Corticosteroids given during acute viral infection may trigger myalgic encephalomyelitis

Acute viral infection plus corticosteroids may cause ME/CFS
Dr John Chia has observed that corticosteroids inadvertently prescribed during an acute viral infection substantially increase the risk of developing myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) from that infection. Via his meticulous investigations into patients' medical histories, Dr Chia discovered that hundreds of his ME/CFS patients were given corticosteroids precisely during the time that they came down with a flu-like illness, gastrointestinal upset or other viral infection. Thus there appears to be a causal equation of:

Acute infection + corticosteroids = ME/CFS

Dr Chia says one reason corticosteroids can be inadvertently prescribed during an acute enteroviral infection is because an enterovirus rash can look like hives, so if a doctor questions what the patient ate, and they happened to eat shellfish recently, the doctor may incorrectly assume the rash is a hives rash, resulting from allergy to shellfish. So the doctor may then put the patient on a course of corticosteroids such as prednisone, as this is the normal treatment for hives.

Thus the patient has an acute enterovirus infection, and needs a strong immune response to fight this infection, yet receives immunosuppressing corticosteroids, because the viral rash was misdiagnosed as hives.

Similarly, if a patient comes down with an acute viral infection and its symptoms are suggestive of asthma, they may also be inappropriately prescribed corticosteroids, because that is how asthma is treated.

Immunosuppression by corticosteroids and chronic stress
Corticosteroids suppress the Th1 antiviral/intracellular immune response, and suppresses T-cell function.

Interestingly, ME/CFS is usually precipitated by viral infection, and several studies found it is common to experience major psychological chronic stress in the year prior to developing ME/CFS. Chronic psychological stress elevates cortisol which suppresses the Th1 antiviral/intracellular immune response, and the T-cell response. Thus immonologically, chronic stress has a similar effect to corticosteroid administration, and both these factors appear to increase the risk of development of ME/CFS from viral infection.