As with any illness, it is vital to get a proper diagnosis from your Doctor.  This is particularly hard in the case of M.E/C.F.S, as a reliable diagnostic marker has not yet arisen, and as a result, a diagnosis can only be done on the basis of your symptoms.  This is complicated by the fact that the predominant symptom of 'fatigue' is shared with many other conditions. Dr. Alan Stewart has thus likened investigating fatigue as a symptom to opening Pandora's Box. For he argues that "the doctor who is confronted with a patient with fatigue that has been severe enough to disrupt work, home or social life, also has an overwhelming number of physical ills to consider in the diagnosis and assessment of that patient's health."[1]

A proper diagnosis is essential as otherwise people may wrongly diagnose themselves and be suffering from an illness with similar symptoms. For as Dr. Anne Macintyre states, "there are many people who read about M.E. and C.F.S. in the press and in books and then decide this is the reason why they feel tired.  Such self-diagnosed people may in fact have something quite different and which could well be treatable."[2]  For instance, in Dr. Charles Shepherd's experience of seeing in excess of 800 M.E./C.F.S patients, around 5-10% of patients may have some other medical or psychiatric explanation - which might respond to drug treatment.[3]

Consequently, it is important to be aware of other conditions which may also cause chronic fatigue.  These according to Dr. Charles Shepherd (1999) include:

§         Blood Disorders e.g. Anaemia…

§         Drug Abuse

§         Gastrointestinal Disorders e.g. Coeliac disease…

§         Heart Conditions e.g. Low blood pressure…

§         Hormonal Problems e.g. Addison's disease, hyper/hypothyroidism…

§         Chronic Infections e.g. Giardia, hepatitis, HIV…

§         Liver Disease e.g. Gilbert's disease…

§         Malignancy e.g. Hodgkins disease…

§         Muscle Disorders e.g. Polymyositis

§         Neurological Disorders e.g. Multiple Sclerosis, Parkinson's disease…

§         Poisoning e.g. Carbon monoxide poisoning…

§         Psychiatric Disorders e.g. Depression, S.A.D…

§         Respiratory Disorders e.g. Tuberculosis…

§         Rheumatic Diseases e.g. Systemic lupus erythematosus

§         Others e.g. Alcoholism

§         Disorders which share many symptoms e.g. Fibromyalgia, Gulf War Syndrome…[4] [5] [6]

As a consequence of these many other possible causes of fatigue, a diagnosis of M.E./C.F.S should only be arrived at after a number of other conditions have been excluded.  However, if you still feel that your Doctor does not believe in M.E./C.F.S., you should use your right to a second opinion.

Further Information

For further information on other causes of fatigue, obtaining a diagnosis, and the appropriate tests to be carried out, we strongly recommend Dr.Charles Shepherd's book, 'Living with M.E.' (1999) and Dr. Anne Macintyre's, 'M.E./Chronic Fatigue Syndrome: A Practical Guide' (1998).

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