What are the main symptoms of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)?

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex, long-term medical condition affecting multiple body systems, causing significant disability that may prevent individuals from performing usual daily activities, and in some cases, can lead to complete bedridden status [1]. The main symptoms of this syndrome are central to its diagnosis and include:

Severe Persistent Fatigue

Severe, persistent fatigue is a primary symptom of ME/CFS. This fatigue differs from normal tiredness; it does not improve with rest, persists for six months or longer, and is severe enough to prevent a person from performing activities they were able to do before becoming ill [1]. It is not the result of unusual or intense exertion [3].

Post-Exertional Malaise (PEM)

Post-Exertional Malaise (PEM) is defined as the worsening of symptoms after any physical or mental activity, even if mild [1]. This malaise can occur after grocery shopping, potentially requiring a nap before returning home, or the person may need assistance to return [3]. There is no way to predict what will trigger the malaise or how long it will take to recover, which may last for days, weeks, or even longer [3]. To avoid worsening symptoms, individuals with ME/CFS must carefully balance activity and rest, and keeping a symptom journal may help in learning how to pace activities [2].

Sleep Disorders

People with ME/CFS suffer from sleep problems, such as difficulty falling or staying asleep [3]. Most importantly, a full night's rest does not relieve the fatigue or other symptoms; instead, the person wakes up feeling tired even after sufficient sleep [2].

Cognitive and Orthostatic Intolerance Issues

In addition to the primary symptoms, a person must experience one or both of the following to be diagnosed with ME/CFS:

• Problems with thinking and memory: This includes difficulty concentrating, forgetfulness, and trouble following details, sometimes referred to as "brain fog" [3].
• Worsening of symptoms upon standing or sitting upright (Orthostatic Intolerance): This can cause dizziness, lightheadedness, weakness, or fainting when standing or sitting [1]. This can occur when the body has difficulty regulating blood pressure and heart rate when changing positions or standing for long periods [2].

Additional Symptoms

ME/CFS can also cause a range of other symptoms, which may vary from person to person and change over time [1]. These include:

• Various pains, including muscle and joint pain and headaches [1].
• Sore throat or painful swollen lymph nodes in the neck or armpits [1].
• Digestive issues, such as Irritable Bowel Syndrome (IBS) [1].
• Chills and night sweats [1].
• Sensitivity to foods, odors, chemicals, light, or noise [1].

Since there is no specific test to diagnose ME/CFS, doctors rely on excluding other diseases that cause similar symptoms, as well as a comprehensive evaluation of symptoms and medical history [1]. If you are experiencing severe fatigue or any of these symptoms, it is important to consult a healthcare provider to rule out more serious conditions and receive a proper diagnosis and care. For more information about this syndrome, you may visit Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Challenging Diagnosis and Daily Management (Arabic).

Medical references

• Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
• ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome)
• Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)