https://me-pedia.org/w/api.php?action=feedcontributions&feedformat=atom&user=MEcfsFMS 2026-08-02T20:44:05Z User contributions MediaWiki 1.43.9 https://me-pedia.org/w/index.php?title=Robin_Brown&diff=44683 2018-11-30T02:34:24Z

<p>MEcfsFMS:/* Online presence */ x</p> <hr /> <div>{{stub}}<br /> [[File:Robin Brown.jpg|200px|thumb|right|]]<br /> '''K.N. Hng''', also known as '''Robin Brown''',&lt;ref&gt;{{Cite web|url=https://www.facebook.com/RobinBrown76?hc_ref=ARS2IVPUHah35qebAfedrEIKFkyUieP_ggZcKzslkyAlyiOWpmx6MNRspA6DrB4A9H8&amp;fref=nf&amp;__tn__=CH-R|title=Robin Brown|website=www.facebook.com|language=en|access-date=2018-11-30}}&lt;/ref&gt; is a [[United Kingdom|British]] physician with [[ME/CFS]]. Dr. Hng authored the book, [[M.E. and Me: A Doctor's Struggle with Chronic Fatigue Syndrome]], which chronicles her experience as a Gastroenterology trainee who developed [[ME/CFS]].&lt;ref&gt;{{Cite web|url=https://www.facebook.com/DrHng|title=Dr Hng Page|website=www.facebook.com|language=en|access-date=2018-11-13}}&lt;/ref&gt;<br /> <br /> ==Talks and interviews==<br /> <br /> == Books published ==<br /> * 2018, ''[[M.E. and Me: A Doctor's Struggle with Chronic Fatigue Syndrome]]''<br /> <br /> ==Online presence==<br /> *[https://www.facebook.com/DrHng Facebook] (Dr. Hng)<br /> *[https://www.facebook.com/RobinBrown76?hc_ref=ARS2IVPUHah35qebAfedrEIKFkyUieP_ggZcKzslkyAlyiOWpmx6MNRspA6DrB4A9H8&amp;fref=nf&amp;__tn__=CH-R Facebook] (Robin Brown)<br /> *[http://www.twitter.com/DoctorwithME Twitter] (Dr. Hng)<br /> <br /> ==See also==<br /> <br /> * [[M.E. and Me: A Doctor's Struggle with Chronic Fatigue Syndrome]]<br /> * [[NHS ]]<br /> * [[NICE]]<br /> * [[NICE guidelines]]<br /> <br /> ==Learn more==<br /> * [https://www.change.org/p/nice-stop-harming-me-cfs-patients-take-cbt-get-out-of-me-cfs-guidelines-now NICE stop harming ME/CFS patients - Take CBT and GET out of the CFS guidelines NOW!]&lt;ref&gt;{{Cite web|url=https://www.change.org/p/nice-stop-harming-me-cfs-patients-take-cbt-get-out-of-me-cfs-guidelines-now|title=Sign the Petition|last=Hng|first=K.N.|authorlink=Robin Brown|last2=|first2=|authorlink2=|date=|website=Change.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-11-30}}&lt;/ref&gt; (Petition by Dr. Hng)<br /> <br /> ==References==<br /> &lt;references /&gt;<br /> <br /> [[Category:People with ME, CFS, and/or FMS]] <br /> [[Category:Advocates or allies]]</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Robin_Brown&diff=44680 2018-11-30T02:05:45Z

<p>MEcfsFMS:heading and internal link</p> <hr /> <div>{{stub}}<br /> [[File:Robin Brown.jpg|200px|thumb|right|]]<br /> '''K.N. Hng''', also known as '''Robin Brown''',&lt;ref&gt;{{Cite web|url=https://www.facebook.com/RobinBrown76?hc_ref=ARS2IVPUHah35qebAfedrEIKFkyUieP_ggZcKzslkyAlyiOWpmx6MNRspA6DrB4A9H8&amp;fref=nf&amp;__tn__=CH-R|title=Robin Brown|website=www.facebook.com|language=en|access-date=2018-11-30}}&lt;/ref&gt; is a [[United Kingdom|British]] physician with [[ME/CFS]]. Dr. Hng authored the book, [[M.E. and Me: A Doctor's Struggle with Chronic Fatigue Syndrome]], which chronicles her experience as a Gastroenterology trainee who developed [[ME/CFS]].&lt;ref&gt;{{Cite web|url=https://www.facebook.com/DrHng|title=Dr Hng Page|website=www.facebook.com|language=en|access-date=2018-11-13}}&lt;/ref&gt;<br /> <br /> ==Talks and interviews==<br /> <br /> == Books published ==<br /> * 2018, ''[[M.E. and Me: A Doctor's Struggle with Chronic Fatigue Syndrome]]''<br /> <br /> ==Online presence==<br /> *[http://www.twitter.com/DoctorwithME Twitter]<br /> *[https://www.facebook.com/DrHng Facebook]<br /> *[https://www.facebook.com/RobinBrown76?hc_ref=ARS2IVPUHah35qebAfedrEIKFkyUieP_ggZcKzslkyAlyiOWpmx6MNRspA6DrB4A9H8&amp;fref=nf&amp;__tn__=CH-R Facebook] (Robin Brown)<br /> <br /> ==See also==<br /> <br /> * [[M.E. and Me: A Doctor's Struggle with Chronic Fatigue Syndrome]]<br /> * [[NHS ]]<br /> * [[NICE]]<br /> * [[NICE guidelines]]<br /> <br /> ==Learn more==<br /> * [https://www.change.org/p/nice-stop-harming-me-cfs-patients-take-cbt-get-out-of-me-cfs-guidelines-now NICE stop harming ME/CFS patients - Take CBT and GET out of the CFS guidelines NOW!]&lt;ref&gt;{{Cite web|url=https://www.change.org/p/nice-stop-harming-me-cfs-patients-take-cbt-get-out-of-me-cfs-guidelines-now|title=Sign the Petition|last=Hng|first=K.N.|authorlink=Robin Brown|last2=|first2=|authorlink2=|date=|website=Change.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-11-30}}&lt;/ref&gt; (Petition by Dr. Hng)<br /> <br /> ==References==<br /> &lt;references /&gt;<br /> <br /> [[Category:People with ME, CFS, and/or FMS]] <br /> [[Category:Advocates or allies]]</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Robin_Brown&diff=44677 2018-11-30T01:33:54Z

<p>MEcfsFMS:citation</p> <hr /> <div>{{stub}}<br /> [[File:Robin Brown.jpg|200px|thumb|right|]]<br /> '''K.N. Hng''', also known as '''Robin Brown''',&lt;ref&gt;{{Cite web|url=https://www.facebook.com/RobinBrown76?hc_ref=ARS2IVPUHah35qebAfedrEIKFkyUieP_ggZcKzslkyAlyiOWpmx6MNRspA6DrB4A9H8&amp;fref=nf&amp;__tn__=CH-R|title=Robin Brown|website=www.facebook.com|language=en|access-date=2018-11-30}}&lt;/ref&gt; is a [[United Kingdom|British]] physician with [[ME/CFS]]. Dr. Hng authored the book, [[M.E. and Me: A Doctor's Struggle with Chronic Fatigue Syndrome]], which chronicles her experience as a Gastroenterology trainee who developed [[ME/CFS]].&lt;ref&gt;{{Cite web|url=https://www.facebook.com/DrHng|title=Dr Hng Page|website=www.facebook.com|language=en|access-date=2018-11-13}}&lt;/ref&gt;<br /> <br /> ==Talks and interviews==<br /> <br /> ==Online presence==<br /> *[http://www.twitter.com/DoctorwithME Twitter]<br /> *[https://www.facebook.com/DrHng Facebook]<br /> *[https://www.facebook.com/RobinBrown76?hc_ref=ARS2IVPUHah35qebAfedrEIKFkyUieP_ggZcKzslkyAlyiOWpmx6MNRspA6DrB4A9H8&amp;fref=nf&amp;__tn__=CH-R Facebook] (Robin Brown)<br /> <br /> ==See also==<br /> <br /> * [[M.E. and Me: A Doctor's Struggle with Chronic Fatigue Syndrome]]<br /> * [[NHS ]]<br /> * [[NICE]]<br /> * [[NICE guidelines]]<br /> <br /> ==Learn more==<br /> * [https://www.change.org/p/nice-stop-harming-me-cfs-patients-take-cbt-get-out-of-me-cfs-guidelines-now NICE stop harming ME/CFS patients - Take CBT and GET out of the CFS guidelines NOW!]&lt;ref&gt;{{Cite web|url=https://www.change.org/p/nice-stop-harming-me-cfs-patients-take-cbt-get-out-of-me-cfs-guidelines-now|title=Sign the Petition|last=Hng|first=K.N.|authorlink=Robin Brown|last2=|first2=|authorlink2=|date=|website=Change.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-11-30}}&lt;/ref&gt; (Petition by Dr. Hng)<br /> <br /> ==References==<br /> &lt;references /&gt;<br /> <br /> [[Category:People with ME, CFS, and/or FMS]] <br /> [[Category:Advocates or allies]]</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Robin_Brown&diff=44676 2018-11-30T01:30:10Z

<p>MEcfsFMS:image</p> <hr /> <div>{{stub}}<br /> [[File:Robin Brown.jpg|200px|thumb|right|]]<br /> '''K.N. Hng''', also known as '''Robin Brown''',&lt;ref&gt;{{Cite web|url=https://www.facebook.com/RobinBrown76?hc_ref=ARS2IVPUHah35qebAfedrEIKFkyUieP_ggZcKzslkyAlyiOWpmx6MNRspA6DrB4A9H8&amp;fref=nf&amp;__tn__=CH-R|title=Robin Brown|website=www.facebook.com|language=en|access-date=2018-11-30}}&lt;/ref&gt; is a [[United Kingdom|British]] physician with [[ME/CFS]]. Dr. Hng authored the book, [[M.E. and Me: A Doctor's Struggle with Chronic Fatigue Syndrome]], which chronicles her experience as a Gastroenterology trainee who developed [[ME/CFS]].&lt;ref&gt;{{Cite web|url=https://www.facebook.com/DrHng|title=Dr Hng Page|website=www.facebook.com|language=en|access-date=2018-11-13}}&lt;/ref&gt;<br /> <br /> ==Talks and interviews==<br /> <br /> ==Online presence==<br /> *[http://www.twitter.com/DoctorwithME Twitter]<br /> *[https://www.facebook.com/DrHng Facebook]<br /> *[https://www.facebook.com/RobinBrown76?hc_ref=ARS2IVPUHah35qebAfedrEIKFkyUieP_ggZcKzslkyAlyiOWpmx6MNRspA6DrB4A9H8&amp;fref=nf&amp;__tn__=CH-R Facebook] (Robin Brown)<br /> <br /> ==See also==<br /> <br /> * [[M.E. and Me: A Doctor's Struggle with Chronic Fatigue Syndrome]]<br /> * [[NHS ]]<br /> * [[NICE]]<br /> * [[NICE guidelines]]<br /> <br /> ==Learn more==<br /> * Petition by Dr. Hng [https://www.change.org/p/nice-stop-harming-me-cfs-patients-take-cbt-get-out-of-me-cfs-guidelines-now NICE stop harming ME/CFS patients - Take CBT and GET out of the CFS guidelines NOW!]<br /> <br /> ==References==<br /> &lt;references /&gt;<br /> <br /> [[Category:People with ME, CFS, and/or FMS]] <br /> [[Category:Advocates or allies]]</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=File:Robin_Brown.jpg&diff=44675 2018-11-30T01:28:09Z

<p>MEcfsFMS:Title: Robin Brown Source: [https://www.facebook.com/RobinBrown76?hc_ref=ARS2IVPUHah35qebAfedrEIKFkyUieP_ggZcKzslkyAlyiOWpmx6MNRspA6DrB4A9H8&amp;fref=nf&amp;__tn__=CH-R FaceBook: Robin Brown] Author: Robin Brown</p> <hr /> <div>== Summary ==<br /> Title: Robin Brown<br /> <br /> Source: [https://www.facebook.com/RobinBrown76?hc_ref=ARS2IVPUHah35qebAfedrEIKFkyUieP_ggZcKzslkyAlyiOWpmx6MNRspA6DrB4A9H8&amp;fref=nf&amp;__tn__=CH-R FaceBook: Robin Brown]<br /> <br /> Author: Robin Brown<br /> <br /> <br /> == Licensing ==<br /> {{PD}}</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Periodic_paralysis&diff=44662 2018-11-30T00:23:50Z

<p>MEcfsFMS:internal links</p> <hr /> <div>'''Periodic paralysis''' is a temporary paralysis of part of the body, with reoccurring episodes that last from minutes to hours.&lt;ref&gt;{{Cite journal|last=Dissanayake|first=HA|last2=Padmaperuma|first2=PACD|date=2018-07-18|title=Periodic paralysis: what clinician needs to know?|url=https://medcraveonline.com/EMIJ/EMIJ-06-00189.php|journal=Endocrinology &amp; Metabolism International Journal|volume=6|issue=4|doi=10.15406/emij.2018.06.0018|issn=2473-0815}}&lt;/ref&gt; There are different types of periodic paralysis, and it can be ''genetic (inherited)'' or ''acquired''. Some people with [[ME/CFS]] develop acquired periodic paralysis; the episodes of limb [[paralysis]] occur because of the [[ion transportation]] symptoms found in some people with ME/CFS.&lt;ref name=&quot;canadianconsensus&quot;&gt;{{Citation<br /> | last1 = Carruthers | first1 = Bruce M. | authorlink1 = Bruce Carruthers <br /> | last2 = Jain | first2 = Anil Kumar | authorlink2 = Anil Kumar Jain<br /> | last3 = De Meirleir | first3 = Kenny L. | authorlink3 = Kenny De Meirleir<br /> | last4 = Peterson | first4 = Daniel L. | authorlink4 = Daniel Peterson<br /> | last5 = Klimas | first5 = Nancy G. | authorlink5 = Nancy Klimas<br /> | last6 = Lerner | first6 = A. Martin | authorlink6 = Martin Lerner<br /> | last7 = Bested | first7 = Alison C. | authorlink7 = Alison Bested<br /> | last8 = Flor-Henry | first8 = Pierre | authorlink8 = Pierre Flor-Henry <br /> | last9 = Joshi | first9 = Pradip | authorlink9 = Pradip Joshi<br /> | last10 = Powles | first10 = A C Peter | authorlink10 = A C Peter Powles<br /> | last11 = Sherkey | first11 = Jeffrey A. | authorlink11 = Jeffrey Sherkey<br /> | last12 = van de Sande | first12 = Marjorie I. | authorlink12 = Marjorie van de Sande<br /> | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols<br /> | journal = Journal of Chronic Fatigue Syndrome | volume = 11 | issue = 2 | page = 7-115<br /> | date = 2003<br /> | pmid = <br /> | doi = 10.1300/J092v11n01_02<br /> | url = http://www.investinme.org/Documents/PDFdocuments/CanadianDefinitionME-CFS.pdf<br /> }}&lt;/ref&gt;&lt;ref name=&quot;ICP2011primer&quot;&gt;{{citation<br /> | last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers<br /> | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande<br /> | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir<br /> | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas<br /> | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick<br /> | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell<br /> | last7 = Staines | first7 = D | authorlink7 = Donald Staines<br /> | last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles<br /> | last9 = Speight | first9 = N | authorlink9 = Nigel Speight<br /> | last10 = Vallings | first10= R | authorlink10= Rosamund Vallings<br /> | last11 = Bateman | first11= L | authorlink11= Lucinda Bateman<br /> | last12 = Bell | first12= DS | authorlink12= David Bell<br /> | last13 = Carlo-Stella | first13= N | authorlink13= Nicoletta Carlo-Stella<br /> | last14 = Chia | first14= J | authorlink14= John Chia<br /> | last15 = Darragh | first15= A | authorlink15= Austin Darragh<br /> | last16 = Gerken | first16= A | authorlink16= Anne Gerken<br /> | last17 = Jo | first17= D | authorlink17= Daehyun Jo<br /> | last18 = Lewis | first18= DP | authorlink18= Donald Lewis<br /> | last19 = Light | first19= AR | authorlink19= Alan Light<br /> | last20 = Light | first20= KC | authorlink20= Kathleen Light<br /> | last21 = Marshall-Gradisnik | first21= S | authorlink21= Sonya Marshall-Gradisnik<br /> | last22 = McLaren-Howard | first22= J | authorlink22= John McLaren-Howard<br /> | last23 = Mena | first23= I | authorlink23= Ismael Mena<br /> | last24 = Miwa | first24= K | authorlink24= Kunihisa Miwa<br /> | last25 = Murovska | first25= M | authorlink25= Modra Murovska<br /> | last26 = Stevens | first26= SR | authorlink26= Staci Stevens<br /> | title = Myalgic encephalomyelitis: Adult &amp; Paediatric: International Consensus Primer for Medical Practitioners <br /> | date = 2012<br /> | isbn = 978-0-9739335-3-6<br /> | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf<br /> }}&lt;/ref&gt; Paralysis is not recognized in the International Consensus Primer, but the ion transport and [[channelopathy]] impairments that cause it are mentioned in the pathophysiology section, and the response to [[exercise]] section.&lt;ref name=&quot;ICP2011primer&quot; /&gt;<br /> <br /> ==Types==<br /> * [[Hyperkalemic periodic paralysis]] - caused by high [[potassium]]<br /> <br /> * [[Hypokalemic periodic paralysis]] - caused by low potassium <br /> <br /> ==See also==<br /> * [[Channelopathy]]<br /> * [[Channelopathy hypothesis]]<br /> * [[Electrolytes]]<br /> * [[Ion transportation]]<br /> <br /> * [[Paralysis]]<br /> * [[Potassium]]<br /> * [[Severe and very severe ME]]<br /> <br /> ==Learn more ==<br /> <br /> * [https://medcraveonline.com/EMIJ/EMIJ-06-00189.php Periodic paralysis - what clinician needs to know?]<br /> <br /> ==References ==<br /> &lt;references /&gt;</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Periodic_paralysis&diff=44661 2018-11-30T00:22:36Z

<p>MEcfsFMS:italics instead of bolding</p> <hr /> <div>'''Periodic paralysis''' is a temporary paralysis of part of the body, with reoccurring episodes that last from minutes to hours.&lt;ref&gt;{{Cite journal|last=Dissanayake|first=HA|last2=Padmaperuma|first2=PACD|date=2018-07-18|title=Periodic paralysis: what clinician needs to know?|url=https://medcraveonline.com/EMIJ/EMIJ-06-00189.php|journal=Endocrinology &amp; Metabolism International Journal|volume=6|issue=4|doi=10.15406/emij.2018.06.0018|issn=2473-0815}}&lt;/ref&gt; There are different types of periodic paralysis, and it can be ''genetic (inherited)'' or ''acquired''. Some people with [[ME/CFS]] develop acquired periodic paralysis; the episodes of limb [[paralysis]] occur because of the [[ion transportation]] symptoms found in some people with ME/CFS.&lt;ref name=&quot;canadianconsensus&quot;&gt;{{Citation<br /> | last1 = Carruthers | first1 = Bruce M. | authorlink1 = Bruce Carruthers <br /> | last2 = Jain | first2 = Anil Kumar | authorlink2 = Anil Kumar Jain<br /> | last3 = De Meirleir | first3 = Kenny L. | authorlink3 = Kenny De Meirleir<br /> | last4 = Peterson | first4 = Daniel L. | authorlink4 = Daniel Peterson<br /> | last5 = Klimas | first5 = Nancy G. | authorlink5 = Nancy Klimas<br /> | last6 = Lerner | first6 = A. Martin | authorlink6 = Martin Lerner<br /> | last7 = Bested | first7 = Alison C. | authorlink7 = Alison Bested<br /> | last8 = Flor-Henry | first8 = Pierre | authorlink8 = Pierre Flor-Henry <br /> | last9 = Joshi | first9 = Pradip | authorlink9 = Pradip Joshi<br /> | last10 = Powles | first10 = A C Peter | authorlink10 = A C Peter Powles<br /> | last11 = Sherkey | first11 = Jeffrey A. | authorlink11 = Jeffrey Sherkey<br /> | last12 = van de Sande | first12 = Marjorie I. | authorlink12 = Marjorie van de Sande<br /> | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols<br /> | journal = Journal of Chronic Fatigue Syndrome | volume = 11 | issue = 2 | page = 7-115<br /> | date = 2003<br /> | pmid = <br /> | doi = 10.1300/J092v11n01_02<br /> | url = http://www.investinme.org/Documents/PDFdocuments/CanadianDefinitionME-CFS.pdf<br /> }}&lt;/ref&gt;&lt;ref name=&quot;ICP2011primer&quot;&gt;{{citation<br /> | last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers<br /> | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande<br /> | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir<br /> | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas<br /> | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick<br /> | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell<br /> | last7 = Staines | first7 = D | authorlink7 = Donald Staines<br /> | last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles<br /> | last9 = Speight | first9 = N | authorlink9 = Nigel Speight<br /> | last10 = Vallings | first10= R | authorlink10= Rosamund Vallings<br /> | last11 = Bateman | first11= L | authorlink11= Lucinda Bateman<br /> | last12 = Bell | first12= DS | authorlink12= David Bell<br /> | last13 = Carlo-Stella | first13= N | authorlink13= Nicoletta Carlo-Stella<br /> | last14 = Chia | first14= J | authorlink14= John Chia<br /> | last15 = Darragh | first15= A | authorlink15= Austin Darragh<br /> | last16 = Gerken | first16= A | authorlink16= Anne Gerken<br /> | last17 = Jo | first17= D | authorlink17= Daehyun Jo<br /> | last18 = Lewis | first18= DP | authorlink18= Donald Lewis<br /> | last19 = Light | first19= AR | authorlink19= Alan Light<br /> | last20 = Light | first20= KC | authorlink20= Kathleen Light<br /> | last21 = Marshall-Gradisnik | first21= S | authorlink21= Sonya Marshall-Gradisnik<br /> | last22 = McLaren-Howard | first22= J | authorlink22= John McLaren-Howard<br /> | last23 = Mena | first23= I | authorlink23= Ismael Mena<br /> | last24 = Miwa | first24= K | authorlink24= Kunihisa Miwa<br /> | last25 = Murovska | first25= M | authorlink25= Modra Murovska<br /> | last26 = Stevens | first26= SR | authorlink26= Staci Stevens<br /> | title = Myalgic encephalomyelitis: Adult &amp; Paediatric: International Consensus Primer for Medical Practitioners <br /> | date = 2012<br /> | isbn = 978-0-9739335-3-6<br /> | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf<br /> }}&lt;/ref&gt; Paralysis is not recognized in the International Consensus Primer, but the ion transport and channelopathy impairments that cause it are mentioned in the pathophysiology section, and the response to [[exercise]] section.&lt;ref name=&quot;ICP2011primer&quot; /&gt;<br /> <br /> ==Types==<br /> * [[Hyperkalemic periodic paralysis]] - caused by high [[potassium]]<br /> <br /> * [[Hypokalemic periodic paralysis]] - caused by low potassium <br /> <br /> ==See also==<br /> * [[Channelopathy]]<br /> * [[Electrolytes]]<br /> * [[Ion transportation]]<br /> <br /> * [[Paralysis]]<br /> * [[Potassium]]<br /> * [[Severe and very severe ME]]<br /> <br /> ==Learn more ==<br /> <br /> * [https://medcraveonline.com/EMIJ/EMIJ-06-00189.php Periodic paralysis - what clinician needs to know?]<br /> <br /> ==References ==<br /> &lt;references /&gt;</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Periodic_paralysis&diff=44660 2018-11-30T00:21:37Z

<p>MEcfsFMS:/* Types */ broke dupe link, chron order</p> <hr /> <div>'''Periodic paralysis''' is a temporary paralysis of part of the body, with reoccurring episodes that last from minutes to hours.&lt;ref&gt;{{Cite journal|last=Dissanayake|first=HA|last2=Padmaperuma|first2=PACD|date=2018-07-18|title=Periodic paralysis: what clinician needs to know?|url=https://medcraveonline.com/EMIJ/EMIJ-06-00189.php|journal=Endocrinology &amp; Metabolism International Journal|volume=6|issue=4|doi=10.15406/emij.2018.06.0018|issn=2473-0815}}&lt;/ref&gt; There are different types of periodic paralysis, and it can be '''genetic (inherited)''' or '''acquired'''. Some people with [[ME/CFS]] develop acquired periodic paralysis; the episodes of limb [[paralysis]] occur because of the [[ion transportation]] symptoms found in some people with ME/CFS.&lt;ref name=&quot;canadianconsensus&quot;&gt;{{Citation<br /> | last1 = Carruthers | first1 = Bruce M. | authorlink1 = Bruce Carruthers <br /> | last2 = Jain | first2 = Anil Kumar | authorlink2 = Anil Kumar Jain<br /> | last3 = De Meirleir | first3 = Kenny L. | authorlink3 = Kenny De Meirleir<br /> | last4 = Peterson | first4 = Daniel L. | authorlink4 = Daniel Peterson<br /> | last5 = Klimas | first5 = Nancy G. | authorlink5 = Nancy Klimas<br /> | last6 = Lerner | first6 = A. Martin | authorlink6 = Martin Lerner<br /> | last7 = Bested | first7 = Alison C. | authorlink7 = Alison Bested<br /> | last8 = Flor-Henry | first8 = Pierre | authorlink8 = Pierre Flor-Henry <br /> | last9 = Joshi | first9 = Pradip | authorlink9 = Pradip Joshi<br /> | last10 = Powles | first10 = A C Peter | authorlink10 = A C Peter Powles<br /> | last11 = Sherkey | first11 = Jeffrey A. | authorlink11 = Jeffrey Sherkey<br /> | last12 = van de Sande | first12 = Marjorie I. | authorlink12 = Marjorie van de Sande<br /> | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols<br /> | journal = Journal of Chronic Fatigue Syndrome | volume = 11 | issue = 2 | page = 7-115<br /> | date = 2003<br /> | pmid = <br /> | doi = 10.1300/J092v11n01_02<br /> | url = http://www.investinme.org/Documents/PDFdocuments/CanadianDefinitionME-CFS.pdf<br /> }}&lt;/ref&gt;&lt;ref name=&quot;ICP2011primer&quot;&gt;{{citation<br /> | last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers<br /> | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande<br /> | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir<br /> | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas<br /> | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick<br /> | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell<br /> | last7 = Staines | first7 = D | authorlink7 = Donald Staines<br /> | last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles<br /> | last9 = Speight | first9 = N | authorlink9 = Nigel Speight<br /> | last10 = Vallings | first10= R | authorlink10= Rosamund Vallings<br /> | last11 = Bateman | first11= L | authorlink11= Lucinda Bateman<br /> | last12 = Bell | first12= DS | authorlink12= David Bell<br /> | last13 = Carlo-Stella | first13= N | authorlink13= Nicoletta Carlo-Stella<br /> | last14 = Chia | first14= J | authorlink14= John Chia<br /> | last15 = Darragh | first15= A | authorlink15= Austin Darragh<br /> | last16 = Gerken | first16= A | authorlink16= Anne Gerken<br /> | last17 = Jo | first17= D | authorlink17= Daehyun Jo<br /> | last18 = Lewis | first18= DP | authorlink18= Donald Lewis<br /> | last19 = Light | first19= AR | authorlink19= Alan Light<br /> | last20 = Light | first20= KC | authorlink20= Kathleen Light<br /> | last21 = Marshall-Gradisnik | first21= S | authorlink21= Sonya Marshall-Gradisnik<br /> | last22 = McLaren-Howard | first22= J | authorlink22= John McLaren-Howard<br /> | last23 = Mena | first23= I | authorlink23= Ismael Mena<br /> | last24 = Miwa | first24= K | authorlink24= Kunihisa Miwa<br /> | last25 = Murovska | first25= M | authorlink25= Modra Murovska<br /> | last26 = Stevens | first26= SR | authorlink26= Staci Stevens<br /> | title = Myalgic encephalomyelitis: Adult &amp; Paediatric: International Consensus Primer for Medical Practitioners <br /> | date = 2012<br /> | isbn = 978-0-9739335-3-6<br /> | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf<br /> }}&lt;/ref&gt; Paralysis is not recognized in the International Consensus Primer, but the ion transport and channelopathy impairments that cause it are mentioned in the pathophysiology section, and the response to [[exercise]] section.&lt;ref name=&quot;ICP2011primer&quot; /&gt;<br /> <br /> ==Types==<br /> * [[Hyperkalemic periodic paralysis]] - caused by high [[potassium]]<br /> <br /> * [[Hypokalemic periodic paralysis]] - caused by low potassium <br /> <br /> ==See also==<br /> * [[Channelopathy]]<br /> * [[Electrolytes]]<br /> * [[Ion transportation]]<br /> <br /> * [[Paralysis]]<br /> * [[Potassium]]<br /> * [[Severe and very severe ME]]<br /> <br /> ==Learn more ==<br /> <br /> * [https://medcraveonline.com/EMIJ/EMIJ-06-00189.php Periodic paralysis - what clinician needs to know?]<br /> <br /> ==References ==<br /> &lt;references /&gt;</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Periodic_paralysis&diff=44659 2018-11-30T00:19:40Z

<p>MEcfsFMS:bolding, alpha</p> <hr /> <div>'''Periodic paralysis''' is a temporary paralysis of part of the body, with reoccurring episodes that last from minutes to hours.&lt;ref&gt;{{Cite journal|last=Dissanayake|first=HA|last2=Padmaperuma|first2=PACD|date=2018-07-18|title=Periodic paralysis: what clinician needs to know?|url=https://medcraveonline.com/EMIJ/EMIJ-06-00189.php|journal=Endocrinology &amp; Metabolism International Journal|volume=6|issue=4|doi=10.15406/emij.2018.06.0018|issn=2473-0815}}&lt;/ref&gt; There are different types of periodic paralysis, and it can be '''genetic (inherited)''' or '''acquired'''. Some people with [[ME/CFS]] develop acquired periodic paralysis; the episodes of limb [[paralysis]] occur because of the [[ion transportation]] symptoms found in some people with ME/CFS.&lt;ref name=&quot;canadianconsensus&quot;&gt;{{Citation<br /> | last1 = Carruthers | first1 = Bruce M. | authorlink1 = Bruce Carruthers <br /> | last2 = Jain | first2 = Anil Kumar | authorlink2 = Anil Kumar Jain<br /> | last3 = De Meirleir | first3 = Kenny L. | authorlink3 = Kenny De Meirleir<br /> | last4 = Peterson | first4 = Daniel L. | authorlink4 = Daniel Peterson<br /> | last5 = Klimas | first5 = Nancy G. | authorlink5 = Nancy Klimas<br /> | last6 = Lerner | first6 = A. Martin | authorlink6 = Martin Lerner<br /> | last7 = Bested | first7 = Alison C. | authorlink7 = Alison Bested<br /> | last8 = Flor-Henry | first8 = Pierre | authorlink8 = Pierre Flor-Henry <br /> | last9 = Joshi | first9 = Pradip | authorlink9 = Pradip Joshi<br /> | last10 = Powles | first10 = A C Peter | authorlink10 = A C Peter Powles<br /> | last11 = Sherkey | first11 = Jeffrey A. | authorlink11 = Jeffrey Sherkey<br /> | last12 = van de Sande | first12 = Marjorie I. | authorlink12 = Marjorie van de Sande<br /> | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols<br /> | journal = Journal of Chronic Fatigue Syndrome | volume = 11 | issue = 2 | page = 7-115<br /> | date = 2003<br /> | pmid = <br /> | doi = 10.1300/J092v11n01_02<br /> | url = http://www.investinme.org/Documents/PDFdocuments/CanadianDefinitionME-CFS.pdf<br /> }}&lt;/ref&gt;&lt;ref name=&quot;ICP2011primer&quot;&gt;{{citation<br /> | last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers<br /> | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande<br /> | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir<br /> | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas<br /> | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick<br /> | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell<br /> | last7 = Staines | first7 = D | authorlink7 = Donald Staines<br /> | last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles<br /> | last9 = Speight | first9 = N | authorlink9 = Nigel Speight<br /> | last10 = Vallings | first10= R | authorlink10= Rosamund Vallings<br /> | last11 = Bateman | first11= L | authorlink11= Lucinda Bateman<br /> | last12 = Bell | first12= DS | authorlink12= David Bell<br /> | last13 = Carlo-Stella | first13= N | authorlink13= Nicoletta Carlo-Stella<br /> | last14 = Chia | first14= J | authorlink14= John Chia<br /> | last15 = Darragh | first15= A | authorlink15= Austin Darragh<br /> | last16 = Gerken | first16= A | authorlink16= Anne Gerken<br /> | last17 = Jo | first17= D | authorlink17= Daehyun Jo<br /> | last18 = Lewis | first18= DP | authorlink18= Donald Lewis<br /> | last19 = Light | first19= AR | authorlink19= Alan Light<br /> | last20 = Light | first20= KC | authorlink20= Kathleen Light<br /> | last21 = Marshall-Gradisnik | first21= S | authorlink21= Sonya Marshall-Gradisnik<br /> | last22 = McLaren-Howard | first22= J | authorlink22= John McLaren-Howard<br /> | last23 = Mena | first23= I | authorlink23= Ismael Mena<br /> | last24 = Miwa | first24= K | authorlink24= Kunihisa Miwa<br /> | last25 = Murovska | first25= M | authorlink25= Modra Murovska<br /> | last26 = Stevens | first26= SR | authorlink26= Staci Stevens<br /> | title = Myalgic encephalomyelitis: Adult &amp; Paediatric: International Consensus Primer for Medical Practitioners <br /> | date = 2012<br /> | isbn = 978-0-9739335-3-6<br /> | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf<br /> }}&lt;/ref&gt; Paralysis is not recognized in the International Consensus Primer, but the ion transport and channelopathy impairments that cause it are mentioned in the pathophysiology section, and the response to [[exercise]] section.&lt;ref name=&quot;ICP2011primer&quot; /&gt;<br /> <br /> ==Types==<br /> <br /> * [[Hypokalemic periodic paralysis]] - caused by low [[potassium]] <br /> <br /> * [[Hyperkalemic periodic paralysis]] - caused by high [[potassium]] <br /> <br /> ==See also==<br /> * [[Channelopathy]]<br /> * [[Electrolytes]]<br /> * [[Ion transportation]]<br /> <br /> * [[Paralysis]]<br /> * [[Potassium]]<br /> * [[Severe and very severe ME]]<br /> <br /> ==Learn more ==<br /> <br /> * [https://medcraveonline.com/EMIJ/EMIJ-06-00189.php Periodic paralysis - what clinician needs to know?]<br /> <br /> ==References ==<br /> &lt;references /&gt;</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Caroline_Struthers&diff=44658 2018-11-30T00:15:48Z

