Referrals to the ME/CFS Service
The ME/CFS service is accessed by GP referral. As part of the referral process, we ask GPs to do a range of blood tests in order to exclude any underlying condition that could be contributing to your symptoms.
Currently there is no diagnostic test for ME/CFS and it is recognised on clinical grounds alone.
The NICE guidelines indicate that ME/CFS may be suspected if:
The symptoms are not explained by another condition and
- the person's ability to engage in occupational, educational, social or personal activities is significantly reduced from pre‑illness levels and
- the person has had all of the following persistent symptoms (see below) for a minimum of 6 weeks in adults and 4 weeks in children and young people
All of these symptoms should be present:
- Debilitating fatigue that is worsened by activity, is not caused by excessive cognitive, physical, emotional or social exertion, and is not significantly relieved by rest.
- Post-exertional malaise after activity in which the worsening of symptoms:
- is often delayed in onset by hours or days
- is disproportionate to the activity
- has a prolonged recovery time that may last hours, days, weeks or longer.
- Unrefreshing sleep or sleep disturbance (or both), which may include:
- feeling exhausted, feeling flu-like and stiff on waking
- broken or shallow sleep, altered sleep pattern or hypersomnia
- Cognitive difficulties (sometimes described as 'brain fog'), which may include problems finding words or numbers, difficulty in speaking, slowed responsiveness, short-term memory problems, and difficulty concentrating or multitasking.
A diagnosis of ME/CFS can be made if the symptoms above have persisted for 3 months and are not explained by another condition.
Be aware that the following symptoms may also be associated with, but are not exclusive to, ME/CFS:
- orthostatic intolerance and autonomic dysfunction, including dizziness, palpitations, fainting, nausea on standing or sitting upright from a reclining position
- temperature hypersensitivity resulting in profuse sweating, chills, hot flushes, or feeling very cold
- neuromuscular symptoms, including twitching and myoclonic jerks
- flu-like symptoms, including sore throat, tender glands, nausea, chills or muscle aches
- intolerance to alcohol, or to certain foods and chemicals
- heightened sensory sensitivities, including to light, sound, touch, taste and smell
- pain, including pain on touch, myalgia, headaches, eye pain, abdominal pain or joint pain without acute redness, swelling or effusion.