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68-554: [REDACTED] Look up CFS in Wiktionary, the free dictionary. CFS may refer to: Organizations [ edit ] Canadian Federation of Students Canadian Forest Service Center for Financial Studies , a research institute affiliated with Goethe University Frankfurt, Germany Center for Subjectivity Research , a research institute affiliated with

136-730: A blunted heart rate response to exercise , but a higher heart rate during a tilt table test when the body is rotated from lying flat to an upright position. This again suggests dysfunction in the autonomic nervous system. People with ME/CFS often have immune system abnormalities. A consistent finding in studies is a decreased function of natural killer cells, a type of immune cell that targets virus-infected and tumour cells. They are also more likely to have active viral infections, correlating with cognitive issues and fatigue. T cells show less metabolic activity. This may reflect they have reached an exhausted state and cannot respond effectively against pathogens . Autoimmunity has been proposed to be

204-503: A neurological disease by the World Health Organization (WHO) since 1969, initially under the name benign myalgic encephalomyelitis . The classification of ME/CFS as a neurological disease is based on symptoms which indicate a central role of the nervous system. Alternatively, based on abnormalities in immune cells , ME/CFS is sometimes labelled a neuroimmune condition. The disease can further be regarded as

272-476: A post-acute infection syndrome (PAIS) or an infection-associated chronic illness. PAISes such as long COVID and post-treatment Lyme disease syndrome share many symptoms with ME/CFS and are suspected to have a similar cause. Many names have been proposed for the illness. The most commonly used are chronic fatigue syndrome , myalgic encephalomyelitis , and the umbrella term myalgic encephalomyelitis/chronic fatigue syndrome ( ME/CFS ). Reaching consensus on

340-601: A professional certification Microsoft Combat Flight Simulator ( CFS1 ), a game Topics referred to by the same term [REDACTED] This disambiguation page lists articles associated with the title CFS . If an internal link led you here, you may wish to change the link to point directly to the intended article. Retrieved from " https://en.wikipedia.org/w/index.php?title=CFS&oldid=1254728323 " Categories : Disambiguation pages Place name disambiguation pages Hidden categories: Articles containing French-language text Short description

408-601: A professional certification Microsoft Combat Flight Simulator ( CFS1 ), a game Topics referred to by the same term [REDACTED] This disambiguation page lists articles associated with the title CFS . If an internal link led you here, you may wish to change the link to point directly to the intended article. Retrieved from " https://en.wikipedia.org/w/index.php?title=CFS&oldid=1254728323 " Categories : Disambiguation pages Place name disambiguation pages Hidden categories: Articles containing French-language text Short description

476-441: A change in brain structure and metabolism . Observed changes in the immune system include decreased natural killer cell function and, in some cases, autoimmunity . A range of structural, biochemical, and functional abnormalities are found in brain imaging studies of people with ME/CFS. Common findings are changes in the brainstem and the use of additional brain areas for cognitive tasks. Other consistent findings, based on

544-540: A clearly defined onset. Symptoms must be present at least half of the time, and be of moderate severity or worse; previous criteria just required symptoms to be present. In 2021, NICE revised its criteria based on the IOM criteria. The updated criteria require fatigue, PEM, non-restorative sleep, and cognitive difficulties persisting for at least three months. Separate diagnostic criteria have been developed for children and young people. A diagnosis for children often requires

612-789: A diagnosis, and diagnoses may be missed altogether. Specialists in ME/CFS may be asked to confirm the diagnosis, as primary care physicians often lack a good understanding of the illness. Multiple research and clinical criteria exist to diagnose ME/CFS. These include the NICE guidelines, Institute of Medicine (IOM) criteria, the International Consensus Criteria (ICC), the Canadian Consensus Criteria (CCC), and CDC criteria. The criteria sets were all developed based on expert consensus and differ in

680-501: A factor in ME/CFS. There is a subset of people with ME/CFS with increased levels of autoantibodies , possibly as a result of viral mimicry . Some may have higher levels of autoantibodies to muscarinic acetylcholine receptors as well as to β2 adrenergic receptors . Problems with these receptors can lead to impaired blood flow. Objective signs of PEM have been found with the 2-day cardiopulmonary exercise test . People with ME/CFS have lower performance compared to healthy controls on