<p>MEcfsFMS:heading, hyperlink, citations, block quote</p> <hr /> <div>[[File:Caroline.jpg|200px|thumb|right|]]<br /> '''Caroline Struthers''' is a [[United Kingdom|UK]] citizen and is part of the [https://www.csm.ox.ac.uk/research/equator-network EQUATOR Network] team. Ms. Struthers is involved in many aspects of their mission to improve &quot;the planning, conduct and reporting of healthcare studies.&quot;&lt;ref name=&quot;:0&quot;&gt;{{Cite web|url=https://www.csm.ox.ac.uk/team/caroline-struthers|title=Caroline Struthers — Centre for Statistics in Medicine|website=www.csm.ox.ac.uk|language=en|access-date=2018-11-29}}&lt;/ref&gt; Struthers has developed a web-tool called [http://www.goodreports.org Good Reports] &quot;to help authors identify and use the most appropriate reporting guideline when they are submitting their manuscript to a journal.&quot;&lt;ref name=&quot;:0&quot; /&gt; She is also part of [https://www.ndorms.ox.ac.uk/csm Centre for Statistics in Medicine] and blogs for the [https://www.nationalelfservice.net/ National Elf Service] on dementia research.&lt;ref name=&quot;:0&quot; /&gt;<br /> <br /> Ms. Struthers has worked for The Cochrane Collaboration, Oxford University Press, and Freelance.&lt;ref name=&quot;:1&quot;&gt;{{Cite web|url=https://uk.linkedin.com/in/carolinestruthers?trk=pub-pbmap|title=Caroline Struthers|last=|first=|authorlink=|last2=|first2=|authorlink2=|date=|website=LinkedIn|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt; <br /> <br /> Caroline is an [[ME/CFS]] patient ally and blogs about the [[PACE trial]] and [[Cochrane]] at [https://healthycontrolblog.wordpress.com/author/cstruthers222/ Healthy Control], WordPress.com. <br /> <br /> == Education ==<br /> * Durham University Business School&lt;ref name=&quot;:1&quot; /&gt;<br /> <br /> == Cochrane review of PACE trial ==<br /> On November 29, 2018, Ms. Struthers submitted a complaint to the Cochrane Governing Board citing 15 points on their review of [[exercise]] for [[chronic fatigue syndrome]] (CFS). She concluded her complaint by stating &quot;This review should be retracted and Cochrane should issue a full unreserved apology to patients.&quot;&lt;ref&gt;{{Cite news|url=https://healthycontrolblog.wordpress.com/2018/11/29/my-complaint-to-the-cochrane-governing-board-about-the-cochrane-review-of-exercise-for-chronic-fatigue-syndrome/|title=My complaint to the Cochrane Governing Board about the Cochrane review of Exercise for chronic fatigue syndrome|last=Struthers|first=Caroline|date=2018-11-29|work=Healthy Control|access-date=2018-11-29|archive-url=|archive-date=|dead-url=|language=en-US|quote=|author-link=}}&lt;/ref&gt;<br /> <br /> == Awards ==<br /> * Sep 24, 2018, [http://www.equator-network.org/2018/09/24/equator-network-awarded-for-reducing-waste-in-research/ The Cochrane-REWARD Prize]&lt;ref name=&quot;:2&quot;&gt;{{Cite web|url=http://www.equator-network.org/2018/09/24/equator-network-awarded-for-reducing-waste-in-research/|title=EQUATOR Network awarded for reducing waste in research {{!}} The EQUATOR Network|website=www.equator-network.org|language=en-US|access-date=2018-11-30}}&lt;/ref&gt; <br /> &lt;blockquote&gt;Struthers was rewarded for her work in the UK EQUATOR Centre building GoodReports.org, and for her collaboration with [https://www.penelope.ai/ Penelope.ai] to test the tool in a journal submission workflow.&lt;ref name=&quot;:2&quot; /&gt;&lt;/blockquote&gt;<br /> <br /> == Online presence ==<br /> * E-mail: caroline.struthers@csm.ox.ac.uk<br /> * [https://uk.linkedin.com/in/carolinestruthers?trk=pub-pbmap LinkedIn]<br /> * [https://www.nationalelfservice.net/author/caroline-struthers/ National Elf Service]<br /> <br /> * [https://twitter.com/Good_Reports Twitter]<br /> <br /> * [https://healthycontrolblog.wordpress.com/2018/10/22/the-journey-begins/ WordPress.com]<br /> <br /> == See also ==<br /> * [[Cochrane]]<br /> <br /> * [[PACE trial]]<br /> <br /> == References ==<br /> <br /> [[Category:Advocates or allies]]<br /> [[Category:Psychological paradigm critics]]<br /> [[Category:PACE trial critics]]<br /> &lt;references /&gt;</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Caroline_Struthers&diff=44654 2018-11-29T23:28:27Z

<p>MEcfsFMS:heading, internal links, copy edit, hyperlink</p> <hr /> <div>[[File:Caroline.jpg|200px|thumb|right|]]<br /> '''Caroline Struthers''' is a [[United Kingdom|UK]] citizen and is part of the [https://www.csm.ox.ac.uk/research/equator-network EQUATOR Network] team. Ms. Struthers is involved in many aspects of their mission to improve &quot;the planning, conduct and reporting of healthcare studies.&quot;&lt;ref name=&quot;:0&quot;&gt;{{Cite web|url=https://www.csm.ox.ac.uk/team/caroline-struthers|title=Caroline Struthers — Centre for Statistics in Medicine|website=www.csm.ox.ac.uk|language=en|access-date=2018-11-29}}&lt;/ref&gt; Struthers has developed a web-tool called [http://www.goodreports.org Good Reports] &quot;to help authors identify and use the most appropriate reporting guideline when they are submitting their manuscript to a journal.&quot;&lt;ref name=&quot;:0&quot; /&gt; She is also part of [https://www.ndorms.ox.ac.uk/csm Centre for Statistics in Medicine].&lt;ref name=&quot;:0&quot; /&gt;<br /> <br /> Ms. Struthers has worked for The Cochrane Collaboration, Oxford University Press, and Freelance.&lt;ref name=&quot;:1&quot;&gt;{{Cite web|url=https://uk.linkedin.com/in/carolinestruthers?trk=pub-pbmap|title=Caroline Struthers|last=|first=|authorlink=|last2=|first2=|authorlink2=|date=|website=LinkedIn|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt; <br /> <br /> Caroline is an [[ME/CFS]] patient ally and blogs about the [[PACE trial]] and [[Cochrane]] at [https://healthycontrolblog.wordpress.com/author/cstruthers222/ Healthy Control], WordPress.com. <br /> <br /> == Education ==<br /> * Durham University Business School&lt;ref name=&quot;:1&quot; /&gt;<br /> <br /> == Cochrane review of PACE trial ==<br /> On November 29, 2018, Ms. Struthers submitted a complaint to the Cochrane Governing Board citing 15 points on their review of [[exercise]] for [[chronic fatigue syndrome]] (CFS). She concluded her complaint by stating &quot;This review should be retracted and Cochrane should issue a full unreserved apology to patients.&quot;&lt;ref&gt;{{Cite news|url=https://healthycontrolblog.wordpress.com/2018/11/29/my-complaint-to-the-cochrane-governing-board-about-the-cochrane-review-of-exercise-for-chronic-fatigue-syndrome/|title=My complaint to the Cochrane Governing Board about the Cochrane review of Exercise for chronic fatigue syndrome|last=Struthers|first=Caroline|date=2018-11-29|work=Healthy Control|access-date=2018-11-29|archive-url=|archive-date=|dead-url=|language=en-US|quote=|author-link=}}&lt;/ref&gt;<br /> <br /> == Online presence ==<br /> * E-mail: caroline.struthers@csm.ox.ac.uk<br /> * [https://uk.linkedin.com/in/carolinestruthers?trk=pub-pbmap LinkedIn]<br /> <br /> * [https://twitter.com/Good_Reports Twitter]<br /> <br /> * [https://healthycontrolblog.wordpress.com/2018/10/22/the-journey-begins/ WordPress.com]<br /> <br /> == See also ==<br /> * [[Cochrane]]<br /> <br /> * [[PACE trial]]<br /> <br /> == References ==<br /> <br /> [[Category:Advocates or allies]]<br /> [[Category:Psychological paradigm critics]]<br /> [[Category:PACE trial critics]]<br /> &lt;references /&gt;</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Caroline_Struthers&diff=44653 2018-11-29T23:21:06Z

<p>MEcfsFMS:x</p> <hr /> <div>[[File:Caroline.jpg|200px|thumb|right|]]<br /> '''Caroline Struthers''' lives in Oxford, England and is part of the [https://www.csm.ox.ac.uk/research/equator-network EQUATOR Network] team. Ms. Struthers is involved in many aspects of their mission to improve &quot;the planning, conduct and reporting of healthcare studies.&quot;&lt;ref name=&quot;:0&quot;&gt;{{Cite web|url=https://www.csm.ox.ac.uk/team/caroline-struthers|title=Caroline Struthers — Centre for Statistics in Medicine|website=www.csm.ox.ac.uk|language=en|access-date=2018-11-29}}&lt;/ref&gt; Struthers has developed a web-tool called [http://www.goodreports.org Good Reports] &quot;to help authors identify and use the most appropriate reporting guideline when they are submitting their manuscript to a journal.&quot;&lt;ref name=&quot;:0&quot; /&gt; She is also part of [https://www.ndorms.ox.ac.uk/csm Centre for Statistics in Medicine].&lt;ref name=&quot;:0&quot; /&gt; <br /> <br /> Caroline is an [[ME/CFS]] patient ally and blogs about the [[PACE trial]] and [[Cochrane]] at [https://healthycontrolblog.wordpress.com/author/cstruthers222/ Healthy Control], WordPress.com. <br /> <br /> == Cochrane review of PACE trial ==<br /> On November 29, 2018, Ms. Struthers submitted a complaint to the Cochrane Governing Board citing 15 points on their review of [[exercise]] for [[chronic fatigue syndrome]] (CFS). She concluded her complaint by stating &quot;This review should be retracted and Cochrane should issue a full unreserved apology to patients.&quot;&lt;ref&gt;{{Cite news|url=https://healthycontrolblog.wordpress.com/2018/11/29/my-complaint-to-the-cochrane-governing-board-about-the-cochrane-review-of-exercise-for-chronic-fatigue-syndrome/|title=My complaint to the Cochrane Governing Board about the Cochrane review of Exercise for chronic fatigue syndrome|last=Struthers|first=Caroline|date=2018-11-29|work=Healthy Control|access-date=2018-11-29|archive-url=|archive-date=|dead-url=|language=en-US|quote=|author-link=}}&lt;/ref&gt;<br /> <br /> == Online presence ==<br /> * E-mail: caroline.struthers@csm.ox.ac.uk<br /> <br /> * [https://twitter.com/Good_Reports Twitter]<br /> <br /> * [https://healthycontrolblog.wordpress.com/2018/10/22/the-journey-begins/ WordPress.com]<br /> <br /> == See also ==<br /> * [[Cochrane]]<br /> <br /> * [[PACE trial]]<br /> <br /> == References ==<br /> <br /> [[Category:Advocates or allies]]<br /> [[Category:Psychological paradigm critics]]<br /> [[Category:PACE trial critics]]<br /> &lt;references /&gt;</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Caroline_Struthers&diff=44652 2018-11-29T23:11:24Z

<p>MEcfsFMS:image</p> <hr /> <div>[[File:Caroline.jpg|200px|thumb|right|]]<br /> '''Caroline Struthers''' lives in Oxford, England and is part of the [https://www.csm.ox.ac.uk/research/equator-network EQUATOR Network] team. Ms. Struthers is involved in many aspects of their mission to improve &quot;the planning, conduct and reporting of healthcare studies.&quot;&lt;ref name=&quot;:0&quot;&gt;{{Cite web|url=https://www.csm.ox.ac.uk/team/caroline-struthers|title=Caroline Struthers — Centre for Statistics in Medicine|website=www.csm.ox.ac.uk|language=en|access-date=2018-11-29}}&lt;/ref&gt; Struthers has developed a web-tool called [http://www.goodreports.org Good Reports] &quot;to help authors identify and use the most appropriate reporting guideline when they are submitting their manuscript to a journal.&quot;&lt;ref name=&quot;:0&quot; /&gt; She is also part of [https://www.ndorms.ox.ac.uk/csm Centre for Statistics in Medicine].&lt;ref name=&quot;:0&quot; /&gt; <br /> <br /> Caroline is an [[ME/CFS]] patient ally and blogs about the [[PACE trial]] and [[Cochrane]] at [https://healthycontrolblog.wordpress.com Healthy Control], WordPress.com. <br /> <br /> == Cochrane review of PACE trial ==<br /> On November 29, 2018, Ms. Struthers submitted a complaint to the Cochrane Governing Board citing 15 points on their review of [[exercise]] for [[chronic fatigue syndrome]] (CFS). She concluded her complaint by stating &quot;This review should be retracted and Cochrane should issue a full unreserved apology to patients.&quot;&lt;ref&gt;{{Cite news|url=https://healthycontrolblog.wordpress.com/2018/11/29/my-complaint-to-the-cochrane-governing-board-about-the-cochrane-review-of-exercise-for-chronic-fatigue-syndrome/|title=My complaint to the Cochrane Governing Board about the Cochrane review of Exercise for chronic fatigue syndrome|last=Struthers|first=Caroline|date=2018-11-29|work=Healthy Control|access-date=2018-11-29|archive-url=|archive-date=|dead-url=|language=en-US|quote=|author-link=}}&lt;/ref&gt;<br /> <br /> == Online presence ==<br /> * E-mail: caroline.struthers@csm.ox.ac.uk<br /> <br /> * [https://twitter.com/Good_Reports Twitter]<br /> <br /> * [https://healthycontrolblog.wordpress.com WordPress.com]<br /> <br /> == See also ==<br /> * [[Cochrane]]<br /> <br /> * [[PACE trial]]<br /> <br /> == References ==<br /> <br /> [[Category:Advocates or allies]]<br /> [[Category:Psychological paradigm critics]]<br /> [[Category:PACE trial critics]]<br /> &lt;references /&gt;</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=File:Caroline.jpg&diff=44651 2018-11-29T23:10:18Z

<p>MEcfsFMS:Title: Caroline Struthers Source: [https://twitter.com/Good_Reports Twitter @Good_Reports] Author: [https://www.csm.ox.ac.uk/team/caroline-struthers Caroline Struthers]</p> <hr /> <div>== Summary ==<br /> Title: Caroline Struthers<br /> <br /> Source: [https://twitter.com/Good_Reports Twitter @Good_Reports]<br /> <br /> Author: [https://www.csm.ox.ac.uk/team/caroline-struthers Caroline Struthers]<br /> <br /> <br /> == Licensing ==<br /> {{PD}}</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Graded_exercise_therapy&diff=44641 2018-11-29T22:39:38Z

<p>MEcfsFMS:/* Notable studies */ cleanup</p> <hr /> <div>'''Graded exercise therapy''' (GET) is a form of physical therapy for the management of [[chronic fatigue syndrome]] (CFS) where physical activity is gradually increased over time. It is a treatment offered to [[ME/CFS]] patients in the [[UK]] by the [[National Health Service]] (NHS) as specified in the [[NICE guidelines]]. The use of Graded Exercise Therapy as a treatment is based on the disputed [[deconditioning]] hypothesis, and the highly controversial [[biopsychosocial model]] of ME/CFS.&lt;ref name=&quot;:0&quot; /&gt;<br /> <br /> == Evidence ==<br /> <br /> === Patient reports of harm ===<br /> Clinical trials have resulted in mixed results.&lt;ref name=&quot;:0&quot; /&gt;&lt;ref name=&quot;:1&quot; /&gt;&lt;ref name=&quot;:5&quot; /&gt; Surveys of patients conducted by patient charities have universally found Graded Exercise Therapy to be harmful, although a minority of patients found it helped them or simply ineffective.&lt;ref name=&quot;:2&quot; /&gt;&lt;ref name=&quot;:3&quot; /&gt; A number of severely ill patients have reported that starting Graded Exercise Therapy will moderate symptoms cause a severe escalation of symptoms, leaving them permanently worse. Two highly influential peer-reviewed articles often used to support the use of Graded Exercise Therapy, the [[Cochrane]] review and the [[PACE trial]], have had widescale calls for retraction based on criticism of the scientific method and standards used.&lt;ref name=&quot;:5&quot; /&gt;<br /> <br /> [[Robin Brown]], a British doctor with ME/CFS has created petition that many thousands have signed calling for GET and related [[Cognitive behavioral therapy|CBT]] to be removed from the UK treatment guidelines immediately.&lt;ref&gt;{{Cite web|url=https://www.change.org/p/nice-stop-harming-me-cfs-patients-take-cbt-get-out-of-me-cfs-guidelines-now|title=NICE stop harming ME/CFS patients - Take CBT and GET out of the CFS guidelines NOW! {{!}} Sign the Petition|last=Brown|first=Robin|authorlink=Robin Brown|date=|website=Change.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-11-13}}&lt;/ref&gt;<br /> <br /> === Physical fitness unchanged ===<br /> A number of studies by proponents of GET have found that it did not improve fitness, when self-rated perception of fatigue did improve after GET, no improvements in exercise capacity were statistically significant.&lt;ref name=&quot;:0&quot; /&gt;&lt;ref&gt;{{Cite journal|last=Moss-Morris|first=Rona|author-link=Rona Moss-Morris|last2=Sharon|first2=Cynthia|author-link2=Cynthia Sharon|last3=Tobin|first3=Roseanne|author-link3=Roseanne Tobin|last4=Baldi|first4=James C.|author-link4=James Baldi|author-link5=|date=Mar 2005|title=A Randomized Controlled Graded Exercise Trial for Chronic Fatigue Syndrome: Outcomes and Mechanisms of Change|url=https://journals.sagepub.com/doi/abs/10.1177/1359105305049774|journal=Journal of Health Psychology|language=en|volume=10|issue=2|pages=245–259|doi=10.1177/1359105305049774|issn=1359-1053|quote=|via=}}&lt;/ref&gt;&lt;ref name=&quot;:4&quot; /&gt; The controversial [[PACE trial]]'s 6 minute walk test results showed those successfully completing GET were unable to walk as far as older patients awaiting a lung transplant or those with heart failure; data that was omitted from the original trial report.&lt;ref name=&quot;:4&quot; /&gt;<br /> <br /> ==Patient analysis of PACE results==<br /> [[Graham McPhee]] and others created videos investigating the PACE trial data in relation to GET.&lt;ref&gt;{{Cite web|url=https://vimeo.com/21850334|title=PACEindividuals|website=Vimeo|language=en|access-date=2018-10-13}}&lt;/ref&gt;&lt;ref&gt;{{Cite web|url=https://vimeo.com/21852891|title=PACEgraph|website=Vimeo|language=en|access-date=2018-10-13}}&lt;/ref&gt; Several re-analyses of the PACE trial results have been published since the detailed PACE trial data was released into the public domain.&lt;ref name=&quot;:4&quot; /&gt; <br /> <br /> ==Fear of exercise==<br /> The [[PACE Trial Management Group|PACE trial investigators]] have stated that they believe a significant maintaining factor in the persistence of ME/CFS is fear of [[exercise]].&lt;ref&gt;{{Cite journal|last=Torjesen|first=Ingrid|date=2015-10-28|title=Tackling fear about exercise produces long term benefit in chronic fatigue syndrome|url=https://www.bmj.com/content/351/bmj.h5771|journal=BMJ|language=en|volume=351|pages=h5771|doi=10.1136/bmj.h5771|issn=1756-1833|pmid=26511755}}&lt;/ref&gt; This claim as been criticized as unsupported by trial results.&lt;ref&gt;{{Cite journal|date=2018-10-13|title=Objective measures found a lack of improvement for CBT &amp; GET in the PACE Trial: subjective improvements may simply represent response biases or placebo effects in this non-blinded trial|url=https://www.bmj.com/content/350/bmj.h227/rr-10|journal=The BMJ|language=en}}&lt;/ref&gt; A study by [[Jo Nijs|Nijs]] et al. in 2004 concluded:<br /> <br /> {{Quote box|quote=These results indicate a lack of correlation between [[kinesiophobia]] and exercise capacity, activity limitations, or participation restrictions, at least in patients with [[chronic fatigue syndrome |CFS]] who are experiencing widespread [[myalgia |muscle]] or [[arthralgia |joint pain]].|title=Chronic Fatigue Syndrome: Lack of Association between Pain-Related Fear of Movement and Exercise Capacity and Disability|source=Jo Nij, Katrien Vanherberghen, William Duquet &amp; Kenny De Meirleir (2004)}}<br /> <br /> == Articles explaining GET not appropriate for ME/CFS ==<br /> * 2005, [http://stonebird.co.uk/GET.pdf Issues relating to Severe ME And Graded Exercise]&lt;ref&gt;{{Cite web|url=http://stonebird.co.uk/GET.pdf|title=Issues relating to Severe ME And Graded Exercise|last=Crowhurst|first=Greg|authorlink=Greg Crowhurst|last2=|first2=|authorlink2=|date=Sep 3, 2005|website=Stonebird|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt;<br /> * 2016, [https://undark.org/article/chronic-fatigue-graded-exercise-pace/ Worse Than the Disease: A popular therapy for chronic fatigue syndrome made many patients worse. Adding insult to injury, research supporting it is now unraveling.]&lt;ref name=&quot;:6&quot; /&gt;<br /> * 2017, [https://www.buzzfeed.com/camillamaxted/this-is-why-i-quit-exercise-therapy This is why I quit Exercise Therapy]&lt;ref&gt;{{Cite news|url=https://www.buzzfeed.com/camillamaxted/this-is-why-i-quit-exercise-therapy|title=This Is Why I Quit Exercise Therapy|last=Maxted|first=Camilla|date=Aug 6, 2017|work=BuzzFeed|access-date=2018-11-29|archive-url=|archive-date=|dead-url=|language=en|quote=|author-link=}}&lt;/ref&gt; <br /> * 2017, [http://journals.sagepub.com/doi/full/10.1177/1359105317697323 Do graded activity therapies cause harm in chronic fatigue syndrome?]&lt;ref&gt;{{Cite journal|last=Kindlon|first=Tom|date=2017-03-20|title=Do graded activity therapies cause harm in chronic fatigue syndrome?|url=http://journals.sagepub.com/doi/full/10.1177/1359105317697323|journal=Journal of Health Psychology|language=en|volume=22|issue=9|pages=1146–1154|doi=10.1177/1359105317697323|issn=1359-1053}}&lt;/ref&gt;<br /> <br /> ==Criticism==<br /> *2010, At the [[Invest in ME International ME Conference]] Doctor [[Paul Cheney]] said &quot;The whole idea that you can take a disease like this and exercise your way to health is foolishness. It is insane&quot;.&lt;ref&gt;{{Cite news|url=https://paradigmchange.me/me/exercise-quotes/|title=Quotes About Exercise Intolerance from M.E. Experts|work=Myalgic Encephalomyelitis|access-date=2018-10-13|language=en-US}}&lt;/ref&gt;<br /> <br /> *2011, [http://iacfsme.org/PDFS/Reporting-of-Harms-Associated-with-GET-and-CBT-in.aspx Reporting of Harms Associated with Graded Exercise Therapy and Cognitive Behavioural Therapy in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome]&lt;ref name=&quot;:2&quot;&gt;{{Cite web|url=http://iacfsme.org/PDFS/Reporting-of-Harms-Associated-with-GET-and-CBT-in.aspx|title=Bulletin of the IACFS/ME 59 Reporting of Harms Associated with Graded Exercise Therapy and Cognitive Behavioural Therapy in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome|last=Kindlon|first=Tom|date=|website=iacfsme.org|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt;<br /> <br /> *2011, Health-related quality of life in patients with chronic fatigue syndrome: group [[Cognitive behavioral therapy|cognitive behavioural therapy]] and graded exercise versus usual treatment. A randomised controlled trial with 1 year of follow-up&lt;ref&gt;{{Cite journal|last=Núñez|first=Montserrat|author-link=Montserrat Núñez|last2=Fernández-Solà|first2=Joaquim|author-link2=Joaquim Fernández-Solà|last3=Nuñez|first3=Esther|author-link3=Esther Nuñez|last4=Fernández-Huerta|first4=José-Manuel|author-link4=José-Manuel Fernández-Huerta|last5=Godás-Sieso|first5=Teresa|author-link5=Teresa Godás-Sieso|last6=Gomez-Gil|first6=Esther|author-link6=Esther Gomez-Gil|date=Mar 2011|title=Health-related quality of life in patients with chronic fatigue syndrome: group cognitive behavioural therapy and graded exercise versus usual treatment. A randomised controlled trial with 1 year of follow-up|url=http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.467.4965&amp;rep=rep1&amp;type=pdf|journal=Clinical Rheumatology|volume=30|issue=3|pages=381–389|doi=10.1007/s10067-010-1677-y|issn=1434-9949|pmid=21234629|quote=|via=}}&lt;/ref&gt; [http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.467.4965&amp;rep=rep1&amp;type=pdf (Full Text)]<br /> *2015, [http://www.meassociation.org.uk/wp-content/uploads/2015-ME-Association-Illness-Management-Report-No-decisions-about-me-without-me-30.05.15.pdf ME/CFS Illness Management Survey Results “No decisions about me without me”]&lt;ref name=&quot;:3&quot;&gt;{{Cite web|url=http://www.meassociation.org.uk/wp-content/uploads/2015-ME-Association-Illness-Management-Report-No-decisions-about-me-without-me-30.05.15.pdf|title=ME/CFS Illness Management Survey Results - “No decisions about me without me” Part 1|last=|first=|date=May 2015|website=meassociation.org|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt;<br /> <br /> *2016, Do graded activity therapies cause harm in chronic fatigue syndrome?&lt;ref&gt;{{Cite journal|last=Kindlon|first=Tom|date=2017-03-20|title=Do graded activity therapies cause harm in chronic fatigue syndrome?|url=http://journals.sagepub.com/doi/full/10.1177/1359105317697323|journal=Journal of Health Psychology|language=en|volume=22|issue=9|pages=1146–1154|doi=10.1177/1359105317697323|issn=1359-1053|quote=|author-link=Tom Kindlon|author-link2=|author-link3=|author-link4=|author-link5=|via=}}&lt;/ref&gt; [https://journals.sagepub.com/doi/full/10.1177/1359105317697323 (Full Text)] <br /> <br /> *2016, Can patients with chronic fatigue syndrome really recover after graded exercise or cognitive behavioural therapy? A critical commentary and preliminary re-analysis of the PACE trial&lt;ref name=&quot;:4&quot;&gt;{{Cite journal|last=Wilshire|first=Carolyn|last2=Kindlon|first2=Tom|last3=Matthees|first3=Alem|last4=McGrath|first4=Simon|date=2016-12-14|title=Can patients with chronic fatigue syndrome really recover after graded exercise or cognitive behavioural therapy? A critical commentary and preliminary re-analysis of the PACE trial|url=http://www.tandfonline.com/doi/full/10.1080/21641846.2017.1259724|journal=Fatigue: Biomedicine, Health &amp; Behavior|language=en|volume=5|issue=1|pages=43–56|doi=10.1080/21641846.2017.1259724|issn=2164-1846}}&lt;/ref&gt; [http://www.tandfonline.com/doi/full/10.1080/21641846.2017.1259724 (Full Text)]<br /> *2016, [https://undark.org/article/chronic-fatigue-graded-exercise-pace/ Worse Than the Disease: A popular therapy for chronic fatigue syndrome made many patients worse. Adding insult to injury, research supporting it is now unraveling.]&lt;ref name=&quot;:6&quot;&gt;{{Cite news|url=https://undark.org/article/chronic-fatigue-graded-exercise-pace/|title=For Chronic Fatigue Syndrome Sufferers, a Dubious Treatment Unravels|last=Tuller|first=David|date=2016-10-27|work=Undark|access-date=2018-11-27|archive-url=|archive-date=|dead-url=|language=en-US|author-link=David Tuller}}&lt;/ref&gt; <br /> *2017, Bias, misleading information and lack of respect for alternative views have distorted perceptions of [[ME/CFS|myalgic encephalomyelitis/chronic fatigue syndrome]] and its treatment&lt;ref name=&quot;Goudsmit, 2017&quot; /&gt; [http://journals.sagepub.com/doi/full/10.1177/1359105317707216 (Full Text)]<br /> *2017, [https://www.nytimes.com/2017/03/18/opinion/sunday/getting-it-wrong-on-chronic-fatigue-syndrome.html Getting it wrong on chronic fatigue syndrome]&lt;ref&gt;{{Cite news|url=https://www.nytimes.com/2017/03/18/opinion/sunday/getting-it-wrong-on-chronic-fatigue-syndrome.html|title=Opinion {{!}} Getting It Wrong on Chronic Fatigue Syndrome|last=Rehmeyer|first=Julie|date=2018-03-18|work=New York Times|access-date=2018-11-27|archive-url=|archive-date=|dead-url=|publisher=New York Times|last2=Tuller|first2=David|publication-date=Jul 2018|language=en|author-link=Julie Rehmeyer|author-link2=David Tuller}}&lt;/ref&gt; <br /> *2018, Rethinking the treatment of Chronic Fatigue Syndrome—a reanalysis and evaluation of findings from a recent major trial of graded exercise and CBT&lt;ref&gt;{{Cite journal|last=Wilshire|first=Carolyn E.|author-link=Carolyn Wilshire|last2=Kindlon|first2=Tom|author-link2=Tom Kindlon|last3=Courtney|first3=Robert|author-link3=Robert Courtney|last4=Matthees|first4=Alem|author-link4=Alem Matthees|last5=Tuller|first5=David|author-link5=David Tuller|last6=Geraghty|first6=Keith|author-link6=Keith Geraghty|last7=Levin|first7=Bruce|author-link7=Bruce Levin|date=2018-03-22|title=Rethinking the treatment of chronic fatigue syndrome—a reanalysis and evaluation of findings from a recent major trial of graded exercise and CBT|url=https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-018-0218-3|journal=BMC Psychology|language=En|volume=6|issue=1|pages=|doi=10.1186/s40359-018-0218-3|issn=2050-7283|pmc=5863477|pmid=29562932|quote=|via=}}&lt;/ref&gt; [https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-018-0218-3 (Full Text)] <br /> *2018, Graded exercise therapy for myalgic encephalomyelitis/chronic fatigue syndrome is not effective and unsafe. Re-analysis of a Cochrane review&lt;ref name=&quot;:5&quot;&gt;{{Cite journal|last=Vink|first=Mark|author-link=Mark Vink|last2=Vink-Niese|first2=Alexandra|author-link2=Alexandra Vink-Niese|author-link3=|author-link4=|author-link5=|date=2018-10-08|title=Graded exercise therapy for myalgic encephalomyelitis/chronic fatigue syndrome is not effective and unsafe. Re-analysis of a Cochrane review|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6176540/|journal=Health Psychology Open|volume=5|issue=2|pages=|doi=10.1177/2055102918805187|issn=2055-1029|pmc=6176540|pmid=30305916|quote=|via=}}&lt;/ref&gt; [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6176540/ (Full Text)]<br /> <br /> ==CDC withdrawal of GET treatment ==<br /> <br /> July 3, 2017, The [[Centers for Disease Control and Prevention]]'s (CDC) website Chronic Fatigue Syndrome page has been changed to &quot;[[ME/CFS|Myalgic Encephalomyelitis/Chronic Fatigue Syndrome]] (ME/CFS)&quot; and GET and CBT recommendations have been removed.&lt;ref&gt;[http://www.virology.ws/2017/07/10/trial-by-error-the-cdc-drops-cbtget/ Trial By Error: The CDC Drops CBT/GET - Virology Blog]&lt;/ref&gt;&lt;ref&gt;[https://www.cdc.gov/me-cfs/index.html Myalgic Encephalomyelitis/Chronic Fatigue Syndrome - CDC.gov]&lt;/ref&gt;<br /> <br /> ==StopGET petitions==<br /> <br /> A number of different patients and patient charities have created &lt;nowiki&gt;#stopGET&lt;/nowiki&gt; petitions to campaign for an end to graded exercise therapy treatment in [[ME/CFS]]:<br /> * Stop GET trials - MEAction&lt;ref&gt;{{Cite news|url=https://my.meaction.net/petitions/stop-graded-exercise-therapy-trials-for-me-cfs|title=STOP GRADED EXERCISE THERAPY TRIALS FOR ME/CFS|work=#MEAction|access-date=2018-10-20|language=en}}&lt;/ref&gt;<br /> * Stop harming ME/CFS patients - take CBT/GET out of NICE guidelines NOW. - Dr. Hng's UK petition to stop GET and CBT<br /> * The NICE guideline for CFS/ME is not fit for purpose and needs a complete revision - a petition the ME Association delivered to Andrew Dillon at NICE <br /> * Suspend all trials of graded exercise therapy in children and adults with ME/CFS - [[UK]] parliament petition (archived)&lt;ref&gt;{{Cite news|url=https://petition.parliament.uk/petitions/166601|title=Archived Petition: Suspend all trials of graded exercise therapy in children and adults with ME/CFS|work=Petitions - UK Government and Parliament|access-date=2018-10-20|language=en-GB}}&lt;/ref&gt;<br /> <br /> ==Notable studies==<br /> *2004, Chronic Fatigue Syndrome: Lack of Association between Pain-Related Fear of Movement and Exercise Capacity and Disability &lt;ref&gt;{{Cite journal|last=Nijs|first=Jo|author-link=Jo Nijs|last2=Vanherberghen|first2=Katrien|author-link2=Katrien Vanherberghen|last3=Duquet|first3=William|author-link3=William Duquet|last4=De Meirleir|first4=Kenny|author-link4=Kenny De Meirleir|date=2004-08-01|title=Chronic Fatigue Syndrome: Lack of Association Between Pain-Related Fear of Movement and Exercise Capacity and Disability|url=https://doi.org/10.1093/ptj/84.8.696|journal=Physical Therapy|language=en|volume=84|issue=8|pages=|doi=10.1093/ptj/84.8.696|issn=1538-6724|quote=These results indicate a lack of correlation between kinesiophobia and exercise capacity, activity limitations, or participation restrictions, at least in patients with CFS who are experiencing widespread muscle or joint pain.|via=}}&lt;/ref&gt; [https://academic.oup.com/ptj/article/84/8/696/2857531 (Full Text)]<br /> *2009, A review on cognitive behavorial therapy (CBT) and graded exercise therapy (GET) in myalgic encephalomyelitis (ME) / chronic fatigue syndrome (CFS): CBT/GET is not only ineffective and not evidence-based, but also potentially harmful for many patients with ME/CFS&lt;ref name=&quot;:0&quot;&gt;{{Cite journal|last=Twisk|first=Frank N. M.|last2=Maes|first2=Michael|date=2009|title=A review on cognitive behavorial therapy (CBT) and graded exercise therapy (GET) in myalgic encephalomyelitis (ME) / chronic fatigue syndrome (CFS): CBT/GET is not only ineffective and not evidence-based, but also potentially harmful for many patients with ME/CFS|url=https://www.ncbi.nlm.nih.gov/m/pubmed/19855350/|journal=Neuro Endocrinology Letters|volume=30|issue=3|pages=284–299|issn=0172-780X|pmid=19855350}}&lt;/ref&gt; [https://www.ncbi.nlm.nih.gov/m/pubmed/19855350/ (Abstract)]<br /> *2016, Exercise therapy for chronic fatigue syndrome&lt;ref name=&quot;:1&quot;&gt;{{Cite journal|last=Larun|first=Lillebeth|last2=Brurberg|first2=Kjetil G.|last3=Odgaard‐Jensen|first3=Jan|last4=Price|first4=Jonathan R.|date=2016|title=Exercise therapy for chronic fatigue syndrome|url=https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003200.pub5/abstract|journal=Cochrane Database of Systematic Reviews|language=en|issue=6|doi=10.1002/14651858.CD003200.pub5|issn=1465-1858}}&lt;/ref&gt; [https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003200.pub5/abstract (Full Text)]<br /> *2016, Neurocognitive improvements after best-practice intervention for chronic fatigue syndrome: Preliminary evidence of divergence between objective indices and subjective perceptions.&lt;ref&gt;{{Cite journal|last=Cvejic|first=Erin|last2=Lloyd|first2=Andrew R.|last3=Vollmer-Conna|first3=Uté|date=2016|title=Neurocognitive improvements after best-practice intervention for chronic fatigue syndrome: Preliminary evidence of divergence between objective indices and subjective perceptions|url=https://www.ncbi.nlm.nih.gov/pubmed/26995250|journal=Comprehensive Psychiatry|volume=66|pages=166–175|doi=10.1016/j.comppsych.2016.02.002|issn=1532-8384|pmid=26995250|via=}}&lt;/ref&gt; [[pubmed:26995250|(Abstract)]]<br /> *2017, PACE investigators' response is misleading regarding patient survey results&lt;ref&gt;{{Cite journal|last=Kirke|first=Karen D|author-link=Karen Kirke|author-link2=|author-link3=|author-link4=|author-link5=|date=2017-05-11|title=PACE investigators’ response is misleading regarding patient survey results|url=https://doi.org/10.1177/1359105317703787|journal=Journal of Health Psychology|language=en|volume=22|issue=9|pages=1168–1176|doi=10.1177/1359105317703787|issn=1359-1053|quote=|via=}}&lt;/ref&gt; [https://doi.org/10.1177%2F1359105317703787 (Full Text)]<br /> *2018, Rethinking the treatment of chronic fatigue syndrome—a reanalysis and evaluation of findings from a recent major trial of graded exercise and CBT &lt;ref&gt;{{Cite journal|last=Wilshire|first=Carolyn E.|author-link=Carolyn Wilshire|last2=Kindlon|first2=Tom|author-link2=Tom Kindlon|last3=Courtney|first3=Robert|author-link3=Robert Courtney|last4=Matthees|first4=Alem|author-link4=Alem Matthees|last5=Tuller|first5=David|author-link5=David Tuller|last6=Geraghty|first6=Keith|author-link6=Keith Geraghty|last7=Levin|first7=Bruce|author-link7=|date=2018-03-22|title=Rethinking the treatment of chronic fatigue syndrome—a reanalysis and evaluation of findings from a recent major trial of graded exercise and CBT|url=https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-018-0218-3|journal=BMC Psychology|language=En|volume=6|issue=1|pages=|doi=10.1186/s40359-018-0218-3|issn=2050-7283|quote=|via=}}&lt;/ref&gt; [https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-018-0218-3 (Full Text)]<br /> <br /> ==Learn more==<br /> *[https://en.wikipedia.org/wiki/Graded_exercise_therapy Wikipedia - Graded Exercise Therapy&quot;]<br /> *[http://funktionellelidelser.dk/fileadmin/www.funktionellelidelser.au.dk/patient_Pjecer/GET_booklet_web_July_2009__2_.pdf NHS Graded Exercise Therapy Booklet - A self-help guide for those with chronic fatigue syndrome/myalgic encephalomyelitis]&lt;ref&gt;{{Cite web|url=http://funktionellelidelser.dk/fileadmin/www.funktionellelidelser.au.dk/patient_Pjecer/GET_booklet_web_July_2009__2_.pdf|title=Graded Exercise Therapy - A self-help guide for those with chronic fatigue syndrome/myalgic encephalomyelitis|last=|first=|date=Jul 2009|website=http://funktionellelidelser.dk|publisher=NHS|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt;<br /> <br /> ==See also==<br /> *[[Deconditioning]]<br /> *[[Biopsychosocial model|Biopsychosocial hypothesis]]<br /> *[[Cognitive behavioral therapy]]<br /> *[[Illness beliefs]]<br /> *[[Exercise]]<br /> *[[PACE trial]]<br /> *[[Post-exertional malaise]]<br /> <br /> ==References==<br /> &lt;references /&gt;<br /> <br /> [[Category:Psychological paradigm]]<br /> [[Category:Potential treatments]]</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Graded_exercise_therapy&diff=44640 2018-11-29T22:30:43Z

