorsteinmd.ca/blog/4-step-treatment

  Many of my email correspondents asked me questions such as what vitamins are good for myalgic encephalomyelitis (ME) and what supplements are good for chronic fatigue syndrome (CFS). In this blog post, I will share a new 4-step treatment for the severely ill with ME/CFS. […] This 4-step treatment was created by Dr. Dag Stola and his team at the Rysumtunet Hospital, who I learned about at a conference this year. […] The first of the four steps starts with general supplements and hydration: thiamine 600 1800 mg, oral rehydration salts 20 mg in 1 L of water twice per week, N-acetyl cysteine, multi-vitamin, and multi-mineral including potassium and magnesium. […] When considering what supplements are good for myalgic encephalomyelitis/chronic fatigue syndrome, keep in mind that mitochondrial support is key. The following supplements can support mitochondrial function: NADH 20 mg/day, CoQ10 200 mg/day, Hydroxy B12 10 mg/2 ml subcutaneously twice/week.

• #70

  https://www.eleanorsteinmd.ca/blog/4-step-treatment

  Many of my email correspondents asked me questions such as what vitamins are good for myalgic encephalomyelitis (ME) and what supplements are good for chronic fatigue syndrome (CFS). In this blog post, I will share a new 4-step treatment for the severely ill with ME/CFS. […] This 4-step treatment was created by Dr. Dag Stola and his team at the Rysumtunet Hospital, who I learned about at a conference this year. […] The first of the four steps starts with general supplements and hydration: thiamine 600 1800 mg, oral rehydration salts 20 mg in 1 L of water twice per week, N-acetyl cysteine, multi-vitamin, and multi-mineral including potassium and magnesium. […] When considering what supplements are good for myalgic encephalomyelitis/chronic fatigue syndrome, keep in mind that mitochondrial support is key. The following supplements can support mitochondrial function: NADH 20 mg/day, CoQ10 200 mg/day, Hydroxy B12 10 mg/2 ml subcutaneously twice/week.

• #71

  https://www.eleanorsteinmd.ca/blog/4-step-treatment

  Many of my email correspondents asked me questions such as what vitamins are good for myalgic encephalomyelitis (ME) and what supplements are good for chronic fatigue syndrome (CFS). In this blog post, I will share a new 4-step treatment for the severely ill with ME/CFS. […] This 4-step treatment was created by Dr. Dag Stola and his team at the Rysumtunet Hospital, who I learned about at a conference this year. […] The first of the four steps starts with general supplements and hydration: thiamine 600 1800 mg, oral rehydration salts 20 mg in 1 L of water twice per week, N-acetyl cysteine, multi-vitamin, and multi-mineral including potassium and magnesium. […] When considering what supplements are good for myalgic encephalomyelitis/chronic fatigue syndrome, keep in mind that mitochondrial support is key. The following supplements can support mitochondrial function: NADH 20 mg/day, CoQ10 200 mg/day, Hydroxy B12 10 mg/2 ml subcutaneously twice/week.

• #72 Chronic Fatigue Syndrome | Arthritis Foundation

  https://www.arthritis.org/diseases/chronic-fatigue-syndrome

  Manage orthostatic symptoms. Adding more salt to the diet, drinking plenty of water and wearing compression hose can help stabilize blood pressure. […] Improve sleep. Do you toss and turn even when you follow all the rules of sleep hygiene cool, dark bedroom, no large meals, alcohol or screens before bed? Then consider meditation, free sleep apps like Calm, or cognitive behavioral therapy for insomnia (CBT-i), which is also available on various evidence-based apps. […] Avoid trigger foods. Stay away from foods that aggravate symptoms, especially sugar, alcohol and caffeine. People with ME/CFS often have food sensitivities; a food diary can help you track the most troublesome. […] Try unsaturated fatty acids. Evidence suggests that fish oil supplements or foods rich in unsaturated fatty acids such as wild salmon, olive oil and nuts may reduce inflammation in ME/CFS.

• #73 Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.myalgic-encephalomyelitis-chronic-fatigue-syndrome.hw32907

  An ME/CFS support group can be a good source of information and tips for managing your illness. […] Get specialized care if you need it. For example: A rehabilitation specialist can help you treat pain and improve your ability to do your daily tasks. […] Different kinds of pain can be treated in different ways. If one treatment doesn’t work, you and your doctor can try another until you find what works best for you. […] Along with daily self-care and the treatment you get from your doctor, you might find that other treatments help too. […] Some popular complementary treatments include: Acupuncture, Massage therapy, Mind-body techniques like mindfulness, meditation, and yoga. […] Some people may try different diets, vitamins, or supplements to help manage their symptoms. Talk with your doctor before you try a new diet, vitamin, or supplement.

• #74

  https://journals.lww.com/mgar/fulltext/2024/14020/successful_treatment_of_myalgic.7.aspx

  However, following vigorous H2 gas inhalation, symptoms recovered to pre-vaccination levels after 14 weeks, and the severity score returned to 15. […] After 8 to 9 weeks of H2 gas inhalation, headache, general aches and pains, sleep disturbances, bowel movements, decreased motivation, and brain fog improved in all three patients. […] These four cases are the first in which H2 gas inhalation has been shown to attenuate the symptoms of ME/CFS. […] Nevertheless, the results obtained suggest the potential of H2 gas as a therapeutic gas for ME/CFS. Further large-scale clinical studies are needed to evaluate the efficacy of H2 gas as a therapeutic agent for ME/CFS and the underlying mechanism of action.

• #75

  https://journals.lww.com/mgar/fulltext/2024/14020/successful_treatment_of_myalgic.7.aspx

  However, following vigorous H2 gas inhalation, symptoms recovered to pre-vaccination levels after 14 weeks, and the severity score returned to 15. […] After 8 to 9 weeks of H2 gas inhalation, headache, general aches and pains, sleep disturbances, bowel movements, decreased motivation, and brain fog improved in all three patients. […] These four cases are the first in which H2 gas inhalation has been shown to attenuate the symptoms of ME/CFS. […] Nevertheless, the results obtained suggest the potential of H2 gas as a therapeutic gas for ME/CFS. Further large-scale clinical studies are needed to evaluate the efficacy of H2 gas as a therapeutic agent for ME/CFS and the underlying mechanism of action.

• #76 Oxaloacetate Treatment For Mental And Physical Fatigue In Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Long-COVID fatigue patients: a non-randomized controlled clinical trial | Journal of Translational Medicine | Full Text

  https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-022-03488-3

  There is no approved pharmaceutical intervention for Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome (ME/CFS). […] Anhydrous Enol-Oxaloacetate, (AEO) a nutritional supplement, has been anecdotally reported to relieve physical and mental fatigue and is diminished in ME/CFS patients. […] Here, we examine the use of higher dosage AEO as a medical food to relieve pathological fatigue. […] Significant reductions in physical and mental fatigue for ME/CFS and Long-COVID patients were seen after 6 weeks of treatment. […] As there has been little progress in providing fatigue relief for the millions of ME/CFS and Long COVID patients, anhydrous enol oxaloacetate may bridge this important medical need. […] Further study of oxaloacetate supplementation for the treatment of ME/CFS and Long COVID is warranted.

• #77 Oxaloacetate Treatment For Mental And Physical Fatigue In Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Long-COVID fatigue patients: a non-randomized controlled clinical trial | Journal of Translational Medicine | Full Text

  https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-022-03488-3

  The clinical trial is an open label, dose escalating Proof of Concept study for the use of anhydrous enol-oxaloacetate in the treatment of fatigue. […] This small, non-randomized open-label dose escalating Proof-of-Concept clinical trial yielded impressive highly significant improvements in fatigue in both ME/CFS patients and Long-COVID patients. […] Up to 33% of the patients with ME/CFS and up to 46.8% of Long COVID fatigue patients achieved clinical efficacy against fatigue with oral anhydrous enol-oxaloacetate treatment at 6 weeks. […] Both physical and mental fatigue were significantly improved in both ME/CFS and Long COVID fatigue patients. […] This proof-of-concept study supports the further development of anhydrous enol-oxaloacetate for the treatment of ME/CFS patients and Long COVID fatigue patients with longer randomized placebo-controlled studies.