748-593: A file system which is shared by being simultaneously mounted on multiple servers Other uses [ edit ] Canada Flight Supplement , a publication Certificat de formation à la sécurité , the French national degree required to be flight attendant in France Call for service , an incident that emergency services are assigned to resolve Chicken-fried steak or country fried steak Consolidated financial statement Certified Finance Specialist,

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816-480: A file system which is shared by being simultaneously mounted on multiple servers Other uses [ edit ] Canada Flight Supplement , a publication Certificat de formation à la sécurité , the French national degree required to be flight attendant in France Call for service , an incident that emergency services are assigned to resolve Chicken-fried steak or country fried steak Consolidated financial statement Certified Finance Specialist,

884-468: A full-time job. The cause of ME/CFS is not yet known. Between 60% and 80% of cases start after an infection, usually a viral infection. A genetic factor is believed to contribute, but there is no single gene responsible for increased risk. Instead, many gene variants probably have a small individual effect, but their combined effect can be strong. Other factors may include problems with the nervous and immune systems, as well as energy metabolism. ME/CFS

952-575: A genetic factor. In the United States, white Americans are diagnosed more frequently than other groups, but the illness is probably at least as prevalent among African Americans and Hispanics. It used to be thought that ME/CFS was more common among those with higher incomes. Instead, people in minority groups or lower income groups may have increased risks due to poorer nutrition, lower healthcare access, and increased work stress. Viral infections have long been suspected to cause ME/CFS, based on

1020-730: A military installation of the Canadian Armed Forces Congo Free State , a recognized national entity in central Africa 1885–1908 Côte française des Somalis , the French Somaliland Transportation [ edit ] Citywide Ferry Service , a commuter ferry in New York City, US Coffs Harbour Airport (IATA airport code) Empire Airlines (ICAO code: CFS), originally named Clearwater Flying Service Syrian Railways (French: Chemins de fer syriens ),

1088-483: A military installation of the Canadian Armed Forces Congo Free State , a recognized national entity in central Africa 1885–1908 Côte française des Somalis , the French Somaliland Transportation [ edit ] Citywide Ferry Service , a commuter ferry in New York City, US Coffs Harbour Airport (IATA airport code) Empire Airlines (ICAO code: CFS), originally named Clearwater Flying Service Syrian Railways (French: Chemins de fer syriens ),

1156-509: A name has been challenging because the cause and pathology remain unknown. In the WHO's most recent classification, the ICD-11 , chronic fatigue syndrome and myalgic encephalomyelitis are named under post-viral fatigue syndrome. The term post-infectious fatigue syndrome was initially proposed as a subset of "chronic fatigue syndrome" with a documented triggering infection, but might also be used as

1224-752: A research institute affiliated with the University of Copenhagen, Denmark Child and family services , a government or non-profit organisation Christian Family Solutions , a Christian non-profit social service agency headquartered in Germantown, Wisconsin, US Citizens for Sunshine , an Ohio, US nonprofit promoting access to public records Committee on World Food Security , in the United Nations System Commonwealth Fusion Systems , an American fusion energy company Conservative Future Scotland ,

1292-436: A school event, food shopping, or even taking a shower. For some, being in a stimulating environment can be sufficient to trigger PEM. PEM usually starts 12 to 48 hours after the activity, but can also follow immediately after. PEM can last hours, days, weeks, or months. Extended periods of PEM, commonly referred to as "crashes" or "flare-ups" by people with the illness, can lead to a prolonged relapse. Unrefreshing sleep

1360-499: A shorter symptom duration. For example, the CCC definition only requires three months of persistent symptoms in children compared to six months for adults. NICE requires only four weeks of symptoms to suspect ME/CFS in children, compared to six weeks in adults. Exclusionary diagnoses also differ; for instance, children and teenagers may have anxiety related to school attendance , which could explain symptoms. Screening can be done using