<p>MEcfsFMS:/* Criticism */ cleanup</p> <hr /> <div>'''Graded exercise therapy''' (GET) is a form of physical therapy for the management of [[chronic fatigue syndrome]] (CFS) where physical activity is gradually increased over time. It is a treatment offered to [[ME/CFS]] patients in the [[UK]] by the [[National Health Service]] (NHS) as specified in the [[NICE guidelines]]. The use of Graded Exercise Therapy as a treatment is based on the disputed [[deconditioning]] hypothesis, and the highly controversial [[biopsychosocial model]] of ME/CFS.&lt;ref name=&quot;:0&quot; /&gt;<br /> <br /> == Evidence ==<br /> <br /> === Patient reports of harm ===<br /> Clinical trials have resulted in mixed results.&lt;ref name=&quot;:0&quot; /&gt;&lt;ref name=&quot;:1&quot; /&gt;&lt;ref name=&quot;:5&quot; /&gt; Surveys of patients conducted by patient charities have universally found Graded Exercise Therapy to be harmful, although a minority of patients found it helped them or simply ineffective.&lt;ref name=&quot;:2&quot; /&gt;&lt;ref name=&quot;:3&quot; /&gt; A number of severely ill patients have reported that starting Graded Exercise Therapy will moderate symptoms cause a severe escalation of symptoms, leaving them permanently worse. Two highly influential peer-reviewed articles often used to support the use of Graded Exercise Therapy, the [[Cochrane]] review and the [[PACE trial]], have had widescale calls for retraction based on criticism of the scientific method and standards used.&lt;ref name=&quot;:5&quot; /&gt;<br /> <br /> [[Robin Brown]], a British doctor with ME/CFS has created petition that many thousands have signed calling for GET and related [[Cognitive behavioral therapy|CBT]] to be removed from the UK treatment guidelines immediately.&lt;ref&gt;{{Cite web|url=https://www.change.org/p/nice-stop-harming-me-cfs-patients-take-cbt-get-out-of-me-cfs-guidelines-now|title=NICE stop harming ME/CFS patients - Take CBT and GET out of the CFS guidelines NOW! {{!}} Sign the Petition|last=Brown|first=Robin|authorlink=Robin Brown|date=|website=Change.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-11-13}}&lt;/ref&gt;<br /> <br /> === Physical fitness unchanged ===<br /> A number of studies by proponents of GET have found that it did not improve fitness, when self-rated perception of fatigue did improve after GET, no improvements in exercise capacity were statistically significant.&lt;ref name=&quot;:0&quot; /&gt;&lt;ref&gt;{{Cite journal|last=Moss-Morris|first=Rona|author-link=Rona Moss-Morris|last2=Sharon|first2=Cynthia|author-link2=Cynthia Sharon|last3=Tobin|first3=Roseanne|author-link3=Roseanne Tobin|last4=Baldi|first4=James C.|author-link4=James Baldi|author-link5=|date=Mar 2005|title=A Randomized Controlled Graded Exercise Trial for Chronic Fatigue Syndrome: Outcomes and Mechanisms of Change|url=https://journals.sagepub.com/doi/abs/10.1177/1359105305049774|journal=Journal of Health Psychology|language=en|volume=10|issue=2|pages=245–259|doi=10.1177/1359105305049774|issn=1359-1053|quote=|via=}}&lt;/ref&gt;&lt;ref name=&quot;:4&quot; /&gt; The controversial [[PACE trial]]'s 6 minute walk test results showed those successfully completing GET were unable to walk as far as older patients awaiting a lung transplant or those with heart failure; data that was omitted from the original trial report.&lt;ref name=&quot;:4&quot; /&gt;<br /> <br /> ==Patient analysis of PACE results==<br /> [[Graham McPhee]] and others created videos investigating the PACE trial data in relation to GET.&lt;ref&gt;{{Cite web|url=https://vimeo.com/21850334|title=PACEindividuals|website=Vimeo|language=en|access-date=2018-10-13}}&lt;/ref&gt;&lt;ref&gt;{{Cite web|url=https://vimeo.com/21852891|title=PACEgraph|website=Vimeo|language=en|access-date=2018-10-13}}&lt;/ref&gt; Several re-analyses of the PACE trial results have been published since the detailed PACE trial data was released into the public domain.&lt;ref name=&quot;:4&quot; /&gt; <br /> <br /> ==Fear of exercise==<br /> The [[PACE Trial Management Group|PACE trial investigators]] have stated that they believe a significant maintaining factor in the persistence of ME/CFS is fear of [[exercise]].&lt;ref&gt;{{Cite journal|last=Torjesen|first=Ingrid|date=2015-10-28|title=Tackling fear about exercise produces long term benefit in chronic fatigue syndrome|url=https://www.bmj.com/content/351/bmj.h5771|journal=BMJ|language=en|volume=351|pages=h5771|doi=10.1136/bmj.h5771|issn=1756-1833|pmid=26511755}}&lt;/ref&gt; This claim as been criticized as unsupported by trial results.&lt;ref&gt;{{Cite journal|date=2018-10-13|title=Objective measures found a lack of improvement for CBT &amp; GET in the PACE Trial: subjective improvements may simply represent response biases or placebo effects in this non-blinded trial|url=https://www.bmj.com/content/350/bmj.h227/rr-10|journal=The BMJ|language=en}}&lt;/ref&gt; A study by [[Jo Nijs|Nijs]] et al. in 2004 concluded:<br /> <br /> {{Quote box|quote=These results indicate a lack of correlation between [[kinesiophobia]] and exercise capacity, activity limitations, or participation restrictions, at least in patients with [[chronic fatigue syndrome |CFS]] who are experiencing widespread [[myalgia |muscle]] or [[arthralgia |joint pain]].|title=Chronic Fatigue Syndrome: Lack of Association between Pain-Related Fear of Movement and Exercise Capacity and Disability|source=Jo Nij, Katrien Vanherberghen, William Duquet &amp; Kenny De Meirleir (2004)}}<br /> <br /> == Articles explaining GET not appropriate for ME/CFS ==<br /> * 2005, [http://stonebird.co.uk/GET.pdf Issues relating to Severe ME And Graded Exercise]&lt;ref&gt;{{Cite web|url=http://stonebird.co.uk/GET.pdf|title=Issues relating to Severe ME And Graded Exercise|last=Crowhurst|first=Greg|authorlink=Greg Crowhurst|last2=|first2=|authorlink2=|date=Sep 3, 2005|website=Stonebird|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt;<br /> * 2016, [https://undark.org/article/chronic-fatigue-graded-exercise-pace/ Worse Than the Disease: A popular therapy for chronic fatigue syndrome made many patients worse. Adding insult to injury, research supporting it is now unraveling.]&lt;ref name=&quot;:6&quot; /&gt;<br /> * 2017, [https://www.buzzfeed.com/camillamaxted/this-is-why-i-quit-exercise-therapy This is why I quit Exercise Therapy]&lt;ref&gt;{{Cite news|url=https://www.buzzfeed.com/camillamaxted/this-is-why-i-quit-exercise-therapy|title=This Is Why I Quit Exercise Therapy|last=Maxted|first=Camilla|date=Aug 6, 2017|work=BuzzFeed|access-date=2018-11-29|archive-url=|archive-date=|dead-url=|language=en|quote=|author-link=}}&lt;/ref&gt; <br /> * 2017, [http://journals.sagepub.com/doi/full/10.1177/1359105317697323 Do graded activity therapies cause harm in chronic fatigue syndrome?]&lt;ref&gt;{{Cite journal|last=Kindlon|first=Tom|date=2017-03-20|title=Do graded activity therapies cause harm in chronic fatigue syndrome?|url=http://journals.sagepub.com/doi/full/10.1177/1359105317697323|journal=Journal of Health Psychology|language=en|volume=22|issue=9|pages=1146–1154|doi=10.1177/1359105317697323|issn=1359-1053}}&lt;/ref&gt;<br /> <br /> ==Criticism==<br /> *2010, At the [[Invest in ME International ME Conference]] Doctor [[Paul Cheney]] said &quot;The whole idea that you can take a disease like this and exercise your way to health is foolishness. It is insane&quot;.&lt;ref&gt;{{Cite news|url=https://paradigmchange.me/me/exercise-quotes/|title=Quotes About Exercise Intolerance from M.E. Experts|work=Myalgic Encephalomyelitis|access-date=2018-10-13|language=en-US}}&lt;/ref&gt;<br /> <br /> *2011, [http://iacfsme.org/PDFS/Reporting-of-Harms-Associated-with-GET-and-CBT-in.aspx Reporting of Harms Associated with Graded Exercise Therapy and Cognitive Behavioural Therapy in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome]&lt;ref name=&quot;:2&quot;&gt;{{Cite web|url=http://iacfsme.org/PDFS/Reporting-of-Harms-Associated-with-GET-and-CBT-in.aspx|title=Bulletin of the IACFS/ME 59 Reporting of Harms Associated with Graded Exercise Therapy and Cognitive Behavioural Therapy in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome|last=Kindlon|first=Tom|date=|website=iacfsme.org|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt;<br /> <br /> *2011, Health-related quality of life in patients with chronic fatigue syndrome: group [[Cognitive behavioral therapy|cognitive behavioural therapy]] and graded exercise versus usual treatment. A randomised controlled trial with 1 year of follow-up&lt;ref&gt;{{Cite journal|last=Núñez|first=Montserrat|author-link=Montserrat Núñez|last2=Fernández-Solà|first2=Joaquim|author-link2=Joaquim Fernández-Solà|last3=Nuñez|first3=Esther|author-link3=Esther Nuñez|last4=Fernández-Huerta|first4=José-Manuel|author-link4=José-Manuel Fernández-Huerta|last5=Godás-Sieso|first5=Teresa|author-link5=Teresa Godás-Sieso|last6=Gomez-Gil|first6=Esther|author-link6=Esther Gomez-Gil|date=Mar 2011|title=Health-related quality of life in patients with chronic fatigue syndrome: group cognitive behavioural therapy and graded exercise versus usual treatment. A randomised controlled trial with 1 year of follow-up|url=http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.467.4965&amp;rep=rep1&amp;type=pdf|journal=Clinical Rheumatology|volume=30|issue=3|pages=381–389|doi=10.1007/s10067-010-1677-y|issn=1434-9949|pmid=21234629|quote=|via=}}&lt;/ref&gt; [http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.467.4965&amp;rep=rep1&amp;type=pdf (Full Text)]<br /> *2015, [http://www.meassociation.org.uk/wp-content/uploads/2015-ME-Association-Illness-Management-Report-No-decisions-about-me-without-me-30.05.15.pdf ME/CFS Illness Management Survey Results “No decisions about me without me”]&lt;ref name=&quot;:3&quot;&gt;{{Cite web|url=http://www.meassociation.org.uk/wp-content/uploads/2015-ME-Association-Illness-Management-Report-No-decisions-about-me-without-me-30.05.15.pdf|title=ME/CFS Illness Management Survey Results - “No decisions about me without me” Part 1|last=|first=|date=May 2015|website=meassociation.org|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt;<br /> <br /> *2016, Do graded activity therapies cause harm in chronic fatigue syndrome?&lt;ref&gt;{{Cite journal|last=Kindlon|first=Tom|date=2017-03-20|title=Do graded activity therapies cause harm in chronic fatigue syndrome?|url=http://journals.sagepub.com/doi/full/10.1177/1359105317697323|journal=Journal of Health Psychology|language=en|volume=22|issue=9|pages=1146–1154|doi=10.1177/1359105317697323|issn=1359-1053|quote=|author-link=Tom Kindlon|author-link2=|author-link3=|author-link4=|author-link5=|via=}}&lt;/ref&gt; [https://journals.sagepub.com/doi/full/10.1177/1359105317697323 (Full Text)] <br /> <br /> *2016, Can patients with chronic fatigue syndrome really recover after graded exercise or cognitive behavioural therapy? A critical commentary and preliminary re-analysis of the PACE trial&lt;ref name=&quot;:4&quot;&gt;{{Cite journal|last=Wilshire|first=Carolyn|last2=Kindlon|first2=Tom|last3=Matthees|first3=Alem|last4=McGrath|first4=Simon|date=2016-12-14|title=Can patients with chronic fatigue syndrome really recover after graded exercise or cognitive behavioural therapy? A critical commentary and preliminary re-analysis of the PACE trial|url=http://www.tandfonline.com/doi/full/10.1080/21641846.2017.1259724|journal=Fatigue: Biomedicine, Health &amp; Behavior|language=en|volume=5|issue=1|pages=43–56|doi=10.1080/21641846.2017.1259724|issn=2164-1846}}&lt;/ref&gt; [http://www.tandfonline.com/doi/full/10.1080/21641846.2017.1259724 (Full Text)]<br /> *2016, [https://undark.org/article/chronic-fatigue-graded-exercise-pace/ Worse Than the Disease: A popular therapy for chronic fatigue syndrome made many patients worse. Adding insult to injury, research supporting it is now unraveling.]&lt;ref name=&quot;:6&quot;&gt;{{Cite news|url=https://undark.org/article/chronic-fatigue-graded-exercise-pace/|title=For Chronic Fatigue Syndrome Sufferers, a Dubious Treatment Unravels|last=Tuller|first=David|date=2016-10-27|work=Undark|access-date=2018-11-27|archive-url=|archive-date=|dead-url=|language=en-US|author-link=David Tuller}}&lt;/ref&gt; <br /> *2017, Bias, misleading information and lack of respect for alternative views have distorted perceptions of [[ME/CFS|myalgic encephalomyelitis/chronic fatigue syndrome]] and its treatment&lt;ref name=&quot;Goudsmit, 2017&quot; /&gt; [http://journals.sagepub.com/doi/full/10.1177/1359105317707216 (Full Text)]<br /> *2017, [https://www.nytimes.com/2017/03/18/opinion/sunday/getting-it-wrong-on-chronic-fatigue-syndrome.html Getting it wrong on chronic fatigue syndrome]&lt;ref&gt;{{Cite news|url=https://www.nytimes.com/2017/03/18/opinion/sunday/getting-it-wrong-on-chronic-fatigue-syndrome.html|title=Opinion {{!}} Getting It Wrong on Chronic Fatigue Syndrome|last=Rehmeyer|first=Julie|date=2018-03-18|work=New York Times|access-date=2018-11-27|archive-url=|archive-date=|dead-url=|publisher=New York Times|last2=Tuller|first2=David|publication-date=Jul 2018|language=en|author-link=Julie Rehmeyer|author-link2=David Tuller}}&lt;/ref&gt; <br /> *2018, Rethinking the treatment of Chronic Fatigue Syndrome—a reanalysis and evaluation of findings from a recent major trial of graded exercise and CBT&lt;ref&gt;{{Cite journal|last=Wilshire|first=Carolyn E.|author-link=Carolyn Wilshire|last2=Kindlon|first2=Tom|author-link2=Tom Kindlon|last3=Courtney|first3=Robert|author-link3=Robert Courtney|last4=Matthees|first4=Alem|author-link4=Alem Matthees|last5=Tuller|first5=David|author-link5=David Tuller|last6=Geraghty|first6=Keith|author-link6=Keith Geraghty|last7=Levin|first7=Bruce|author-link7=Bruce Levin|date=2018-03-22|title=Rethinking the treatment of chronic fatigue syndrome—a reanalysis and evaluation of findings from a recent major trial of graded exercise and CBT|url=https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-018-0218-3|journal=BMC Psychology|language=En|volume=6|issue=1|pages=|doi=10.1186/s40359-018-0218-3|issn=2050-7283|pmc=5863477|pmid=29562932|quote=|via=}}&lt;/ref&gt; [https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-018-0218-3 (Full Text)] <br /> *2018, Graded exercise therapy for myalgic encephalomyelitis/chronic fatigue syndrome is not effective and unsafe. Re-analysis of a Cochrane review&lt;ref name=&quot;:5&quot;&gt;{{Cite journal|last=Vink|first=Mark|author-link=Mark Vink|last2=Vink-Niese|first2=Alexandra|author-link2=Alexandra Vink-Niese|author-link3=|author-link4=|author-link5=|date=2018-10-08|title=Graded exercise therapy for myalgic encephalomyelitis/chronic fatigue syndrome is not effective and unsafe. Re-analysis of a Cochrane review|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6176540/|journal=Health Psychology Open|volume=5|issue=2|pages=|doi=10.1177/2055102918805187|issn=2055-1029|pmc=6176540|pmid=30305916|quote=|via=}}&lt;/ref&gt; [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6176540/ (Full Text)]<br /> <br /> ==CDC withdrawal of GET treatment ==<br /> <br /> July 3, 2017, The [[Centers for Disease Control and Prevention]]'s (CDC) website Chronic Fatigue Syndrome page has been changed to &quot;[[ME/CFS|Myalgic Encephalomyelitis/Chronic Fatigue Syndrome]] (ME/CFS)&quot; and GET and CBT recommendations have been removed.&lt;ref&gt;[http://www.virology.ws/2017/07/10/trial-by-error-the-cdc-drops-cbtget/ Trial By Error: The CDC Drops CBT/GET - Virology Blog]&lt;/ref&gt;&lt;ref&gt;[https://www.cdc.gov/me-cfs/index.html Myalgic Encephalomyelitis/Chronic Fatigue Syndrome - CDC.gov]&lt;/ref&gt;<br /> <br /> ==StopGET petitions==<br /> <br /> A number of different patients and patient charities have created &lt;nowiki&gt;#stopGET&lt;/nowiki&gt; petitions to campaign for an end to graded exercise therapy treatment in [[ME/CFS]]:<br /> * Stop GET trials - MEAction&lt;ref&gt;{{Cite news|url=https://my.meaction.net/petitions/stop-graded-exercise-therapy-trials-for-me-cfs|title=STOP GRADED EXERCISE THERAPY TRIALS FOR ME/CFS|work=#MEAction|access-date=2018-10-20|language=en}}&lt;/ref&gt;<br /> * Stop harming ME/CFS patients - take CBT/GET out of NICE guidelines NOW. - Dr. Hng's UK petition to stop GET and CBT<br /> * The NICE guideline for CFS/ME is not fit for purpose and needs a complete revision - a petition the ME Association delivered to Andrew Dillon at NICE <br /> * Suspend all trials of graded exercise therapy in children and adults with ME/CFS - [[UK]] parliament petition (archived)&lt;ref&gt;{{Cite news|url=https://petition.parliament.uk/petitions/166601|title=Archived Petition: Suspend all trials of graded exercise therapy in children and adults with ME/CFS|work=Petitions - UK Government and Parliament|access-date=2018-10-20|language=en-GB}}&lt;/ref&gt;<br /> <br /> ==Notable studies==<br /> *2004, [https://doi.org/10.1093/ptj/84.8.696 Chronic Fatigue Syndrome: Lack of Association between Pain-Related Fear of Movement and Exercise Capacity and Disability] &lt;ref&gt;{{Cite journal|last=Nijs|first=Jo|author-link=Jo Nijs|last2=Vanherberghen|first2=Katrien|author-link2=Katrien Vanherberghen|last3=Duquet|first3=William|author-link3=William Duquet|last4=De Meirleir|first4=Kenny|author-link4=Kenny De Meirleir|date=2004-08-01|title=Chronic Fatigue Syndrome: Lack of Association Between Pain-Related Fear of Movement and Exercise Capacity and Disability|url=https://doi.org/10.1093/ptj/84.8.696|journal=Physical Therapy|language=en|volume=84|issue=8|pages=|doi=10.1093/ptj/84.8.696|issn=1538-6724|quote=These results indicate a lack of correlation between kinesiophobia and exercise capacity, activity limitations, or participation restrictions, at least in patients with CFS who are experiencing widespread muscle or joint pain.|via=}}&lt;/ref&gt;<br /> *2009, [https://www.ncbi.nlm.nih.gov/m/pubmed/19855350/ A review on cognitive behavorial therapy (CBT) and graded exercise therapy (GET) in myalgic encephalomyelitis (ME) / chronic fatigue syndrome (CFS): CBT/GET is not only ineffective and not evidence-based, but also potentially harmful for many patients with ME/CFS]&lt;ref name=&quot;:0&quot;&gt;{{Cite journal|last=Twisk|first=Frank N. M.|last2=Maes|first2=Michael|date=2009|title=A review on cognitive behavorial therapy (CBT) and graded exercise therapy (GET) in myalgic encephalomyelitis (ME) / chronic fatigue syndrome (CFS): CBT/GET is not only ineffective and not evidence-based, but also potentially harmful for many patients with ME/CFS|url=https://www.ncbi.nlm.nih.gov/m/pubmed/19855350/|journal=Neuro Endocrinology Letters|volume=30|issue=3|pages=284–299|issn=0172-780X|pmid=19855350}}&lt;/ref&gt;<br /> *2016, [http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003200.pub5/full Exercise therapy for chronic fatigue syndrome]&lt;ref name=&quot;:1&quot;&gt;{{Cite journal|last=Larun|first=Lillebeth|last2=Brurberg|first2=Kjetil G.|last3=Odgaard‐Jensen|first3=Jan|last4=Price|first4=Jonathan R.|date=2016|title=Exercise therapy for chronic fatigue syndrome|url=https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003200.pub5/abstract|journal=Cochrane Database of Systematic Reviews|language=en|issue=6|doi=10.1002/14651858.CD003200.pub5|issn=1465-1858}}&lt;/ref&gt;<br /> *2016, [https://www.ncbi.nlm.nih.gov/pubmed/26995250 Neurocognitive improvements after best-practice intervention for chronic fatigue syndrome: Preliminary evidence of divergence between objective indices and subjective perceptions.]&lt;ref&gt;{{Cite journal|last=Cvejic|first=Erin|last2=Lloyd|first2=Andrew R.|last3=Vollmer-Conna|first3=Uté|date=2016|title=Neurocognitive improvements after best-practice intervention for chronic fatigue syndrome: Preliminary evidence of divergence between objective indices and subjective perceptions|url=https://www.ncbi.nlm.nih.gov/pubmed/26995250|journal=Comprehensive Psychiatry|volume=66|pages=166–175|doi=10.1016/j.comppsych.2016.02.002|issn=1532-8384|pmid=26995250|via=}}&lt;/ref&gt;<br /> *2017, PACE investigators' response is misleading regarding patient survey results&lt;ref&gt;{{Cite journal|last=Kirke|first=Karen D|author-link=Karen Kirke|author-link2=|author-link3=|author-link4=|author-link5=|date=2017-05-11|title=PACE investigators’ response is misleading regarding patient survey results|url=https://doi.org/10.1177/1359105317703787|journal=Journal of Health Psychology|language=en|volume=22|issue=9|pages=1168–1176|doi=10.1177/1359105317703787|issn=1359-1053|quote=|via=}}&lt;/ref&gt; [https://doi.org/10.1177%2F1359105317703787 (Full)]<br /> *2018, Rethinking the treatment of chronic fatigue syndrome—a reanalysis and evaluation of findings from a recent major trial of graded exercise and CBT &lt;ref&gt;{{Cite journal|last=Wilshire|first=Carolyn E.|author-link=Carolyn Wilshire|last2=Kindlon|first2=Tom|author-link2=Tom Kindlon|last3=Courtney|first3=Robert|author-link3=Robert Courtney|last4=Matthees|first4=Alem|author-link4=Alem Matthees|last5=Tuller|first5=David|author-link5=David Tuller|last6=Geraghty|first6=Keith|author-link6=Keith Geraghty|last7=Levin|first7=Bruce|author-link7=|date=2018-03-22|title=Rethinking the treatment of chronic fatigue syndrome—a reanalysis and evaluation of findings from a recent major trial of graded exercise and CBT|url=https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-018-0218-3|journal=BMC Psychology|language=En|volume=6|issue=1|pages=|doi=10.1186/s40359-018-0218-3|issn=2050-7283|quote=|via=}}&lt;/ref&gt;<br /> <br /> ==Learn more==<br /> *[https://en.wikipedia.org/wiki/Graded_exercise_therapy Wikipedia - Graded Exercise Therapy&quot;]<br /> *[http://funktionellelidelser.dk/fileadmin/www.funktionellelidelser.au.dk/patient_Pjecer/GET_booklet_web_July_2009__2_.pdf NHS Graded Exercise Therapy Booklet - A self-help guide for those with chronic fatigue syndrome/myalgic encephalomyelitis]&lt;ref&gt;{{Cite web|url=http://funktionellelidelser.dk/fileadmin/www.funktionellelidelser.au.dk/patient_Pjecer/GET_booklet_web_July_2009__2_.pdf|title=Graded Exercise Therapy - A self-help guide for those with chronic fatigue syndrome/myalgic encephalomyelitis|last=|first=|date=Jul 2009|website=http://funktionellelidelser.dk|publisher=NHS|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt;<br /> <br /> ==See also==<br /> *[[Deconditioning]]<br /> *[[Biopsychosocial model|Biopsychosocial hypothesis]]<br /> *[[Cognitive behavioral therapy]]<br /> *[[Illness beliefs]]<br /> *[[Exercise]]<br /> *[[PACE trial]]<br /> *[[Post-exertional malaise]]<br /> <br /> ==References==<br /> &lt;references /&gt;<br /> <br /> [[Category:Psychological paradigm]]<br /> [[Category:Potential treatments]]</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Caroline_Struthers&diff=44635 2018-11-29T21:37:36Z

<p>MEcfsFMS:/* Cochrane review of PACE trial */ CFS</p> <hr /> <div>'''Caroline Struthers''' lives in Oxford, England and is part of the [https://www.csm.ox.ac.uk/research/equator-network EQUATOR Network] team. Ms. Struthers is involved in many aspects of their mission to improve &quot;the planning, conduct and reporting of healthcare studies.&quot;&lt;ref name=&quot;:0&quot;&gt;{{Cite web|url=https://www.csm.ox.ac.uk/team/caroline-struthers|title=Caroline Struthers — Centre for Statistics in Medicine|website=www.csm.ox.ac.uk|language=en|access-date=2018-11-29}}&lt;/ref&gt; Struthers has developed a web-tool called [http://www.goodreports.org Good Reports] &quot;to help authors identify and use the most appropriate reporting guideline when they are submitting their manuscript to a journal.&quot;&lt;ref name=&quot;:0&quot; /&gt; She is also part of [https://www.ndorms.ox.ac.uk/csm Centre for Statistics in Medicine].&lt;ref name=&quot;:0&quot; /&gt; <br /> <br /> Caroline is an [[ME/CFS]] patient ally and blogs about the [[PACE trial]] and [[Cochrane]] at [https://healthycontrolblog.wordpress.com Healthy Control], WordPress.com. <br /> <br /> == Cochrane review of PACE trial ==<br /> On November 29, 2018, Ms. Struthers submitted a complaint to the Cochrane Governing Board citing 15 points on their review of [[exercise]] for [[chronic fatigue syndrome]] (CFS). She concluded her complaint by stating &quot;This review should be retracted and Cochrane should issue a full unreserved apology to patients.&quot;&lt;ref&gt;{{Cite news|url=https://healthycontrolblog.wordpress.com/2018/11/29/my-complaint-to-the-cochrane-governing-board-about-the-cochrane-review-of-exercise-for-chronic-fatigue-syndrome/|title=My complaint to the Cochrane Governing Board about the Cochrane review of Exercise for chronic fatigue syndrome|last=Struthers|first=Caroline|date=2018-11-29|work=Healthy Control|access-date=2018-11-29|archive-url=|archive-date=|dead-url=|language=en-US|quote=|author-link=}}&lt;/ref&gt;<br /> <br /> == Online presence ==<br /> * E-mail: caroline.struthers@csm.ox.ac.uk<br /> <br /> * [https://twitter.com/Good_Reports Twitter]<br /> <br /> * [https://healthycontrolblog.wordpress.com WordPress.com]<br /> <br /> == See also ==<br /> * [[Cochrane]]<br /> <br /> * [[PACE trial]]<br /> <br /> == References ==<br /> <br /> [[Category:Advocates or allies]]<br /> [[Category:Psychological paradigm critics]]<br /> [[Category:PACE trial critics]]<br /> &lt;references /&gt;</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Caroline_Struthers&diff=44634 2018-11-29T21:36:55Z

<p>MEcfsFMS:wording</p> <hr /> <div>'''Caroline Struthers''' lives in Oxford, England and is part of the [https://www.csm.ox.ac.uk/research/equator-network EQUATOR Network] team. Ms. Struthers is involved in many aspects of their mission to improve &quot;the planning, conduct and reporting of healthcare studies.&quot;&lt;ref name=&quot;:0&quot;&gt;{{Cite web|url=https://www.csm.ox.ac.uk/team/caroline-struthers|title=Caroline Struthers — Centre for Statistics in Medicine|website=www.csm.ox.ac.uk|language=en|access-date=2018-11-29}}&lt;/ref&gt; Struthers has developed a web-tool called [http://www.goodreports.org Good Reports] &quot;to help authors identify and use the most appropriate reporting guideline when they are submitting their manuscript to a journal.&quot;&lt;ref name=&quot;:0&quot; /&gt; She is also part of [https://www.ndorms.ox.ac.uk/csm Centre for Statistics in Medicine].&lt;ref name=&quot;:0&quot; /&gt; <br /> <br /> Caroline is an [[ME/CFS]] patient ally and blogs about the [[PACE trial]] and [[Cochrane]] at [https://healthycontrolblog.wordpress.com Healthy Control], WordPress.com. <br /> <br /> == Cochrane review of PACE trial ==<br /> On November 29, 2018, Ms. Struthers submitted a complaint to the Cochrane Governing Board citing 15 points on their review of [[exercise]] for [[chronic fatigue syndrome]]. She concluded her complaint by stating &quot;This review should be retracted and Cochrane should issue a full unreserved apology to patients.&quot;&lt;ref&gt;{{Cite news|url=https://healthycontrolblog.wordpress.com/2018/11/29/my-complaint-to-the-cochrane-governing-board-about-the-cochrane-review-of-exercise-for-chronic-fatigue-syndrome/|title=My complaint to the Cochrane Governing Board about the Cochrane review of Exercise for chronic fatigue syndrome|last=Struthers|first=Caroline|date=2018-11-29|work=Healthy Control|access-date=2018-11-29|archive-url=|archive-date=|dead-url=|language=en-US|quote=|author-link=}}&lt;/ref&gt;<br /> <br /> == Online presence ==<br /> * E-mail: caroline.struthers@csm.ox.ac.uk<br /> <br /> * [https://twitter.com/Good_Reports Twitter]<br /> <br /> * [https://healthycontrolblog.wordpress.com WordPress.com]<br /> <br /> == See also ==<br /> * [[Cochrane]]<br /> <br /> * [[PACE trial]]<br /> <br /> == References ==<br /> <br /> [[Category:Advocates or allies]]<br /> [[Category:Psychological paradigm critics]]<br /> [[Category:PACE trial critics]]<br /> &lt;references /&gt;</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Caroline_Struthers&diff=44633 2018-11-29T21:32:28Z