• #78 Peptide Therapy: A Potential Treatment for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | Cureus

  https://www.cureus.com/posters/2458-peptide-therapy-a-potential-treatment-for-myalgic-encephalomyelitischronic-fatigue-syndrome

  Objective: Mitochondrial-derived peptides (MDPs), specifically mitochondrial ORF of the twelve S-c (MOTS-c), a metabolic homeostasis regulator is being evaluated as a potential therapy for the mitochondrial and glycolytic impairments associated Fatigue in ME/CFS. […] Results: MOTS-c is a peptide expressed by a mitochondrial gene that regulates the energy production of the mitochondria. […] MOTS-c regulates nuclear genes, including those related to metabolism, and glucose and amino acid metabolism in skeletal muscle. […] It also mediates an exercise-induced mitohormesis response stimulating physiological adaptation and increased tolerance to exercise. […] Considering the important physiological spectrum of MOTS-c activity, it appears as a viable candidate for ME/CFS associated Fatigue. […] Conclusion: The results of this study demonstrate that the peptide MOTS-c plays an essential physiological role in the mitochondrial function and appears to be a promising therapy for ME/CFS.

• #79

  https://www.eleanorsteinmd.ca/blog/4-step-treatment

  High-dose B12 is a remedy I have found very useful; it ranks in my Top 3 all-time remedies. […] Low-dose naltrexone (LDN) is a medication that makes Dr. Stolas list. […] A low-dose of aripiprazole can be beneficial for energy in people severely ill with ME/CFS: Low-dose aripiprazole – begin at 0.25 mg/day and increase slowly to a maximum of 2 mg (at which point its no longer low dose). […] What I love about these four steps is that they involve relatively inexpensive, safe, and well-understood remedies that most physicians would be comfortable prescribing. […] If youve been asking yourself, How can I improve myalgic encephalomyelitis, I think that youll feel more hopeful after you read this. […] Dr. Dag Stola and his team at the Rysumtunet Hospital combed the literature to find approved, safe, and mostly natural remedies with at least one randomized controlled trial supporting their use in ME or some related fatigue disorder.

• #80 Patient-Reported Treatment Outcomes in ME/CFS and Long COVID | medRxiv

  https://www.medrxiv.org/content/10.1101/2024.11.27.24317656v1.full-text

  Reported effect on overall condition was summarized using a Net Assessment Score (NAS). […] The leading treatments and categories that contributed to improving patients overall conditions as reported in self-assessments included fluids/electrolytes, pacing, compression stockings, intravenous/subcutaneous immunoglobulin (IgG), maraviroc, manual lymphatic drainage, antihistamines, low-dose naltrexone (LDN), beta blocker or ivabradine, and melatonin. […] It is also important to note that while the majority of patients reported benefits from medications such as beta-blockers, ivabradine, ADHD medications, and Mestinon, a smaller group (17%-21%) indicated that these medications worsened their condition. […] These results indicate that treatments have varying effects on disease symptoms, suggesting that patients potentially can benefit from different treatment options based on their individual needs. […] Our findings represent an early effort to identify traits of patients most likely to benefit or be harmed by medications, which can eventually assist in establishing effective criteria or algorithms to determine which patients may benefit in clinical settings, i.e., precision medicine.

• #81 Myalgic Encephalomyelitis  | PM&R KnowledgeNow

  https://now.aapmr.org/myalgic-encephalomyelitis/

  Coordination of care between multiple sub-specialty providers is key to adequately caring for these patients. […] Education on the disease process and PEM phenomenon are important aspects of helping patients not only feel validated in their experience but also assist in improving quality of life and preventing acute exacerbations.

• #82 Myalgic encephalomyelitis (Chronic fatigue syndrome) – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/277

  The chronic but fluctuating debilitating symptoms require substantial lifestyle changes to carefully plan each day’s activities, conserve energy resources for the most important tasks, schedule rest periods to avoid individuals overtaxing themselves, and to improve the quality of sleep. […] Primary care clinicians play a key role in management of patients with ME/CFS, typically retaining responsibility for long-term care and monitoring, in partnership with the ME/CFS specialist team in secondary care. […] Newer diagnostic criteria emphasise the importance of PEM as a key, defining feature of ME/CFS. […] Symptoms of PEM include fatigue, headaches, muscle aches, cognitive deficits, and insomnia. It can occur after even simple tasks (e.g., walking, or holding a conversation) and requires people to make significant lifestyle changes to conserve their physical resources and mental concentration to stay competent in normal occupational, educational, and social settings.

• #83 Chronic fatigue syndrome (CFS) | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/chronic-fatigue-syndrome-cfs

  Find a doctor who understands ME/CFS. […] Managing symptoms with your trusted healthcare professional can help to stabilise your ME/CFS and improve your quality of life. […] Pacing and rest are two self-management strategies commonly used with ME/CFS. The main goal of pacing is to reduce the intensity and frequency of PEM by limiting activity to the energy available. A key component of pacing is rest. […] While there is currently no cure and no evidence-based treatments, it is important to find a doctor who is not only sympathetic to ME/CFS, but can work with you to help manage your symptoms. […] Pacing, or keeping within your available energy, is a self-management strategy to help people with ME/CFS make sure that they dont overdo activity or exercise. It reduces the likelihood of triggering PEM and can help reduce symptoms. Pacing is not a cure for ME/CFS and does not treat the underlying, physical cause of the disease.

• #84 Manage Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | ME/CFS | CDC

  https://www.cdc.gov/me-cfs/management/index.html

  Rehabilitation specialists or exercise physiologists who understand ME/CFS may help people with ME/CFS adjust to living with the disease. […] Exercise is not a cure for ME/CFS. […] Standard exercise recommendations for healthy people can be harmful for patients with ME/CFS. However, it is important that patients with ME/CFS undertake activities that they can tolerate, as described above. […] If people are still not sleeping well after using these tips, they might want to try over-the-counter sleep medicines. […] People with ME/CFS should always talk to their healthcare provider before trying any medication. […] Other pain management methods include stretching and movement therapies, gentle massage, heat, toning exercises, and water therapy. […] If people with ME/CFS have depression or anxiety, they should be treated.

• #85 Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) – symptoms and treatment | healthdirect

  https://www.healthdirect.gov.au/chronic-fatigue-syndrome-cfs-me

  Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex illness where extreme tiredness and other symptoms reduce your ability to function. […] There’s no cure for ME/CFS but your doctor can suggest treatments that can help improve your symptoms. […] Your treatment will depend on your most severe complaint. For instance, sleep disturbance can be helped with good sleep hygiene. […] Your doctor may also recommend energy management, or pacing, as a coping strategy. […] Pacing, or energy management, aims to find the right balance between rest and everyday activities. […] Your doctor may also suggest working with other healthcare professionals such as: an occupational therapist for home adaptations, a physiotherapist, a psychologist can help provide symptom relief through cognitive behaviour therapy or mindfulness.

• #86

  https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/treatment/

  Your doctor may discuss with you whether cognitive behavioural therapy (CBT) is a suitable option. […] CBT aims to help you live with your symptoms. It does not directly treat the symptoms of ME/CFS. […] There’s no specific medicine for treating ME/CFS, but medicine can be used to relieve some of the symptoms. […] Painkillers you buy from a pharmacy or supermarket can help ease headaches, as well as muscle and joint pain. […] Antidepressants can be useful for people with ME/CFS who are in pain or having trouble sleeping. […] As well as specialist treatments for ME/CFS, making lifestyle changes can also help. […] It’s important you eat regularly and have a healthy, balanced diet. […] You may be referred to a dietitian who has experience of working with people with ME/CFS. […] Diets that exclude certain food types are not recommended for people with ME/CFS.

• #87 Myalgic encephalomyelitis/chronic fatigue syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Myalgic_encephalomyelitis/chronic_fatigue_syndrome

  Addressing sleep problems with good sleep hygiene, 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 over-the-counter painkillers are insufficient. […] For cognitive impairment, adaptations like organisers and calendars may be helpful. […] Co-occurring conditions that may interact with and worsen ME/CFS symptoms are common, and treating these may help manage ME/CFS. […] The debilitating nature of ME/CFS can cause depression, anxiety, 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.