1428-670: A slowdown in information processing. Individuals may have difficulty speaking, struggling to find words and names. They may have trouble concentrating or multitasking , or may have difficulties with short-term memory. Tests often show problems with short-term visual memory, reaction time and reading speed . There may also be problems with attention and verbal memory . People with ME/CFS often experience orthostatic intolerance , symptoms that start or worsen with standing or sitting. Symptoms, which include nausea, lightheadedness, and cognitive impairment, often improve again after lying down. Weakness and vision changes may also be triggered by

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1496-575: A smaller number of studies, are low metabolism in some areas, reduced serotonin transporters , and problems with neurovascular coupling . Neuroinflammation has been proposed as an underlying mechanism of ME/CFS that could explain a large set of symptoms. Several studies suggest neuroinflammation in the cortical and limbic regions of the brain. Individuals with ME/CFS, for instance, have higher brain lactate and choline levels, which are signs of neuroinflammation. More direct evidence from two small Positron emission tomography studies of microglia ,

1564-446: A sore throat. People may also develop allergies or become sensitive to foods, lights, noise, smells or chemicals. ME/CFS often leads to serious disability, but the degree varies considerably. ME/CFS is generally classified into four categories of illness severity: Roughly a quarter of those living with ME/CFS fall into the mild category, and half fall into the moderate or moderate-to-severe categories. The final quarter falls into

1632-462: A synonym of ME/CFS or as a broader set of fatigue conditions after infection. Many individuals with ME/CFS object to the term chronic fatigue syndrome . They consider the term simplistic and trivialising, which in turn prevents the illness from being taken seriously. At the same time, there are also issues with the use of myalgic encephalomyelitis (myalgia means muscle pain and encephalomyelitis means brain and spinal cord inflammation), as there

1700-502: A tilt table test. If that is unavailable, it can also be assessed with the simpler NASA 10-minute lean test , which tests the response to prolonged standing. Standard laboratory findings are usually normal. Standard tests when suspecting ME/CFS include an HIV test, and blood tests to determine full blood count , red blood cell sedimentation rate (ESR), C-reactive protein , blood glucose and thyroid-stimulating hormone . Tests for antinuclear antibodies may come back positive, but below

1768-411: A trigger. ME/CFS can also begin with multiple minor triggering events, followed by a final trigger that leads to a clear onset of symptoms. ME/CFS can affect people of all ages, ethnicities, and income levels, but it is more common in women than men. People with a history of frequent infections are more likely to develop it. Those with family members who have ME/CFS are also at higher risk, suggesting

1836-400: A type of immune cell in the brain, were contradictory, however. ME/CFS affects sleep. Individuals experience decreased sleep efficiency , take longer to fall asleep , and take longer to achieve REM sleep , a phase of sleep characterised by rapid eye movement. Changes to non-REM sleep have also been found, together suggesting a role of the autonomic nervous system. Individuals often have

1904-513: A weather prediction and climate model Cold-formed steel , a goods manufacturing technique Continuous flash suppression , adapted version of flash suppression Cubic feet per second (cfs or CFS), a unit of fluid flow rate Computing [ edit ] CFS (file format) , an open file format for archiving and compressing files Completely Fair Scheduler , a Linux operating system scheduler Continuous flow system , printer ink feeding via tubes and bottles Clustered file system ,

1972-513: A weather prediction and climate model Cold-formed steel , a goods manufacturing technique Continuous flash suppression , adapted version of flash suppression Cubic feet per second (cfs or CFS), a unit of fluid flow rate Computing [ edit ] CFS (file format) , an open file format for archiving and compressing files Completely Fair Scheduler , a Linux operating system scheduler Continuous flow system , printer ink feeding via tubes and bottles Clustered file system ,

2040-450: Is post-exertional malaise , a worsening of the illness which starts hours to days after minor physical or mental activity. This "crash" can last from hours or days to several months. Further common symptoms include dizziness , nausea and pain. The cause of the disease is unknown. ME/CFS often starts after an infection, such as mononucleosis . It can run in families, but no genes that contribute to ME/CFS have been confirmed. ME/CFS