<p>MEcfsFMS:copy/edit</p> <hr /> <div>'''Caroline Struthers''' lives in Oxford, England and is part of the [https://www.csm.ox.ac.uk/research/equator-network EQUATOR Network] team and is involved in many aspects of their mission to improve &quot;the planning, conduct and reporting of healthcare studies.&quot;&lt;ref name=&quot;:0&quot;&gt;{{Cite web|url=https://www.csm.ox.ac.uk/team/caroline-struthers|title=Caroline Struthers — Centre for Statistics in Medicine|website=www.csm.ox.ac.uk|language=en|access-date=2018-11-29}}&lt;/ref&gt; She is also part of [https://www.ndorms.ox.ac.uk/csm Centre for Statistics in Medicine].&lt;ref name=&quot;:0&quot; /&gt; <br /> <br /> She blogs about the [[PACE trial]] and [[Cochrane]] at [https://healthycontrolblog.wordpress.com Healthy Control], WordPress.com. She has developed a web-tool called [http://www.goodreports.org Good Reports] &quot;to help authors identify and use the most appropriate reporting guideline when they are submitting their manuscript to a journal.&quot;&lt;ref name=&quot;:0&quot; /&gt;<br /> <br /> She is an [[ME/CFS]] patient ally.<br /> <br /> == Cochrane review of PACE trial ==<br /> On November 29, 2018, Ms. Struthers submitted a complaint to the Cochrane Governing Board citing 15 points on their review of [[exercise]] for [[chronic fatigue syndrome]]. She concluded her complaint by stating &quot;This review should be retracted and Cochrane should issue a full unreserved apology to patients.&quot;&lt;ref&gt;{{Cite news|url=https://healthycontrolblog.wordpress.com/2018/11/29/my-complaint-to-the-cochrane-governing-board-about-the-cochrane-review-of-exercise-for-chronic-fatigue-syndrome/|title=My complaint to the Cochrane Governing Board about the Cochrane review of Exercise for chronic fatigue syndrome|last=Struthers|first=Caroline|date=2018-11-29|work=Healthy Control|access-date=2018-11-29|archive-url=|archive-date=|dead-url=|language=en-US|quote=|author-link=}}&lt;/ref&gt;<br /> <br /> == Online presence ==<br /> * E-mail: caroline.struthers@csm.ox.ac.uk<br /> <br /> * [https://twitter.com/Good_Reports Twitter]<br /> <br /> * [https://healthycontrolblog.wordpress.com WordPress.com]<br /> <br /> == See also ==<br /> * [[Cochrane]]<br /> <br /> * [[PACE trial]]<br /> <br /> == References ==<br /> <br /> [[Category:Advocates or allies]]<br /> [[Category:Psychological paradigm critics]]<br /> [[Category:PACE trial critics]]<br /> &lt;references /&gt;</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Caroline_Struthers&diff=44632 2018-11-29T21:26:48Z

<p>MEcfsFMS:headings, internal links, citations</p> <hr /> <div>'''Caroline Struthers''' lives in Oxford, England and is part of the [https://www.csm.ox.ac.uk/research/equator-network EQUATOR Network] team and is involved in many aspects of their mission to improve &quot;the planning, conduct and reporting of healthcare studies.&quot;&lt;ref name=&quot;:0&quot;&gt;{{Cite web|url=https://www.csm.ox.ac.uk/team/caroline-struthers|title=Caroline Struthers — Centre for Statistics in Medicine|website=www.csm.ox.ac.uk|language=en|access-date=2018-11-29}}&lt;/ref&gt; She is also part of [https://www.ndorms.ox.ac.uk/csm Centre for Statistics in Medicine].&lt;ref name=&quot;:0&quot; /&gt; <br /> <br /> She blogs about the [[PACE trial]] and [[Cochrane]] at [https://healthycontrolblog.wordpress.com Healthy Control], WordPress.com. She has developed a web-tool called &quot;[http://www.goodreports.org Good Reports]&quot; &quot;to help authors identify and use the most appropriate reporting guideline when they are submitting their manuscript to a journal.&quot;&lt;ref name=&quot;:0&quot; /&gt;<br /> <br /> == Cochrane review of PACE trial ==<br /> On November 29, 2018, Ms. Struthers submitted a complaint to the Cochrane Governing Board citing 15 points on their review of [[exercise]] for [[chronic fatigue syndrome]]. She concluded her complaint by stating &quot;This review should be retracted and Cochrane should issue a full unreserved apology to patients.&quot;&lt;ref&gt;{{Cite news|url=https://healthycontrolblog.wordpress.com/2018/11/29/my-complaint-to-the-cochrane-governing-board-about-the-cochrane-review-of-exercise-for-chronic-fatigue-syndrome/|title=My complaint to the Cochrane Governing Board about the Cochrane review of Exercise for chronic fatigue syndrome|last=Struthers|first=Caroline|date=2018-11-29|work=Healthy Control|access-date=2018-11-29|archive-url=|archive-date=|dead-url=|language=en-US|quote=|author-link=}}&lt;/ref&gt;<br /> <br /> == Online presence ==<br /> * E-mail: caroline.struthers@csm.ox.ac.uk<br /> <br /> * [https://twitter.com/Good_Reports Twitter]<br /> <br /> * [https://healthycontrolblog.wordpress.com WordPress.com]<br /> <br /> == See also ==<br /> * [[Cochrane]]<br /> <br /> * [[PACE trial]]<br /> <br /> == References ==<br /> <br /> [[Category:Advocates or allies]]<br /> [[Category:Psychological paradigm critics]]<br /> [[Category:PACE trial critics]]</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Caroline_Struthers&diff=44631 2018-11-29T21:10:40Z

<p>MEcfsFMS:x</p> <hr /> <div>'''Caroline Struthers''' is an ally for ME/CFS patients and part of the [[https://www.csm.ox.ac.uk/research/equator-network EQUATOR Network]] team and is involved in many aspects of their mission to improve &quot;the planning, conduct and reporting of healthcare studies.&quot; <br /> <br /> Caroline lives in Oxford, England. She blogs on ME/CFS at [https://healthycontrolblog.wordpress.com Healthy Control], WordPress.com. She has developed a web-tool called &quot;Good Reports&quot; &quot;to help authors identify and use the most appropriate reporting guideline when they are submitting their manuscript to a journal.&quot;<br /> <br /> == Cochrane review of PACE trial ==<br /> On November 29, 2018, Ms. Struthers submitted a complaint to the [[Cochrane]] Governing Board citing 15 points of their review of [[exercise]] for [[chronic fatigue syndrome]].<br /> <br /> == Online presence ==<br /> * [https://healthycontrolblog.wordpress.com WordPress.com]<br /> <br /> == References ==<br /> <br /> [[Category:Advocates or allies]]<br /> [[Category:Psychological paradigm critics]]<br /> [[Category:PACE trial critics]]</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=A_Life_Hidden&diff=44629 2018-11-29T20:24:31Z

<p>MEcfsFMS:/* See also */ internal link</p> <hr /> <div>[[File:A Life Hidden.JPG|400px|thumb|right|]]<br /> '''A Life Hidden''' is a [https://alifehidden.com blog] by [[Naomi Whittingham]] which is &quot;dedicated to those shut away from the world through the [[Severe and very severe ME|intense suffering of ME]]; suffering that is compounded by the failure of governments, the medical profession and society to adequately support them.&quot;&lt;ref&gt;{{Cite news|url=https://alifehidden.com/a-life-hidden-2/|title=A Life Hidden|last=Whittingham|first=Naomi|date=2018-10-12|work=A Life Hidden|access-date=2018-11-29|archive-url=|archive-date=|dead-url=|language=en-GB|quote=|author-link=Naomi Whittingham|at=About: A Life Hidden}}&lt;/ref&gt;<br /> <br /> <br /> == Mission statement ==<br /> * [https://alifehidden.com A Life Hidden]&lt;ref name=&quot;:0&quot;&gt;{{Cite web|url=https://alifehidden.com|title=A Life Hidden|last=Whittingham|first=Naomi|authorlink=Naomi Whittingham|last2=|first2=|authorlink2=|date=|website=A Life Hidden|at=HOME|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-11-29}}&lt;/ref&gt;<br /> &lt;blockquote&gt;A Life Hidden is dedicated to those shut away from the world because of the intense suffering of ME ([[myalgic encephalomyelitis]]). This site is a collection of my advocacy work, and I hope that it will serve as a resource for anyone wishing to understand more about the illness.&lt;/blockquote&gt;&lt;blockquote&gt;In raising awareness of ME, my greatest inspiration comes from friends and loved ones whose every moment is consumed by the most extreme physical suffering.  They are alone and forgotten by the world, but every day demonstrate the most immense courage, simply by continuing their struggle to survive. &lt;/blockquote&gt;&lt;blockquote&gt;Through my writing, I have become less hidden.  I want to use my voice to speak for those who cannot.&lt;ref name=&quot;:0&quot; /&gt;&lt;/blockquote&gt;<br /> <br /> == See also ==<br /> * [[Myalgic encephalomyelitis|Myalgic encaphalomyelitis]]<br /> <br /> * [[Severe and very severe ME]]<br /> <br /> * [[Naomi Whittingham]]<br /> <br /> == References ==<br /> <br /> [[Category:Blogs]]<br /> [[Category:Websites]]<br /> &lt;references /&gt;</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=File:A_Life_Hidden.JPG&diff=44627 2018-11-29T20:18:24Z

<p>MEcfsFMS:x</p> <hr /> <div>== Summary ==<br /> Title: A Life Hidden<br /> <br /> Source: [https://alifehidden.com A Life Hidden Blog]<br /> <br /> Author: [https://alifehidden.com/about-naomi/ Naomi Whittingham]<br /> <br /> <br /> == Licensing ==<br /> {{Fair_Use_License}}</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=File:A_Life_Hidden.JPG&diff=44626 2018-11-29T20:17:58Z

<p>MEcfsFMS:Title: A Life Hidden Source: https://alifehidden.com A Life Hidden Blog Author: https://alifehidden.com/about-naomi/ Naomi Whittingham</p> <hr /> <div>== Summary ==<br /> Title: A Life Hidden<br /> <br /> Source: [[https://alifehidden.com A Life Hidden Blog]]<br /> <br /> Author: [[https://alifehidden.com/about-naomi/ Naomi Whittingham]]<br /> <br /> <br /> == Licensing ==<br /> {{Fair_Use_License}}</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Myalgic_encephalomyelitis&diff=44553 2018-11-28T16:22:01Z