• #88 Myalgic Encephalomyelitis  | PM&R KnowledgeNow

  https://now.aapmr.org/myalgic-encephalomyelitis/

  Coordination of care between multiple sub-specialty providers is key to adequately caring for these patients. […] Education on the disease process and PEM phenomenon are important aspects of helping patients not only feel validated in their experience but also assist in improving quality of life and preventing acute exacerbations.

• #89 Chronic Fatigue Syndrome: Causes, Symptoms, and Treatment

  https://www.healthline.com/health/chronic-fatigue-syndrome

  Making some lifestyle changes may help reduce your symptoms. […] Typically, no one medication can treat all of your symptoms. […] If lifestyle changes dont give you a restful nights sleep, your doctor may suggest a sleep aid. Pain-reducing medication can also help you cope with aches and joint pain caused by CFS. […] If medication therapy is needed, it will have to be tailored for your needs. Work closely with your doctor. Theres no one-size-fits-all treatment for CFS. […] Acupuncture, tai chi, yoga, and massage may help relieve the pain associated with CFS. Always talk to your doctor before beginning any alternative or complementary treatments. […] CFS progresses differently in everyone, so its important to work with your doctor to create a treatment plan that meets your needs.

• #90 Chronic Fatigue Syndrome | Arthritis Foundation

  https://www.arthritis.org/diseases/chronic-fatigue-syndrome

  Manage orthostatic symptoms. Adding more salt to the diet, drinking plenty of water and wearing compression hose can help stabilize blood pressure. […] Improve sleep. Do you toss and turn even when you follow all the rules of sleep hygiene cool, dark bedroom, no large meals, alcohol or screens before bed? Then consider meditation, free sleep apps like Calm, or cognitive behavioral therapy for insomnia (CBT-i), which is also available on various evidence-based apps. […] Avoid trigger foods. Stay away from foods that aggravate symptoms, especially sugar, alcohol and caffeine. People with ME/CFS often have food sensitivities; a food diary can help you track the most troublesome. […] Try unsaturated fatty acids. Evidence suggests that fish oil supplements or foods rich in unsaturated fatty acids such as wild salmon, olive oil and nuts may reduce inflammation in ME/CFS.

• #91 Myalgic encephalomyelitis/chronic fatigue syndrome | Healthify

  https://healthify.nz/health-a-z/m/mecfs

  The important thing is that you build a good relationship with a healthcare provider you trust, and work out a plan together that suits you and your circumstances. […] There are medicines that may be used to relieve some of the symptoms. […] Antidepressants can be important for people with ME/CFS who are experiencing depression or anxiety as a result of living with the condition. Talk to your healthcare provider about whether these might be useful for you. […] Things you can do to help manage this condition include: learning about ME/CFS, reducing your stress, getting plenty of rest, making sleep a priority, eating a healthy diet to make sure your body is getting the nutrients it needs, having plenty of salt if you have low blood pressure and a tendency to feel dizzy or even faint on standing, learning to prioritise the things you need to get done, and then pacing yourself by dividing them into short times of activity with rest breaks in between, learning mindfulness, meditation or creative visualisation, getting out into nature regularly, listening to music and enjoying your pets, developing a support network of understanding friends and whānau for when you need help, joining a support group if there is one in your area or an online group if not, talking to your healthcare provider about whether there are any medicines or supplements that may help you.

• #92 Chronic Fatigue Syndrome – Harvard Health

  https://www.health.harvard.edu/a_to_z/chronic-fatigue-syndrome-a-to-z

  There is no FDA proven treatment for ME/CFS. However, clinician acknowledgement of the patients condition as ME/CFS and symptom guided approaches can improve quality of life. […] In general, doctors use a combination of the following: […] Patients are often initially encouraged to slow down, minimize physical exertion and try to avoid psychological stress. They learn to save their energy for essential activities at home or work and to cut back on less-important activities. […] Patients must first recognize the level of physical exertion that will trigger post-exertional malaise (PEM) symptoms and avoid reaching that level. […] Staying well hydrated, adding salt, wearing compression stockings, and avoiding prolonged standing can help prevent lightheadedness and extreme fatigue. […] This starts with sleep hygiene. Your doctor may suggest low dose trazadone or a tricyclic antidepressant before bed. […] Aspirin, acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) are used to treat headaches, muscle pain and joint pain. Antidepressant medications also may help to reduce chronic pain.

• #93 Myalgic encephalomyelitis/chronic fatigue syndrome | Healthify

  https://healthify.nz/health-a-z/m/mecfs

  ME/CFS isn’t well understood. Diagnosis can be difficult and there’s no specific treatment. […] There’s no specific treatment for ME/CFS, but there are things that can be done to help manage your symptoms. […] As there is no treatment that can cure ME/CFS the condition is 'treated’ by treating or managing the symptoms experienced. […] A management plan for ME/CFS aims to relieve your symptoms to improve your quality of life. The plan could include: how to manage stress, a very gentle exercise plan personally designed to help you maintain muscle strength but not bring on a worsening of symptoms (known as post-exertional malaise or PEM), a nutritious diet, with regular meals/snacks to keep up your energy, supplements, if your diet lacks a good balance or if your blood tests indicate deficiencies, a sleep management plan, which may include medicine, physiotherapy to help with pain and good breathing techniques, medicine for pain, psychological input if you are particularly stressed or depressed. Counselling, psychotherapy, cognitive behavioural therapy and group therapy can all be helpful.

• #94 Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | HealthLink BC

  https://www.healthlinkbc.ca/healthwise/myalgic-encephalomyelitischronic-fatigue-syndrome

  Good sleep habits can help improve the quality of your sleep. […] Your doctor may have you wear pressure stockings, put your legs up while sitting, or increase your salt intake. […] Different kinds of pain can be treated in different ways. […] Work with your doctor to watch for signs of depression. […] An ME/CFS support group can be a good source of information and tips for managing your illness. […] Get specialized care if you need it. […] Medicines don’t cure ME/CFS. But they can help relieve your symptoms. […] Along with daily self-care and the treatment you get from your doctor, you might find that other treatments help too. […] Some popular complementary treatments include: acupuncture, massage therapy, and mind-body techniques like mindfulness, meditation, and yoga.

• #95 Myalgic encephalomyelitis/chronic fatigue syndrome | Healthify

  https://healthify.nz/health-a-z/m/mecfs

  The important thing is that you build a good relationship with a healthcare provider you trust, and work out a plan together that suits you and your circumstances. […] There are medicines that may be used to relieve some of the symptoms. […] Antidepressants can be important for people with ME/CFS who are experiencing depression or anxiety as a result of living with the condition. Talk to your healthcare provider about whether these might be useful for you. […] Things you can do to help manage this condition include: learning about ME/CFS, reducing your stress, getting plenty of rest, making sleep a priority, eating a healthy diet to make sure your body is getting the nutrients it needs, having plenty of salt if you have low blood pressure and a tendency to feel dizzy or even faint on standing, learning to prioritise the things you need to get done, and then pacing yourself by dividing them into short times of activity with rest breaks in between, learning mindfulness, meditation or creative visualisation, getting out into nature regularly, listening to music and enjoying your pets, developing a support network of understanding friends and whānau for when you need help, joining a support group if there is one in your area or an online group if not, talking to your healthcare provider about whether there are any medicines or supplements that may help you.

• #96 Myalgic encephalomyelitis/chronic fatigue syndrome | Healthify

  https://healthify.nz/health-a-z/m/mecfs

  The important thing is that you build a good relationship with a healthcare provider you trust, and work out a plan together that suits you and your circumstances. […] There are medicines that may be used to relieve some of the symptoms. […] Antidepressants can be important for people with ME/CFS who are experiencing depression or anxiety as a result of living with the condition. Talk to your healthcare provider about whether these might be useful for you. […] Things you can do to help manage this condition include: learning about ME/CFS, reducing your stress, getting plenty of rest, making sleep a priority, eating a healthy diet to make sure your body is getting the nutrients it needs, having plenty of salt if you have low blood pressure and a tendency to feel dizzy or even faint on standing, learning to prioritise the things you need to get done, and then pacing yourself by dividing them into short times of activity with rest breaks in between, learning mindfulness, meditation or creative visualisation, getting out into nature regularly, listening to music and enjoying your pets, developing a support network of understanding friends and whānau for when you need help, joining a support group if there is one in your area or an online group if not, talking to your healthcare provider about whether there are any medicines or supplements that may help you.

