Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

From hibernation straight to spring fatigue: For many people, this is more of an excuse than a severe illness. But for an estimated 250,000 people in Germany, “I’m so tired” is the bitter truth: they feel physically and mentally exhausted, and the symptoms worsen after exertion. Learn all about the causes, signs and treatment of this condition.

What is Chronic Fatigue Syndrome?

In Germany and internationally, the dual designation “Myalgic Encephalomyelitis/Chronic Fatigue Syndrome” or “Myalgic Encephalomyelitis/Chronic Fatigue Syndrome” has now been established for the disease.

At first, ME/CFS is flu-like. Patients complain of sore throats, headaches, muscle and joint pain. There are also memory problems, which can be severe, and significant problems concentrating.

Several other symptoms can vary significantly from person to person, such as fever, tachycardia, dizziness, sleep problems and nausea. The decisive factor for the naming was the long-term, paralyzing exhaustion of the patients, which could not be eliminated even with sleep and rest.

Those affected lack the energy for the simplest tasks of daily life. Whether making coffee or brushing your teeth, even minor exertion can worsen the symptoms. This is referred to as the so-called post-exertional malaise. This can also occur with a time delay of 24 to 48 hours. In addition to the symptoms caused by the illness, those affected often have to accept considerable restrictions in their social environment.


Diagnosis and therapy in chronic fatigue syndrome

The multitude of symptoms and their combinations is one reason why the diagnosis of ME/CFS is so tricky. There is no single symptom that can be used to diagnose ME/CFS. The numerous complaints can only be grasped insufficiently scientifically.

The focus of the diagnosis is, therefore, a severe, long-lasting exhaustion that cannot be remedied. Other diseases that cause similarly severe states of exhaustion must be ruled out. These include fibromyalgia (a rheumatic disease), leukaemia (blood cancer) or mental disorders such as depression. Since the symptoms are similar to many other diseases, it can sometimes take a long time before the correct diagnosis.

If all other possibilities are ruled out, there are the following internationally recognized diagnostic criteria:

  • permanent mental and physical exhaustion
  • flu-like symptoms, sore throat
  • painful lymph nodes
  • muscle discomfort
  • Poor concentration, forgetfulness
  • visual disturbances
  • Reizempfindlichkeit
  • Worsening of the condition after exertion (post-exertional malaise)

Not every symptom occurs with the same frequency and with the same intensity. If many criteria come together and all other possible diseases have been ruled out, one can speak of ME/CFS. Studies in the USA show that those affected led a particularly active life before their illness. The disease is prevalent between ages 10 and 19 and between 30 and 39. Women are affected twice as often as men.

Therapy of chronic fatigue syndrome

The treatment of chronic fatigue syndrome is just as complex as the diagnosis. There is no single drug that will help. On the contrary, the gentlest possible treatment of the symptoms is recommended, with the medication dosage often being below the usual minimum dosage. Many ME/CFS patients have an increased sensitivity to medication.

A balanced diet, regulated sleep and rest times, the rehabilitation of diseased teeth and the elimination of existing infections are part of the treatment plan.

There is currently no reliable information about the course of the disease or the chances of recovery. British researchers estimate that 35 per cent of all those affected recover slowly but steadily. This and possibly a complete improvement, however, drags on for years.


Coping with illness usually requires help.

Great value is placed on supportive psychological treatment because those affected need competent help in overcoming their illness. After the start of treatment, there is often a phase in which the impairments are particularly pronounced: many patients can then only lie in bed and are unable to take care of themselves.

The goal of treatment is not to cure ME/CFS because the symptoms are not psychological. However, with the help of psychological treatment, the remaining energy reserves should be used as sensibly as possible. For those affected and those around them, this means adapting their lifestyle to the disease, which depends on how they are on the day and the individual assessment of the patient. Therapy can also help patients better process the circumstances that the illness brings.

ME/CFS: Causes and Research

The exact causes of myalgic encephalomyelitis/chronic fatigue syndrome are not known. Researchers are discussing numerous variants: Viruses, fungi, or environmental toxins can be the triggers. Hormonal disorders and permanent mental or physical overload are also possible.

The researchers are interested, among other things, in a protein usually formed by the body during virus defence. This protein is highly elevated in many, but not all, ME/CFS patients. However, it is still unclear whether a viral involvement in chronic fatigue syndrome can be determined this way.

However, some experts assume that it is a disorder similar to an autoimmune disease, which usually occurs as a result of an infection. In an autoimmune disease, the immune system misdirects itself against endogenous structures such as cells or receptors. The latest studies also indicate a disrupted energy metabolism. Despite the relatively large number of people affected, extensive research still needs to be done.


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