2108-434: Is a biological disease, not a psychological condition, and is not due to deconditioning . Besides viruses, other reported triggers include stress, traumatic events, and environmental exposures such as to mould . Bacterial infections such as Q-fever are other potential triggers. ME/CFS may further occur after physical trauma, such as an accident or surgery. Pregnancy has been reported in around 3% to 10% of cases as

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2176-615: Is a further core symptom. People wake up exhausted and stiff rather than restored after a night's sleep. This can be caused by a pattern of sleeping during the day and being awake at night , shallow sleep, or broken sleep. However, even a full night's sleep is typically non-restorative. Some individuals experience insomnia, hypersomnia (excessive sleepiness), or vivid nightmares. Cognitive dysfunction in ME/CFS can be as disabling as physical symptoms, leading to difficulties at work or school, as well as in social interactions. People with ME/CFS sometimes describe it as "brain fog", and report

2244-493: Is associated with changes in the nervous and immune systems, as well as in energy production. Diagnosis is based on symptoms and a differential diagnosis because no diagnostic test is available. The illness can improve or worsen over time, but 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

2312-421: Is based on symptoms and involves taking a medical history and a mental and physical examination. No specific lab tests are approved for diagnosis; while physical abnormalities can be found, no single finding is considered sufficient for diagnosis. Blood and urine tests are used to rule out other conditions that could be responsible for the symptoms. People with ME/CFS often face significant delays in obtaining

2380-500: Is different from Wikidata All article disambiguation pages All disambiguation pages CFS [REDACTED] Look up CFS in Wiktionary, the free dictionary. CFS may refer to: Organizations [ edit ] Canadian Federation of Students Canadian Forest Service Center for Financial Studies , a research institute affiliated with Goethe University Frankfurt, Germany Center for Subjectivity Research ,

2448-403: Is different from Wikidata All article disambiguation pages All disambiguation pages Chronic fatigue syndrome Myalgic encephalomyelitis/chronic fatigue syndrome ( ME/CFS ) is a disabling chronic illness . People with ME/CFS experience profound fatigue that does not go away with rest, sleep issues, and problems with memory or concentration. The hallmark symptom of ME/CFS

2516-575: Is of a longer duration and greater severity than in other conditions characterized by fatigue. The hallmark feature of ME/CFS is a worsening of symptoms after exertion, known as post-exertional malaise or post-exertional symptom exacerbation . PEM involves increased fatigue and is disabling. It can also include flu-like symptoms, pain, cognitive difficulties, gastrointestinal issues, nausea , and sleep problems. All types of activities that require energy, whether physical, cognitive, social, or emotional, can trigger PEM. Examples include attending

2584-502: Is only limited evidence of brain inflammation implied by the name. The umbrella term ME/CFS would retain the better-known phrase CFS without trivialising the disease, but some people object to this name too, as they see CFS and ME as distinct illnesses. A 2015 report from the US Institute of Medicine recommended the illness be renamed systemic exertion intolerance disease ( SEID ) and suggested new diagnostic criteria. While

2652-402: Is present in about 90% of people, usually in a latent state. The levels of antibodies to EBV are commonly higher in people with ME/CFS, indicating possible viral reactivation. ME/CFS is associated with changes in several areas, including the nervous and immune systems, as well as disturbances in energy metabolism. Neurological differences include autonomic nervous system dysfunction and

2720-508: The DePaul Symptom Questionnaire , which assesses the frequency and severity of ME/CFS symptoms. Individuals may struggle to answer questions related to PEM, if they are unfamiliar with the symptom. To find patterns in symptoms, they may be asked to keep a diary. A physical exam may appear completely normal, particularly if the individual has rested substantially before a doctor's visit. There may be tenderness in