• #97 Myalgic encephalomyelitis/chronic fatigue syndrome | Healthify

  https://healthify.nz/health-a-z/m/mecfs

  The important thing is that you build a good relationship with a healthcare provider you trust, and work out a plan together that suits you and your circumstances. […] There are medicines that may be used to relieve some of the symptoms. […] Antidepressants can be important for people with ME/CFS who are experiencing depression or anxiety as a result of living with the condition. Talk to your healthcare provider about whether these might be useful for you. […] Things you can do to help manage this condition include: learning about ME/CFS, reducing your stress, getting plenty of rest, making sleep a priority, eating a healthy diet to make sure your body is getting the nutrients it needs, having plenty of salt if you have low blood pressure and a tendency to feel dizzy or even faint on standing, learning to prioritise the things you need to get done, and then pacing yourself by dividing them into short times of activity with rest breaks in between, learning mindfulness, meditation or creative visualisation, getting out into nature regularly, listening to music and enjoying your pets, developing a support network of understanding friends and whānau for when you need help, joining a support group if there is one in your area or an online group if not, talking to your healthcare provider about whether there are any medicines or supplements that may help you.

• #98 Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.myalgic-encephalomyelitis-chronic-fatigue-syndrome.hw32907

  An ME/CFS support group can be a good source of information and tips for managing your illness. […] Get specialized care if you need it. For example: A rehabilitation specialist can help you treat pain and improve your ability to do your daily tasks. […] Different kinds of pain can be treated in different ways. If one treatment doesn’t work, you and your doctor can try another until you find what works best for you. […] Along with daily self-care and the treatment you get from your doctor, you might find that other treatments help too. […] Some popular complementary treatments include: Acupuncture, Massage therapy, Mind-body techniques like mindfulness, meditation, and yoga. […] Some people may try different diets, vitamins, or supplements to help manage their symptoms. Talk with your doctor before you try a new diet, vitamin, or supplement.

• #99 Myalgic Encephalomyelitis/Chronic Fatigue Syndrome – Boris Bentsianov, MD

  https://www.brooklynentdoc.com/patient-education/health-library?DOCHWID=hw33387

  The most common ME/CFS symptoms can also be the most treatable. […] Learning how to manage your activity can help you be as active as possible without causing your symptoms to get worse. […] Good sleep habits can help improve the quality of your sleep. […] Your doctor may have you wear pressure stockings, put your legs up while sitting, or increase your salt intake. […] Different kinds of pain can be treated in different ways. […] Work with your doctor to watch for signs of depression. […] An ME/CFS support group can be a good source of information and tips for managing your illness. […] Get specialized care if you need it.

• #100 Myalgic Encephalomyelitis  | PM&R KnowledgeNow

  https://now.aapmr.org/myalgic-encephalomyelitis/

  Coordination of care between multiple sub-specialty providers is key to adequately caring for these patients. […] Education on the disease process and PEM phenomenon are important aspects of helping patients not only feel validated in their experience but also assist in improving quality of life and preventing acute exacerbations.

• #101 Myalgic Encephalomyelitis  | PM&R KnowledgeNow

  https://now.aapmr.org/myalgic-encephalomyelitis/

  Coordination of care between multiple sub-specialty providers is key to adequately caring for these patients. […] Education on the disease process and PEM phenomenon are important aspects of helping patients not only feel validated in their experience but also assist in improving quality of life and preventing acute exacerbations.

• #102 Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-fatigue-syndrome/diagnosis-treatment/drc-20360510

  The goal of pacing is to reduce post-exertional malaise, rather than getting back to the same activity level you had when you were healthy. […] Lack of sleep can make other symptoms more difficult to deal with. Your health care team might suggest avoiding caffeine or changing your bedtime routine. […] Many alternative therapies have been promoted for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), but very few have evidence that they work. […] Emotional support and counseling may help you and your loved ones deal with the uncertainties and restrictions of this disorder.

• #103 Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/myalgic-encephalomyelitischronic-fatigue-syndrome-mecfs

  People with ME/CFS have a worsening of their symptoms after physical, mental or emotional effort. This is called post-exertional malaise. It usually begins within 12 to 24 hours after the activity, and it can last for days or weeks. […] The goal of pacing is to reduce post-exertional malaise, rather than getting back to the same activity level you had when you were healthy. […] Lack of sleep can make other symptoms more difficult to deal with. Your health care team might suggest avoiding caffeine or changing your bedtime routine. Sleep apnea can be treated by using a machine that delivers air pressure through a mask while you sleep. […] Many alternative therapies have been promoted for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), but very few have evidence that they work. Patients with this condition may be sensitive to medications, including herbal products and supplements. Treatments that are expensive or potentially harmful should be avoided.

• #104

  https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/treatment/

  Your doctor may discuss with you whether cognitive behavioural therapy (CBT) is a suitable option. […] CBT aims to help you live with your symptoms. It does not directly treat the symptoms of ME/CFS. […] There’s no specific medicine for treating ME/CFS, but medicine can be used to relieve some of the symptoms. […] Painkillers you buy from a pharmacy or supermarket can help ease headaches, as well as muscle and joint pain. […] Antidepressants can be useful for people with ME/CFS who are in pain or having trouble sleeping. […] As well as specialist treatments for ME/CFS, making lifestyle changes can also help. […] It’s important you eat regularly and have a healthy, balanced diet. […] You may be referred to a dietitian who has experience of working with people with ME/CFS. […] Diets that exclude certain food types are not recommended for people with ME/CFS.

• #105 Recommendations | Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management | Guidance | NICE

  https://www.nice.org.uk/guidance/ng206/chapter/recommendations

  Only offer CBT to adults, children and young people with ME/CFS if, after discussing it, they would like to use it to support them in managing their symptoms. […] Be aware that other conditions may coexist with ME/CFS and should be investigated and managed according to best practice. […] Explain that flare-ups and relapses can happen in ME/CFS even if the person’s symptoms are well managed. […] Once a flareup or relapse has resolved or stabilised, discuss with the person whether their care and support plan needs to be reviewed and adjusted to reflect their current symptoms and energy limit if this is different from before the flareup or relapse.

• #106 Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.myalgic-encephalomyelitis-chronic-fatigue-syndrome.hw32907

  An ME/CFS support group can be a good source of information and tips for managing your illness. […] Get specialized care if you need it. For example: A rehabilitation specialist can help you treat pain and improve your ability to do your daily tasks. […] Different kinds of pain can be treated in different ways. If one treatment doesn’t work, you and your doctor can try another until you find what works best for you. […] Along with daily self-care and the treatment you get from your doctor, you might find that other treatments help too. […] Some popular complementary treatments include: Acupuncture, Massage therapy, Mind-body techniques like mindfulness, meditation, and yoga. […] Some people may try different diets, vitamins, or supplements to help manage their symptoms. Talk with your doctor before you try a new diet, vitamin, or supplement.

• #107 Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Research Centers

  https://mecfs.rti.org/centers/

  The Center for Solutions for ME/CFS (CfS for ME/CFS) is an interdisciplinary, inter-institutional center comprising clinicians, clinical investigators, and basic scientists who work together to understand the pathogenesis of ME/CFS and develop evidence-based strategies for interventions that prevent and mitigate disease. […] The Cornell Center for Enervating NeuroImmune Disease conducts and promotes interdisciplinary research to identify the causes, biomarkers, and pathophysiology of ME/CFS that will contribute to prevention efforts and effective treatments. […] The goal of this project is to assess whether changes in antibody titers in people with ME/CFS correlate with changes in clinical status. […] The goal of this project is to identify genetic variants whose frequencies significantly differ between people with ME/CFS and healthy controls.

• #108 Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Research Centers

  https://mecfs.rti.org/centers/

  The Center for Solutions for ME/CFS (CfS for ME/CFS) is an interdisciplinary, inter-institutional center comprising clinicians, clinical investigators, and basic scientists who work together to understand the pathogenesis of ME/CFS and develop evidence-based strategies for interventions that prevent and mitigate disease. […] The Cornell Center for Enervating NeuroImmune Disease conducts and promotes interdisciplinary research to identify the causes, biomarkers, and pathophysiology of ME/CFS that will contribute to prevention efforts and effective treatments. […] The goal of this project is to assess whether changes in antibody titers in people with ME/CFS correlate with changes in clinical status. […] The goal of this project is to identify genetic variants whose frequencies significantly differ between people with ME/CFS and healthy controls.