<p>MEcfsFMS:/* History */ Main article info came up twice</p> <hr /> <div>'''Myalgic Encephalomyelitis''' (ME) is a chronic, [[Inflammation|inflammatory]], physically and [[neurological|neurologically]] disabling disease that presents with symptoms involving multiple bodily systems. Frequently triggered by a [[viral infection]], it affects the [[central nervous system]] (CNS), [[autonomic nervous system]] (ANS), [[immune system]], [[cardiovascular system]], [[endocrine system]], [[digestive system]], and [[musculoskeletal system]].&lt;ref name=&quot;:8&quot;&gt;{{Cite news|url=https://rarediseases.org/rare-diseases/myalgic-encephalomyelitis/|title=Myalgic Encephalomyelitis - NORD (National Organization for Rare Disorders)|work=NORD (National Organization for Rare Disorders)|access-date=2018-09-07|language=en-US}}&lt;/ref&gt;&lt;ref&gt;{{Cite web|url=http://paradigmchange.me/wp-content/uploads/2016/04/ME-CFS-Medical-Abormalities-040416.pdf|title=Myalgic Encephalomyelitis (ME) and Chronic Fatigue Syndrome (CFS) Medical Abnormalities Research Citations|last=Petrison|first=Lisa|date=Apr 4, 2016|website=paradigmchange.me|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt; It has been classified by the [[World Health Organization]] (WHO) as a neurological disease since 1969&lt;ref&gt;{{Cite journal|date=2018-07-22|title=History of chronic fatigue syndrome|url=https://en.wikipedia.org/w/index.php?title=History_of_chronic_fatigue_syndrome&amp;oldid=851489536|journal=Wikipedia|language=en}}&lt;/ref&gt;&lt;ref&gt;{{Cite news|url=https://rarediseases.org/rare-diseases/myalgic-encephalomyelitis/|title=Myalgic Encephalomyelitis - NORD (National Organization for Rare Disorders)|work=NORD (National Organization for Rare Disorders)|access-date=2018-09-08|language=en-US}}&lt;/ref&gt; and has occurred in both [[Epidemic myalgic encephalomyelitis|epidemic]] and sporadic forms since at least the 1930s. <br /> <br /> A hallmark symptom of ME is [[Post-exertional malaise|post-exertional malaise]] (PEM), which is an intolerance to previously achievable cognitive or physical [[exertion]].&lt;ref name=&quot;:0&quot;&gt;{{Cite news|url=https://prevention.nih.gov/programs-events/pathways-to-prevention/workshops/me-cfs|title=Pathways to Prevention (P2P) Advancing the Research on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)|last=|first=|date=|work=Office of Disease Prevention|access-date=2018-09-07|archive-url=|archive-date=|dead-url=|language=en}}&lt;/ref&gt;&lt;ref name=&quot;:1&quot;&gt;[http://www.meactionuk.org.uk/definition.html Research Descriptions of M.E. - ME Action UK]&lt;/ref&gt;&lt;ref name=&quot;:2&quot;&gt;{{Cite web|url=http://www.cfids-me.org/ramsay86.html|title=The Clinical Features of Myalgic Encephalomyelitis|last=Ramsey|first=Melvin|date=1986|website=www.cfids-me.org|archive-url=|archive-date=|dead-url=|access-date=2018-09-07}}&lt;/ref&gt;&lt;ref name=&quot;:3&quot;&gt;{{Cite news|url=https://www.verywell.com/what-is-post-exertional-malaise-716023|title=What is Post-Exertional Malaise? Learn About a Key ME/CFS Symptom|last=Dellwo|first=Adrienne|date=Aug 1, 2018|work=Verywell Health|access-date=2018-09-07|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt;&lt;ref name=&quot;:5&quot;&gt;{{Cite news|url=http://www.webmd.com/chronic-fatigue-syndrome/chronic-fatigue-syndrome-symptoms|title=Think You Might Have Chronic Fatigue Syndrome? Here are The Symptoms|work=WebMD|access-date=2018-09-07|language=en-US}}&lt;/ref&gt;&lt;ref name=&quot;:6&quot;&gt;{{Cite web|url=http://solvecfs.org/wp-content/uploads/2013/10/pem-series.pdf|title=Post-Exertional Malaise in Chronic Fatigue Syndrome|last=Spotila|first=Jennifer|date=2010|website=solvecfs.org|publisher=The CFIDS Association of America|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt; Other key symptoms include [[muscle]] [[Muscle weakness|weakness]] and easy [[Muscle fatigability|fatiguability]], [[sleep disturbance]], and [[cognitive dysfunction]]. ANS dysfunction is frequent, although specific symptoms vary from patient to patient and may include [[Postural orthostatic tachycardia syndrome|postural orthostatic tachycardia]] (POTS), [[Orthostatic intolerance|orthostatic hypotension]] (OI), and both [[Body temperature|cold and heat intolerance]]. Other common symptoms include [[myalgia]] (muscle pain), [[neuralgia]] (neuropathic pain), [[Neck stiffness|neck]] and [[spine stiffness]], and sensory symptoms including [[sensitivity to light]], [[Hyperacusis|sound]], [[touch]], [[Paresthesia|paraesthesia]] (skin tingling or [[numbness]]) and hyperaesthesia (skin sensitivity and pain, and [[allodynia]]). <br /> <br /> Among adults, ME is more common in women than men. New onset has been [[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome|observed in children]] and in adults as old as 80 years old. Its course is usually relapsing-remitting with new symptoms occurring either in discrete relapses (or 'crashes') or accruing over time.&lt;ref&gt;{{Cite web|url=https://login.medscape.com/login/sso/getlogin?urlCache=aHR0cHM6Ly93d3cubWVkc2NhcGUuY29tL3ZpZXdhcnRpY2xlLzg3MTQ4Mg==&amp;ac=401|title=Postexertion 'Crash,' not Fatigue per se, Marks Syndrome|last=|first=|date=|website=medscape.com|format=Login Needed|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt; There is a progressive form of ME but it is rarer than the relapsing-remitting type.&lt;ref&gt;{{Cite web|url=http://www.meassociation.org.uk/wp-content/uploads/fulltext_pmr-v2-id10521.pdf|title=Progressive Myalgic Encephalomyelitis (ME) or A New Disease? A Case Report|last=Howes|first=S|date=Jul 7, 2015|website=meassocation.org|publisher=Physical Medicine and Rehabilitation - International|via=Austin Publishers Group|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt;<br /> <br /> There are no approved pharmacological treatments for ME anywhere in the world, except in [[Argentina]], which has approved the immunomodulator [[Ampligen]] for [[Severe and very severe ME|severe ME/CFS]] as of August 23, 2016.&lt;ref name=&quot;:9&quot;&gt;{{Cite news|title=Hemispherx Biopharma Announces Major Breakthrough: Approval for Commercial Sale of Rintatolimod (U.S. Tradename: Ampligen®) to Treat Severe Cases of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) in the Argentine Republic|url=http://www.globenewswire.com/news-release/2016/08/23/866212/0/en/Hemispherx-Biopharma-Announces-Major-Breakthrough-Approval-for-Commercial-Sale-of-Rintatolimod-U-S-Tradename-Ampligen-to-Treat-Severe-Cases-of-Myalgic-Encephalomyelitis-Chronic-Fat.html|work=GlobeNewswire News Room|access-date=2018-08-12|language=en-US|first=Hemispherx Biopharma,|last=Inc.|date=Aug 23, 2016|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt;<br /> <br /> ME is accurately diagnosed with the [[International Consensus Criteria]] (ICC) and a diagnosis should be made immediately. Other criterion such as the [[Canadian Consensus Criteria]] (CCC) and [[Systemic Exertion Intolerance Disease|SEID]] cannot be used to diagnose immediately nor speak to the array and severity of CNS, neurological, ANS, and immune system symptoms patients experience.<br /> <br /> [[File:Linda Crowhurst.JPG|200x200px|thumb|Linda Crowhurst is married to [[Greg Crowhurst]]; they reside in Belfast, [[Northern Ireland]]. Greg is Linda's full-time carer as she is [[Severe and very severe ME|very severely ill with ME]]. As of June 2018, Linda has been ill for 25 years. [https://www.youtube.com/watch?v=rVsOeZjhMFY Greg posted a YouTube video] in 2006 (reposted in 2007) of Linda speaking of her condition and showing her severe symptoms which are the first known public visual document of severe ME. She is now bedbound barely able to move and unable to feed herself]]<br /> <br /> [[File:Jenny Spotlia.jpg|300px|thumb|right|[[Jennie Spotila]] is an American ME patient who fell ill on October 6, 1994. Jennie is [[Severe and very severe ME|disabled, mostly housebound, and uses a wheelchair]] but has been an [[ME/CFS]] advocate for many years. She writes the blog [[Occupy M.E.]] She served on the Board of Directors of [[Solve ME/CFS Initiative|The CFIDS Association of America]] and testified before the [[Chronic Fatigue Syndrome Advisory Committee|CFSAC]]]]<br /> <br /> <br /> <br /> == History ==<br /> [[File:Hillary Johnson.jpg|200px|thumb|[[Hillary Johnson]] is an [[United States|American]] journalist and while ill herself, wrote the book [[Osler's Web]] which is the historical account of the early years of a &quot;new&quot; illness that had an outbreak at [[1984 Incline Village chronic fatigue syndrome outbreak|Incline Village]] which she shared the same symptoms. The illness came to be known as [[chronic fatigue syndrome]] (CFS). Johnson spent nine years investigating the outbreak and the [[CDC]]'s refusal to acknowledge a devastating disease (deeming sufferers of Incline Village as having &quot;[https://en.wikipedia.org/wiki/Mass_psychogenic_illness mass hysteria]&quot;) that can be spread through casual contact. She appears in the documentary ''[[Forgotten Plague]]'' and currently writes at<br /> [https://www.oslersweb.com/ Oslersweb.com] ]]<br /> <br /> {{Main article | page_name =History of myalgic encephalomyelitis and chronic fatigue syndrome}}&lt;div role=&quot;note&quot; class=&quot;hatnote navigation-not-searchable&quot;&gt;<br /> <br /> ME has occurred in both epidemic and sporadic form since at least the 1930s, although is probably much older. The first recorded outbreak of [[epidemic myalgic encephalomyelitis]] was in [[1934 Los Angeles atypical polio outbreak|1934 in Los Angeles]] and was thought to be an outbreak of atypical [[polio]]. After the outbreak in [[Akureyri]], Iceland in 1946, the disease came to be called 'Akureyri Disease' or [[Icelandic disease]] through much of the 1940s and 1950s. It was named ME after London's [[Royal Free Hospital outbreak]] in 1955. Other names included benign myalgic encephalomyelitis and [[Epidemic myalgic encephalomyelitis|epidemic neuromyasthenia]].<br /> <br /> After the [[1984 Incline Village chronic fatigue syndrome outbreak|Incline Village]] outbreak in Nevada in 1984, the disease came to be called and redefined as [[chronic fatigue syndrome]] (CFS). The most recent putative outbreak was in Arizona in 1996. <br /> <br /> ==Disease Name==<br /> <br /> [[File:Merry Crofts sick.JPG|200px|thumb|[[Merryn Crofts]] was [[Severe and very severe ME|bedbound and unable to eat.]] Merryn weighed six stone (84 lbs) at her death; her autopsy revealed inflammation of the [[Dorsal root ganglia|ganglia]]. It is suspected that in the later years of her illness Merryn also suffered from [[Ehlers-Danlos syndrome|EDS]] and [[Mast cell activation disorder|MCAD]]. Her death certificate is the 2nd in the [[United Kingdom|UK]] to attribute a death to ME]]<br /> {{Main article |page_name = Names of myalgic encephalomyelitis and chronic fatigue syndrome}}<br /> * ''Myalgic adj. - of or relating to [[myalgia]].'' Is [[muscle pain]].&lt;ref&gt;{{Cite news|url=https://www.thefreedictionary.com/myalgic|title=myalgic|work=TheFreeDictionary.com|access-date=2018-08-12}}&lt;/ref&gt;<br /> <br /> * ''Encephalo'': Refers to the [[brain]].&lt;ref&gt;{{Cite news|url=https://medical-dictionary.thefreedictionary.com/encephalo-|title=encephalo-|work=TheFreeDictionary.com|access-date=2018-08-12}}&lt;/ref&gt;<br /> <br /> * ''Myel'': Relating to the [[spinal cord]].&lt;ref&gt;{{Cite news|url=https://www.thefreedictionary.com/myel-|title=myel-|work=TheFreeDictionary.com|access-date=2018-08-12}}&lt;/ref&gt; <br /> <br /> * ''Itis'': [[Inflammation]].&lt;ref&gt;{{Cite news|url=https://www.thefreedictionary.com/-itis|title=Itis|work=TheFreeDictionary.com|access-date=2018-08-12|last=|first=|date=|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt;<br /> The name ME&lt;ref&gt;{{Cite news|url=https://www.verywell.com/myalgic-encephalomyelitis-me-715663|title=Myalgic Encephalomyelitis: Chronic Fatigue Syndrome's Other Name|last=Dellwo|first=Adrienne|date=Jul 23, 2018|work=Verywell Health|access-date=2018-08-12|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt; was coined by Dr. [[Melvin Ramsay]] following the [[1955 Royal Free Hospital outbreak]]&lt;ref&gt;{{Cite journal|last=|first=|date=1957-10-19|title=An Outbreak of Encephalomyelitis in the Royal Free Hospital Group, London, in 1955|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1962472/|journal=British Medical Journal|volume=2|issue=5050|pages=895–904|issn=0007-1447|pmid=13472002|via=}}&lt;/ref&gt; and is a portmanteau of several of the key signs and symptoms of the disease: myalgic (muscle pain), encephalo (brain), myel (spinal cord), itis (inflammation).&lt;ref&gt;[http://www.name-us.org/DefintionsPages/DefinitionsArticles/Hoopersdescription.pdf The Terminology of ME &amp; CFS By Professor Malcolm Hooper]&lt;/ref&gt; The [[central nervous system]] (brain and spinal cord) are inflamed.&lt;ref name=&quot;:02&quot;&gt;{{Cite news|url=https://www.verywellhealth.com/myalgic-encephalomyelitis-me-715663|title=Myalgic Encephalomyelitis or Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Nov 24, 2018|work=Verywell Health|access-date=2018-11-28|archive-url=|archive-date=|dead-url=|quote=|author-link=}}&lt;/ref&gt; <br /> <br /> Several other names have been used or proposed throughout the history of the disease, including [[atypical polio]], [[Icelandic disease]], benign ME, [[epidemic neuromyasthenia]], CFS, and [[systemic exertion intolerance disease]] (SEID). This has lead to much confusion as a variety of names have been used at different times to describe discrete outbreaks as well as a larger and potentially more heterogenous population of sporadic cases, defined by a wide variety of [[Definitions of myalgic encephalomyelitis and chronic fatigue syndrome|case definitions]]. <br /> <br /> A survey by [[The MEAction Network]] in 2016 found that the majority of patients prefer the name ME to other names including chronic fatigue syndrome.&lt;ref&gt;{{Cite news|url=http://www.meaction.net/2016/08/07/meaction-rfi-poll-report-1-of-3/|title=#MEAction RFI Poll Report (Part 1 of 3) - #MEAction|date=2016-08-07|work=#MEAction|access-date=2018-09-08|language=en-US}}&lt;/ref&gt; Most government agencies and researchers around the world use the term [[ME/CFS]].{{Citation needed}}<br /> <br /> Myalgic encephalomyelitis (ME) was the original name for [[chronic fatigue syndrome]] (CFS); the names are used interchangeably or with the acronym [[ME/CFS]].&lt;ref name=&quot;:02&quot; /&gt;<br /> <br /> == Onset ==<br /> Following after an incubation period of 4 to 7 days, the [[wikipedia:Prodrome|prodromal]] phase generally involve a [[flu-like illness]] with [[low-grade fever]]. In the majority but not all cases, an [[infection]] or infectious process is evident.&lt;ref&gt;[http://www.nightingale.ca/documents/Nightingale_ME_Definition_en.pdf ME Definition - Nightingale - PDF pg. 6]&lt;/ref&gt; Two to seven days later, a chronic phase commences, characterized by a measurable diffuse change in the function of the CNS. It is this second phase, persistent phase that most characterizes ME.&lt;ref&gt;{{Cite web|url=https://www.scribd.com/document/32848597/Nightingale-ME-Definition-En|title=Nightingale ME Definition En {{!}} Chronic Fatigue Syndrome {{!}} Infection|last=|first=|date=|website=Scribd|page=5|pages=|at=|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-09-08}}&lt;/ref&gt;&lt;ref name=&quot;:8&quot; /&gt;<br /> <br /> In some patients, the initial presentation involved a severe, incapacitating prolonged illness. In theirs, an apparent remission was followed by relapses brought on by exertion, [[menstrual period]], or cold.<br /> <br /> <br /> <br /> ==Signs and Symptoms==<br /> Symptoms can range from mild to very severe and can include:<br /> [[File:J Brea TED.JPG|200px|thumb|right|[[Jen Brea|Jennifer Brea]] is an American who was attending Harvard and while on a trip to Kenya she became very ill and never recovered. Brea began experiencing neurological problems. Her neurologist diagnosed her with &quot;conversion disorder&quot; ([[hysteria]]). When walking home from his office, she collapsed. [[Severe and very severe ME|Jen now needs to use a wheelchair]] keeping her legs up due to [[Postural orthostatic tachycardia syndrome|POTS]] as her blood pools into her legs. View her TED Talk ''[https://www.ted.com/talks/jen_brea_what_happens_when_you_have_a_disease_doctors_can_t_diagnose What happens when you have a disease doctors can't diagnose]'']]<br /> <br /> &lt;div style=&quot;column-count:2;-moz-column-count:2;-webkit-column-count:2&quot;&gt;<br /> <br /> *[[low-grade fever]], [[Temperature dysregulation|temperature instability]] <br /> *[[post-exertional malaise]] <br /> *[[cognitive dysfunction]]<br /> *[[muscle]] [[Muscle weakness|weakness]] and [[Muscle fatigability|fatiguability]]<br /> *[[headache]]<br /> *[[myalgia|myalgia (muscle pain)]]<br /> *[[neuralgia|neuralgia (nerve pain)]]<br /> *[[ataxia|ataxia (coordination difficulties)]]<br /> *[[gastrointestinal]] symptoms<br /> *[[sleep dysfunction]]<br /> *neck and back or [[spinal cord]] stiffness<br /> *sensitivity to [[Light sensitivity|light]], [[Hyperacusis|sound]] and/or [[Allodynia|touch]]<br /> *sensitivity to [[Temperature sensitivity|heat or cold]]<br /> <br /> &lt;/div&gt;<br /> <br /> Symptoms presentation and severity can vary considerably day to day and even hour to hour.&lt;ref name=&quot;:8&quot; /&gt; Overexertion can make all symptoms worse, the effects are often delayed and may not be seen within 24 hours.&lt;ref&gt;{{Cite web|url=http://www.investinme.org/landerP5.shtml|title=Invest in ME Research - Invest in ME Research Home Page|last=Research|first=Invest in ME|website=www.investinme.org|access-date=2018-09-08}}&lt;/ref&gt; &lt;ref name=&quot;:8&quot; /&gt; The US [[National Institutes of Health]] (NIH) notes that sensitivity to noise, light and [[Chemical sensitivities|chemical]]&lt;nowiki/&gt;s may force patients to withdraw from society.&lt;ref&gt;{{Cite news|url=https://prevention.nih.gov/programs-events/pathways-to-prevention/workshops/me-cfs|title=Pathways to Prevention (P2P) Advancing the Research on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)|last=|first=|date=|work=Office of Disease Prevention|access-date=2018-09-08|archive-url=|archive-date=|dead-url=|language=en}}&lt;/ref&gt;<br /> <br /> The severity of a patient's symptoms often depends on the time period since the disease was contacted and rate of progression of each patient. The rate of progression can be accelerated by ''physical or cognitive activity'' beyond a patient's limits, which typically entails [[anaerobic]] activity &lt;ref&gt;{{Cite web|url=https://www.me-pedia.org/wiki/Unrest|title=Unrest - MEpedia|website=www.me-pedia.org|language=en|access-date=2018-08-12}}&lt;/ref&gt; <br /> <br /> === Post-exertional malaise ===<br /> {{Main article | page_name =Post-exertional malaise}}<br /> A core symptom, [[post-exertional malaise]], is intolerance to previously trivial effort such as walking to the mailbox, running an errand or grocery shopping, taking a shower or brushing teeth, and deterioration of health from persistent or repeated exertion.&lt;ref name=&quot;:0&quot; /&gt;&lt;ref name=&quot;:1&quot; /&gt;&lt;ref name=&quot;:2&quot; /&gt;&lt;ref name=&quot;:3&quot; /&gt;&lt;ref name=&quot;:5&quot; /&gt;&lt;ref name=&quot;:6&quot; /&gt;&lt;ref name=&quot;:4&quot;&gt;{{Cite news|url=https://www.verywell.com/post-exertional-malaise-715670|title=What is Post-Exertional Malaise? Learn About a Key ME/CFS Symptom|work=Verywell Health|access-date=2018-09-07}}&lt;/ref&gt;<br /> <br /> == Clinical Findings ==<br /> [[File:Alem Matthee.png|200px|thumb|right|[[Alem Matthees]] is an [[Australia|Australian]] ME patient that filed an FOI request for data from the [[PACE trial]]. At a [[Severe and very severe ME|great cost to his health]], Alem appealed the denial of the data and won. This data proved the results published in [[The Lancet|''The Lancet'']] were untrue. Alem's health suffered significantly in part from the efforts required for the FOI request and tribunal]]<br /> Although there is no definitive [[biomarker]], several signs and findings have been frequently observed in clinical settings:&lt;div style=&quot;column-count:2;-moz-column-count:2;-webkit-column-count:2&quot;&gt;<br /> <br /> *high antibody titers to specific infections (including [[Epstein-Barr virus|EBV]], [[Human herpesvirus 6|HHV-6]], and [[Coxsackie B virus|Coxsackie B]] among others)<br /> *[[Hormones|hormone]] imbalance<br /> *[[Immune system|immunological abnormalities]]<br /> *[[Natural Killer Cell (NKC) function|low natural killer cell function]]<br /> *low red blood cell [[magnesium]]<br /> *[[natural killer cell]] (NKC)<br /> *[[Postural orthostatic tachycardia syndrome|postural orthostatic tachychardia]] (POTS)<br /> *[[Post-exertional malaise|reaction to physical and mental activity and sensory input]] (PEM)<br /> &lt;/div&gt;<br /> <br /> ==Diagnosis==<br /> <br /> [[File:Tom Kindlon.png|300px|thumb|[[Tom Kindlon]] became [[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome|ill at 16]] and never recovered. He is an ME/CFS advocate with published works in Research Gate and PubMed. Kindlon lives in [[Ireland]] and is Assistant Chairperson of the [[Irish ME/CFS Association]]. Tom and others analyzed the data for the PACE trial proving out that its published results were untrue. He uses a [[Severe and very severe ME|wheelchair and his full-time carer]] is his mother, Vera]]<br /> <br /> {{Main article | page_name =Definitions of myalgic encephalomyelitis and chronic fatigue syndrome}}There are several proposed criteria for diagnosing ME including the [[International Consensus Criteria]] (ICC) and the [[Canadian Consensus Criteria]] (CCC). The original criteria developed by [[Melvin Ramsay]], the [[Ramsay definition]], is not used for diagnosing ME today.&lt;span&gt;&lt;/span&gt;&lt;span&gt;&lt;/span&gt;<br /> === Other diagnostic criteria ===<br /> Several, overly broad criteria have been proposed and are in use. These criteria likely capture some patients with the disease characterized in the medical literature on [[Epidemic myalgic encephalomyelitis|epidemic ME]], exclude others, and also include patients with a wide range of other undiagnosed conditions including cancer, depression, and a range of autoimmune diseases. The United Kingdom's [[Oxford criteria]] is the broadest and likely most heterogenous definition. (The US [[Institute of Medicine report]] called for its complete retirement.)&lt;ref&gt;{{Cite web|url=http://theargusreport.com/us-nih-report-calls-uk-definition-mecfs-scrapped/|title=US NIH Report Calls for UK Definition of ME/CFS to be Scrapped|last=Swift|first=Penny|date=|website=theargusreport.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-09-08}}&lt;/ref&gt; The US [[Centers for Disease Control and Prevention|Centers for Disease Control]]'s (CDC) [[Fukuda criteria]], in use since 1994, is also overly broad.<br /> <br /> ===Differential diagnosis===<br /> The signs and symptoms of ME can be similar to other medical problems, &quot;such as cancer, [[multiple sclerosis]], [[Systemic lupus erythematosus|lupus]], [[brucellosis]], or another condition.&quot;&lt;ref name=&quot;:8&quot; /&gt; Additional testing may be needed to help distinguish ME from these other problems.<br /> <br /> ==Course and Prognosis ==<br /> {{Main article | page_name =Prognosis for myalgic encephalomyelitis and chronic fatigue syndrome}}<br /> <br /> ME relapses are often a result of over-activity, but can occur without warning with no obvious inciting factors. Exposure to increased sensory information in light, sound, and movement can provoke a sensory storm. <br /> <br /> Infections, such as the common cold, [[influenza]] and gastroenteritis, also increase the risk for a relapse. Heat and cold can transiently increase symptoms.<br /> <br /> Pregnancy can directly affect the susceptibility for relapse. Later pregnancy appears to offer a natural protection against relapses, and there are anecdotal reports of postpartum remission. However, pregnancy does not seem to influence long-term disability.<br /> <br /> About 25% of patients become [https://www.me-pedia.org/wiki/Severe_and_very_severe_M.E. severe or very severely ill with ME].<br /> <br /> ==Clinical Subtypes==<br /> Kerr et al proposed 7 different subsets for 'CFS' as it is defined today:&lt;ref name=&quot;:7&quot;&gt;{{Cite web|url=http://me-ireland.com/genes2.pdf|title=Seven genomic subtypes of chronic fatigue phenotypes analysis of gene networks and clinical syndrome/myalgic encephalomyelitis: a detailed|last=Kerr|first=JR|last2=Burke|first2=R|date=May 30, 2008|website=me-ireland.com|doi=10.1136/jcp.2007.053553|archive-url=|archive-date=|dead-url=|access-date=|last3=Petty|first3=R|last4=Gough|first4=J|last5=Fear|first5=D|last6=Mattey|first6=D L|last7=Axford|first7=J S|last8=Dalgleish|first8=A G|last9=Nutt|first9=D J|publisher=JCP Online}}&lt;/ref&gt;&lt;ref&gt;{{Cite journal|last=Kerr|first=J. R.|last2=Burke|first2=B.|last3=Petty|first3=R.|last4=Gough|first4=J.|last5=Fear|first5=D.|last6=Mattey|first6=D. L.|last7=Axford|first7=J. S.|last8=Dalgleish|first8=A. G.|last9=Nutt|first9=D. J.|date=2008-06-01|title=Seven genomic subtypes of chronic fatigue syndrome/myalgic encephalomyelitis: a detailed analysis of gene networks and clinical phenotypes|url=https://jcp.bmj.com/content/61/6/730|journal=Journal of Clinical Pathology|language=en|volume=61|issue=6|pages=730–739|doi=10.1136/jcp.2007.053553|issn=0021-9746|pmid=18057078}}&lt;/ref&gt;<br /> <br /> [[File:Whitney.JPG|200px|thumb|[[Whitney Dafoe]] is an American photographer who has a [[Severe and very severe ME|very severe form]] of ME. Whitney can no longer speak or handle contact with anyone but his parents. His father is [[Ronald Davis|Ron Davis]], a world-renowned geneticist who is working to solve his son's disease]]<br /> <br /> * Subtype 1 This is one of the more severe subtypes. Effects are cognitive, [[Musculoskeletal system|musculoskeletal]], [[Sleep dysfunction|sleep-related]] and [[anxiety]]/[[depression]].<br /> <br /> * Subtype 2 This is one of the more severe subtypes. Effects are musculoskeletal, pain and anxiety/depression.<br /> <br /> * Subtype 3 This subtype has the mildest symptoms.<br /> <br /> * Subtype 4 This subtype is dominated by cognitive issues.<br /> <br /> * Subtype 5 Effects are musculoskeletal and gastrointestinal.<br /> <br /> * Subtype 6 This subtype is dominated by post-exertional malaise (extreme crash after [[exercise]] or exertion.)<br /> <br /> * Subtype 7 This is one of the more severe subtypes. Effects are [[pain]], infections, musculoskeletal, sleep-related, [[Nervous system|neurological]], gastrointestinal, [[Cognitive dysfunction|neurocognitive]] and anxiety/depression.&lt;ref name=&quot;:7&quot; /&gt;<br /> <br /> ==Pathophysiology==<br /> [[File:Vanessa Li.jpg|thumb|right|[[Vanessa Li]] lived in Hong Kong, the UK, and the US. She became ill with a [[flu-like illness]] while skiing in [[Italy]] and never recovered. Vanessa founded a crowdfund for the [[Microbe Discovery Project]]. She was in [[Severe and very severe ME|excruciating pain, suffered from breathing issues, and occasional paralysis]] for 15 years. She took her own life in 2015]]<br /> {{Main article | page_name =List of abnormal findings in chronic fatigue syndrome and myalgic encephalomyelitis}}<br /> <br /> ME is a multi-system disease. Numerous biological abnormalities have been found in multiple bodily system, however no common, central cause or mechanism has yet been elucidated.<br /> <br /> === Central nervous system ===<br /> [[File:Sophia mirza.jpg|thumb|right|[[Sophia Mirza]] was a [[Severe and very severe ME|very severely ill]] ME patient who lived in the UK. Sophia's death came not long after a forced entry into her mother's home and being sectioned and taken to a mental hospital in 2003. An independent Neuropathologist found Sophia's spine contained a massive infection. Her death certificate was the first in the UK to attribute a death to CFS]]<br /> {{Main article |page_name =Central nervous system}}Radiological research on ME has shown [https://medical-dictionary.thefreedictionary.com/hypoperfusion hypoperfusion] of the [[brain stem]] and an abnormal response to exertion, but research on CFS is often inconsistent and must be interpreted with caution. For example, some research stated that a reduced volume of [[grey matter]] may be a result of a lack of activity and is reversible with [[cognitive behavioral therapy]] (CBT).<br /> <br /> === Autonomic nervous system ===<br /> {{Main article |page_name =Autonomic nervous system}}<br /> <br /> === Peripheral nervous system ===<br /> {{Main article |page_name =Peripheral nervous system}}<br /> <br /> === Musculoskeletal system ===<br /> {{Main article |page_name =Muscle}}<br /> <br /> === Immune system ===<br /> {{Main article |page_name =Immune system}}&lt;div role=&quot;note&quot; class=&quot;hatnote navigation-not-searchable&quot;&gt;{{Main article |page_name =Immune system}}&lt;/div&gt;&lt;span&gt;&lt;/span&gt;<br /> <br /> According to a strictly immunological explanation of CFS, the inflammatory processes triggered by [[T cell]]s create leaks in the [[blood-brain barrier]] (a capillary system that should prevent entrance of T-cells in the nervous system). These leaks, in turn, cause a number of other damaging effects such as swelling, activation of macrophages, and more activation of [[cytokine]]s and other destructive proteins such as [[RNase L|Rnase-L]]. [[Channelopathy]], a reduced ability to move metabolites in and out of cells has been implicated in this process. This may also be applicable to ME.<br /> <br /> === Chronic infection ===<br /> Some evidence shows viral infection of muscle and brain in at least a proportion of sufferers. This triggers inflammatory processes, stimulating other immune cells and soluble factors like cytokines and antibodies. A model for late ME has been proposed analogously to post-polio syndrome in which repaired nerve tissue forms inappropriately [The Late Effects of ME: Can they be distinguished from the post-polio syndrome?]. <br /> [[File:Emma Shorter.JPG|400px|thumb|[[Emma Shorter]] is a [[Scotland|Scottish]] citizen who has ME. She did [[Graded exercise therapy]] (GET) and went from walking a few minutes a day to being [[Severe and very severe ME|in a wheelchair.]] Here, Emma gives testimony before Scotland's Parliament's Petitions Committee. <br /> View her [https://youtu.be/wDayJXxZSQE?t=106 testimony] ]]<br /> <br /> === Cardiovascular ===<br /> [[wikipedia:Hemodynamics|Hemodynamic]] abnormalities are widely found, including serum and RBC [[wikipedia:Hypovolemia|hypovolemia]], [[neurally mediated hypotension]], (NMH) and cerebral hypoperfusion. Vascular and endothelial abnormalities have been published by MERUK. However, none of these studies used research criteria for ME so the results may not be applicable to ME.<br /> <br /> Some cardiologic features such as cardiac insufficiency, inverted T-waves and myofiber disarray have been reported in CFS and recently added to by findings of reduced Q-value. This has led clinician and researcher Dr [[Paul Cheney]] to posit that CFS is form of partially compensated cardiomyopathy in which [[orthostatic intolerance]] and rapid fatiguability are secondary protective mechanisms. Due to the heterogeneity of the population, a single cause is unlikely, but one-third of people with ME have abnormalities when tested with [[wikipedia:Holter_monitor|Holter monitors]].<br /> <br /> === Gastrointestinal system ===<br /> {{Main article |page_name =Gastrointestinal system}}<br /> <br /> <br /> <br /> == Sex Differences ==<br /> [[File:Florence Nightingale.png|200px|thumb|right|[[Florence Nightingale]] was a British citizen and pioneer of modern nursing. Nightingale was stationed in Crimea when she developed &quot;Crimean fever&quot; (a bacterial infection now known as [[brucellosis]]) and never recovered. She remained [[Severe and very severe ME|mostly bedbound]] the rest of her life. Although ME and CFS were not defined in her lifetime, many current physicians and medical historians believe she developed ME/CFS as a result of a chronic brucellosis infection]]<br /> <br /> {{Main article |page_name = Sex differences in myalgic encephalomyelitis and chronic fatigue syndrome}}<br /> A Norwegian [[CFS/ME]] study shows that the disease affects all ages, with two peak ages of 10-19 years and 30-39 years; it is more common in women than in men.&lt;ref&gt;{{Cite journal|last=Bakken|first=Inger Johanne|last2=Tveito|first2=Kari|last3=Gunnes|first3=Nina|last4=Ghaderi|first4=Sara|last5=Stoltenberg|first5=Camilla|last6=Trogstad|first6=Lill|last7=H åberg|first7=Siri Eldevik|last8=Magnus|first8=Per|date=2014-10-01|title=Two age peaks in the incidence of chronic fatigue syndrome/myalgic encephalomyelitis: a population-based registry study from Norway 2008-2012|url=http://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-014-0167-5|journal=BMC Medicine|language=En|volume=12|issue=1|pages=|doi=10.1186/s12916-014-0167-5|issn=1741-7015|pmid=25274261|via=}}&lt;/ref&gt; Research by the [[Open Medicine Foundation]] cited in its paper, [[Metabolic features of chronic fatigue syndrome|''Metabolic features of chronic fatigue syndrome'']] which studied severe [[CFS]], found that the disease is different in men and women but this is not related to testosterone or estrogen. [[Michael VanElzakker]] notes there are [http://me-pedia.org/wiki/Michael_VanElzakker#Male_and_female_differences_in_neuropathic_pain male and female differences in neuropathic pain]. A study of UK and Dutch cohorts found &quot;younger children had a more equal gender balance compared to adolescents and adults.&quot;&lt;ref&gt;{{Cite journal|last=Collin|first=Simon M.|last2=Nuevo|first2=Roberto|last3=van de Putte|first3=Elise M.|last4=Nijhof|first4=Sanne L.|last5=Crawley|first5=Esther|date=2015-10-28|title=Chronic fatigue syndrome (CFS) or myalgic encephalomyelitis (ME) is different in children compared to in adults: a study of UK and Dutch clinical cohorts|url=https://www.ncbi.nlm.nih.gov/pubmed/26510728|journal=BMJ open|volume=5|issue=10|pages=e008830|doi=10.1136/bmjopen-2015-008830|issn=2044-6055|pmid=26510728|via=}}&lt;/ref&gt;<br /> <br /> ==Risk Factors and Potential Causes==<br /> <br /> {{Main article | page_name =Risk factors and potential causes of myalgic encephalomyelitis and chronic fatigue syndrome}}<br /> <br /> ===Risk factors===<br /> <br /> ===Potential causes===<br /> Although risk factors for myalgic encephalomyelitis have been identified, no single definitive virus has been found in all cases, which has led to the claim that ME is a common end path of a variety of infectious insults.&lt;ref&gt;{{Cite web|url=http://via.library.depaul.edu/csh_etd/117/|title=Onset Patterns of Chronic Fatigue Syndrome and Myalgic Encephalomyelitis: A Mixed Method Approach|last=Evans|first=Meredyth|date=Aug 23, 2015|website=via.library.depaul.edu|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt;&lt;ref&gt;{{Cite web|url=http://me-pedia.org/wiki/Vagus_nerve_infection_hypothesis|title=Vagus nerve infection hypothesis - MEpedia|website=me-pedia.org|language=en|access-date=2018-09-08}}&lt;/ref&gt;&lt;ref&gt;{{Cite web|url=http://www.clevelandclinicmeded.com/online/casebased/decisionmaking/chronic-fatigue/case3.htm|title=Case Presentation - Chronic Fatigue Syndrome|website=www.clevelandclinicmeded.com|access-date=2018-09-08}}&lt;/ref&gt;&lt;ref&gt;{{Cite journal|last=Magnus|first=Per|last2=Gunnes|first2=Nina|last3=Tveito|first3=Kari|last4=Bakken|first4=Inger Johanne|last5=Ghaderi|first5=Sara|last6=Stoltenberg|first6=Camilla|last7=Hornig|first7=Mady|last8=Lipkin|first8=W. Ian|last9=Trogstad|first9=Lill|date=2015-11-17|title=Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is associated with pandemic influenza infection, but not with an adjuvanted pandemic influenza vaccine|url=https://www.ncbi.nlm.nih.gov/pubmed/26475444/|journal=Vaccine|volume=33|issue=46|pages=6173–6177|doi=10.1016/j.vaccine.2015.10.018|issn=1873-2518|pmid=26475444}}&lt;/ref&gt; It is still possible ME involves some combination of both environmental and genetic factors. Various theories try to combine the known data into plausible explanations.&lt;ref&gt;{{Cite journal|last=Underhill|first=R. A.|date=2015|title=Myalgic encephalomyelitis, chronic fatigue syndrome: An infectious disease|url=https://www.ncbi.nlm.nih.gov/pubmed/26604026|journal=Medical Hypotheses|volume=85|issue=6|pages=765–773|doi=10.1016/j.mehy.2015.10.011|issn=1532-2777|pmid=26604026|via=}}&lt;/ref&gt;&lt;ref&gt;{{Cite journal|last=Schlauch|first=K A|last2=Khaiboullina|first2=S F|last3=De Meirleir|first3=K L|last4=Rawat|first4=S|last5=Petereit|first5=J|last6=Rizvanov|first6=A A|last7=Blatt|first7=N|last8=Mijatovic|first8=T|last9=Kulick|first9=D|date=2016|title=Genome-wide association analysis identifies genetic variations in subjects with myalgic encephalomyelitis/chronic fatigue syndrome|url=http://www.nature.com/tp/journal/v6/n2/full/tp2015208a.html|journal=Translational Psychiatry|language=En|volume=6|issue=2|pages=e730–e730|doi=10.1038/tp.2015.208|issn=2158-3188|via=}}&lt;/ref&gt; Several theories suggest that ME is an inappropriate immune response to an infection, a theory bolstered by the observation that there is sometimes a family history of [[autoimmune disease]].&lt;ref&gt;{{Cite web|url=https://www.facebook.com/permalink.php?story_fbid=564532390371988&amp;id=564526123705948|title=Klimas ME CFS Genes Study|last=|first=|date=Nov 23, 2015|website=www.facebook.com|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-09-08}}&lt;/ref&gt; There is also a shift from the [[Th1]] type of helper [[T cell]]s, which fight infection, to the [[Th2]] type, which are more active in allergy and more likely to attack the body.&lt;ref&gt;{{Cite journal|date=2015-03-01|title=Cytokine expression provides clues to the pathophysiology of Gulf War illness and myalgic encephalomyelitis|url=https://www.sciencedirect.com/science/article/abs/pii/S1043466614006024|journal=Cytokine|language=en|volume=72|issue=1|pages=1–8|doi=10.1016/j.cyto.2014.11.019|issn=1043-4666}}&lt;/ref&gt;&lt;ref&gt;{{Cite web|url=http://www.m-hikari.com/bmgt/bmgt2014/bmgt1-4-2014/hardcastleBMGT1-4-2014.pdf|title=Chronic Fatigue Syndrome/Myalgic Encephalomyelitis and the Potential Role of T Cells|last=Hardcastle|first=S.L.|last2=Brenu|first2=E.W.|date=2014|website=m-hikari.com|archive-url=|archive-date=|dead-url=|access-date=|last3=Staines|first3=D.R.|last4=Marshall-Gradisni|first4=S.}}&lt;/ref&gt;<br /> <br /> [[File:Naomi Whittingham .png|300px|thumb|[[Naomi Whittingham]] lives in the UK with a [[Severe and very severe ME|severe case of ME]]. Naomi became ill at [[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome|age 12]] with a routine virus and never recovered. She advocates for ME by doing interviews, writing, and supporting her brother [[Tom Whittingham]]'s marathon fundraising for [[ME Research UK]]]]<br /> ===Viruses===<br /> {{Main article |page_name = Viruses}}<br /> <br /> Other theories describe ME as an immune response to a chronic infection. The association between ME and the [[Coxsackie B]], [[HHV-6]], and [[HHV-7]] viruses&lt;ref&gt;{{Cite journal|last=Bell|first=E. J.|last2=McCartney|first2=R. A.|last3=Riding|first3=M. H.|date=1988|title=Coxsackie B viruses and myalgic encephalomyelitis|url=https://www.ncbi.nlm.nih.gov/pubmed/2841461|journal=Journal of the Royal Society of Medicine|volume=81|issue=6|pages=329–331|doi=10.1177/014107688808100609|issn=0141-0768|pmid=2841461|via=}}&lt;/ref&gt;&lt;ref&gt;{{Cite news|url=http://solvecfs.org/ramsay-research-team-5-the-potential-role-of-hhv-6-in-mecfs/|title=Ramsay Research Team 5 – The Potential Role of HHV-6 in ME/CFS - Solve ME/CFS Initiative|last=|first=|date=2016-12-16|work=Solve ME/CFS Initiative|access-date=2018-09-08|archive-url=|archive-date=|dead-url=|publisher=VOLKMEDIA|language=en-US}}&lt;/ref&gt; &lt;ref&gt;{{Cite journal|last=Chapenko|first=Svetlana|last2=Krumina|first2=Angelika|last3=Logina|first3=Inara|last4=Rasa|first4=Santa|last5=Chistjakovs|first5=Maksims|last6=Sultanova|first6=Alina|last7=Viksna|first7=Ludmila|last8=Murovska|first8=Modra|date=2012|title=Association of active human herpesvirus-6, -7 and parvovirus b19 infection with clinical outcomes in patients with myalgic encephalomyelitis/chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/22927850|journal=Advances in Virology|volume=2012|pages=205085|doi=10.1155/2012/205085|issn=1687-8647|pmid=22927850|via=}}&lt;/ref&gt; suggests a potential viral contribution in at least some individuals. Evidence from [[epidemic myalgic encephalomyelitis]] strongly point to an enterovirus, however, in most outbreaks, no virus was successfully isolated.<br /> <br /> === Bacteria ===<br /> {{Main article |page_name = Bacteria}}<br /> <br /> Others believe ME may sometimes result from a chronic infection with spirochetal bacteria, such as [[lyme disease]]. Another bacterium that has been implicated in ME is [[chlamydia pneumoniae]].&lt;ref&gt;{{Cite journal|date=2018-09-05|others=John E.Tovey|title=Chlamydia pneumoniae infection a treatable cause of Chronic Fatigue Syndrome|url=https://www.bmj.com/rapid-response/2011/11/01/chlamydia-pneumoniae-infection-treatable-cause-chronic-fatigue-syndrome|journal=The BMJ|language=en|last=|first=|volume=|pages=|via=}}&lt;/ref&gt;&lt;ref&gt;{{Cite news|url=https://www.prohealth.com/library/new-me-cfs-study-at-stanford-dr-montoya-to-test-for-scores-of-infections-27346|title=New ME/CFS Study at Stanford: Dr. Montoya to test for scores of Infections - Prohealth|date=2010-06-04|work=Prohealth|access-date=2018-09-08|language=en-US}}&lt;/ref&gt; Protein findings relating to several infections have seen found in the oligoclonal bands ME of patients.&lt;ref&gt;{{Cite web|url=http://www.bjmp.org/content/role-chronic-bacterial-and-viral-infections-neurodegenerative-neurobehavioral-psychiatric-au|title=Role of Chronic Bacterial and Viral Infections in Neurodegenerative, Neurobehavioral, Psychiatric, Autoimmune and Fatiguing Illnesses: Part 1 {{!}} British Journal of Medical Practitioners|last=|first=|date=2009|website=www.bjmp.org|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-09-08}}&lt;/ref&gt; <br /> <br /> The [[vagus nerve infection hypothesis]] (VNIH) accounts for why so many different infectious onsets could be responsible. The [[vagus nerve]] runs from the brain stem and throughout the body and has an impact on many body systems.<br /> <br /> Given the uncertainty regarding the cause, ME and CFS patients are barred from donating blood or organs in the [[United Kingdom]], [[United States]] and [[New Zealand]] while symptoms persist.&lt;ref&gt;{{Cite web|url=http://www.meassociation.org.uk/2010/08/people-with-mecfs-to-be-permanently-excluded-from-giving-blood-in-the-uk-from-1-november-this-year-department-of-health-announcement/|title=People with ME/CFS to be permanently excluded from giving blood in the UK from 1 November this year – Department of Health announcement|last=|first=|date=Aug 2010|website=www.meassociation.org.uk|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-09-08}}&lt;/ref&gt;&lt;ref&gt;{{Cite news|url=http://www.washingtonpost.com/wp-dyn/content/article/2010/12/03/AR2010120305888.html|title=Chronic fatigue patients barred from blood donation|last=Stein|first=Rob|date=2010-12-03|access-date=2018-09-08|language=en-US|issn=0190-8286}}&lt;/ref&gt;&lt;ref&gt;{{Cite web|url=http://www.nzblood.co.nz/Give-blood/Donating/Detailed-eligibility-criteria#C|title=Detailed eligibility criteria|website=www.nzblood.co.nz|language=en-NZ|access-date=2018-09-08}}&lt;/ref&gt;<br /> <br /> ==Treatments==<br /> [[File:Karina Hansen.jpg|200px|thumb|right|[[Karina Hansen]] became [[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome|ill as an adult teenager]] and is [[Severe and very severe ME|severely ill]] with ME. She was forcibly institutionalized for 3 1/2 years as the [[Denmark]] healthcare system designates ME as psychosomatic. Karina is now home with her family where she received cards from well-wishers from around the world. Karina's Danish High Court case and return home were featured in the documentary film [[Unrest|''Unrest'']]]]<br /> <br /> {{Main article |page_name = Potential treatments for myalgic encephalomyelitis and chronic fatigue syndrome}}<br /> <br /> There is no cure for ME and no country has approved any pharmacological treatment for the disease except, [[Argentina]] which has approved [[Ampligen]] for the treatment of severe ME/CFS.&lt;ref name=&quot;:9&quot; /&gt; However the effectiveness of Ampligen is under dispute.&lt;ref&gt;{{Cite web|url=https://www.bizjournals.com/philadelphia/stories/2009/11/30/daily23.html|title=FDA rejects Hemispherx’s chronic fatigue drug Ampligen|website=www.bizjournals.com|access-date=2018-08-12|date=Dec 2, 2009|last=George|first=John|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt; Other off label medications have been used with varying effectiveness in some patients.&lt;ref&gt;{{Cite web|url=https://www.me-pedia.org/wiki/Valganciclovir|title=Valganciclovir - MEpedia|website=www.me-pedia.org|language=en|access-date=2018-08-12}}&lt;/ref&gt;&lt;ref&gt;{{Cite web|url=https://www.me-pedia.org/wiki/Oxymatrine|title=Oxymatrine - MEpedia|website=www.me-pedia.org|language=en|access-date=2018-08-12}}&lt;/ref&gt;<br /> <br /> Treatments for sleep problems, headaches and pain are utilized by some doctors for some patients although these are treating symptoms and not ME itself.<br /> <br /> Success of treating symptoms of ME is not well researched or documented.<br /> <br /> An immune system modulator drug called [[Rituximab]] has failed in a phase III clinical trial.&lt;ref&gt;{{Cite news|url=http://simmaronresearch.com/2017/11/norwegian-rituximab-chronic-fatigue-syndrome-mecfs-trial-fails/|title=Norwegian Rituximab Chronic Fatigue Syndrome (ME/CFS) Trial Fails - Simmaron Research|last=Johnson|first=Cort|date=2017-11-26|work=Simmaron Research|access-date=2018-09-07|archive-url=|archive-date=|dead-url=|language=en-US}}&lt;/ref&gt;<br /> <br /> ==Epidemiology ==<br /> <br /> {{Main article |page_name = Epidemiology of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome}}<br /> <br /> ME has been found world-wide, in at least 75 [[Outbreaks|epidemics]] documented in published papers from the 1930s to the 1980s.&lt;ref&gt;{{Cite web|url=http://www.hfme.org/methemedicalfacts.htm|title=M.E.: The medical facts|last=Bassett|first=Jodi|date=Sep 2010|website=The Hummingbirds' Foundation for M.E.|archive-url=|archive-date=|dead-url=|access-date=2018-09-08}}&lt;/ref&gt; Epidemics often occur in enclosed communities such as schools and hospitals.<br /> <br /> As observed in many autoimmune disorders, ME is more common in females than males; the mean sex ratio is approximately 2-3 females for every male.&lt;ref&gt;{{Cite journal|last=Bakken|first=Inger Johanne|last2=Tveito|first2=Kari|last3=Gunnes|first3=Nina|last4=Ghaderi|first4=Sara|last5=Stoltenberg|first5=Camilla|last6=Trogstad|first6=Lill|last7=H åberg|first7=Siri Eldevik|last8=Magnus|first8=Per|date=2014-10-01|title=Two age peaks in the incidence of chronic fatigue syndrome/myalgic encephalomyelitis: a population-based registry study from Norway 2008-2012|url=http://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-014-0167-5|journal=BMC Medicine|language=En|volume=12|issue=1|pages=|doi=10.1186/s12916-014-0167-5|issn=1741-7015|pmid=25274261|via=}}&lt;/ref&gt; In children the sex ratio is approximately equal.&lt;ref&gt;{{Cite journal|last=Collin|first=Simon M.|last2=Nuevo|first2=Roberto|last3=van de Putte|first3=Elise M.|last4=Nijhof|first4=Sanne L.|last5=Crawley|first5=Esther|date=2015-10-28|title=Chronic fatigue syndrome (CFS) or myalgic encephalomyelitis (ME) is different in children compared to in adults: a study of UK and Dutch clinical cohorts|url=https://www.ncbi.nlm.nih.gov/pubmed/26510728|journal=BMJ open|volume=5|issue=10|pages=e008830|doi=10.1136/bmjopen-2015-008830|issn=2044-6055|pmid=26510728|via=}}&lt;/ref&gt;<br /> <br /> == Co-morbidities ==<br /> [[File:Chronically_Hopeful_Char_Profile_Pic.jpg|250px|thumb|right|Char, author at [[Chronically Hopeful]], must use sunglasses due to light sensitivity ([[photophobia]]) and noise canceling ear protection due to sound sensitivity ([[hyperacusis]])]]<br /> Clinicians have observed several predisposing conditions, co-morbidities, overlapping conditions,&lt;ref&gt;{{Cite web|url=https://ammes.org/overlapping-conditions/|title=Overlapping Conditions – American ME and CFS Society|website=ammes.org|language=en-US|access-date=2018-08-12}}&lt;/ref&gt; and increased risks for secondary diseases in patients with ME. However, as no large-scale epidemiological studies, genetic studies, or family studies have been done, there is little that can be said definitively about the rate or underlying biological reasons for these potentially related conditions. Overlapping diagnostic criteria and the lack of a biomarker in many of these conditions add to the confusion and diagnostic uncertainty. Moreover, certain conditions such as [[postural orthostatic tachycardia syndrome]] (POTS) and idiopathic [[intracranial hypertension]] (IH/IIH) are symptoms that can occur in or be co-morbid with numerous conditions, including ME. <br /> <br /> The following are some syndromes and diseases that have been associated with or misdiagnosed as ME:<br /> <br /> &lt;div style=&quot;column-count:2;-moz-column-count:2;-webkit-column-count:2&quot;&gt;<br /> *[[fibromyalgia]] <br /> *[[Chronic lyme disease|chronic Lyme disease]]<br /> *[[Postural orthostatic tachycardia syndrome|postural orthostatic tachychardia syndrome]]<br /> *[[mast cell activation disorder]]<br /> *[[small intestinal bacterial overgrowth]] (SIBO)<br /> *[[thyroid disease]]<br /> *[[Ehlers-Danlos syndrome]]<br /> *[[endometriosis]]<br /> *[[Sjögren's syndrome]]<br /> *[[mold illness]]<br /> *[[multiple chemical sensitivity]]<br /> *[[environmentally acquired illness]]<br /> *[[chronic inflammatory response syndrome]]<br /> *[[cancer]]<br /> *[[idiopathic intracranial hypertension]]<br /> *[[Chiari malformation]]<br /> *[[craniocervical instability]]<br /> *See more [[:Category:Diagnoses|diagnoses]].<br /> <br /> &lt;/div&gt;<br /> <br /> == Notable studies ==<br /> {{Main article |page_name = Notable studies}}Due to lack of funding by governments around the world there has been little biological research into [[ME/CFS]]. There are studies which do reveal [[Nervous system|neurological]] involvement, [[metabolic]] features, and other abnormalities. <br /> * 2014, [[Brains of People With Chronic Fatigue Syndrome Offer Clues About Disorder - New York Times: Well (2014)|Brains of People With Chronic Fatigue Syndrome Offer Clues About Disorder]]<br /> <br /> * 2016, [[Metabolic features of chronic fatigue syndrome]]<br /> * 2016, [[CDC Multi-site Clinical Assessment of CFS]]<br /> * [[List of abnormal findings in chronic fatigue syndrome and myalgic encephalomyelitis]]<br /> <br /> == See also ==<br /> * [[Chronic fatigue syndrome]]<br /> * [[ME/CFS]]<br /> * [[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome]]<br /> * [[Severe and very severe ME]]<br /> <br /> *[[Systemic Exertion Intolerance Disease]]<br /> ===Generally accepted criteria for diagnosing ME/CFS and ME===<br /> *[[Canadian Consensus Criteria]] (CCC) A diagnosis of moderate and severe forms of [[ME/CFS]] are accurately made using this criterion. Adults can be diagnosed at six months while pediatric cases are diagnosed at three months.<br /> * [[International Consensus Criteria]] (ICC)&lt;ref&gt;{{Cite journal|last=Carruthers|first=Bruce M.|author-link=Bruce Carruthers|last2=van de Sande|first2=Marjorie I.|author-link2=Marjorie van de Sande|last3=De Meirleir|first3=Kenny L.|author-link3=Kenny De Meirleir|last4=Klimas|first4=Nancy G.|author-link4=Nancy Klimas|last5=Broderick|first5=Gordon|author-link5=Gordon Broderick|last6=Mitchell|first6=Terry|author-link6=Terry Mitchell|last7=Staines|first7=Donald|author-link7=Donald Staines|last8=Powles|first8=A. C. Peter|author-link8=A C Peter Powles|last9=Speight|first9=Nigel|author-link9=Nigel Speight|last10=Vallings|first10=Rosamund|author-link10=Rosamund Vallings|last11=Bateman|first11=Lucinda|author-link11=Lucinda Bateman|last12=Baumgarten-Austrheim|first12=Barbara|author-link12=Barbara Baumgarten-Austrheim|last13=Bell|first13=David|author-link13=David Bell|last14=Carlo-Stella|first14=Nicoletta|author-link14=Nicoletta Carlo-Stella|last15=Chia|first15=John|author-link15=John Chia|last16=Darragh|first16=Austin|author-link16=Austin Darragh|last17=Jo|first17=Daehyun|author-link17=Daehyun Jo|last18=Lewis|first18=Donald|author-link18=Donald Lewis|last19=Light|first19=Alan|author-link19=Alan Light|last20=Marshall-Gradisnik|first20=Sonya|author-link20=Sonya Marshall-Gradisnik|last21=Mena|first21=Ismael|author-link21=Ismael Mena|last22=Mikovits|first22=Judy|author-link22=Judy Mikovits|last23=Miwa|first23=Kunihisa|author-link23=Kunihisa Miwa|last24=Murovska|first24=Modra|author-link24=Modra Murovska|last25=Pall|first25=Martin|author-link25=Martin Pall|last26=Stevens|first26=Staci|author-link26=Staci Stevens|date=2011-08-22|title=Myalgic encephalomyelitis: International Consensus Criteria|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2796.2011.02428.x|journal=Journal of Internal Medicine|language=en|volume=270|issue=4|pages=327–338|doi=10.1111/j.1365-2796.2011.02428.x|issn=0954-6820|pmc=3427890|pmid=21777306|via=}}&lt;/ref&gt; - This criterion will accurately diagnose myalgic encephalomyelitis (ME). There is no requirement that the individual have symptoms for a specified period of time for diagnosis, as opposed to [[Fukuda criteria|Fukuda]] and [[Systemic Exertion Intolerance Disease|SEID]], which both require 6 months in adults. <br /> *[[Systemic Exertion Intolerance Disease]] (SEID) - ME/CFS (SEID) is accurately diagnosed when the basic criteria&lt;ref&gt;{{Cite web|url=https://www.me-pedia.org/wiki/Systemic_Exertion_Intolerance_Disease#Diagnostic_criteria|title=Systemic Exertion Intolerance Disease - MEpedia|website=www.me-pedia.org|language=en|access-date=2018-10-15}}&lt;/ref&gt; are met. The [[Institute of Medicine report]] as a whole is a comprehensive review of the medical literature available at time of publication (2015). Adults can be diagnosed at six months while pediatric cases are diagnosed at three months.<br /> <br /> == Learn more ==<br /> <br /> == References ==<br /> <br /> [[Category:Diagnoses]]<br /> [[Category:Disease names]]<br /> &lt;references /&gt;</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Names_of_myalgic_encephalomyelitis_and_chronic_fatigue_syndrome&diff=44551 2018-11-28T16:15:23Z