2788-686: The Fukuda criteria. The 2011 International Consensus Criteria defines ME using symptom clusters and has no minimum duration of symptoms. Similarly to the CCC criteria, ICC is stricter than the Fukuda criteria and selects more severely ill people. The 2015 IOM criteria share significant similarities with the CCC but were developed to be easy to use for clinicians. Diagnosis requires fatigue, PEM, non-restorative sleep, and either cognitive issues (such as memory impairment) or orthostatic intolerance. Additionally, fatigue must persist for at least six months, substantially impair activities in all areas of life, and have

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2856-602: The Syrian state railway system Sartigan Railway (French: Chemin de fer Sartigan ), a short-line railway in Quebec Science and technology [ edit ] Causal fermion systems , a fundamental physics theory Chromosomal fragile site , a part of the chromosome prone to breakage Chronic fatigue syndrome , a chronic illness now mainly called Myalgic encephalomyelitis/chronic fatigue syndrome Climate Forecast System (NCEP) or coupled forecast system,

2924-485: The Syrian state railway system Sartigan Railway (French: Chemin de fer Sartigan ), a short-line railway in Quebec Science and technology [ edit ] Causal fermion systems , a fundamental physics theory Chromosomal fragile site , a part of the chromosome prone to breakage Chronic fatigue syndrome , a chronic illness now mainly called Myalgic encephalomyelitis/chronic fatigue syndrome Climate Forecast System (NCEP) or coupled forecast system,

2992-486: The University of Copenhagen, Denmark Child and family services , a government or non-profit organisation Christian Family Solutions , a Christian non-profit social service agency headquartered in Germantown, Wisconsin, US Citizens for Sunshine , an Ohio, US nonprofit promoting access to public records Committee on World Food Security , in the United Nations System Commonwealth Fusion Systems , an American fusion energy company Conservative Future Scotland ,

3060-459: The ability to function and typically last for three to six months before a diagnosis can be confirmed. ME/CFS usually starts after an infection. Onset can be sudden or more gradual over weeks to months. People with ME/CFS experience persistent debilitating fatigue . It is made worse by normal physical, mental, emotional, and social activity, and is not a result of ongoing overexertion. Rest provides limited relief from fatigue. Particularly in

3128-791: The ability to speak, swallow, or communicate completely due to cognitive issues. They can further experience severe pain and hypersensitivities to touch, light, sound, and smells. Minor day-to-day activities can be sufficient to trigger PEM. Individuals with ME/CFS have decreased quality of life when evaluated by the SF-36 questionnaire, especially in the domains of physical and social functioning, general health, and vitality. However, their emotional functioning and mental health are not much lower than those of healthy individuals. Functional impairment in ME/CFS can be greater than multiple sclerosis , heart disease , or lung cancer . Fewer than half of people with ME/CFS are employed, and roughly one in five have

3196-421: The brain under orthostatic stress (as found in a tilt table test), small-fibre neuropathy , and an increase in the amount of gut microbes entering the blood. The diversity of gut microbes is reduced compared to healthy controls. Women with ME/CFS are more likely to experience endometriosis , early menopause , and other menstrual irregularities compared to women without the condition. Diagnosis of ME/CFS

3264-595: The diagnostic criteria for ME/CFS. Of people who get infectious mononucleosis , which is caused by the Epstein–Barr virus (EBV), around 8% to 15% develop ME/CFS, depending on criteria. Other viral infections that can trigger ME/CFS are the H1N1 influenza virus , varicella zoster (the virus that causes chickenpox and shingles ), and SARS-CoV-1 . Reactivation of latent viruses, in particular EBV and human herpesvirus 6 , has also been hypothesised to drive symptoms. EBV

3332-494: The disease can be socially isolating. About a quarter of those affected are unable to leave their bed or home. People with ME/CFS often face stigma in healthcare settings, and care is complicated by controversies around the cause and treatments of the illness. Doctors may be unfamiliar with ME/CFS, as it is often not fully covered in medical school. Historically, research funding for ME/CFS has been far below that of diseases with comparable impact. ME/CFS has been classified as

3400-478: The eyes and in the neck, as well as neuropathic pain (related to disorders of the nervous system). Headaches and migraines that were not present before the illness can occur as well. However, chronic daily headaches may indicate an alternative diagnosis. Additional common symptoms include irritable bowel syndrome or other problems with digestion, chills and night sweats , shortness of breath or an irregular heartbeat . Some experience sore lymph nodes and