• #109 Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Research Centers

  https://mecfs.rti.org/centers/

  This study will conduct prospective serological surveillance to determine whether people with ME/CFS are more likely than controls to have immunological evidence of exposure to one or more microbial organisms prior to diagnosis with ME/CFS. […] The goal of this project is to determine whether RNA released into the plasma after exercise is different between people with ME/CFS and healthy controls. […] The goal of this project is to comprehensively investigate monocyte and platelet abnormalities in ME/CFS. […] The network aims to establish collaborative work by bringing different fields of study together to develop novel approaches to test and treat ME.

• #110 Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Research Centers

  https://mecfs.rti.org/centers/

  This study will conduct prospective serological surveillance to determine whether people with ME/CFS are more likely than controls to have immunological evidence of exposure to one or more microbial organisms prior to diagnosis with ME/CFS. […] The goal of this project is to determine whether RNA released into the plasma after exercise is different between people with ME/CFS and healthy controls. […] The goal of this project is to comprehensively investigate monocyte and platelet abnormalities in ME/CFS. […] The network aims to establish collaborative work by bringing different fields of study together to develop novel approaches to test and treat ME.

• #111 Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Research Centers

  https://mecfs.rti.org/centers/

  This study will conduct prospective serological surveillance to determine whether people with ME/CFS are more likely than controls to have immunological evidence of exposure to one or more microbial organisms prior to diagnosis with ME/CFS. […] The goal of this project is to determine whether RNA released into the plasma after exercise is different between people with ME/CFS and healthy controls. […] The goal of this project is to comprehensively investigate monocyte and platelet abnormalities in ME/CFS. […] The network aims to establish collaborative work by bringing different fields of study together to develop novel approaches to test and treat ME.

• #112 Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): Where will the drugs come from? | Michigan Drug Discovery

  https://drugdiscovery.umich.edu/myalgic-encephalomyelitis-chronic-fatigue-sydrome/

  Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic debilitating disease characterized by severe and disabling fatigue that fails to improve with rest; it is commonly accompanied by multifocal pain, as well as sleep disruption, and cognitive dysfunction. […] Current treatments are largely palliative and limited to alleviating symptoms and addressing the psychological sequelae associated with long-term disability. […] Herein, we review the current understanding, diagnosis and treatment of ME/CFS and summarize past clinical studies aimed at identifying effective therapies. […] We describe the current status of mechanistic studies, including the identification of multiple targets for potential pharmacological intervention, and ongoing efforts towards the discovery of new medicines for ME/CFS treatment.

• #113 Cyclophosphamide may be an effective treatment for myalgic encephalomyelitis | 2 Minute Medicine

  https://www.2minutemedicine.com/cyclophosphamide-may-be-an-effective-treatment-for-myalgic-encephalomyelitis/

  Cyclophosphamide may be an effective treatment for myalgic encephalomyelitis. […] Six-year follow-up data reveal that ME/CFS patients treated with cyclophosphamide reported greater and more lasting improvements than those treated with rituximab or placebo. […] Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a disease with unknown etiology, no validated biomarker, and no approved effective treatment. […] These observations suggest that ME/CFS may be associated with an autoimmune pathomechanism involving B cells/plasma cells and antibodies. […] Overall, study results support the hypothesis that ME/CFS may be associated with an autoimmune pathomechanism which may be targetable by immunomodulatory drugs. […] Despite encouraging results in the CycloME trial, cyclophosphamide should not be used for ME/CFS patients outside of clinical trials until future research is available as it carries toxicity concerns.

• #114 Stanford Myalgic Encephalomyelitis – Chronic Fatigue Syndrome | ME/CFS Initiative | Stanford Medicine

  https://med.stanford.edu/chronicfatiguesyndrome.html

  A. Martin Lerner, MD, president of the Treatment Center for ME/CFS, has reported in several publications that long-term antiviral treatment of a subgroup of CFS patients identified by different markers for herpesviruses have resulted in significant clinical improvement of their CFS related symptoms. […] Furthermore, it is possible that if the infectious trigger is appropriately identified, significant clinical benefit can be observed with appropriate long-term antimicrobial therapy.

• #115 Advancing Research and Treatment: An Overview of Clinical Trials in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Future Perspectives

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10816159/

  Results regarding the benefit of FMT in ME/CFS patients are conflicting and need to be confirmed in RCTs in larger cohorts of ME/CFS patients with GI disturbances. […] In this review, we have discussed published CTs in ME/CFS that have occurred over the past 33 years targeting immunological, metabolic, GI, neurological, and neuroendocrine disturbances in ME/CFS patients. Rintatolimod is the standout and the only current example of a successful treatment for ME/CFS. Yet, its status as an experimental drug means it cannot be incorporated into routine treatment. Other interventions including the use of the antivirals VACV, VGVC, and artesunate, metabolic supplements, and probiotics have shown promising results but need to demonstrate clinical efficacy in larger RCTs.

• #116 Advancing Research and Treatment: An Overview of Clinical Trials in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Future Perspectives

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10816159/

  Results regarding the benefit of FMT in ME/CFS patients are conflicting and need to be confirmed in RCTs in larger cohorts of ME/CFS patients with GI disturbances. […] In this review, we have discussed published CTs in ME/CFS that have occurred over the past 33 years targeting immunological, metabolic, GI, neurological, and neuroendocrine disturbances in ME/CFS patients. Rintatolimod is the standout and the only current example of a successful treatment for ME/CFS. Yet, its status as an experimental drug means it cannot be incorporated into routine treatment. Other interventions including the use of the antivirals VACV, VGVC, and artesunate, metabolic supplements, and probiotics have shown promising results but need to demonstrate clinical efficacy in larger RCTs.

• #117 Peptide Therapy: A Potential Treatment for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | Cureus

  https://www.cureus.com/posters/2458-peptide-therapy-a-potential-treatment-for-myalgic-encephalomyelitischronic-fatigue-syndrome

  Objective: Mitochondrial-derived peptides (MDPs), specifically mitochondrial ORF of the twelve S-c (MOTS-c), a metabolic homeostasis regulator is being evaluated as a potential therapy for the mitochondrial and glycolytic impairments associated Fatigue in ME/CFS. […] Results: MOTS-c is a peptide expressed by a mitochondrial gene that regulates the energy production of the mitochondria. […] MOTS-c regulates nuclear genes, including those related to metabolism, and glucose and amino acid metabolism in skeletal muscle. […] It also mediates an exercise-induced mitohormesis response stimulating physiological adaptation and increased tolerance to exercise. […] Considering the important physiological spectrum of MOTS-c activity, it appears as a viable candidate for ME/CFS associated Fatigue. […] Conclusion: The results of this study demonstrate that the peptide MOTS-c plays an essential physiological role in the mitochondrial function and appears to be a promising therapy for ME/CFS.

• #118 Patient-Reported Treatment Outcomes in ME/CFS and Long COVID | medRxiv

  https://www.medrxiv.org/content/10.1101/2024.11.27.24317656v1.full-text

  Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and Long COVID are persistent multi-system illnesses affecting many patients. With no known effective FDA-approved treatments for either condition, patient-reported outcomes of treatments are invaluable for guiding management strategies in patient care and generating new avenues for research. […] Patients with each condition who participated in the study shared similar symptom profiles, including all the core symptoms of ME/CFS, e.g., 89.7% of ME/CFS and 79.4% of Long COVID reported post-exertional malaise (PEM). Treatments with the greatest perceived benefits were identified, which had varied effects on different core symptoms. […] Patient subgroups with distinct profiles of symptoms and comorbidities showed varied responses to treatments, e.g., a POTS-dominant cluster benefiting from autonomic modulators and a cognitive-dysfunction cluster from CNS stimulants. This study underscores the symptomatic and therapeutic similarities between ME/CFS and Long COVID and highlights the commonalities and nuanced complexities of infection-associated chronic diseases and related conditions.