<p>MEcfsFMS:info on criterion</p> <hr /> <div>The name [[myalgic encephalomyelitis]] was coined by Dr. [[Melvin Ramsay]] following the [[1955 Royal Free Hospital outbreak]]&lt;ref&gt;{{Cite journal|last=|first=|date=1957-10-19|title=An Outbreak of Encephalomyelitis in the Royal Free Hospital Group, London, in 1955|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1962472/|journal=British Medical Journal|volume=2|issue=5050|pages=895–904|issn=0007-1447|pmc=|pmid=13472002|via=}}&lt;/ref&gt; and is a portmanteau of several of the key signs and symptoms of the disease: myalgic ([[muscle pain]]), encephalo ([[brain]]), myel ([[spinal cord]]), itis ([[inflammation]]).&lt;ref&gt;{{Cite web|url=http://www.investinme.org/Article%20010-Encephalopathy%20Hooper.shtml|title=Invest in ME Research - The Terminology of ME &amp; CFS|last=Hooper|first=Malcolm|date=Feb 2005|website=www.investinme.org|archive-url=|archive-date=|dead-url=|access-date=2018-08-13}}&lt;/ref&gt;<br /> <br /> Several other names have been used or proposed throughout the history of the disease, including [[atypical polio]], [[Icelandic disease]], benign myalgic encephalomyelitis, [[epidemic neuromyasthenia]], [[chronic fatigue syndrome]], and [[systemic exertion intolerance disease]]. This has lead to much confusion as a variety of names have been used at different times to describe discrete [[outbreaks]], a wider and potentially more heterogenous population of sporadic cases, and with a wide variety of [[Definitions of myalgic encephalomyelitis and chronic fatigue syndrome|case definitions]].<br /> <br /> A survey by [[The MEAction Network]] in 2016 found that the majority of patients prefer the name myalgic encephalomyelitis to other names including [[Chronic Fatigue Syndrome|chronic fatigue syndrome]].&lt;ref&gt;{{Cite web|url=http://www.meaction.net/2016/08/07/meaction-rfi-poll-report-1-of-3/|title=#MEAction RFI Poll Report (Part 1 of 3) {{!}} #MEAction|last=|first=|date=Aug 7, 2016|website=www.meaction.net|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-13}}&lt;/ref&gt; Most government agencies and researchers around the world use the term [[ME/CFS]].{{Citation needed}}<br /> <br /> == Criterion defining ME, CFS, and ME/CFS ==<br /> {{Main article |page_name = Definitions of myalgic encephalomyelitis and chronic fatigue syndrome}}<br /> <br /> Patients that meet the [[International Consensus Criteria]] (ICC) defining ME are usually more severely impaired than patients that meet the [[Canadian Consensus Criteria]] (CCC) defining ME/CFS, or the minimum symptoms defined in the criteria for patients with [[Systemic Exertion Intolerance Disease]] (SEID) which also defines ME/CFS. Researchers believe all patients meeting these criteria, including [[Fukuda criteria]] defining CFS, are experiencing brain inflammation.{{Citation needed}}<br /> <br /> == References ==<br /> &lt;references /&gt;</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Myalgic_encephalomyelitis&diff=44550 2018-11-28T16:11:09Z

<p>MEcfsFMS:/* Disease Name */ copy/edit</p> <hr /> <div>'''Myalgic Encephalomyelitis''' (ME) is a chronic, [[Inflammation|inflammatory]], physically and [[neurological|neurologically]] disabling disease that presents with symptoms involving multiple bodily systems. Frequently triggered by a [[viral infection]], it affects the [[central nervous system]] (CNS), [[autonomic nervous system]] (ANS), [[immune system]], [[cardiovascular system]], [[endocrine system]], [[digestive system]], and [[musculoskeletal system]].&lt;ref name=&quot;:8&quot;&gt;{{Cite news|url=https://rarediseases.org/rare-diseases/myalgic-encephalomyelitis/|title=Myalgic Encephalomyelitis - NORD (National Organization for Rare Disorders)|work=NORD (National Organization for Rare Disorders)|access-date=2018-09-07|language=en-US}}&lt;/ref&gt;&lt;ref&gt;{{Cite web|url=http://paradigmchange.me/wp-content/uploads/2016/04/ME-CFS-Medical-Abormalities-040416.pdf|title=Myalgic Encephalomyelitis (ME) and Chronic Fatigue Syndrome (CFS) Medical Abnormalities Research Citations|last=Petrison|first=Lisa|date=Apr 4, 2016|website=paradigmchange.me|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt; It has been classified by the [[World Health Organization]] (WHO) as a neurological disease since 1969&lt;ref&gt;{{Cite journal|date=2018-07-22|title=History of chronic fatigue syndrome|url=https://en.wikipedia.org/w/index.php?title=History_of_chronic_fatigue_syndrome&amp;oldid=851489536|journal=Wikipedia|language=en}}&lt;/ref&gt;&lt;ref&gt;{{Cite news|url=https://rarediseases.org/rare-diseases/myalgic-encephalomyelitis/|title=Myalgic Encephalomyelitis - NORD (National Organization for Rare Disorders)|work=NORD (National Organization for Rare Disorders)|access-date=2018-09-08|language=en-US}}&lt;/ref&gt; and has occurred in both [[Epidemic myalgic encephalomyelitis|epidemic]] and sporadic forms since at least the 1930s. <br /> <br /> A hallmark symptom of ME is [[Post-exertional malaise|post-exertional malaise]] (PEM), which is an intolerance to previously achievable cognitive or physical [[exertion]].&lt;ref name=&quot;:0&quot;&gt;{{Cite news|url=https://prevention.nih.gov/programs-events/pathways-to-prevention/workshops/me-cfs|title=Pathways to Prevention (P2P) Advancing the Research on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)|last=|first=|date=|work=Office of Disease Prevention|access-date=2018-09-07|archive-url=|archive-date=|dead-url=|language=en}}&lt;/ref&gt;&lt;ref name=&quot;:1&quot;&gt;[http://www.meactionuk.org.uk/definition.html Research Descriptions of M.E. - ME Action UK]&lt;/ref&gt;&lt;ref name=&quot;:2&quot;&gt;{{Cite web|url=http://www.cfids-me.org/ramsay86.html|title=The Clinical Features of Myalgic Encephalomyelitis|last=Ramsey|first=Melvin|date=1986|website=www.cfids-me.org|archive-url=|archive-date=|dead-url=|access-date=2018-09-07}}&lt;/ref&gt;&lt;ref name=&quot;:3&quot;&gt;{{Cite news|url=https://www.verywell.com/what-is-post-exertional-malaise-716023|title=What is Post-Exertional Malaise? Learn About a Key ME/CFS Symptom|last=Dellwo|first=Adrienne|date=Aug 1, 2018|work=Verywell Health|access-date=2018-09-07|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt;&lt;ref name=&quot;:5&quot;&gt;{{Cite news|url=http://www.webmd.com/chronic-fatigue-syndrome/chronic-fatigue-syndrome-symptoms|title=Think You Might Have Chronic Fatigue Syndrome? Here are The Symptoms|work=WebMD|access-date=2018-09-07|language=en-US}}&lt;/ref&gt;&lt;ref name=&quot;:6&quot;&gt;{{Cite web|url=http://solvecfs.org/wp-content/uploads/2013/10/pem-series.pdf|title=Post-Exertional Malaise in Chronic Fatigue Syndrome|last=Spotila|first=Jennifer|date=2010|website=solvecfs.org|publisher=The CFIDS Association of America|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt; Other key symptoms include [[muscle]] [[Muscle weakness|weakness]] and easy [[Muscle fatigability|fatiguability]], [[sleep disturbance]], and [[cognitive dysfunction]]. ANS dysfunction is frequent, although specific symptoms vary from patient to patient and may include [[Postural orthostatic tachycardia syndrome|postural orthostatic tachycardia]] (POTS), [[Orthostatic intolerance|orthostatic hypotension]] (OI), and both [[Body temperature|cold and heat intolerance]]. Other common symptoms include [[myalgia]] (muscle pain), [[neuralgia]] (neuropathic pain), [[Neck stiffness|neck]] and [[spine stiffness]], and sensory symptoms including [[sensitivity to light]], [[Hyperacusis|sound]], [[touch]], [[Paresthesia|paraesthesia]] (skin tingling or [[numbness]]) and hyperaesthesia (skin sensitivity and pain, and [[allodynia]]). <br /> <br /> Among adults, ME is more common in women than men. New onset has been [[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome|observed in children]] and in adults as old as 80 years old. Its course is usually relapsing-remitting with new symptoms occurring either in discrete relapses (or 'crashes') or accruing over time.&lt;ref&gt;{{Cite web|url=https://login.medscape.com/login/sso/getlogin?urlCache=aHR0cHM6Ly93d3cubWVkc2NhcGUuY29tL3ZpZXdhcnRpY2xlLzg3MTQ4Mg==&amp;ac=401|title=Postexertion 'Crash,' not Fatigue per se, Marks Syndrome|last=|first=|date=|website=medscape.com|format=Login Needed|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt; There is a progressive form of ME but it is rarer than the relapsing-remitting type.&lt;ref&gt;{{Cite web|url=http://www.meassociation.org.uk/wp-content/uploads/fulltext_pmr-v2-id10521.pdf|title=Progressive Myalgic Encephalomyelitis (ME) or A New Disease? A Case Report|last=Howes|first=S|date=Jul 7, 2015|website=meassocation.org|publisher=Physical Medicine and Rehabilitation - International|via=Austin Publishers Group|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt;<br /> <br /> There are no approved pharmacological treatments for ME anywhere in the world, except in [[Argentina]], which has approved the immunomodulator [[Ampligen]] for [[Severe and very severe ME|severe ME/CFS]] as of August 23, 2016.&lt;ref name=&quot;:9&quot;&gt;{{Cite news|title=Hemispherx Biopharma Announces Major Breakthrough: Approval for Commercial Sale of Rintatolimod (U.S. Tradename: Ampligen®) to Treat Severe Cases of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) in the Argentine Republic|url=http://www.globenewswire.com/news-release/2016/08/23/866212/0/en/Hemispherx-Biopharma-Announces-Major-Breakthrough-Approval-for-Commercial-Sale-of-Rintatolimod-U-S-Tradename-Ampligen-to-Treat-Severe-Cases-of-Myalgic-Encephalomyelitis-Chronic-Fat.html|work=GlobeNewswire News Room|access-date=2018-08-12|language=en-US|first=Hemispherx Biopharma,|last=Inc.|date=Aug 23, 2016|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt;<br /> <br /> ME is accurately diagnosed with the [[International Consensus Criteria]] (ICC) and a diagnosis should be made immediately. Other criterion such as the [[Canadian Consensus Criteria]] (CCC) and [[Systemic Exertion Intolerance Disease|SEID]] cannot be used to diagnose immediately nor speak to the array and severity of CNS, neurological, ANS, and immune system symptoms patients experience.<br /> <br /> [[File:Linda Crowhurst.JPG|200x200px|thumb|Linda Crowhurst is married to [[Greg Crowhurst]]; they reside in Belfast, [[Northern Ireland]]. Greg is Linda's full-time carer as she is [[Severe and very severe ME|very severely ill with ME]]. As of June 2018, Linda has been ill for 25 years. [https://www.youtube.com/watch?v=rVsOeZjhMFY Greg posted a YouTube video] in 2006 (reposted in 2007) of Linda speaking of her condition and showing her severe symptoms which are the first known public visual document of severe ME. She is now bedbound barely able to move and unable to feed herself]]<br /> <br /> [[File:Jenny Spotlia.jpg|300px|thumb|right|[[Jennie Spotila]] is an American ME patient who fell ill on October 6, 1994. Jennie is [[Severe and very severe ME|disabled, mostly housebound, and uses a wheelchair]] but has been an [[ME/CFS]] advocate for many years. She writes the blog [[Occupy M.E.]] She served on the Board of Directors of [[Solve ME/CFS Initiative|The CFIDS Association of America]] and testified before the [[Chronic Fatigue Syndrome Advisory Committee|CFSAC]]]]<br /> <br /> <br /> <br /> == History ==<br /> [[File:Hillary Johnson.jpg|200px|thumb|[[Hillary Johnson]] is an [[United States|American]] journalist and while ill herself, wrote the book [[Osler's Web]] which is the historical account of the early years of a &quot;new&quot; illness that had an outbreak at [[1984 Incline Village chronic fatigue syndrome outbreak|Incline Village]] which she shared the same symptoms. The illness came to be known as [[chronic fatigue syndrome]] (CFS). Johnson spent nine years investigating the outbreak and the [[CDC]]'s refusal to acknowledge a devastating disease (deeming sufferers of Incline Village as having &quot;[https://en.wikipedia.org/wiki/Mass_psychogenic_illness mass hysteria]&quot;) that can be spread through casual contact. She appears in the documentary ''[[Forgotten Plague]]'' and currently writes at<br /> [https://www.oslersweb.com/ Oslersweb.com] ]]<br /> <br /> {{Main article | page_name =History of myalgic encephalomyelitis and chronic fatigue syndrome}}&lt;div role=&quot;note&quot; class=&quot;hatnote navigation-not-searchable&quot;&gt;{{Main article | page_name =History of myalgic encephalomyelitis and chronic fatigue syndrome}}&lt;/div&gt;&lt;span&gt;&lt;/span&gt;<br /> <br /> ME has occurred in both epidemic and sporadic form since at least the 1930s, although is probably much older. The first recorded outbreak of [[epidemic myalgic encephalomyelitis]] was in [[1934 Los Angeles atypical polio outbreak|1934 in Los Angeles]] and was thought to be an outbreak of atypical [[polio]]. After the outbreak in [[Akureyri]], Iceland in 1946, the disease came to be called 'Akureyri Disease' or [[Icelandic disease]] through much of the 1940s and 1950s. It was named ME after London's [[Royal Free Hospital outbreak]] in 1955. Other names included benign myalgic encephalomyelitis and [[Epidemic myalgic encephalomyelitis|epidemic neuromyasthenia]].<br /> <br /> After the [[1984 Incline Village chronic fatigue syndrome outbreak|Incline Village]] outbreak in Nevada in 1984, the disease came to be called and redefined as [[chronic fatigue syndrome]] (CFS). The most recent putative outbreak was in Arizona in 1996. <br /> <br /> ==Disease Name==<br /> <br /> [[File:Merry Crofts sick.JPG|200px|thumb|[[Merryn Crofts]] was [[Severe and very severe ME|bedbound and unable to eat.]] Merryn weighed six stone (84 lbs) at her death; her autopsy revealed inflammation of the [[Dorsal root ganglia|ganglia]]. It is suspected that in the later years of her illness Merryn also suffered from [[Ehlers-Danlos syndrome|EDS]] and [[Mast cell activation disorder|MCAD]]. Her death certificate is the 2nd in the [[United Kingdom|UK]] to attribute a death to ME]]<br /> {{Main article |page_name = Names of myalgic encephalomyelitis and chronic fatigue syndrome}}<br /> * ''Myalgic adj. - of or relating to [[myalgia]].'' Is [[muscle pain]].&lt;ref&gt;{{Cite news|url=https://www.thefreedictionary.com/myalgic|title=myalgic|work=TheFreeDictionary.com|access-date=2018-08-12}}&lt;/ref&gt;<br /> <br /> * ''Encephalo'': Refers to the [[brain]].&lt;ref&gt;{{Cite news|url=https://medical-dictionary.thefreedictionary.com/encephalo-|title=encephalo-|work=TheFreeDictionary.com|access-date=2018-08-12}}&lt;/ref&gt;<br /> <br /> * ''Myel'': Relating to the [[spinal cord]].&lt;ref&gt;{{Cite news|url=https://www.thefreedictionary.com/myel-|title=myel-|work=TheFreeDictionary.com|access-date=2018-08-12}}&lt;/ref&gt; <br /> <br /> * ''Itis'': [[Inflammation]].&lt;ref&gt;{{Cite news|url=https://www.thefreedictionary.com/-itis|title=Itis|work=TheFreeDictionary.com|access-date=2018-08-12|last=|first=|date=|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt;<br /> The name ME&lt;ref&gt;{{Cite news|url=https://www.verywell.com/myalgic-encephalomyelitis-me-715663|title=Myalgic Encephalomyelitis: Chronic Fatigue Syndrome's Other Name|last=Dellwo|first=Adrienne|date=Jul 23, 2018|work=Verywell Health|access-date=2018-08-12|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt; was coined by Dr. [[Melvin Ramsay]] following the [[1955 Royal Free Hospital outbreak]]&lt;ref&gt;{{Cite journal|last=|first=|date=1957-10-19|title=An Outbreak of Encephalomyelitis in the Royal Free Hospital Group, London, in 1955|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1962472/|journal=British Medical Journal|volume=2|issue=5050|pages=895–904|issn=0007-1447|pmid=13472002|via=}}&lt;/ref&gt; and is a portmanteau of several of the key signs and symptoms of the disease: myalgic (muscle pain), encephalo (brain), myel (spinal cord), itis (inflammation).&lt;ref&gt;[http://www.name-us.org/DefintionsPages/DefinitionsArticles/Hoopersdescription.pdf The Terminology of ME &amp; CFS By Professor Malcolm Hooper]&lt;/ref&gt; The [[central nervous system]] (brain and spinal cord) are inflamed.&lt;ref name=&quot;:02&quot;&gt;{{Cite news|url=https://www.verywellhealth.com/myalgic-encephalomyelitis-me-715663|title=Myalgic Encephalomyelitis or Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Nov 24, 2018|work=Verywell Health|access-date=2018-11-28|archive-url=|archive-date=|dead-url=|quote=|author-link=}}&lt;/ref&gt; <br /> <br /> Several other names have been used or proposed throughout the history of the disease, including [[atypical polio]], [[Icelandic disease]], benign ME, [[epidemic neuromyasthenia]], CFS, and [[systemic exertion intolerance disease]] (SEID). This has lead to much confusion as a variety of names have been used at different times to describe discrete outbreaks as well as a larger and potentially more heterogenous population of sporadic cases, defined by a wide variety of [[Definitions of myalgic encephalomyelitis and chronic fatigue syndrome|case definitions]]. <br /> <br /> A survey by [[The MEAction Network]] in 2016 found that the majority of patients prefer the name ME to other names including chronic fatigue syndrome.&lt;ref&gt;{{Cite news|url=http://www.meaction.net/2016/08/07/meaction-rfi-poll-report-1-of-3/|title=#MEAction RFI Poll Report (Part 1 of 3) - #MEAction|date=2016-08-07|work=#MEAction|access-date=2018-09-08|language=en-US}}&lt;/ref&gt; Most government agencies and researchers around the world use the term [[ME/CFS]].{{Citation needed}}<br /> <br /> Myalgic encephalomyelitis (ME) was the original name for [[chronic fatigue syndrome]] (CFS); the names are used interchangeably or with the acronym [[ME/CFS]].&lt;ref name=&quot;:02&quot; /&gt;<br /> <br /> == Onset ==<br /> Following after an incubation period of 4 to 7 days, the [[wikipedia:Prodrome|prodromal]] phase generally involve a [[flu-like illness]] with [[low-grade fever]]. In the majority but not all cases, an [[infection]] or infectious process is evident.&lt;ref&gt;[http://www.nightingale.ca/documents/Nightingale_ME_Definition_en.pdf ME Definition - Nightingale - PDF pg. 6]&lt;/ref&gt; Two to seven days later, a chronic phase commences, characterized by a measurable diffuse change in the function of the CNS. It is this second phase, persistent phase that most characterizes ME.&lt;ref&gt;{{Cite web|url=https://www.scribd.com/document/32848597/Nightingale-ME-Definition-En|title=Nightingale ME Definition En {{!}} Chronic Fatigue Syndrome {{!}} Infection|last=|first=|date=|website=Scribd|page=5|pages=|at=|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-09-08}}&lt;/ref&gt;&lt;ref name=&quot;:8&quot; /&gt;<br /> <br /> In some patients, the initial presentation involved a severe, incapacitating prolonged illness. In theirs, an apparent remission was followed by relapses brought on by exertion, [[menstrual period]], or cold.<br /> <br /> <br /> <br /> ==Signs and Symptoms==<br /> Symptoms can range from mild to very severe and can include:<br /> [[File:J Brea TED.JPG|200px|thumb|right|[[Jen Brea|Jennifer Brea]] is an American who was attending Harvard and while on a trip to Kenya she became very ill and never recovered. Brea began experiencing neurological problems. Her neurologist diagnosed her with &quot;conversion disorder&quot; ([[hysteria]]). When walking home from his office, she collapsed. [[Severe and very severe ME|Jen now needs to use a wheelchair]] keeping her legs up due to [[Postural orthostatic tachycardia syndrome|POTS]] as her blood pools into her legs. View her TED Talk ''[https://www.ted.com/talks/jen_brea_what_happens_when_you_have_a_disease_doctors_can_t_diagnose What happens when you have a disease doctors can't diagnose]'']]<br /> <br /> &lt;div style=&quot;column-count:2;-moz-column-count:2;-webkit-column-count:2&quot;&gt;<br /> <br /> *[[low-grade fever]], [[Temperature dysregulation|temperature instability]] <br /> *[[post-exertional malaise]] <br /> *[[cognitive dysfunction]]<br /> *[[muscle]] [[Muscle weakness|weakness]] and [[Muscle fatigability|fatiguability]]<br /> *[[headache]]<br /> *[[myalgia|myalgia (muscle pain)]]<br /> *[[neuralgia|neuralgia (nerve pain)]]<br /> *[[ataxia|ataxia (coordination difficulties)]]<br /> *[[gastrointestinal]] symptoms<br /> *[[sleep dysfunction]]<br /> *neck and back or [[spinal cord]] stiffness<br /> *sensitivity to [[Light sensitivity|light]], [[Hyperacusis|sound]] and/or [[Allodynia|touch]]<br /> *sensitivity to [[Temperature sensitivity|heat or cold]]<br /> <br /> &lt;/div&gt;<br /> <br /> Symptoms presentation and severity can vary considerably day to day and even hour to hour.&lt;ref name=&quot;:8&quot; /&gt; Overexertion can make all symptoms worse, the effects are often delayed and may not be seen within 24 hours.&lt;ref&gt;{{Cite web|url=http://www.investinme.org/landerP5.shtml|title=Invest in ME Research - Invest in ME Research Home Page|last=Research|first=Invest in ME|website=www.investinme.org|access-date=2018-09-08}}&lt;/ref&gt; &lt;ref name=&quot;:8&quot; /&gt; The US [[National Institutes of Health]] (NIH) notes that sensitivity to noise, light and [[Chemical sensitivities|chemical]]&lt;nowiki/&gt;s may force patients to withdraw from society.&lt;ref&gt;{{Cite news|url=https://prevention.nih.gov/programs-events/pathways-to-prevention/workshops/me-cfs|title=Pathways to Prevention (P2P) Advancing the Research on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)|last=|first=|date=|work=Office of Disease Prevention|access-date=2018-09-08|archive-url=|archive-date=|dead-url=|language=en}}&lt;/ref&gt;<br /> <br /> The severity of a patient's symptoms often depends on the time period since the disease was contacted and rate of progression of each patient. The rate of progression can be accelerated by ''physical or cognitive activity'' beyond a patient's limits, which typically entails [[anaerobic]] activity &lt;ref&gt;{{Cite web|url=https://www.me-pedia.org/wiki/Unrest|title=Unrest - MEpedia|website=www.me-pedia.org|language=en|access-date=2018-08-12}}&lt;/ref&gt; <br /> <br /> === Post-exertional malaise ===<br /> {{Main article | page_name =Post-exertional malaise}}<br /> A core symptom, [[post-exertional malaise]], is intolerance to previously trivial effort such as walking to the mailbox, running an errand or grocery shopping, taking a shower or brushing teeth, and deterioration of health from persistent or repeated exertion.&lt;ref name=&quot;:0&quot; /&gt;&lt;ref name=&quot;:1&quot; /&gt;&lt;ref name=&quot;:2&quot; /&gt;&lt;ref name=&quot;:3&quot; /&gt;&lt;ref name=&quot;:5&quot; /&gt;&lt;ref name=&quot;:6&quot; /&gt;&lt;ref name=&quot;:4&quot;&gt;{{Cite news|url=https://www.verywell.com/post-exertional-malaise-715670|title=What is Post-Exertional Malaise? Learn About a Key ME/CFS Symptom|work=Verywell Health|access-date=2018-09-07}}&lt;/ref&gt;<br /> <br /> == Clinical Findings ==<br /> [[File:Alem Matthee.png|200px|thumb|right|[[Alem Matthees]] is an [[Australia|Australian]] ME patient that filed an FOI request for data from the [[PACE trial]]. At a [[Severe and very severe ME|great cost to his health]], Alem appealed the denial of the data and won. This data proved the results published in [[The Lancet|''The Lancet'']] were untrue. Alem's health suffered significantly in part from the efforts required for the FOI request and tribunal]]<br /> Although there is no definitive [[biomarker]], several signs and findings have been frequently observed in clinical settings:&lt;div style=&quot;column-count:2;-moz-column-count:2;-webkit-column-count:2&quot;&gt;<br /> <br /> *high antibody titers to specific infections (including [[Epstein-Barr virus|EBV]], [[Human herpesvirus 6|HHV-6]], and [[Coxsackie B virus|Coxsackie B]] among others)<br /> *[[Hormones|hormone]] imbalance<br /> *[[Immune system|immunological abnormalities]]<br /> *[[Natural Killer Cell (NKC) function|low natural killer cell function]]<br /> *low red blood cell [[magnesium]]<br /> *[[natural killer cell]] (NKC)<br /> *[[Postural orthostatic tachycardia syndrome|postural orthostatic tachychardia]] (POTS)<br /> *[[Post-exertional malaise|reaction to physical and mental activity and sensory input]] (PEM)<br /> &lt;/div&gt;<br /> <br /> ==Diagnosis==<br /> <br /> [[File:Tom Kindlon.png|300px|thumb|[[Tom Kindlon]] became [[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome|ill at 16]] and never recovered. He is an ME/CFS advocate with published works in Research Gate and PubMed. Kindlon lives in [[Ireland]] and is Assistant Chairperson of the [[Irish ME/CFS Association]]. Tom and others analyzed the data for the PACE trial proving out that its published results were untrue. He uses a [[Severe and very severe ME|wheelchair and his full-time carer]] is his mother, Vera]]<br /> <br /> {{Main article | page_name =Definitions of myalgic encephalomyelitis and chronic fatigue syndrome}}There are several proposed criteria for diagnosing ME including the [[International Consensus Criteria]] (ICC) and the [[Canadian Consensus Criteria]] (CCC). The original criteria developed by [[Melvin Ramsay]], the [[Ramsay definition]], is not used for diagnosing ME today.&lt;span&gt;&lt;/span&gt;&lt;span&gt;&lt;/span&gt;<br /> === Other diagnostic criteria ===<br /> Several, overly broad criteria have been proposed and are in use. These criteria likely capture some patients with the disease characterized in the medical literature on [[Epidemic myalgic encephalomyelitis|epidemic ME]], exclude others, and also include patients with a wide range of other undiagnosed conditions including cancer, depression, and a range of autoimmune diseases. The United Kingdom's [[Oxford criteria]] is the broadest and likely most heterogenous definition. (The US [[Institute of Medicine report]] called for its complete retirement.)&lt;ref&gt;{{Cite web|url=http://theargusreport.com/us-nih-report-calls-uk-definition-mecfs-scrapped/|title=US NIH Report Calls for UK Definition of ME/CFS to be Scrapped|last=Swift|first=Penny|date=|website=theargusreport.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-09-08}}&lt;/ref&gt; The US [[Centers for Disease Control and Prevention|Centers for Disease Control]]'s (CDC) [[Fukuda criteria]], in use since 1994, is also overly broad.<br /> <br /> ===Differential diagnosis===<br /> The signs and symptoms of ME can be similar to other medical problems, &quot;such as cancer, [[multiple sclerosis]], [[Systemic lupus erythematosus|lupus]], [[brucellosis]], or another condition.&quot;&lt;ref name=&quot;:8&quot; /&gt; Additional testing may be needed to help distinguish ME from these other problems.<br /> <br /> ==Course and Prognosis ==<br /> {{Main article | page_name =Prognosis for myalgic encephalomyelitis and chronic fatigue syndrome}}<br /> <br /> ME relapses are often a result of over-activity, but can occur without warning with no obvious inciting factors. Exposure to increased sensory information in light, sound, and movement can provoke a sensory storm. <br /> <br /> Infections, such as the common cold, [[influenza]] and gastroenteritis, also increase the risk for a relapse. Heat and cold can transiently increase symptoms.<br /> <br /> Pregnancy can directly affect the susceptibility for relapse. Later pregnancy appears to offer a natural protection against relapses, and there are anecdotal reports of postpartum remission. However, pregnancy does not seem to influence long-term disability.<br /> <br /> About 25% of patients become [https://www.me-pedia.org/wiki/Severe_and_very_severe_M.E. severe or very severely ill with ME].<br /> <br /> ==Clinical Subtypes==<br /> Kerr et al proposed 7 different subsets for 'CFS' as it is defined today:&lt;ref name=&quot;:7&quot;&gt;{{Cite web|url=http://me-ireland.com/genes2.pdf|title=Seven genomic subtypes of chronic fatigue phenotypes analysis of gene networks and clinical syndrome/myalgic encephalomyelitis: a detailed|last=Kerr|first=JR|last2=Burke|first2=R|date=May 30, 2008|website=me-ireland.com|doi=10.1136/jcp.2007.053553|archive-url=|archive-date=|dead-url=|access-date=|last3=Petty|first3=R|last4=Gough|first4=J|last5=Fear|first5=D|last6=Mattey|first6=D L|last7=Axford|first7=J S|last8=Dalgleish|first8=A G|last9=Nutt|first9=D J|publisher=JCP Online}}&lt;/ref&gt;&lt;ref&gt;{{Cite journal|last=Kerr|first=J. R.|last2=Burke|first2=B.|last3=Petty|first3=R.|last4=Gough|first4=J.|last5=Fear|first5=D.|last6=Mattey|first6=D. L.|last7=Axford|first7=J. S.|last8=Dalgleish|first8=A. G.|last9=Nutt|first9=D. J.|date=2008-06-01|title=Seven genomic subtypes of chronic fatigue syndrome/myalgic encephalomyelitis: a detailed analysis of gene networks and clinical phenotypes|url=https://jcp.bmj.com/content/61/6/730|journal=Journal of Clinical Pathology|language=en|volume=61|issue=6|pages=730–739|doi=10.1136/jcp.2007.053553|issn=0021-9746|pmid=18057078}}&lt;/ref&gt;<br /> <br /> [[File:Whitney.JPG|200px|thumb|[[Whitney Dafoe]] is an American photographer who has a [[Severe and very severe ME|very severe form]] of ME. Whitney can no longer speak or handle contact with anyone but his parents. His father is [[Ronald Davis|Ron Davis]], a world-renowned geneticist who is working to solve his son's disease]]<br /> <br /> * Subtype 1 This is one of the more severe subtypes. Effects are cognitive, [[Musculoskeletal system|musculoskeletal]], [[Sleep dysfunction|sleep-related]] and [[anxiety]]/[[depression]].<br /> <br /> * Subtype 2 This is one of the more severe subtypes. Effects are musculoskeletal, pain and anxiety/depression.<br /> <br /> * Subtype 3 This subtype has the mildest symptoms.<br /> <br /> * Subtype 4 This subtype is dominated by cognitive issues.<br /> <br /> * Subtype 5 Effects are musculoskeletal and gastrointestinal.<br /> <br /> * Subtype 6 This subtype is dominated by post-exertional malaise (extreme crash after [[exercise]] or exertion.)<br /> <br /> * Subtype 7 This is one of the more severe subtypes. Effects are [[pain]], infections, musculoskeletal, sleep-related, [[Nervous system|neurological]], gastrointestinal, [[Cognitive dysfunction|neurocognitive]] and anxiety/depression.&lt;ref name=&quot;:7&quot; /&gt;<br /> <br /> ==Pathophysiology==<br /> [[File:Vanessa Li.jpg|thumb|right|[[Vanessa Li]] lived in Hong Kong, the UK, and the US. She became ill with a [[flu-like illness]] while skiing in [[Italy]] and never recovered. Vanessa founded a crowdfund for the [[Microbe Discovery Project]]. She was in [[Severe and very severe ME|excruciating pain, suffered from breathing issues, and occasional paralysis]] for 15 years. She took her own life in 2015]]<br /> {{Main article | page_name =List of abnormal findings in chronic fatigue syndrome and myalgic encephalomyelitis}}<br /> <br /> ME is a multi-system disease. Numerous biological abnormalities have been found in multiple bodily system, however no common, central cause or mechanism has yet been elucidated.<br /> <br /> === Central nervous system ===<br /> [[File:Sophia mirza.jpg|thumb|right|[[Sophia Mirza]] was a [[Severe and very severe ME|very severely ill]] ME patient who lived in the UK. Sophia's death came not long after a forced entry into her mother's home and being sectioned and taken to a mental hospital in 2003. An independent Neuropathologist found Sophia's spine contained a massive infection. Her death certificate was the first in the UK to attribute a death to CFS]]<br /> {{Main article |page_name =Central nervous system}}Radiological research on ME has shown [https://medical-dictionary.thefreedictionary.com/hypoperfusion hypoperfusion] of the [[brain stem]] and an abnormal response to exertion, but research on CFS is often inconsistent and must be interpreted with caution. For example, some research stated that a reduced volume of [[grey matter]] may be a result of a lack of activity and is reversible with [[cognitive behavioral therapy]] (CBT).<br /> <br /> === Autonomic nervous system ===<br /> {{Main article |page_name =Autonomic nervous system}}<br /> <br /> === Peripheral nervous system ===<br /> {{Main article |page_name =Peripheral nervous system}}<br /> <br /> === Musculoskeletal system ===<br /> {{Main article |page_name =Muscle}}<br /> <br /> === Immune system ===<br /> {{Main article |page_name =Immune system}}&lt;div role=&quot;note&quot; class=&quot;hatnote navigation-not-searchable&quot;&gt;{{Main article |page_name =Immune system}}&lt;/div&gt;&lt;span&gt;&lt;/span&gt;<br /> <br /> According to a strictly immunological explanation of CFS, the inflammatory processes triggered by [[T cell]]s create leaks in the [[blood-brain barrier]] (a capillary system that should prevent entrance of T-cells in the nervous system). These leaks, in turn, cause a number of other damaging effects such as swelling, activation of macrophages, and more activation of [[cytokine]]s and other destructive proteins such as [[RNase L|Rnase-L]]. [[Channelopathy]], a reduced ability to move metabolites in and out of cells has been implicated in this process. This may also be applicable to ME.<br /> <br /> === Chronic infection ===<br /> Some evidence shows viral infection of muscle and brain in at least a proportion of sufferers. This triggers inflammatory processes, stimulating other immune cells and soluble factors like cytokines and antibodies. A model for late ME has been proposed analogously to post-polio syndrome in which repaired nerve tissue forms inappropriately [The Late Effects of ME: Can they be distinguished from the post-polio syndrome?]. <br /> [[File:Emma Shorter.JPG|400px|thumb|[[Emma Shorter]] is a [[Scotland|Scottish]] citizen who has ME. She did [[Graded exercise therapy]] (GET) and went from walking a few minutes a day to being [[Severe and very severe ME|in a wheelchair.]] Here, Emma gives testimony before Scotland's Parliament's Petitions Committee. <br /> View her [https://youtu.be/wDayJXxZSQE?t=106 testimony] ]]<br /> <br /> === Cardiovascular ===<br /> [[wikipedia:Hemodynamics|Hemodynamic]] abnormalities are widely found, including serum and RBC [[wikipedia:Hypovolemia|hypovolemia]], [[neurally mediated hypotension]], (NMH) and cerebral hypoperfusion. Vascular and endothelial abnormalities have been published by MERUK. However, none of these studies used research criteria for ME so the results may not be applicable to ME.<br /> <br /> Some cardiologic features such as cardiac insufficiency, inverted T-waves and myofiber disarray have been reported in CFS and recently added to by findings of reduced Q-value. This has led clinician and researcher Dr [[Paul Cheney]] to posit that CFS is form of partially compensated cardiomyopathy in which [[orthostatic intolerance]] and rapid fatiguability are secondary protective mechanisms. Due to the heterogeneity of the population, a single cause is unlikely, but one-third of people with ME have abnormalities when tested with [[wikipedia:Holter_monitor|Holter monitors]].<br /> <br /> === Gastrointestinal system ===<br /> {{Main article |page_name =Gastrointestinal system}}<br /> <br /> <br /> <br /> == Sex Differences ==<br /> [[File:Florence Nightingale.png|200px|thumb|right|[[Florence Nightingale]] was a British citizen and pioneer of modern nursing. Nightingale was stationed in Crimea when she developed &quot;Crimean fever&quot; (a bacterial infection now known as [[brucellosis]]) and never recovered. She remained [[Severe and very severe ME|mostly bedbound]] the rest of her life. Although ME and CFS were not defined in her lifetime, many current physicians and medical historians believe she developed ME/CFS as a result of a chronic brucellosis infection]]<br /> <br /> {{Main article |page_name = Sex differences in myalgic encephalomyelitis and chronic fatigue syndrome}}<br /> A Norwegian [[CFS/ME]] study shows that the disease affects all ages, with two peak ages of 10-19 years and 30-39 years; it is more common in women than in men.&lt;ref&gt;{{Cite journal|last=Bakken|first=Inger Johanne|last2=Tveito|first2=Kari|last3=Gunnes|first3=Nina|last4=Ghaderi|first4=Sara|last5=Stoltenberg|first5=Camilla|last6=Trogstad|first6=Lill|last7=H åberg|first7=Siri Eldevik|last8=Magnus|first8=Per|date=2014-10-01|title=Two age peaks in the incidence of chronic fatigue syndrome/myalgic encephalomyelitis: a population-based registry study from Norway 2008-2012|url=http://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-014-0167-5|journal=BMC Medicine|language=En|volume=12|issue=1|pages=|doi=10.1186/s12916-014-0167-5|issn=1741-7015|pmid=25274261|via=}}&lt;/ref&gt; Research by the [[Open Medicine Foundation]] cited in its paper, [[Metabolic features of chronic fatigue syndrome|''Metabolic features of chronic fatigue syndrome'']] which studied severe [[CFS]], found that the disease is different in men and women but this is not related to testosterone or estrogen. [[Michael VanElzakker]] notes there are [http://me-pedia.org/wiki/Michael_VanElzakker#Male_and_female_differences_in_neuropathic_pain male and female differences in neuropathic pain]. A study of UK and Dutch cohorts found &quot;younger children had a more equal gender balance compared to adolescents and adults.&quot;&lt;ref&gt;{{Cite journal|last=Collin|first=Simon M.|last2=Nuevo|first2=Roberto|last3=van de Putte|first3=Elise M.|last4=Nijhof|first4=Sanne L.|last5=Crawley|first5=Esther|date=2015-10-28|title=Chronic fatigue syndrome (CFS) or myalgic encephalomyelitis (ME) is different in children compared to in adults: a study of UK and Dutch clinical cohorts|url=https://www.ncbi.nlm.nih.gov/pubmed/26510728|journal=BMJ open|volume=5|issue=10|pages=e008830|doi=10.1136/bmjopen-2015-008830|issn=2044-6055|pmid=26510728|via=}}&lt;/ref&gt;<br /> <br /> ==Risk Factors and Potential Causes==<br /> <br /> {{Main article | page_name =Risk factors and potential causes of myalgic encephalomyelitis and chronic fatigue syndrome}}<br /> <br /> ===Risk factors===<br /> <br /> ===Potential causes===<br /> Although risk factors for myalgic encephalomyelitis have been identified, no single definitive virus has been found in all cases, which has led to the claim that ME is a common end path of a variety of infectious insults.&lt;ref&gt;{{Cite web|url=http://via.library.depaul.edu/csh_etd/117/|title=Onset Patterns of Chronic Fatigue Syndrome and Myalgic Encephalomyelitis: A Mixed Method Approach|last=Evans|first=Meredyth|date=Aug 23, 2015|website=via.library.depaul.edu|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt;&lt;ref&gt;{{Cite web|url=http://me-pedia.org/wiki/Vagus_nerve_infection_hypothesis|title=Vagus nerve infection hypothesis - MEpedia|website=me-pedia.org|language=en|access-date=2018-09-08}}&lt;/ref&gt;&lt;ref&gt;{{Cite web|url=http://www.clevelandclinicmeded.com/online/casebased/decisionmaking/chronic-fatigue/case3.htm|title=Case Presentation - Chronic Fatigue Syndrome|website=www.clevelandclinicmeded.com|access-date=2018-09-08}}&lt;/ref&gt;&lt;ref&gt;{{Cite journal|last=Magnus|first=Per|last2=Gunnes|first2=Nina|last3=Tveito|first3=Kari|last4=Bakken|first4=Inger Johanne|last5=Ghaderi|first5=Sara|last6=Stoltenberg|first6=Camilla|last7=Hornig|first7=Mady|last8=Lipkin|first8=W. Ian|last9=Trogstad|first9=Lill|date=2015-11-17|title=Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is associated with pandemic influenza infection, but not with an adjuvanted pandemic influenza vaccine|url=https://www.ncbi.nlm.nih.gov/pubmed/26475444/|journal=Vaccine|volume=33|issue=46|pages=6173–6177|doi=10.1016/j.vaccine.2015.10.018|issn=1873-2518|pmid=26475444}}&lt;/ref&gt; It is still possible ME involves some combination of both environmental and genetic factors. Various theories try to combine the known data into plausible explanations.&lt;ref&gt;{{Cite journal|last=Underhill|first=R. A.|date=2015|title=Myalgic encephalomyelitis, chronic fatigue syndrome: An infectious disease|url=https://www.ncbi.nlm.nih.gov/pubmed/26604026|journal=Medical Hypotheses|volume=85|issue=6|pages=765–773|doi=10.1016/j.mehy.2015.10.011|issn=1532-2777|pmid=26604026|via=}}&lt;/ref&gt;&lt;ref&gt;{{Cite journal|last=Schlauch|first=K A|last2=Khaiboullina|first2=S F|last3=De Meirleir|first3=K L|last4=Rawat|first4=S|last5=Petereit|first5=J|last6=Rizvanov|first6=A A|last7=Blatt|first7=N|last8=Mijatovic|first8=T|last9=Kulick|first9=D|date=2016|title=Genome-wide association analysis identifies genetic variations in subjects with myalgic encephalomyelitis/chronic fatigue syndrome|url=http://www.nature.com/tp/journal/v6/n2/full/tp2015208a.html|journal=Translational Psychiatry|language=En|volume=6|issue=2|pages=e730–e730|doi=10.1038/tp.2015.208|issn=2158-3188|via=}}&lt;/ref&gt; Several theories suggest that ME is an inappropriate immune response to an infection, a theory bolstered by the observation that there is sometimes a family history of [[autoimmune disease]].&lt;ref&gt;{{Cite web|url=https://www.facebook.com/permalink.php?story_fbid=564532390371988&amp;id=564526123705948|title=Klimas ME CFS Genes Study|last=|first=|date=Nov 23, 2015|website=www.facebook.com|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-09-08}}&lt;/ref&gt; There is also a shift from the [[Th1]] type of helper [[T cell]]s, which fight infection, to the [[Th2]] type, which are more active in allergy and more likely to attack the body.&lt;ref&gt;{{Cite journal|date=2015-03-01|title=Cytokine expression provides clues to the pathophysiology of Gulf War illness and myalgic encephalomyelitis|url=https://www.sciencedirect.com/science/article/abs/pii/S1043466614006024|journal=Cytokine|language=en|volume=72|issue=1|pages=1–8|doi=10.1016/j.cyto.2014.11.019|issn=1043-4666}}&lt;/ref&gt;&lt;ref&gt;{{Cite web|url=http://www.m-hikari.com/bmgt/bmgt2014/bmgt1-4-2014/hardcastleBMGT1-4-2014.pdf|title=Chronic Fatigue Syndrome/Myalgic Encephalomyelitis and the Potential Role of T Cells|last=Hardcastle|first=S.L.|last2=Brenu|first2=E.W.|date=2014|website=m-hikari.com|archive-url=|archive-date=|dead-url=|access-date=|last3=Staines|first3=D.R.|last4=Marshall-Gradisni|first4=S.}}&lt;/ref&gt;<br /> <br /> [[File:Naomi Whittingham .png|300px|thumb|[[Naomi Whittingham]] lives in the UK with a [[Severe and very severe ME|severe case of ME]]. Naomi became ill at [[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome|age 12]] with a routine virus and never recovered. She advocates for ME by doing interviews, writing, and supporting her brother [[Tom Whittingham]]'s marathon fundraising for [[ME Research UK]]]]<br /> ===Viruses===<br /> {{Main article |page_name = Viruses}}<br /> <br /> Other theories describe ME as an immune response to a chronic infection. The association between ME and the [[Coxsackie B]], [[HHV-6]], and [[HHV-7]] viruses&lt;ref&gt;{{Cite journal|last=Bell|first=E. J.|last2=McCartney|first2=R. A.|last3=Riding|first3=M. H.|date=1988|title=Coxsackie B viruses and myalgic encephalomyelitis|url=https://www.ncbi.nlm.nih.gov/pubmed/2841461|journal=Journal of the Royal Society of Medicine|volume=81|issue=6|pages=329–331|doi=10.1177/014107688808100609|issn=0141-0768|pmid=2841461|via=}}&lt;/ref&gt;&lt;ref&gt;{{Cite news|url=http://solvecfs.org/ramsay-research-team-5-the-potential-role-of-hhv-6-in-mecfs/|title=Ramsay Research Team 5 – The Potential Role of HHV-6 in ME/CFS - Solve ME/CFS Initiative|last=|first=|date=2016-12-16|work=Solve ME/CFS Initiative|access-date=2018-09-08|archive-url=|archive-date=|dead-url=|publisher=VOLKMEDIA|language=en-US}}&lt;/ref&gt; &lt;ref&gt;{{Cite journal|last=Chapenko|first=Svetlana|last2=Krumina|first2=Angelika|last3=Logina|first3=Inara|last4=Rasa|first4=Santa|last5=Chistjakovs|first5=Maksims|last6=Sultanova|first6=Alina|last7=Viksna|first7=Ludmila|last8=Murovska|first8=Modra|date=2012|title=Association of active human herpesvirus-6, -7 and parvovirus b19 infection with clinical outcomes in patients with myalgic encephalomyelitis/chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/22927850|journal=Advances in Virology|volume=2012|pages=205085|doi=10.1155/2012/205085|issn=1687-8647|pmid=22927850|via=}}&lt;/ref&gt; suggests a potential viral contribution in at least some individuals. Evidence from [[epidemic myalgic encephalomyelitis]] strongly point to an enterovirus, however, in most outbreaks, no virus was successfully isolated.<br /> <br /> === Bacteria ===<br /> {{Main article |page_name = Bacteria}}<br /> <br /> Others believe ME may sometimes result from a chronic infection with spirochetal bacteria, such as [[lyme disease]]. Another bacterium that has been implicated in ME is [[chlamydia pneumoniae]].&lt;ref&gt;{{Cite journal|date=2018-09-05|others=John E.Tovey|title=Chlamydia pneumoniae infection a treatable cause of Chronic Fatigue Syndrome|url=https://www.bmj.com/rapid-response/2011/11/01/chlamydia-pneumoniae-infection-treatable-cause-chronic-fatigue-syndrome|journal=The BMJ|language=en|last=|first=|volume=|pages=|via=}}&lt;/ref&gt;&lt;ref&gt;{{Cite news|url=https://www.prohealth.com/library/new-me-cfs-study-at-stanford-dr-montoya-to-test-for-scores-of-infections-27346|title=New ME/CFS Study at Stanford: Dr. Montoya to test for scores of Infections - Prohealth|date=2010-06-04|work=Prohealth|access-date=2018-09-08|language=en-US}}&lt;/ref&gt; Protein findings relating to several infections have seen found in the oligoclonal bands ME of patients.&lt;ref&gt;{{Cite web|url=http://www.bjmp.org/content/role-chronic-bacterial-and-viral-infections-neurodegenerative-neurobehavioral-psychiatric-au|title=Role of Chronic Bacterial and Viral Infections in Neurodegenerative, Neurobehavioral, Psychiatric, Autoimmune and Fatiguing Illnesses: Part 1 {{!}} British Journal of Medical Practitioners|last=|first=|date=2009|website=www.bjmp.org|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-09-08}}&lt;/ref&gt; <br /> <br /> The [[vagus nerve infection hypothesis]] (VNIH) accounts for why so many different infectious onsets could be responsible. The [[vagus nerve]] runs from the brain stem and throughout the body and has an impact on many body systems.<br /> <br /> Given the uncertainty regarding the cause, ME and CFS patients are barred from donating blood or organs in the [[United Kingdom]], [[United States]] and [[New Zealand]] while symptoms persist.&lt;ref&gt;{{Cite web|url=http://www.meassociation.org.uk/2010/08/people-with-mecfs-to-be-permanently-excluded-from-giving-blood-in-the-uk-from-1-november-this-year-department-of-health-announcement/|title=People with ME/CFS to be permanently excluded from giving blood in the UK from 1 November this year – Department of Health announcement|last=|first=|date=Aug 2010|website=www.meassociation.org.uk|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-09-08}}&lt;/ref&gt;&lt;ref&gt;{{Cite news|url=http://www.washingtonpost.com/wp-dyn/content/article/2010/12/03/AR2010120305888.html|title=Chronic fatigue patients barred from blood donation|last=Stein|first=Rob|date=2010-12-03|access-date=2018-09-08|language=en-US|issn=0190-8286}}&lt;/ref&gt;&lt;ref&gt;{{Cite web|url=http://www.nzblood.co.nz/Give-blood/Donating/Detailed-eligibility-criteria#C|title=Detailed eligibility criteria|website=www.nzblood.co.nz|language=en-NZ|access-date=2018-09-08}}&lt;/ref&gt;<br /> <br /> ==Treatments==<br /> [[File:Karina Hansen.jpg|200px|thumb|right|[[Karina Hansen]] became [[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome|ill as an adult teenager]] and is [[Severe and very severe ME|severely ill]] with ME. She was forcibly institutionalized for 3 1/2 years as the [[Denmark]] healthcare system designates ME as psychosomatic. Karina is now home with her family where she received cards from well-wishers from around the world. Karina's Danish High Court case and return home were featured in the documentary film [[Unrest|''Unrest'']]]]<br /> <br /> {{Main article |page_name = Potential treatments for myalgic encephalomyelitis and chronic fatigue syndrome}}<br /> <br /> There is no cure for ME and no country has approved any pharmacological treatment for the disease except, [[Argentina]] which has approved [[Ampligen]] for the treatment of severe ME/CFS.&lt;ref name=&quot;:9&quot; /&gt; However the effectiveness of Ampligen is under dispute.&lt;ref&gt;{{Cite web|url=https://www.bizjournals.com/philadelphia/stories/2009/11/30/daily23.html|title=FDA rejects Hemispherx’s chronic fatigue drug Ampligen|website=www.bizjournals.com|access-date=2018-08-12|date=Dec 2, 2009|last=George|first=John|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt; Other off label medications have been used with varying effectiveness in some patients.&lt;ref&gt;{{Cite web|url=https://www.me-pedia.org/wiki/Valganciclovir|title=Valganciclovir - MEpedia|website=www.me-pedia.org|language=en|access-date=2018-08-12}}&lt;/ref&gt;&lt;ref&gt;{{Cite web|url=https://www.me-pedia.org/wiki/Oxymatrine|title=Oxymatrine - MEpedia|website=www.me-pedia.org|language=en|access-date=2018-08-12}}&lt;/ref&gt;<br /> <br /> Treatments for sleep problems, headaches and pain are utilized by some doctors for some patients although these are treating symptoms and not ME itself.<br /> <br /> Success of treating symptoms of ME is not well researched or documented.<br /> <br /> An immune system modulator drug called [[Rituximab]] has failed in a phase III clinical trial.&lt;ref&gt;{{Cite news|url=http://simmaronresearch.com/2017/11/norwegian-rituximab-chronic-fatigue-syndrome-mecfs-trial-fails/|title=Norwegian Rituximab Chronic Fatigue Syndrome (ME/CFS) Trial Fails - Simmaron Research|last=Johnson|first=Cort|date=2017-11-26|work=Simmaron Research|access-date=2018-09-07|archive-url=|archive-date=|dead-url=|language=en-US}}&lt;/ref&gt;<br /> <br /> ==Epidemiology ==<br /> <br /> {{Main article |page_name = Epidemiology of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome}}<br /> <br /> ME has been found world-wide, in at least 75 [[Outbreaks|epidemics]] documented in published papers from the 1930s to the 1980s.&lt;ref&gt;{{Cite web|url=http://www.hfme.org/methemedicalfacts.htm|title=M.E.: The medical facts|last=Bassett|first=Jodi|date=Sep 2010|website=The Hummingbirds' Foundation for M.E.|archive-url=|archive-date=|dead-url=|access-date=2018-09-08}}&lt;/ref&gt; Epidemics often occur in enclosed communities such as schools and hospitals.<br /> <br /> As observed in many autoimmune disorders, ME is more common in females than males; the mean sex ratio is approximately 2-3 females for every male.&lt;ref&gt;{{Cite journal|last=Bakken|first=Inger Johanne|last2=Tveito|first2=Kari|last3=Gunnes|first3=Nina|last4=Ghaderi|first4=Sara|last5=Stoltenberg|first5=Camilla|last6=Trogstad|first6=Lill|last7=H åberg|first7=Siri Eldevik|last8=Magnus|first8=Per|date=2014-10-01|title=Two age peaks in the incidence of chronic fatigue syndrome/myalgic encephalomyelitis: a population-based registry study from Norway 2008-2012|url=http://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-014-0167-5|journal=BMC Medicine|language=En|volume=12|issue=1|pages=|doi=10.1186/s12916-014-0167-5|issn=1741-7015|pmid=25274261|via=}}&lt;/ref&gt; In children the sex ratio is approximately equal.&lt;ref&gt;{{Cite journal|last=Collin|first=Simon M.|last2=Nuevo|first2=Roberto|last3=van de Putte|first3=Elise M.|last4=Nijhof|first4=Sanne L.|last5=Crawley|first5=Esther|date=2015-10-28|title=Chronic fatigue syndrome (CFS) or myalgic encephalomyelitis (ME) is different in children compared to in adults: a study of UK and Dutch clinical cohorts|url=https://www.ncbi.nlm.nih.gov/pubmed/26510728|journal=BMJ open|volume=5|issue=10|pages=e008830|doi=10.1136/bmjopen-2015-008830|issn=2044-6055|pmid=26510728|via=}}&lt;/ref&gt;<br /> <br /> == Co-morbidities ==<br /> [[File:Chronically_Hopeful_Char_Profile_Pic.jpg|250px|thumb|right|Char, author at [[Chronically Hopeful]], must use sunglasses due to light sensitivity ([[photophobia]]) and noise canceling ear protection due to sound sensitivity ([[hyperacusis]])]]<br /> Clinicians have observed several predisposing conditions, co-morbidities, overlapping conditions,&lt;ref&gt;{{Cite web|url=https://ammes.org/overlapping-conditions/|title=Overlapping Conditions – American ME and CFS Society|website=ammes.org|language=en-US|access-date=2018-08-12}}&lt;/ref&gt; and increased risks for secondary diseases in patients with ME. However, as no large-scale epidemiological studies, genetic studies, or family studies have been done, there is little that can be said definitively about the rate or underlying biological reasons for these potentially related conditions. Overlapping diagnostic criteria and the lack of a biomarker in many of these conditions add to the confusion and diagnostic uncertainty. Moreover, certain conditions such as [[postural orthostatic tachycardia syndrome]] (POTS) and idiopathic [[intracranial hypertension]] (IH/IIH) are symptoms that can occur in or be co-morbid with numerous conditions, including ME. <br /> <br /> The following are some syndromes and diseases that have been associated with or misdiagnosed as ME:<br /> <br /> &lt;div style=&quot;column-count:2;-moz-column-count:2;-webkit-column-count:2&quot;&gt;<br /> *[[fibromyalgia]] <br /> *[[Chronic lyme disease|chronic Lyme disease]]<br /> *[[Postural orthostatic tachycardia syndrome|postural orthostatic tachychardia syndrome]]<br /> *[[mast cell activation disorder]]<br /> *[[small intestinal bacterial overgrowth]] (SIBO)<br /> *[[thyroid disease]]<br /> *[[Ehlers-Danlos syndrome]]<br /> *[[endometriosis]]<br /> *[[Sjögren's syndrome]]<br /> *[[mold illness]]<br /> *[[multiple chemical sensitivity]]<br /> *[[environmentally acquired illness]]<br /> *[[chronic inflammatory response syndrome]]<br /> *[[cancer]]<br /> *[[idiopathic intracranial hypertension]]<br /> *[[Chiari malformation]]<br /> *[[craniocervical instability]]<br /> *See more [[:Category:Diagnoses|diagnoses]].<br /> <br /> &lt;/div&gt;<br /> <br /> == Notable studies ==<br /> {{Main article |page_name = Notable studies}}Due to lack of funding by governments around the world there has been little biological research into [[ME/CFS]]. There are studies which do reveal [[Nervous system|neurological]] involvement, [[metabolic]] features, and other abnormalities. <br /> * 2014, [[Brains of People With Chronic Fatigue Syndrome Offer Clues About Disorder - New York Times: Well (2014)|Brains of People With Chronic Fatigue Syndrome Offer Clues About Disorder]]<br /> <br /> * 2016, [[Metabolic features of chronic fatigue syndrome]]<br /> * 2016, [[CDC Multi-site Clinical Assessment of CFS]]<br /> * [[List of abnormal findings in chronic fatigue syndrome and myalgic encephalomyelitis]]<br /> <br /> == See also ==<br /> * [[Chronic fatigue syndrome]]<br /> * [[ME/CFS]]<br /> * [[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome]]<br /> * [[Severe and very severe ME]]<br /> <br /> *[[Systemic Exertion Intolerance Disease]]<br /> ===Generally accepted criteria for diagnosing ME/CFS and ME===<br /> *[[Canadian Consensus Criteria]] (CCC) A diagnosis of moderate and severe forms of [[ME/CFS]] are accurately made using this criterion. Adults can be diagnosed at six months while pediatric cases are diagnosed at three months.<br /> * [[International Consensus Criteria]] (ICC)&lt;ref&gt;{{Cite journal|last=Carruthers|first=Bruce M.|author-link=Bruce Carruthers|last2=van de Sande|first2=Marjorie I.|author-link2=Marjorie van de Sande|last3=De Meirleir|first3=Kenny L.|author-link3=Kenny De Meirleir|last4=Klimas|first4=Nancy G.|author-link4=Nancy Klimas|last5=Broderick|first5=Gordon|author-link5=Gordon Broderick|last6=Mitchell|first6=Terry|author-link6=Terry Mitchell|last7=Staines|first7=Donald|author-link7=Donald Staines|last8=Powles|first8=A. C. Peter|author-link8=A C Peter Powles|last9=Speight|first9=Nigel|author-link9=Nigel Speight|last10=Vallings|first10=Rosamund|author-link10=Rosamund Vallings|last11=Bateman|first11=Lucinda|author-link11=Lucinda Bateman|last12=Baumgarten-Austrheim|first12=Barbara|author-link12=Barbara Baumgarten-Austrheim|last13=Bell|first13=David|author-link13=David Bell|last14=Carlo-Stella|first14=Nicoletta|author-link14=Nicoletta Carlo-Stella|last15=Chia|first15=John|author-link15=John Chia|last16=Darragh|first16=Austin|author-link16=Austin Darragh|last17=Jo|first17=Daehyun|author-link17=Daehyun Jo|last18=Lewis|first18=Donald|author-link18=Donald Lewis|last19=Light|first19=Alan|author-link19=Alan Light|last20=Marshall-Gradisnik|first20=Sonya|author-link20=Sonya Marshall-Gradisnik|last21=Mena|first21=Ismael|author-link21=Ismael Mena|last22=Mikovits|first22=Judy|author-link22=Judy Mikovits|last23=Miwa|first23=Kunihisa|author-link23=Kunihisa Miwa|last24=Murovska|first24=Modra|author-link24=Modra Murovska|last25=Pall|first25=Martin|author-link25=Martin Pall|last26=Stevens|first26=Staci|author-link26=Staci Stevens|date=2011-08-22|title=Myalgic encephalomyelitis: International Consensus Criteria|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2796.2011.02428.x|journal=Journal of Internal Medicine|language=en|volume=270|issue=4|pages=327–338|doi=10.1111/j.1365-2796.2011.02428.x|issn=0954-6820|pmc=3427890|pmid=21777306|via=}}&lt;/ref&gt; - This criterion will accurately diagnose myalgic encephalomyelitis (ME). There is no requirement that the individual have symptoms for a specified period of time for diagnosis, as opposed to [[Fukuda criteria|Fukuda]] and [[Systemic Exertion Intolerance Disease|SEID]], which both require 6 months in adults. <br /> *[[Systemic Exertion Intolerance Disease]] (SEID) - ME/CFS (SEID) is accurately diagnosed when the basic criteria&lt;ref&gt;{{Cite web|url=https://www.me-pedia.org/wiki/Systemic_Exertion_Intolerance_Disease#Diagnostic_criteria|title=Systemic Exertion Intolerance Disease - MEpedia|website=www.me-pedia.org|language=en|access-date=2018-10-15}}&lt;/ref&gt; are met. The [[Institute of Medicine report]] as a whole is a comprehensive review of the medical literature available at time of publication (2015). Adults can be diagnosed at six months while pediatric cases are diagnosed at three months.<br /> <br /> == Learn more ==<br /> <br /> == References ==<br /> <br /> [[Category:Diagnoses]]<br /> [[Category:Disease names]]<br /> &lt;references /&gt;</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Brains_of_People_With_Chronic_Fatigue_Syndrome_Offer_Clues_About_Disorder_-_New_York_Times:_Well_(2014)&diff=44549 2018-11-28T16:04:39Z