3468-595: The first test. On the second test, healthy people's scores stay roughly the same or increase slightly, while those with ME/CFS have a clinically significant decrease in work rate at the anaerobic threshold . Potential causes include mitochondrial dysfunction, and issues with the transport and use of oxygen. Some of the usual recovery processes following exercise may be lacking, providing an alternative explanation for PEM. Studies have observed mitochondrial abnormalities in cellular energy production, but differences between studies make it hard to draw clear conclusions. ATP ,

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3536-606: The food safety authority of the Hong Kong government Central Flying Schools [ edit ] Central Flying School , a Royal Air Force training establishment Central Flying School RAAF , a Royal Australian Air Force training establishment Central Flying School RNZAF , a Royal New Zealand Air Force unit Central Flying School SAAF , a flight school of the South African Air Force Places [ edit ] Canadian Forces Station ,

3604-464: The food safety authority of the Hong Kong government Central Flying Schools [ edit ] Central Flying School , a Royal Air Force training establishment Central Flying School RAAF , a Royal Australian Air Force training establishment Central Flying School RNZAF , a Royal New Zealand Air Force unit Central Flying School SAAF , a flight school of the South African Air Force Places [ edit ] Canadian Forces Station ,

3672-475: The illness. Before the COVID-19 pandemic , ME/CFS affected two to nine out of every 1000 people, depending on the definition. However, many people fit ME/CFS diagnostic criteria after contracting long COVID . ME/CFS occurs more often in women than in men. It most commonly affects adults between ages 40 and 60 but can occur at other ages, including childhood. ME/CFS has a large social and economic impact, and

3740-487: The initial period of illness, this fatigue is described as "flu-like". Individuals may feel "physically drained" and unable to start or finish activities. They may also feel restless while fatigued, describing their experience as "wired but tired". When starting an activity, muscle strength may drop rapidly, which can lead to difficulty with coordination, clumsiness or sudden weakness . Mental fatigue may also make cognitive efforts difficult. The fatigue experienced in ME/CFS

3808-410: The levels that suggest the individual may have lupus . C-reactive protein levels are often at the high end of normal. Serum ferritin levels may be useful to test, as borderline anaemia can make some ME/CFS symptoms worse. Some medical conditions have symptoms similar to ME/CFS. Diagnosis often involves clinical evaluation, testing, and specialist referrals to identify the correct condition. During

3876-429: The lymph nodes and abdomen or signs of hypermobility. Answers to questions may show a temporary difficulty with finding words or other cognitive problems. Cognitive tests and a two-day cardiopulmonary exercise test (CPET) can be helpful to document aspects of the illness, but they may be risky as they can cause severe PEM. They may be warranted to support a disability claim. Orthostatic intolerance can be measured with

3944-604: The new name was not widely adopted, the diagnostic criteria were taken over by the CDC. Like CFS , the name SEID only focuses on a single symptom, and opinion from those affected was generally negative. ME/CFS causes debilitating fatigue, sleep problems, and post-exertional malaise (PEM, overall symptoms getting worse after mild activity). In addition, cognitive issues, orthostatic intolerance (dizziness or nausea when upright) or other physical symptoms may be present (see also § Diagnostic criteria ). Symptoms significantly reduce

4012-523: The observation that ME/CFS sometimes occurs in outbreaks and is possibly connected to autoimmune diseases . How viral infections cause ME/CFS is unclear; it could be via viral persistence or via a "hit and run" mechanism, in which infections dysregulate the immune system or cause autoimmunity. Different types of viral infection have been implicated in ME/CFS, including airway infections, bronchitis , gastroenteritis , or an acute "flu-like illness". Between 15% and 50% of people with long COVID also meet

4080-428: The primary energy carrier in cells, is likely more frequently produced from lipids and amino acids than from carbohydrates . Some people with ME/CFS have abnormalities in their hypothalamic–pituitary–adrenal axis hormones. This can include lower cortisol levels , less change in cortisol levels throughout the day, and a weaker reaction to stress and stimuli. Other proposed abnormalities are reduced blood flow to