• #119 Patient-Reported Treatment Outcomes in ME/CFS and Long COVID | medRxiv

  https://www.medrxiv.org/content/10.1101/2024.11.27.24317656v1.full-text

  Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and Long COVID are persistent multi-system illnesses affecting many patients. With no known effective FDA-approved treatments for either condition, patient-reported outcomes of treatments are invaluable for guiding management strategies in patient care and generating new avenues for research. […] Patients with each condition who participated in the study shared similar symptom profiles, including all the core symptoms of ME/CFS, e.g., 89.7% of ME/CFS and 79.4% of Long COVID reported post-exertional malaise (PEM). Treatments with the greatest perceived benefits were identified, which had varied effects on different core symptoms. […] Patient subgroups with distinct profiles of symptoms and comorbidities showed varied responses to treatments, e.g., a POTS-dominant cluster benefiting from autonomic modulators and a cognitive-dysfunction cluster from CNS stimulants. This study underscores the symptomatic and therapeutic similarities between ME/CFS and Long COVID and highlights the commonalities and nuanced complexities of infection-associated chronic diseases and related conditions.

• #120 Myalgic encephalomyelitis/chronic fatigue syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Myalgic_encephalomyelitis/chronic_fatigue_syndrome

  Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a disabling chronic illness. […] Symptoms of ME/CFS can sometimes be treated and the illness can improve or worsen over time, but a full recovery is uncommon. […] No therapies or medications are approved to treat the condition, and management is aimed at relieving symptoms. […] Pacing of activities can help avoid worsening symptoms, and counselling may help in coping with the illness. […] There is no approved drug treatment or cure for ME/CFS, although some symptoms can be treated or managed. […] Care for ME/CFS involves multidisciplinary healthcare professionals. […] Management may start with treating the most disabling symptom first, and tackle symptoms one by one in further health care visits. […] Pacing, or managing one’s activities to stay within energy limits, can reduce episodes of PEM.

• #121 ME/CFS Patient Education – Bateman Horne Center

  https://batemanhornecenter.org/education/me-cfs/

  Myalgic encephalomyelitis/chronic fatigue syndrome, commonly referred to as ME/CFS, is a disease characterized by profound fatigue, cognitive dysfunction, sleep abnormalities, autonomic manifestations, pain, and other symptoms that are made worse by exertion of any sort (physical, cognitive, emotional, orthostatic stressors). […] ME/CFS can severely impair a patients ability to conduct their normal lives, yet many struggle with symptoms for years before receiving a diagnosis. […] The most important primary intervention for ME/CFS is activity management (pacing), which includes management of physical, cognitive, emotional, and orthostatic stressors. […] Pacing reduces the frequency and severity of PEM and improves both symptoms and function. […] Management resources include addressing other co-morbid conditions that could be compounding cognitive impairment, achieving restorative sleep, and engaging in restorative exercise within reason. […] Recognizing comorbid conditions early, and treating them appropriately, may improve the patients health, function, and quality of life.

• #122 Patient-Reported Treatment Outcomes in ME/CFS and Long COVID | medRxiv

  https://www.medrxiv.org/content/10.1101/2024.11.27.24317656v1.full-text

  Reported effect on overall condition was summarized using a Net Assessment Score (NAS). […] The leading treatments and categories that contributed to improving patients overall conditions as reported in self-assessments included fluids/electrolytes, pacing, compression stockings, intravenous/subcutaneous immunoglobulin (IgG), maraviroc, manual lymphatic drainage, antihistamines, low-dose naltrexone (LDN), beta blocker or ivabradine, and melatonin. […] It is also important to note that while the majority of patients reported benefits from medications such as beta-blockers, ivabradine, ADHD medications, and Mestinon, a smaller group (17%-21%) indicated that these medications worsened their condition. […] These results indicate that treatments have varying effects on disease symptoms, suggesting that patients potentially can benefit from different treatment options based on their individual needs. […] Our findings represent an early effort to identify traits of patients most likely to benefit or be harmed by medications, which can eventually assist in establishing effective criteria or algorithms to determine which patients may benefit in clinical settings, i.e., precision medicine.

• #123 Advancing Research and Treatment: An Overview of Clinical Trials in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Future Perspectives

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10816159/

  There is currently no cure or FDA-recommended treatment for ME/CFS. Consequently, fewer than 5% of patients return to their pre-morbid activity levels. […] In the past, cognitive behavioural therapy (CBT) and graded exercise therapy (GET) were recommended by health agencies for the treatment of ME/CFS. […] Consequently, treatment guidelines have undergone revisions, removing GET as a recommended therapy, while CBT is now provided as a supplementary approach to alleviate the distress related to chronic illness. […] Health agencies recommend a multidisciplinary, individualised approach to treat or manage the symptoms patients experience, utilising both pharmacological and non-pharmacological treatments. […] Treatment and management of comorbid illnesses need to be considered carefully, due to some recommended treatments for the comorbid illnesses having detrimental effects on ME/CFS symptoms.

• #124

  https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/treatment/

  Your treatment plan should be reviewed regularly. […] There are a number of specialist treatments for ME/CFS. […] Energy management is a treatment that aims to teach you how to make best use of your energy levels in your day-to-day life, without making your symptoms worse. […] Some people with ME/CFS have found that exercise programmes can make their symptoms better. But some also found it made no difference or actually made symptoms worse. […] If you think you would benefit from increased levels of exercise you should be offered a personalised plan with support from a healthcare professional (such as a physiotherapist) with experience in working with people with ME/CFS. […] Graded exercise therapy (GET), which aims to gradually increase physical activity levels, is not recommended for people with ME/CFS.

• #125 Chronic Fatigue Syndrome (Myalgic Encephalomyelitis): Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/235980-overview

  Treatment is largely supportive and focuses on symptom relief. Large randomized, controlled trials such as the pacing, graded activity, and cognitive behaviour therapy: a randomised evaluation (PACE) trial and reviews have recommended cognitive behavioral therapy (CBT) as an effective method for treating ME/CFS in adults. […] However, the surveillance report from the National Institute for Health and Care Excellence (NICE) recommends against CBT. […] The Centers for Disease Control and Prevention (CDC) and the Agency for Healthcare Research and Quality (AHRQ) both have removed CBT as a recommended treatment for ME/CFS because of insufficient evidence. […] Exercise is not a cure for ME/CFS. A review evaluated exercise therapy for patients with ME/CFS. The study found that patients felt less fatigued following exercise therapy and felt improved in terms of sleep, physical function, and general health. However, the authors could not conclude that exercise therapy improved the outcomes of pain, quality of life, anxiety, and/or depression. […] The PACE trial found that graded exercise therapy (GET) effectively improved measures of fatigue and physical functioning. […] However, updates from the NICE guideline surveillance report recommend against GET.

• #126 Advancing Research and Treatment: An Overview of Clinical Trials in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Future Perspectives

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10816159/

  There is currently no cure or FDA-recommended treatment for ME/CFS. Consequently, fewer than 5% of patients return to their pre-morbid activity levels. […] In the past, cognitive behavioural therapy (CBT) and graded exercise therapy (GET) were recommended by health agencies for the treatment of ME/CFS. […] Consequently, treatment guidelines have undergone revisions, removing GET as a recommended therapy, while CBT is now provided as a supplementary approach to alleviate the distress related to chronic illness. […] Health agencies recommend a multidisciplinary, individualised approach to treat or manage the symptoms patients experience, utilising both pharmacological and non-pharmacological treatments. […] Treatment and management of comorbid illnesses need to be considered carefully, due to some recommended treatments for the comorbid illnesses having detrimental effects on ME/CFS symptoms.

• #127 Recommendations | Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management | Guidance | NICE

  https://www.nice.org.uk/guidance/ng206/chapter/recommendations

  Be aware that ME/CFS symptoms can be managed but there is currently no cure (non-pharmacological or pharmacological) for ME/CFS. […] Discuss with people with ME/CFS the principles of energy management, the potential benefits and risks and what they should expect. […] Do not advise people with ME/CFS to undertake exercise that is not part of a programme overseen by an ME/CFS specialist team, such as telling them to go to the gym or exercise more, because this may worsen their symptoms. […] Do not offer any medicines or supplements to cure ME/CFS. […] Offer people with ME/CFS a medication review in line with the NICE guidelines on medicines adherence and medicines optimisation. […] Do not offer the Lightning Process, or therapies based on it, to people with ME/CFS. […] Discuss cognitive behavioural therapy (CBT) with adults, children and young people with ME/CFS (and their parents or carers, as appropriate).