<p>MEcfsFMS:ME heading and information on brain and spinal cord inflammation</p> <hr /> <div>[[File:ME-CFS Brain Images.jpg|600px|thumb|right|Top Scans: Control Patient, Bottom Scans: ME/CFS Patient]]<br /> <br /> '''Brains of People With Chronic Fatigue Syndrome Offer Clues About Disorder - New York Times: Well (2014)''' is one of many [[ME/CFS]] articles by [[David Tuller]].&lt;ref&gt;[http://well.blogs.nytimes.com/2014/11/24/brains-of-people-with-chronic-fatigue-syndrome-offer-clues-about-disorder/ Brains of People With Chronic Fatigue Syndrome Offer Clues About Disorder]&lt;/ref&gt;<br /> <br /> The images document [[neuroinflammation]] which causes many [[Nervous system|neurological]] symptoms experienced by patients. <br /> <br /> Plainly seen is the brain being pushed out of normal ranges within the skull.<br /> <br /> == Brain imaging studies mentioned in article ==<br /> *2014, The [[Stanford ME/CFS Initiative]], directed by Dr. [[Jose Montoya]] and working with Dr. [[Michael Zeineh]] and colleagues, studied the brains of patients with [[CFS]] and healthy people and found distinct differences between the two groups. Radiology researchers have discovered that the brains of patients with [[CFS]] have diminished white matter and white matter abnormalities in the right hemisphere.&lt;ref name=&quot;Zeineh2014&quot; /&gt;&lt;ref name=&quot;Goldman20141028&quot; /&gt;&lt;ref name=&quot;Tuller20141124NYT&quot; /&gt;<br /> <br /> *2014, A Japanese [https://en.wikipedia.org/wiki/Positron_emission_tomography PET] study looked at neuroinflammation in 9 patients with ME/CFS and 10 controls. They measured a protein expressed by activated [[microglia]], and found that values in the [[cingulate cortex]], [[hippocampus]], [[amygdala]], [[thalamus]], [[midbrain]], and [[pons]] were 45%–199% higher in [[ME]]/CFS patients than in healthy controls. The values in the amygdala, thalamus, and midbrain positively correlated with cognitive impairment score, the values in the cingulate cortex and thalamus positively correlated with pain score, and the value in the hippocampus positively correlated with depression score.&lt;ref name=&quot;Nakatomi2014&quot; /&gt;&lt;ref name=&quot;Tuller20141124NYT&quot; /&gt;<br /> <br /> == Myalgic encephalomyelitis ==<br /> [[Myalgic encephalomyelitis]] (ME) was the original name for [[chronic fatigue syndrome]] (CFS); the names are used interchangeably or with the acronym [[ME/CFS]].&lt;ref name=&quot;:0&quot;&gt;{{Cite news|url=https://www.verywellhealth.com/myalgic-encephalomyelitis-me-715663|title=Myalgic Encephalomyelitis or Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Nov 24, 2018|work=Verywell Health|access-date=2018-11-28|archive-url=|archive-date=|dead-url=|quote=|author-link=}}&lt;/ref&gt; The name ME&lt;ref&gt;{{Cite news|url=https://www.verywell.com/myalgic-encephalomyelitis-me-715663|title=Myalgic Encephalomyelitis: Chronic Fatigue Syndrome's Other Name|last=Dellwo|first=Adrienne|date=Jul 23, 2018|work=Verywell Health|access-date=2018-08-12|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt; was coined by Dr. [[Melvin Ramsay]] following the [[1955 Royal Free Hospital outbreak]]&lt;ref&gt;{{Cite journal|last=|first=|date=1957-10-19|title=An Outbreak of Encephalomyelitis in the Royal Free Hospital Group, London, in 1955|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1962472/|journal=British Medical Journal|volume=2|issue=5050|pages=895–904|issn=0007-1447|pmid=13472002|via=}}&lt;/ref&gt; and is a portmanteau of several of the key signs and symptoms of the disease: myalgic (muscle pain), encephalo (brain), myel (spinal cord), itis (inflammation).&lt;ref&gt;[http://www.name-us.org/DefintionsPages/DefinitionsArticles/Hoopersdescription.pdf The Terminology of ME &amp; CFS By Professor Malcolm Hooper]&lt;/ref&gt; The [[central nervous system]] (brain and spinal cord) are inflamed.&lt;ref name=&quot;:0&quot; /&gt;<br /> *''Myalgic adj. - of or relating to [[myalgia]].'' Is [[muscle pain]].&lt;ref&gt;{{Cite news|url=https://www.thefreedictionary.com/myalgic|title=myalgic|work=TheFreeDictionary.com|access-date=2018-08-12}}&lt;/ref&gt;<br /> <br /> *''Encephalo'': Refers to the [[brain]].&lt;ref&gt;{{Cite news|url=https://medical-dictionary.thefreedictionary.com/encephalo-|title=encephalo-|work=TheFreeDictionary.com|access-date=2018-08-12}}&lt;/ref&gt;<br /> <br /> *''Myel'': Relating to the [[spinal cord]].&lt;ref&gt;{{Cite news|url=https://www.thefreedictionary.com/myel-|title=myel-|work=TheFreeDictionary.com|access-date=2018-08-12}}&lt;/ref&gt;<br /> <br /> *''Itis'': [[Inflammation]].&lt;ref&gt;{{Cite news|url=https://www.thefreedictionary.com/-itis|title=Itis|work=TheFreeDictionary.com|access-date=2018-08-12|last=|first=|date=|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt;<br /> Patients that meet the [[International Consensus Criteria]] (ICC) defining ME are usually more severely impaired than patients that meet the [[Canadian Consensus Criteria]] (CCC) defining ME/CFS, or the [https://www.me-pedia.org/wiki/Systemic_Exertion_Intolerance_Disease#Diagnostic_criteria minimum symptoms] defined in the criteria for patients with [[Systemic Exertion Intolerance Disease]] (SEID) which also defines ME/CFS. Researchers believe all patients meeting these criteria, including [[Fukuda criteria]] defining CFS, are experiencing brain inflammation.{{Citation needed}}<br /> <br /> == See also ==<br /> * [[Stanford ME/CFS Initiative]]<br /> <br /> == Learn More ==<br /> *[[Brain imaging]]<br /> *[[Brain]]<br /> *[[Functional magnetic resonance imaging|fMRI]]<br /> <br /> == References ==<br /> &lt;references&gt;<br /> &lt;ref name=&quot;Nakatomi2014&quot;&gt;{{citation<br /> | last1 = Nakatomi | first1 = Yasuhito | authorlink1 = <br /> | last2 = Mizuno | first2 = Kei | authorlink2 = <br /> | last3 = Ishii | first3 = Akira | authorlink3 = <br /> | last4 = Wada | first4 = Yasuhiro | authorlink4 = <br /> | last5 = Tanaka | first5 = Masaaki | authorlink5 = <br /> | last6 = Tazawa | first6 = Shusaku | authorlink6 = <br /> | last7 = Onoe | first7 = Kayo | authorlink7 = <br /> | last8 = Fukuda | first8 = Sanae | authorlink8 = <br /> | last9 = Kawabe | first9 = Joji | authorlink9 = <br /> | last10 = Takahashi | first10= Kazuhiro | authorlink10= <br /> | last11 = Kataoka | first11= Yosky | authorlink11= <br /> | last12 = Shiomi | first12= Susumu | authorlink12= <br /> | last13 = Yamaguti | first13= Kouzi | authorlink13= <br /> | last14 = Inaba | first14= Masaaki | authorlink14= <br /> | last15 = Kuratsune | first15= Hirohiko | authorlink15= <br /> | last16 = Watanabe | first16= Yasuyoshi | authorlink16= Yasuyoshi Watanabe<br /> | display-authors = 3<br /> | title = Neuroinflammation in Patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: An ¹¹C-(R)-PK11195 PET Study<br /> | journal = Journal of Nuclear Medicine | volume = 2014 Jun;55(6) | page = 945-50<br /> | date = 2014-03-24<br /> | pmid = 24665088 | doi = 10.2967/jnumed.113.131045<br /> | url = http://jnm.snmjournals.org/content/55/6/945.long<br /> }}&lt;/ref&gt;<br /> &lt;ref name=&quot;Tuller20141124NYT&quot;&gt;{{citation<br /> | last1 = Tuller | first1 = David | authorlink1 = David Tuller<br /> | title = Brains of People With Chronic Fatigue Syndrome Offer Clues About Disorder<br /> | journal = NY Times <br /> | date = 2014-11-24<br /> | url = http://well.blogs.nytimes.com/2014/11/24/brains-of-people-with-chronic-fatigue-syndrome-offer-clues-about-disorder/?_r=0 <br /> }}&lt;/ref&gt;<br /> &lt;ref name=&quot;Zeineh2014&quot;&gt;{{citation<br /> | last1 = Zeineh | first1 = Michael M | authorlink1 = Michael Zeineh<br /> | last2 = Kang | first2 = James | authorlink2 = James Kang<br /> | last3 = Atlas | first3 = Scott W | authorlink3 = Scott Atlas<br /> | last4 = Raman | first4 = Mira M | authorlink4 = Mira Raman<br /> | last5 = Reiss | first5 = Allan L | authorlink5 = Allan Reiss<br /> | last6 = Norris | first6 = Jane L | authorlink6 = Jane Norris<br /> | last7 = Valencia | first7 = Ian | authorlink7 = Ian Valencia<br /> | last8 = Montoya | first8 = Jose G | authorlink8 = Jose Montoya<br /> | display-authors = 3<br /> | title = Right Arcuate Fasciculus Abnormality in Chronic Fatigue Syndrome<br /> | journal = Radiology | volume = 274| issue = 2| pages = 517–526<br /> | date = 2014-10-29<br /> | doi = 10.1148/radiol.14141079<br /> | url = http://pubs.rsna.org/doi/abs/10.1148/radiol.14141079<br /> }}&lt;/ref&gt;<br /> &lt;ref name=&quot;Goldman20141028&quot;&gt;{{citation<br /> | last1 = Goldman | first1 = Bruce | authorlink1 = Bruce Goldman<br /> | title = Study finds brain abnormalities in chronic fatigue patients<br /> | journal = Stanford Medicine News Center<br /> | date = 2014-10-28<br /> | url = http://med.stanford.edu/news/all-news/2014/10/study-finds-brain-abnormalities-in-chronic-fatigue-patients.html<br /> }}&lt;/ref&gt;<br /> &lt;/references&gt;<br /> <br /> [[Category:News articles]]</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Simon_Del_Favero&diff=44358 2018-11-26T01:46:25Z

