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  • Writer's pictureLorna Fedelem, MD

Myalgic Encephalomyelitis

March is National Awareness Month

Chronic Fatigue Syndrome, more accurately known as Myalgic Encephalomyelitis or ME/CFS, is a complicated disorder. It has gained traction recently during the pandemic, as COVID infection has been found to be a cause of this condition.

It causes extreme fatigue that lasts for at least six months. Symptoms worsen with physical or mental activity but don't fully improve with rest. It has been described to me as an overwhelming weakness that requires bedrest, not necessarily sleep. The weakness is so profound that it’s difficult to lift one’s arms or even hold up one’s head.

The cause of ME is unknown, although there are many theories. Experts believe it might be triggered by a combination of factors.

There's no single test to confirm a diagnosis of ME. You may need a variety of medical tests to rule out other health problems that have similar symptoms. Treatment for the condition focuses on easing symptoms.


Symptoms of ME can vary from person to person, and the severity of symptoms can fluctuate from day to day. In addition to fatigue and weakness, symptoms may include:

  • Extreme exhaustion after physical or mental exercise.

  • Problems with memory or thinking skills.

  • Dizziness that worsens with moving from lying down or sitting to standing.

  • Muscle or joint pain.

  • Unrefreshing sleep.

  • Some people with ME have headaches, sore throats, and tender lymph nodes in the neck or armpits. People with this condition also may become extra sensitive to light, sound, smells, food and medicines.


The cause of ME is still unknown. A combination of factors may be involved, including:

Genetics. ME appears to run in some families, so some people may be born with a higher likelihood of developing the disorder.

  • Infections. Some people develop ME symptoms after getting better from a viral or bacterial infection, especially COVID (AKA Long-COVID).

  • Physical or emotional trauma. Some people report that they experienced an injury, surgery, or significant emotional stress shortly before their symptoms began.

  • Problems with energy usage. Some people with ME have problems converting the body's fuel, primarily fats and sugars, into energy.


Symptoms of ME can come and go, and often are triggered by physical activity or emotional stress. This can make it difficult for people to maintain a regular work schedule or to even take care of themselves at home.

Many people may be too weak to get out of bed at different points during their illness. Some may need to use a wheelchair.


There is no cure for ME. Treatment focuses on symptom relief. The most disruptive or disabling symptoms should be addressed first.

Pacing for post-exertional malaise

People with ME 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.

People who have post-exertional malaise often struggle to find a good balance between activity and rest. The goal is to remain active without overdoing it. This is also called pacing.

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. As you improve, you may be able to safely engage in more activity without triggering post-exertional malaise.

It may help to keep a daily diary of your activities and symptoms, so you can track how much activity is too much for you.

Addressing sleep problems

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.

Coping and support

The experience of ME varies from person to person. Emotional support and counseling may help you and your loved ones deal with the uncertainties and restrictions of this disorder.

Talking with a counselor can help build coping skills to deal with chronic illness, address limitations at work or school, and improve family dynamics. It also can be helpful if you are dealing with symptoms of depression.

You may find it helpful to join a support group and meet other people with your condition. Support groups aren't for everyone, and you may find that a support group adds to your stress rather than relieves it. Experiment and use your own judgment to determine what's best for you.

Myalgic Encephalomyelitis is real and now more prevalent in society since the pandemic. Talk to your doctor if you think you have ME. Now that more research is being focused on ME, hopefully there is a chance for a cure!


Call and schedule a complimentary meet and greet with Dr. Fedelem. 9150 Galleria Ct., Suite 200, Naples, FL 34109 | 239.580.6390


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