• #128 Advancing Research and Treatment: An Overview of Clinical Trials in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Future Perspectives

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10816159/

  There is currently no cure or FDA-recommended treatment for ME/CFS. Consequently, fewer than 5% of patients return to their pre-morbid activity levels. […] In the past, cognitive behavioural therapy (CBT) and graded exercise therapy (GET) were recommended by health agencies for the treatment of ME/CFS. […] Consequently, treatment guidelines have undergone revisions, removing GET as a recommended therapy, while CBT is now provided as a supplementary approach to alleviate the distress related to chronic illness. […] Health agencies recommend a multidisciplinary, individualised approach to treat or manage the symptoms patients experience, utilising both pharmacological and non-pharmacological treatments. […] Treatment and management of comorbid illnesses need to be considered carefully, due to some recommended treatments for the comorbid illnesses having detrimental effects on ME/CFS symptoms.

• #129 Recommendations | Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management | Guidance | NICE

  https://www.nice.org.uk/guidance/ng206/chapter/recommendations

  People have the right to be involved in discussions and make informed decisions about their care, as described in NICE’s information on making decisions about your care. […] Unless stated otherwise, these recommendations apply to everyone with myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome (ME/CFS) regardless of symptom severity. […] Health and social care professionals should: take time to build supportive, trusting and empathetic relationships […] Recognise that people with ME/CFS need: timely and accurate diagnosis so they get appropriate care for their symptoms […] Explain to people with ME/CFS and their family or carers (as appropriate) that they can decline or withdraw from any part of their care and support plan and this will not affect access to any other aspects of their care.

• #130 Myalgic encephalomyelitis/chronic fatigue Syndrome (ME/CFS): Investigating care practices pointed out to disparities in diagnosis and treatment across European Union | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0225995

  Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic disease involving central nervous system and immune system disorders, characterised by severe fatigue lasting for at least 6 months that is medically unexplained and not relieved by resting. […] The purpose of the current project was to map the landscape of the Euromene countries in respect of national guidelines and recommendations for case definition, diagnosis and clinical approaches for ME/CFS patients. […] For symptom relief, pain and anti-depressive medication were most often recommended. Cognitive Behavioral Therapy and Graded Exercise treatment were often recommended as disease management and rehabilitative/palliative strategies. […] The lack of consistency in recommendations across European countries urges the development of regulations, guidance and standards.

• #131 Myalgic encephalomyelitis/chronic fatigue Syndrome (ME/CFS): Investigating care practices pointed out to disparities in diagnosis and treatment across European Union | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0225995

  Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic disease involving central nervous system and immune system disorders, characterised by severe fatigue lasting for at least 6 months that is medically unexplained and not relieved by resting. […] The purpose of the current project was to map the landscape of the Euromene countries in respect of national guidelines and recommendations for case definition, diagnosis and clinical approaches for ME/CFS patients. […] For symptom relief, pain and anti-depressive medication were most often recommended. Cognitive Behavioral Therapy and Graded Exercise treatment were often recommended as disease management and rehabilitative/palliative strategies. […] The lack of consistency in recommendations across European countries urges the development of regulations, guidance and standards.

• #132 Chronic fatigue syndrome (CFS) | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/chronic-fatigue-syndrome-cfs

  Find a doctor who understands ME/CFS. […] Managing symptoms with your trusted healthcare professional can help to stabilise your ME/CFS and improve your quality of life. […] Pacing and rest are two self-management strategies commonly used with ME/CFS. The main goal of pacing is to reduce the intensity and frequency of PEM by limiting activity to the energy available. A key component of pacing is rest. […] While there is currently no cure and no evidence-based treatments, it is important to find a doctor who is not only sympathetic to ME/CFS, but can work with you to help manage your symptoms. […] Pacing, or keeping within your available energy, is a self-management strategy to help people with ME/CFS make sure that they dont overdo activity or exercise. It reduces the likelihood of triggering PEM and can help reduce symptoms. Pacing is not a cure for ME/CFS and does not treat the underlying, physical cause of the disease.

• #133 Home – Solve ME/CFS Initiative

  https://solvecfs.org/

  Myalgic encephalomyelitis (ME), formerly known as chronic fatigue syndrome (CFS), is a chronic, complex, neuroimmune disease that profoundly limits the health and productivity of patients and is often triggered by an infection. […] There is no cure for either, nor are there any FDA-approved drugs or treatment so there is a dire need for more research into these disorders. […] Solve M.E. takes a holistic approach to research and advocacy, catalyzing efforts through our various programs to make ME/CFS, Long Covid, and other long haul diseases better understood, diagnosable, and treatable. […] The Solve ME/CFS Initiative (Solve M.E.) is a non-profit organization that serves as a catalyst for critical research into diagnostics, treatments, and cures for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), Long Covid and other infection-associated chronic conditions and illnesses (IACCIs). […] Our work with the scientific, medical, and pharmaceutical communities, advocacy with government agencies, and alliances with patient groups around the world is laying the foundation for breakthroughs that can improve the lives of millions who suffer from various long haul diseases.

• #134 Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness | The National Academies Press

  https://nap.nationalacademies.org/catalog/19012/beyond-myalgic-encephalomyelitischronic-fatigue-syndrome-redefining-an-illness

  Myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) are serious, debilitating conditions that affect millions of people in the United States and around the world. ME/CFS can cause significant impairment and disability. Despite substantial efforts by researchers to better understand ME/CFS, there is no known cause or effective treatment. […] Once diagnosed, patients often complain of receiving hostility from their health care provider as well as being subjected to treatment strategies that exacerbate their symptoms. […] This report lists the major symptoms of SEID and recommends a diagnostic process. One of the report’s most important conclusions is that a thorough history, physical examination, and targeted work-up are necessary and often sufficient for diagnosis. The new criteria will allow a large percentage of undiagnosed patients to receive an accurate diagnosis and appropriate care.

• #135 Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | MedlinePlus

  https://medlineplus.gov/myalgicencephalomyelitischronicfatiguesyndrome.html

  Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a serious, long-term illness that affects many body systems. […] There is no cure or approved treatment for ME/CFS, but you may be able to treat or manage some of your symptoms. […] You, your family, and your provider should work together to decide on a plan. […] Strategies such as learning new ways to manage activity can also be helpful. […] When you have ME/CFS, it can be hard to help develop a treatment plan. […] There are also various resources and strategies that might be helpful to you, such as: […] Make sure to talk to your provider before you try any new treatments. Some treatments that are promoted as cures for ME/CFS are unproven, often costly, and could be dangerous.

• #136

  https://www.federalregister.gov/documents/2021/05/17/2021-10271/the-systematic-review-report-for-diagnosis-and-treatment-of-myalgic-encephalomyelitischronic-fatigue

  Interested persons or organizations are invited to participate by submitting written views, recommendations, and data related to the draft report, including perspectives on and experiences with diagnosis and management of ME/CFS illness. In addition, CDC invites comments specifically on topics for pharmacological or non-pharmacological treatments. […] Public comment may inform the final systematic review report and may be used to inform development of a clinical guideline and related materials, which would help clinicians diagnose and treat patients with ME/CFS.

• #137 Myalgic Encephalomyelitis and Chronic Fatigue Syndrome (ME/CFS) | NHMRCNHMRCNHMRC TaglineNHMRC Tagline

  https://www.nhmrc.gov.au/health-advice/me-cfs

  ME/CFS is a complex and debilitating condition, characterised by profound fatigue following exertion (not relieved by sleep or rest), unrefreshing sleep and cognitive impairment. […] In August 2024, the Department of Health and Ageing allocated $1.1 million to NHMRC to develop clinical practice guidelines for ME/CFS. The goal of these guidelines is to improve diagnosis, treatment and care of patients living with ME/CFS.

