List of symptoms in ME CFS

The list of symptoms in ME CFS can be extensive and most patients will not have every symptom possible.

A minimum list of core symptoms of chronic fatigue (CF); post-exertional malaise (PEM); unrefreshing sleep; cognitive impairment; and/or orthostatic intolerance (OI) can diagnose a person with Systemic Exertion Intolerance Disease (SEID), an ME/CFS definition. Other symptoms can be present but a diagnosis of the SEID criterion for ME/CFS requires less symptoms than the Canadian Consensus Criteria (CCC) or the International Consensus Criteria (ICC). The CCC is another ME/CFS definition which includes the core symptoms and neurological, autonomic, neuroendocrine, and immune symptoms, and myalgia to meet its diagnostic criteria. The ICC is for diagnosing the neurological disease myalgic encephalomyelitis (ME) which was defined by the World Health Organization (WHO) in 1969.

It includes the core symptoms and neurological, immune/gastrointestinal/genitourinary impairment, and energy metabolism/ion transport impairment.

Systemic Exertion Intolerance Disease (SEID) symptom list
These are the minimum of core symptoms necessary to be diagnosed with SEID, an ME/CFS criteria. Patients can have more symptoms and they are outlined in the Institute of Medicine report.

These core symptoms are also part of the CCC and ICC criteria below. However, the CCC lists PEM as optional with Post-exertional fatigue. ICC refers to PEM as Postexertional neuroimmune exhaustion (PENE) and instead of CF the term "lack of stamina" is used. ME/CFS and ME patients will always have the core symptoms and the SEID diagnostic criteria can be used to diagnose these patients also. However, the SEID diagnostic criteria cannot speak to the number of symptoms and their severity all ME/CFS and ME patients experience. The IOM report authors who created the SEID diagnostic criteria did include some additional symptoms in chapters 4 and 5.

Core symptoms

 * profound fatigue, and
 * significant decrease in function, and
 * symptoms last at least 6 months, and
 * post-exertional malaise (PEM), and
 * unrefreshing sleep, and
 * either


 * cognitive impairment
 * or


 * orthostatic intolerance (OI)

Pediatric
Pediatric cases have the same symptoms. However, the CDC notes some differences: orthostatic intolerance (causing dizziness and lightheadedness) is experienced more often, making their other ME/CFS symptoms worse. Sleep problems may be harder to detect; they will experience insomnia, daytime sleepiness, and intense and vidid dreaming. Children and adolescents do not usually have muscle and joint pain but headaches and stomach pain are more common. Dr. David Bell agrees the symptoms for children can be different noting abdominal pain is more common and in teens there can be facial flushing. Although children do not describe having PEM, a hallmark symptom used in diagnosing ME/CFS, they can experience a relapse from exertion, perhaps from just taking the school bus, having to spend prolonged periods in bed.

Children, particularly adolescents, will more likely have an acute illness like the flu or mononucleosis as their onset.

Canadian consensus criteria (CCC) symptom list
The Canadian Consensus Criteria (CCC), an ME/CFS criteria, includes a list of recognized signs and symptoms in the appendix. Only some of these symptoms within the categories below are needed to be diagnosed under the Canadian Consensus Criteria diagnostic criteria. PEM is an and/or option with post-exertional fatigue.

Children and adolescents will have the same symptoms; but the typical presentation of Pediatric Systemic Exertion Intolerance Disease (SEID) is different.

International consensus criteria (ICC) symptom list
The International Consensus Criteria (ICC) will diagnose myalgic encephalomyelitis (ME). Not every symptom listed is necessary to diagnose ME but having symptoms within categories is necessary. The ICC refers to "lack of stamina" instead of chronic fatigue.

Post-exertional Neuroimmune Exhaustion (PENE)
Previously known as Post-Exertional Malaise.

Energy Metabolism/Ion Transportation

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Learn more

 * International Consensus Primer for medical practitioners
 * IOM report - Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
 * Canadian Consensus Criteria