“A diagnosis by exclusion is not a diagnosis.” -Dr. John Sarno, MD
Myalgic encephalomyelitis, or myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic illness characterized primarily by extreme and debilitating fatigue and widespread physical pain. According to the Mayo Clinic, “evidence suggests that problems generating and using the main energy molecule, adenosine triphosphate (ATP), may be a fundamental driver of ME/CFS.” (I describe this sensation here, and liken it to the Keto Flu.) It is a diagnosis of exclusion, meaning the diagnosis is based on the presence of symptoms that can’t be explained by other illnesses. There is no medical consensus as to what causes ME, and the presentation can vary widely between individuals.
Fatigue is generally made worse by exertion (post-exertional malaise,) but doesn’t improve with rest. Sleep disturbance is common, as are heart arrhythmias, and orthostatic intolerance (failure of blood pressure to keep up with changes in body position, sometimes leading to syncope [fainting].) The symptoms of ME indicate widespread systems failures within the body, from immunosuppression, to neurological symptoms such as brain fog and inability to tolerate light and sound, to organ failure (renal failure being most common.)
Presentation may vary widely, and individuals may receive many concurrent diagnoses, such as chronic Lyme, Mold Toxicity, and autoimmunity. Many individuals with the symptoms of ME/CFS never receive a diagnosis.