4148-429: The required symptoms and which conditions preclude a diagnosis of ME/CFS. The definitions differ in their conceptualisation of the cause and mechanisms of ME/CFS. As there is no biomarker for ME/CFS, it is not possible to determine which set of criteria is the most accurate. A trade-off must be made between overdiagnosis and missing more diagnoses. The broad Fukuda criteria have a higher risk of overdiagnosis, whereas

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4216-455: The severe or very severe category. Severity may change over time. Symptoms might get worse, improve, or the illness may go into remission for a period of time. People who feel better for a period of time may overextend their activities, triggering PEM and a worsening of symptoms. Those with severe and very severe ME/CFS experience more extreme and diverse symptoms. They may face severe weakness and greatly limited ability to move. They can lose

4284-611: The strict ICC criteria have a higher risk of missing people. The IOM and NICE criteria fall in the middle. The 1994 CDC criteria, sometimes called the Fukuda criteria, require six months of persistent or relapsing fatigue for diagnosis, as well as the persistent presence of four out of eight other symptoms. While used frequently, the Fukuda criteria have limitations: PEM and cognitive issues are not mandatory. The large variety of optional symptoms can lead to diagnosis of individuals who differ significantly from each other. The Canadian Consensus Criteria, another commonly used criteria set,

4352-1193: The time other possible diagnoses are explored, advice can be given on symptom management to help prevent the condition from getting worse. Before a diagnosis of ME/CFS is confirmed, a waiting period is used to exclude acute medical conditions or symptoms which may resolve within that time frame. Possible differential diagnoses span a large set of specialties and depend on the medical history. Examples are infectious diseases , such as Epstein–Barr virus and Lyme disease , and neuroendocrine disorders, including diabetes and hypothyroidism . Blood disorders , such as anaemia , and some cancers may also present similar symptoms. Various rheumatological and autoimmune diseases, such as Sjögren's syndrome , lupus, and arthritis , may have overlapping symptoms with ME/CFS. Furthermore, it may be necessary to evaluate psychiatric diseases , such as depression or substance use disorder , as well as neurological disorders, such as narcolepsy , multiple sclerosis , and craniocervical instability . Finally, sleep disorders, coeliac disease , and side effects of medications may also explain symptoms. Joint and muscle pain without swelling or inflammation

4420-547: The upright posture. Some have postural orthostatic tachycardia syndrome (POTS), an excessive increase in heart rate after standing up, which can result in fainting . Additionally, individuals may experience orthostatic hypotension , a drop in blood pressure after standing. Pain and hyperalgesia (an abnormally increased sensitivity to pain) are common in ME/CFS. The pain is not accompanied by swelling or redness. The pain can be present in muscles ( myalgia ) and joints . Individuals with ME/CFS may have chronic pain behind

4488-706: The youth branch of the Scottish Conservative Party Co-operative Financial Services , former name of a UK-based banking and insurance company Corpo Forestale dello Stato , the Italian state forestry department South Australian Country Fire Service , a volunteer firefighting service Craigmillar Festival Society , a former community organisation in Edinburgh, Scotland Craniofacial Society of Great Britain and Ireland Centre for Food Safety ,

4556-470: The youth branch of the Scottish Conservative Party Co-operative Financial Services , former name of a UK-based banking and insurance company Corpo Forestale dello Stato , the Italian state forestry department South Australian Country Fire Service , a volunteer firefighting service Craigmillar Festival Society , a former community organisation in Edinburgh, Scotland Craniofacial Society of Great Britain and Ireland Centre for Food Safety ,

4624-415: Was developed in 2003. In addition to PEM, fatigue and sleep problems, pain and neurological or cognitive issues are required for diagnosis. Furthermore, three categories of symptoms are defined (orthostatic, thermal instability, and immunological). At least one symptom in two of these categories needs to be present. People diagnosed under the CCC have more severe symptoms compared to those diagnosed under

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