• #138 Manage Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | ME/CFS | CDC

  https://www.cdc.gov/me-cfs/management/index.html

  There is no cure or approved treatment for myalgic encephalomyelitis/chronic fatigue syndrome. […] However, some symptoms can be treated or managed. […] Taking these actions may provide some relief for people’s worst symptoms and improve quality of life. […] Unfortunately, these strategies may not be effective for everyone who has ME/CFS. […] ME/CFS is a particularly difficult disease to treat or manage because its cause remains unknown. Treatment is also complicated by the fact that the disease affects people differently. So, there is no one-size-fits-all solution to managing the disease. […] Before starting a management plan, people with ME/CFS, their families, and healthcare providers should also discuss the treatment. This discussion should include the possible benefits and harms of any treatment plans, including medicines and other therapies.

• #139 Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-fatigue-syndrome/diagnosis-treatment/drc-20360510

  There is no cure for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Treatment focuses on symptom relief. The most disruptive or disabling symptoms should be addressed first. […] Some problems associated with ME/CFS can be improved with certain medicines. Examples include: […] If medicines such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) don’t help enough, prescription drugs sometimes used to treat fibromyalgia might be options for you. […] Many people with long-term health problems, such as ME/CFS, are also depressed. Treating your depression can make it easier for you to cope with the problems associated with having a chronic disease. […] People with ME/CFS have a worsening of their symptoms after physical, mental or emotional effort. This is called post-exertional malaise.

• #140

  https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/treatment/

  Treatments for myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS) aim to help relieve your symptoms. […] There’s no single way of managing ME/CFS that works for everyone, but there are a number of treatment options. […] The National Institute for Health and Care Excellence (NICE) says you should be offered a treatment plan tailored to your symptoms. […] Your doctor should discuss all of the options with you and explain the benefits and risks of any treatment. […] They should work with you to develop a treatment plan that suits you and takes into account your circumstances and preferences. […] You may need advice about making lifestyle changes, specialist treatments, or a combination of both. […] If your symptoms are severe, your doctor should ask a specialist for advice.

• #141 What is ME?

  https://www.meresearch.org.uk/what-is-me/

  There is not yet any treatment that can cure ME/CFS. […] Until a cure is found, there are a number of approaches that can help people manage their condition, although it is very important that these are discussed with a GP beforehand. […] Drug treatments are available for some of the specific symptoms of ME/CFS, such as sleep disturbances, pain, headaches, abdominal symptoms and balance disorders. […] Many people with ME/CFS find that managing their activity by pacing or other methods helps them to live with the illness day to day, and a variety of coping strategies are available that can make a real difference.

• #142 Recommendations | Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management | Guidance | NICE

  https://www.nice.org.uk/guidance/ng206/chapter/recommendations

  People have the right to be involved in discussions and make informed decisions about their care, as described in NICE’s information on making decisions about your care. […] Unless stated otherwise, these recommendations apply to everyone with myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome (ME/CFS) regardless of symptom severity. […] Health and social care professionals should: take time to build supportive, trusting and empathetic relationships […] Recognise that people with ME/CFS need: timely and accurate diagnosis so they get appropriate care for their symptoms […] Explain to people with ME/CFS and their family or carers (as appropriate) that they can decline or withdraw from any part of their care and support plan and this will not affect access to any other aspects of their care.

• #143 New Hope for Those with Chronic Fatigue Syndrome | Columbia Magazine

  https://magazine.columbia.edu/article/new-hope-those-chronic-fatigue-syndrome

  As many as four million Americans are thought to suffer from chronic fatigue syndrome, a disease characterized by symptoms that include persistent lethargy, headaches, muscle pain, mental fogginess, and sleep problems but the illness, once dismissed as the yuppie flu, has long frustrated scientists seeking to explain its etiology. […] To date, there has been no cure or treatment protocol, or even a way to test for the syndrome, but now a breakthrough by a team of scientists led by Columbia epidemiologist Mady Hornig may provide clinicians with a way to diagnose and treat chronic fatigue in its early stages. […] Hornig says that the discovery, which appeared February 27 in Science Advances, could form the basis of a new diagnostic test. […] She also says that physicians have a difficult time determining when an infectious disease like mononucleosis, Q fever, or Lyme disease all suspected preludes to chronic fatigue syndrome has evolved into the full-blown syndrome, thus necessitating a new treatment strategy.

• #144 New Hope for Those with Chronic Fatigue Syndrome | Columbia Magazine

  https://magazine.columbia.edu/article/new-hope-those-chronic-fatigue-syndrome

  It’s really important to get the diagnosis as soon as possible, so that you can begin to think about appropriate treatment strategies. […] The scientists are also optimistic that their discovery may eventually lead to the development of new treatments for chronic fatigue syndrome the only treatments currently available are drugs that have been approved for other purposes and which physicians prescribe off-label to target a person’s symptoms. […] But this is not a problem of a person’s will to get better. This is a biological disease.

• #145 Advancing Research and Treatment: An Overview of Clinical Trials in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Future Perspectives

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10816159/

  This review evaluates past clinical trials (CTs) in ME/CFS, identifying gaps requiring further investigation and providing recommendations for planning and designing robust future CTs into ME/CFS. […] Rintatolimod is the only drug to date that has undergone a Phase III clinical trial with confirmed improvements in ME/CFS patients. It has been approved for use in severe ME/CFS patients in Argentina, but it is still classified as an experimental drug and not approved for use in other countries. […] Future RCTs should not only validate the effectiveness of these treatments in a larger group of patients but should also explore the potential benefits of combining multiple supplements. […] Most CTs are OPT; therefore, RCTs should be undertaken, first confirming efficacy in ME/CFS patients with GI disturbances prior to trialling in other ME/CFS patient cohorts.

• #146 Cyclophosphamide may be an effective treatment for myalgic encephalomyelitis | 2 Minute Medicine

  https://www.2minutemedicine.com/cyclophosphamide-may-be-an-effective-treatment-for-myalgic-encephalomyelitis/

  Cyclophosphamide may be an effective treatment for myalgic encephalomyelitis. […] Six-year follow-up data reveal that ME/CFS patients treated with cyclophosphamide reported greater and more lasting improvements than those treated with rituximab or placebo. […] Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a disease with unknown etiology, no validated biomarker, and no approved effective treatment. […] These observations suggest that ME/CFS may be associated with an autoimmune pathomechanism involving B cells/plasma cells and antibodies. […] Overall, study results support the hypothesis that ME/CFS may be associated with an autoimmune pathomechanism which may be targetable by immunomodulatory drugs. […] Despite encouraging results in the CycloME trial, cyclophosphamide should not be used for ME/CFS patients outside of clinical trials until future research is available as it carries toxicity concerns.

• #147 Advancing Research and Treatment: An Overview of Clinical Trials in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Future Perspectives

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10816159/

  Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic, debilitating, and multi-faceted illness. Current treatment guidelines focus on symptom management, but with no clear target or causative mechanism, remission rates are low, and fewer than 5% of patients return to their pre-morbid activity levels. Therefore, there is an urgent need to undertake robust clinical trials to identify effective treatments. This review synthesizes insights from clinical trials exploring pharmacological interventions and dietary supplements targeting immunological, metabolic, gastrointestinal, neurological, and neuroendocrine dysfunction in ME/CFS patients which require further exploration. Additionally, the trialling of alternative interventions in ME/CFS based on reported efficacy in the treatment of illnesses with overlapping symptomology is also discussed. Finally, we provide important considerations and make recommendations, focusing on outcome measures, to ensure the execution of future high-quality clinical trials to establish clinical efficacy of evidence-based interventions that are needed for adoption in clinical practice.

• #148 Myalgic encephalomyelitis (Chronic fatigue syndrome) – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/277

  The chronic but fluctuating debilitating symptoms require substantial lifestyle changes to carefully plan each day’s activities, conserve energy resources for the most important tasks, schedule rest periods to avoid individuals overtaxing themselves, and to improve the quality of sleep. […] Primary care clinicians play a key role in management of patients with ME/CFS, typically retaining responsibility for long-term care and monitoring, in partnership with the ME/CFS specialist team in secondary care. […] Newer diagnostic criteria emphasise the importance of PEM as a key, defining feature of ME/CFS. […] Symptoms of PEM include fatigue, headaches, muscle aches, cognitive deficits, and insomnia. It can occur after even simple tasks (e.g., walking, or holding a conversation) and requires people to make significant lifestyle changes to conserve their physical resources and mental concentration to stay competent in normal occupational, educational, and social settings.

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