<p>MEcfsFMS:cat</p> <hr /> <div>[[File:Simon.jpg|200px|thumb|right|Simon Del Favero]]<br /> <br /> '''Simon Del Favero''' is an Australian citizen who developed [[ME/CFS|myalgic encephalomyelitis/chronic fatigue syndrome]] (ME/CFS) after a severe bout of [[Mononucleosis|glandular fever]] in 2011. He was also diagnosed with [[postural orthostatic tachycardia syndrome]] (POTS) in 2014. Prior to developing ME/CFS Simon had studied architecture at the University of Sydney and was working part-time as an architectural model maker. He was 21, healthy, and physically very fit prior to developing ME/CFS.&lt;ref name=&quot;:0&quot;&gt;{{Cite news|url=https://www.sbs.com.au/news/insight/article/2018/11/22/i-was-denial-and-ashamed-my-cfs|title='I was in denial and ashamed by my CFS'|last=Del Favero|first=Simon|date=Nov 22, 2018|work=News|access-date=2018-11-26|archive-url=|archive-date=|dead-url=|language=en}}&lt;/ref&gt; <br /> <br /> Simon now travels to the [[United States|US]] to see Dr. [[Jose Montoya]] for management of his ME/CFS. In 2017, he met Dr. [[Ronald Davis|Ron Davis]], director of Stanford's [[End ME/CFS Project]].&lt;ref name=&quot;:0&quot; /&gt;<br /> <br /> == Media coverage ==<br /> * [https://www.sbs.com.au/news/insight/article/2018/11/22/i-was-denial-and-ashamed-my-cfs 'I was in denial and ashamed by my CFS']&lt;ref name=&quot;:0&quot; /&gt;                      <br /> <br /> == Online presence ==<br /> * [https://twitter.com/simondelfavero Twitter]<br /> * [http://www.simondelfavero.com/ Website]<br /> <br /> == See also ==<br /> * [[Jose Montoya]]<br /> <br /> == Learn more ==<br /> <br /> == References ==<br /> &lt;references /&gt;<br /> <br /> [[Category:People with ME, CFS, and/or FMS]]</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Simon_Del_Favero&diff=44357 2018-11-26T01:42:56Z

<p>MEcfsFMS:x</p> <hr /> <div>[[File:Simon.jpg|200px|thumb|right|Simon Del Favero]]<br /> <br /> '''Simon Del Favero''' is an Australian citizen who developed [[ME/CFS|myalgic encephalomyelitis/chronic fatigue syndrome]] (ME/CFS) after a severe bout of [[Mononucleosis|glandular fever]] in 2011. He was also diagnosed with [[postural orthostatic tachycardia syndrome]] (POTS) in 2014. Prior to developing ME/CFS Simon had studied architecture at the University of Sydney and was working part-time as an architectural model maker. He was 21, healthy, and physically very fit prior to developing ME/CFS.&lt;ref name=&quot;:0&quot;&gt;{{Cite news|url=https://www.sbs.com.au/news/insight/article/2018/11/22/i-was-denial-and-ashamed-my-cfs|title='I was in denial and ashamed by my CFS'|last=Del Favero|first=Simon|date=Nov 22, 2018|work=News|access-date=2018-11-26|archive-url=|archive-date=|dead-url=|language=en}}&lt;/ref&gt; <br /> <br /> Simon now travels to the [[United States|US]] to see Dr. [[Jose Montoya]] for management of his ME/CFS. In 2017, he met Dr. [[Ronald Davis|Ron Davis]], director of Stanford's [[End ME/CFS Project]].&lt;ref name=&quot;:0&quot; /&gt;<br /> <br /> == Media coverage ==<br /> * [https://www.sbs.com.au/news/insight/article/2018/11/22/i-was-denial-and-ashamed-my-cfs 'I was in denial and ashamed by my CFS']&lt;ref name=&quot;:0&quot; /&gt;                      <br /> <br /> == Online presence ==<br /> * [https://twitter.com/simondelfavero Twitter]<br /> * [http://www.simondelfavero.com/ Website]<br /> <br /> == See also ==<br /> * [[Jose Montoya]]<br /> <br /> == Learn more ==<br /> <br /> == References ==<br /> &lt;references /&gt;</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Simon_Del_Favero&diff=44356 2018-11-26T01:36:38Z

<p>MEcfsFMS:x</p> <hr /> <div>[[File:Simon.jpg|200px|thumb|right|Simon Del Favero]]<br /> <br /> '''Simon Del Favero''' is an Australian citizen who developed [[ME/CFS|myalgic encephalomyelitis/chronic fatigue syndrome]] (ME/CFS) after a severe bout of [[Mononucleosis|glandular fever]] in 2011. He was also diagnosed with [[postural orthostatic tachycardia syndrome]] (POTS) in 2014. Prior to developing ME/CFS Simon had studied architecture at the University of Sydney and was working part time as an architectural model maker. He was 21, healthy, and physically very fit prior to developing ME/CFS.&lt;ref name=&quot;:0&quot;&gt;{{Cite news|url=https://www.sbs.com.au/news/insight/article/2018/11/22/i-was-denial-and-ashamed-my-cfs|title='I was in denial and ashamed by my CFS'|last=Del Favero|first=Simon|date=Nov 22, 2018|work=News|access-date=2018-11-26|archive-url=|archive-date=|dead-url=|language=en}}&lt;/ref&gt; <br /> <br /> Simon now travels to the [[United States|US]] to see Dr. [[Jose Montoya]] for management of his ME/CFS. In 2017, he met Dr. [[Ronald Davis|Ron Davis]], director of Stanford's [[End ME/CFS Project]].&lt;ref name=&quot;:0&quot; /&gt;<br /> <br /> == Media coverage ==<br /> * [https://www.sbs.com.au/news/insight/article/2018/11/22/i-was-denial-and-ashamed-my-cfs 'I was in denial and ashamed by my CFS']&lt;ref name=&quot;:0&quot; /&gt;                      <br /> <br /> == Online presence ==<br /> * [https://twitter.com/simondelfavero Twitter]<br /> * [http://www.simondelfavero.com/ Website]<br /> <br /> == See also ==<br /> * [[Jose Montoya]]<br /> <br /> == Learn more ==<br /> <br /> == References ==<br /> &lt;references /&gt;</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Simon_Del_Favero&diff=44355 2018-11-26T01:35:29Z

<p>MEcfsFMS:image</p> <hr /> <div>[[File:Simon.jpg|200px|thumb|right|Simon Del Favero]]<br /> <br /> '''Simon Del Favero''' is an Australian citizen who developed [[ME/CFS|myalgic encephalomyelitis/chronic fatigue syndrome]] (ME/CFS) after a severe bout of [[Mononucleosis|glandular fever]] in 2011. He was also diagnosed with [[postural orthostatic tachycardia syndrome]] (POTS) in 2014. Prior to developing ME/CFS Simon had studied architecture at the University of Sydney and was working part time as an architectural model maker. He was 21, healthy, and physically very fit prior to developing ME/CFS.&lt;ref name=&quot;:0&quot;&gt;{{Cite news|url=https://www.sbs.com.au/news/insight/article/2018/11/22/i-was-denial-and-ashamed-my-cfs|title='I was in denial and ashamed by my CFS'|last=Del Favero|first=Simon|date=Nov 22, 2018|work=News|access-date=2018-11-26|archive-url=|archive-date=|dead-url=|language=en}}&lt;/ref&gt; <br /> <br /> Simon now travels to the [[United States|US]] to see Dr. [[Jose Montoya]] for management of his ME/CFS. In 2017, he met Dr. [[Ronald Davis|Ron Davis]], director of the [[End ME/CFS Project]].&lt;ref name=&quot;:0&quot; /&gt;<br /> <br /> == Media coverage ==<br /> * [https://www.sbs.com.au/news/insight/article/2018/11/22/i-was-denial-and-ashamed-my-cfs 'I was in denial and ashamed by my CFS']&lt;ref name=&quot;:0&quot; /&gt;                      <br /> <br /> == Online presence ==<br /> * [https://twitter.com/simondelfavero Twitter]<br /> * [http://www.simondelfavero.com/ Website]<br /> <br /> == See also ==<br /> * [[Jose Montoya]]<br /> <br /> == Learn more ==<br /> <br /> == References ==<br /> &lt;references /&gt;</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=File:Simon.jpg&diff=44354 2018-11-26T01:33:30Z

<p>MEcfsFMS:Title: Simon Del Favero Source: [https://twitter.com/simondelfavero Twitter Bio Photo]</p> <hr /> <div>== Summary ==<br /> Title: Simon Del Favero<br /> <br /> Source: [https://twitter.com/simondelfavero Twitter Bio Photo]<br /> <br /> <br /> == Licensing ==<br /> {{PD}}</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Systemic_Exertion_Intolerance_Disease&diff=43167 2018-11-01T11:13:54Z

<p>MEcfsFMS:/* Authors */ internal links</p> <hr /> <div>'''Systemic Exertion Intolerance Disease''' (SEID) is the name and diagnostic criteria developed by the [[National Academy of Medicine]] (formerly the Institute of Medicine (IOM)) and published on February 10, 2015: ''Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness'' is also referred to as the [[Institute of Medicine report]]. <br /> <br /> SEID is accurately diagnosed when the most basic of its diagnostic criteria are met. It is also useful for a more severe presentation of the disease; symptom severity and other symptoms are outlined in the Institute of Medicine report. <br /> <br /> Adults can diagnosed at six months and pediatric cases are diagnosed at three months.<br /> [[File:Morgan Fairchild.png |300px|thumb|right|[[Morgan Fairchild]] is an [[United States|American]] actress of film and television. She was diagnosed with [[chronic fatigue syndrome]] (CFS) in 1989. On March 25, 2015, she gave a [https://www.youtube.com/watch?v=lWTF80daWtw speech] during the [[IOM]] briefing of the rollout of SEID where she says compared to others suffering with [[ME/CFS]] she has a mild case]]<br /> <br /> ==Authors==<br /> The committee on the Diagnostic Criteria for [[ME/CFS|Myalgic Encephalomyelitis/Chronic Fatigue Syndrome]] (ME/CFS) consisted of [[Ellen Wright Clayton]], [[Margarita Alegría]], [[Lucinda Bateman]], [[Lily Chu]], [[Charles Cleeland]], [[Ronald Davis]], [[Betty Diamond]], [[Theodore Ganiats]], [[Betsy Keller]], [[Nancy Klimas]], [[A Martin Lerner]], [[Cynthia Mulrow]], [[Benjamin Natelson]], [[Peter Rowe]], and [[Michael Shelanski]].<br /> <br /> ==Development==<br /> In 2014, the [[U.S. Department of Health and Human Services]] (HHS), the [[National Institutes of Health]] (NIH), the [[Agency for Healthcare Research and Quality]] (AHRQ), the [[Centers for Disease Control &amp; Prevention]] (CDC), the [[Food and Drug Administration]] (FDA), and the [[Social Security Administration]] (SSA) asked the [[Institute of Medicine]] (IOM) to convene an expert committee to examine the evidence base for [[ME/CFS]]. In ''Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness'', the committee proposes new diagnostic criteria that will facilitate timely diagnosis and care and enhance understanding among health care providers and the public. These criteria, based on expert analysis and the most up-to-date scientific literature, are streamlined for practical use in the clinical setting. The IOM committee also recommends that the name of the disease be changed—from ME/CFS to systemic exertion intolerance disease (SEID)—to more accurately capture the central characteristics of the illness.&lt;ref&gt;{{Cite web|url=http://iom.nationalacademies.org/~/media/Files/Report%20Files/2015/MECFS/MECFScliniciansguide.pdf|title=Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome - Redefining an Illness|last=|first=|date=|website=nationalacademies.org|page=5|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt;<br /> <br /> '''The proposed name and acronym SEID is meant to hone in on key aspects of''' [[ME/CFS]]'''.''' '''''S'''ystemic'' would give credence to the disease being body wide. '''''E'''xertion '''I'''ntolerance'' would key doctors into understanding that the patient CANNOT tolerate exertion of any kind; physical, cognitive or emotional.&lt;ref&gt;{{Cite news|url=http://www.shoutoutaboutme.com/about-mecfs/seid-diagnostic-criteria-proposed/|title=NIH/IOM 2015 Definition (SEID)|last=Logan|first=Russell|date=Jan 3, 2015|work=Shoutout about ME|access-date=2018-09-03|archive-url=|archive-date=|dead-url=|language=en-us}}&lt;/ref&gt; (Intolerance is well understood in the medical field in that there is a medical problem. Other diseases, such as gluten intolerance, is a serious medical condition; gluten CAN NOT be consumed.) '''''D'''isease'' gave the self-explanatory label of being an organic biological disease.<br /> <br /> ==Diagnostic criteria==<br /> [[File:Rosa SEID.JPG|400px|thumb|right|Rosa age 25 in 1986, when she believes she would have met the SEID criteria developed in 2015. She became worse over the years and in 2003 was diagnosed and disabled with CFS. Rosa now meets the [[CCC]] criteria (with [[PEM]] &quot;option&quot;). ME/CFS onset was [[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome|age 17]] and [[fibromyalgia]] since puberty]]<br /> '''Diagnosis requires that the patient have the following three symptoms:'''<br /> <br /> 1. A substantial reduction or impairment in the ability to engage in pre-illness levels of occupational, educational, social, or personal activities, that persists for more than 6 months and is accompanied <br /> by [[fatigue]], which is often profound, is of new or definite onset (not lifelong), is not the result of ongoing excessive exertion, and is not substantially alleviated by rest, and<br /> <br /> 2. [[Post-exertional malaise]],* and<br /> <br /> 3. [[Unrefreshing sleep]]*<br /> <br /> '''At least one of the two following manifestations is also required:'''<br /> <br /> 1. [[Cognitive impairment]]* or<br /> <br /> 2. [[Orthostatic intolerance]]<br /> <br /> : * Frequency and severity of symptoms should be assessed. The diagnosis of ME/CFS (SEID) should be questioned if patients do not have these symptoms at least half of the time with moderate, substantial, or severe intensity.&lt;ref&gt;{{Cite web|url=http://iom.nationalacademies.org/~/media/Files/Report%20Files/2015/MECFS/MECFScliniciansguide.pdf|title=Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome - Redefining an Illness|last=|first=|date=2015|website=nationacademies.org|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt;<br /> <br /> ===Centers for Disease Control and Prevention (CDC) website===<br /> <br /> :Note: The name &quot;Systemic Exertion Intolerance Disease&quot; (SEID) has not been adopted but the new diagnostic criteria have been incorporated into the CDC's ME/CFS website under the tab [https://www.cdc.gov/me-cfs/healthcare-providers/diagnosis/iom-2015-diagnostic-criteria.html IOM 2015 Diagnostic Criteria].&lt;ref&gt;{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/diagnosis/iom-2015-diagnostic-criteria.html|title=IOM 2015 Diagnostic Criteria {{!}} Diagnosis {{!}} Healthcare Providers {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) {{!}} CDC|date=2018-07-10|website=www.cdc.gov|language=en-us|access-date=2018-09-03}}&lt;/ref&gt;<br /> <br /> == SEID vs Other criteria ==<br /> The SEID criteria are the most symptom liberal of the valid ''disease'' definition criteria. Other ME/CFS disease definition criteria include [[Fukuda criteria]], [[Canadian Consensus Criteria]] (CCC), and [[International Consensus Criteria]] (ICC).&lt;ref&gt;{{Cite journal|last=Chu|first=Lily|last2=Norris|first2=Jane L.|last3=Valencia|first3=Ian J.|last4=Montoya|first4=Jose G.|date=2017-03-13|title=Patients diagnosed with Myalgic encephalomyelitis/chronic fatigue syndrome also fit systemic exertion intolerance disease criteria|url=http://www.tandfonline.com/doi/abs/10.1080/21641846.2017.1299079?journalCode=rftg20|journal=Fatigue: Biomedicine, Health &amp; Behavior|language=en|volume=5|issue=2|pages=114–128|doi=10.1080/21641846.2017.1299079|issn=2164-1846}}&lt;/ref&gt; The IOM report calls for the &quot;retirement&quot; of the [[Oxford criteria]].&lt;ref&gt;{{Cite web|url=http://theargusreport.com/us-nih-report-calls-uk-definition-mecfs-scrapped/|title=US NIH Report Calls for UK Definition of ME/CFS to be Scrapped|last=Swift|first=Penny|date=|website=theargusreport.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-09-03}}&lt;/ref&gt;<br /> <br /> == Clinicians guide ==<br /> The [http://iom.nationalacademies.org/~/media/Files/Report%20Files/2015/MECFS/MECFScliniciansguide.pdf Report Guide for Clinicians] explains the core symptoms, additional symptoms, diagnostic criteria and more. (Feb 10, 2015)<br /> <br /> ===Centers for Disease Control and Prevention (CDC) website===<br /> <br /> : Note: This clinicians guide has been incorporated into the CDC's ME/CFS website under the tab [https://www.cdc.gov/me-cfs/healthcare-providers/index.html Information for Healthcare Providers] under the &quot;Resources&quot; heading with a page disclaimer: &quot;The findings and conclusions in these documents are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention (CDC).&quot;&lt;ref&gt;{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/index.html|title=Information for Healthcare Providers {{!}} ME/CFS {{!}} CDC|date=2018-07-10|website=www.cdc.gov|language=en-us|access-date=2018-09-03}}&lt;/ref&gt;<br /> <br /> == The Institute of Medicine report ==<br /> <br /> '''''Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness''''' <br /> <br /> ===Read the report===<br /> *[http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2015/MECFS/MECFS_KeyFacts.pdf Key facts] (two pages)<br /> *[http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2015/MECFS/MECFS_ReportBrief.pdf Report brief] (four pages)<br /> *[http://www.nationalacademies.org/hmd/Reports/2015/ME-CFS.aspx Download full report] (282 pages)<br /> *[http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2015/MECFS/MECFS_DiagnosticAlgorithm Diagnostic Algorithm Chart]<br /> *[http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2015/MECFS/MECFS_ProposedDiagnosticCriteria Proposed Diagnostic Criteria Chart]<br /> *[http://www.nap.edu/read/19012/chapter/1 Read the full 282 page report online]<br /> **[http://www.nap.edu/read/19012/chapter/1 Front matter]<br /> **[http://www.nap.edu/read/19012/chapter/2 Summary]<br /> **[http://www.nap.edu/read/19012/chapter/3 1. Introduction]<br /> **[http://www.nap.edu/read/19012/chapter/4 2. Background]<br /> **[http://www.nap.edu/read/19012/chapter/5 3. Current Case Definitions and Diagnostic Criteria, Terminology, and Symptom Constructs and Clusters]<br /> **[http://www.nap.edu/read/19012/chapter/6 4. Review of the Evidence on Major ME/CFS Symptoms and Manifestations]<br /> **[http://www.nap.edu/read/19012/chapter/7 5. Review of the Evidence on Other ME/CFS Symptoms and Manifestations]<br /> **[http://www.nap.edu/read/19012/chapter/8 6. Pediatric ME/CFS]<br /> **[http://www.nap.edu/read/19012/chapter/9 7. Recommendations]<br /> **[http://www.nap.edu/read/19012/chapter/10 8. Dissemination Strategy]<br /> **[http://www.nap.edu/read/19012/chapter/11 Public Session Agendas]<br /> **[http://www.nap.edu/read/19012/chapter/12 GRADE Grid Template]<br /> **[http://www.nap.edu/read/19012/chapter/13 Disability in ME/CFS]<br /> **[http://www.nap.edu/read/19012/chapter/14 Questionnaires and Tools That May Be Useful for Assessing ME/CFS Symptoms]<br /> **[http://www.nap.edu/read/19012/chapter/15 Biographical Sketches of Committee Members, Consultants, and Staff]<br /> <br /> <br /> [http://iom.nationalacademies.org/Reports/2015/ME-CFS.aspx &quot;Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness&quot; Official video presentation]<br /> <br /> == Videos ==<br /> *[[Beyond the Data – Chronic Fatigue Syndrome: Advancing Research and Clinical Education]]&lt;ref&gt;{{Cite web|url=https://www.me-pedia.org/wiki/Beyond_the_Data_%E2%80%93_Chronic_Fatigue_Syndrome:_Advancing_Research_and_Clinical_Education|title=Beyond the Data – Chronic Fatigue Syndrome: Advancing Research and Clinical Education - MEpedia|website=www.me-pedia.org|language=en|access-date=2018-09-03}}&lt;/ref&gt;<br /> :[[CDC]] Posted Video - Dr. [[John Iskander]] of CDC interviews Dr. [[Anthony Komaroff]] (Feb 17, 2016)<br /> <br /> *[https://www.youtube.com/watch?v=ZW2Tcsp75a0 SMCI IOM Briefing in Washington, D.C. Full Coverage]&lt;ref&gt;{{Cite web|url=https://www.youtube.com/watch?v=ZW2Tcsp75a0|title=SMCI IOM Briefing in Washington, D.C. Full Coverage|last=|first=|date=Mar 25, 2015|website=YouTube|publisher=SolveCFS|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt;<br /> :[[Carol Head]] of [[Solve ME/CFS]], Dr. [[Ellen Wright Clayton]] and [https://en.wikipedia.org/wiki/Morgan_Fairchild Morgan Fairchild]<br /> <br /> *[https://www.youtube.com/watch?v=X4Tnt2d-5S8 New Clinical Definitions for ME/CFS - Dr. Lucinda Bateman]&lt;ref&gt;{{Cite web|url=https://www.youtube.com/watch?v=X4Tnt2d-5S8|title=&quot;New Clinical Definitions for ME/CFS&quot; Dr. Lucinda Bateman|last=Bateman|first=Lucinda|date=Mar 8, 2015|website=YouTube|publisher=Bateman Horne Center|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt; <br /> :Dr. [[Lucinda Bateman]] of [[Bateman Horne Center]] discusses. (Mar 8, 2015)<br /> <br /> ==Notable studies==<br /> * 2015, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4556426/pdf/nihms699325.pdf Chronic Fatigue Syndrome versus Systemic Exertion Intolerance Disease]&lt;ref name=&quot;Jason, Sunn, 2015&quot; /&gt;<br /> <br /> *2017, [http://www.tandfonline.com/doi/full/10.1080/21641846.2017.1362750 Article commentary - Differences of opinion on systemic exercise intolerance disease are not ‘mistakes’: a rejoinder to Jason Sunnquist, Gleason and Fox]&lt;ref name=&quot;Chu, Valencia, Montoya, 2017&quot; /&gt;<br /> *2017, [http://www.tandfonline.com/doi/abs/10.1080/21641846.2017.1362780 Article commentary - Mistaken conclusions about systemic exercise intolerance disease being comparable to research case definitions of CFS: A rebuttal to Chu et al.]&lt;ref name=&quot;Jason, Sunnquist, Gleason, Fox, 2017&quot; /&gt;<br /> *2017, [http://www.tandfonline.com/doi/abs/10.1080/21641846.2017.1299079?journalCode=rftg20&amp; Patients diagnosed with Myalgic encephalomyelitis/chronic fatigue syndrome also fit systemic exertion intolerance disease criteria]&lt;ref name=&quot;Chu, 2017&quot; /&gt;<br /> <br /> ==In popular culture==<br /> A February 2016 comic strip referred to SEID and implied it is simply tiredness. ''See'': [[Blondie comic]]<br /> <br /> ==See also==<br /> * [[Chronic fatigue syndrome]]<br /> * [[ME/CFS]]<br /> * [[Myalgic encephalomyelitis]]<br /> <br /> *[[NIH Post-Infectious ME/CFS Study]] - [[SEID]] will be used in this study.&lt;ref&gt;{{Cite news|url=http://www.meaction.net/2016/02/09/positive-answers-to-initial-questions-re-nih-clinical-center-protocol/|title=Positive Answers to Initial Questions re NIH Clinical Center Protocol - #MEAction|last=Alexander Miller|first=Courtney|date=2016-02-09|work=#MEAction|access-date=2018-09-03|archive-url=|archive-date=|dead-url=|language=en-US}}&lt;/ref&gt;<br /> *[[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome]]<br /> *[[Severe and very severe ME]]<br /> <br /> ===Generally accepted criteria for diagnosing ME/CFS and ME ===<br /> *[[Canadian Consensus Criteria]] (CCC) - A diagnosis of moderate and severe forms of [[ME/CFS]] are accurately made using this criterion. Adults can be diagnosed at six months while pediatric cases are diagnosed at three months.<br /> <br /> *[[International Consensus Criteria]] (ICC)&lt;ref&gt;{{Cite journal|last=Carruthers|first=Bruce M.|author-link=Bruce Carruthers|last2=van de Sande|first2=Marjorie I.|author-link2=Marjorie van de Sande|last3=De Meirleir|first3=Kenny L.|author-link3=Kenny De Meirleir|last4=Klimas|first4=Nancy G.|author-link4=Nancy Klimas|last5=Broderick|first5=Gordon|author-link5=Gordon Broderick|last6=Mitchell|first6=Terry|author-link6=Terry Mitchell|last7=Staines|first7=Donald|author-link7=Donald Staines|last8=Powles|first8=A. C. Peter|author-link8=A C Peter Powles|last9=Speight|first9=Nigel|author-link9=Nigel Speight|last10=Vallings|first10=Rosamund|author-link10=Rosamund Vallings|last11=Bateman|first11=Lucinda|author-link11=Lucinda Bateman|last12=Baumgarten-Austrheim|first12=Barbara|author-link12=Barbara Baumgarten-Austrheim|last13=Bell|first13=David|author-link13=David Bell|last14=Carlo-Stella|first14=Nicoletta|author-link14=Nicoletta Carlo-Stella|last15=Chia|first15=John|author-link15=John Chia|last16=Darragh|first16=Austin|author-link16=Austin Darragh|last17=Jo|first17=Daehyun|author-link17=Daehyun Jo|last18=Lewis|first18=Donald|author-link18=Donald Lewis|last19=Light|first19=Alan|author-link19=Alan Light|last20=Marshall-Gradisnik|first20=Sonya|author-link20=Sonya Marshall-Gradisnik|last21=Mena|first21=Ismael|author-link21=Ismael Mena|last22=Mikovits|first22=Judy|author-link22=Judy Mikovits|last23=Miwa|first23=Kunihisa|author-link23=Kunihisa Miwa|last24=Murovska|first24=Modra|author-link24=Modra Murovska|last25=Pall|first25=Martin|author-link25=Martin Pall|last26=Stevens|first26=Staci|author-link26=Staci Stevens|date=2011-08-22|title=Myalgic encephalomyelitis: International Consensus Criteria|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2796.2011.02428.x|journal=Journal of Internal Medicine|language=en|volume=270|issue=4|pages=327–338|doi=10.1111/j.1365-2796.2011.02428.x|issn=0954-6820|pmc=3427890|pmid=21777306|via=}}&lt;/ref&gt; - This criterion will accurately diagnose [[myalgic encephalomyelitis]] (ME). There is no requirement that the individual have symptoms for a specified period of time for diagnosis, as opposed to [[Fukuda criteria|Fukuda]] and [[SEID]], which both require 6 months in adults.<br /> <br /> *Systemic Exertion Intolerance Disease (SEID) - ME/CFS (SEID) is accurately diagnosed when the basic criteria&lt;ref&gt;{{Cite web|url=https://www.me-pedia.org/wiki/Systemic_Exertion_Intolerance_Disease#Diagnostic_criteria|title=Systemic Exertion Intolerance Disease - MEpedia|website=www.me-pedia.org|language=en|access-date=2018-10-15}}&lt;/ref&gt; are met. The [[Institute of Medicine report]] as a whole is a comprehensive review of the medical literature available at time of publication (2015). Adults can be diagnosed at six months while pediatric cases are diagnosed at three months.<br /> <br /> ==Learn more==<br /> *2015, [https://www.newscientist.com/article/dn26945-chronic-fatigue-syndrome-gets-yet-another-name/ Chronic fatigue syndrome gets yet another name]&lt;ref&gt;{{Cite news|url=https://www.newscientist.com/article/dn26945-chronic-fatigue-syndrome-gets-yet-another-name/|title=Chronic fatigue syndrome gets yet another name|last=Coghlan|first=Andy|date=Feb 10, 2015|work=New Scientist|access-date=2018-09-03|archive-url=|archive-date=|dead-url=|language=en-US}}&lt;/ref&gt;<br /> *2015, [http://www.asianjournalofpsychiatry.com/article/S1876-2018(16)30248-9/abstract Systemic Exercise Intolerance Disease: What’s in a name?]&lt;ref&gt;{{Cite journal|last=Sen|first=Mahadev Singh|last2=Sahoo|first2=Swapnajeet|last3=Aggarwal|first3=Shivali|last4=Singh|first4=Shubh Mohan|date=2016|title=Systemic exercise intolerance disease: What’s in a name?|url=http://www.asianjournalofpsychiatry.com/article/S1876-2018(16)30248-9/abstract|journal=Asian Journal of Psychiatry|language=English|volume=22|pages=157–158|doi=10.1016/j.ajp.2016.06.003|issn=1876-2018|via=}}&lt;/ref&gt;<br /> *2018, [https://youtu.be/RC9TjgE_PlU?t=89 Diagnosis and Management of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome]&lt;ref&gt;{{Cite web|url=https://youtu.be/RC9TjgE_PlU?t=89|title=Diagnosis and Management of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome|last=Kaufman|first=David|date=Oct 16, 2018|website=YouTube|publisher=Unrest Film|archive-url=|archive-date=|dead-url=|access-date=|quote=Part of the Unrest Continuing Education module.}}&lt;/ref&gt; (Notes the IOM report's diagnostic criteria.)<br /> <br /> == References ==<br /> &lt;references&gt;<br /> &lt;ref name=&quot;Chu, 2017&quot;&gt;{{Citation<br /> | last1 = Chu | first1 = Lily | authorlink1 = Lily Chu<br /> | last2 = Norris | first2 = Jane | authorlink2 = Jane Norris<br /> | last3 = Valencia | first3 = Ian J. | authorlink3 = <br /> | last4 = Montoya | first4 = Jose G. | authorlink4 = Jose Montoya <br /> | title = Patients diagnosed with Myalgic encephalomyelitis/chronic fatigue syndrome also fit systemic exertion intolerance disease criteria<br /> | journal = Fatigue: Biomedicine, Health &amp; Behavior | volume = 5 | issue = | page = <br /> | date = 2017<br /> | doi = 10.1080/21641846.2017.1299079<br /> }}<br /> &lt;/ref&gt;<br /> &lt;ref name=&quot;Chu, Valencia, Montoya, 2017&quot;&gt;{{Citation<br /> | last1 = Chu | first1 = Lily | authorlink1 = Lily Chu<br /> | last2 = Valencia | first2 = Ian J. | authorlink2 = <br /> | last3 = Montoya | first3 = Jose G. | authorlink3 = Jose Montoya <br /> | title = Differences of opinion on systemic exercise intolerance disease are not ‘mistakes’: a rejoinder to Jason Sunnquist, Gleason and Fox<br /> | journal = Fatigue: Biomedicine, Health &amp; Behavior | volume = | issue = | page = <br /> | date = 2017<br /> | doi = 10.1080/21641846.2017.1362750<br /> }}<br /> &lt;/ref&gt;<br /> &lt;ref name=&quot;Jason, Sunn, 2015&quot;&gt;{{Citation<br /> | last1 = Jason | first1 = L.A. | authorlink1 = Leonard Jason<br /> | last2 = Sunnquist | first2 = M. | authorlink2 = Madison Sunnquist<br /> | last3 = Brown | first3 = A. | authorlink3 = <br /> | last4 = Newton | first4 = J.L. | authorlink4 = Julia Newton<br /> | last5 = Strand | first5 = E.B. | authorlink5 = Elin Strand<br /> | last6 = Vernon | first6 = S.D. | authorlink6 = Suzanne Vernon <br /> | title = Chronic fatigue syndrome versus systemic exertion intolerance disease<br /> | journal = Fatigue: Biomedicine, Health &amp; Behavior | volume = 3 | issue = 3 | page = 127-141<br /> | date = 2015<br /> | pmid = <br /> | doi = 10.1080/21641846.2015.1051291<br /> }}&lt;/ref&gt;<br /> &lt;ref name=&quot;Jason, Sunnquist, Gleason, Fox, 2017&quot;&gt;{{Citation<br /> | last1 = Jason | first1 = Leonard A. | authorlink1 = Leonard Jason<br /> | last2 = Sunnquist | first2 = Madison | authorlink2 = Madison Sunnquist<br /> | last3 = Gleason | first3 = Kristen | authorlink3 = Kristen Gleason<br /> | last4 = Fox | first4 = Pamela | authorlink4 = Pamela Fox<br /> | title = Mistaken conclusions about systemic exercise intolerance disease being comparable to research case definitions of CFS: A rebuttal to Chu et al.<br /> | journal = Fatigue: Biomedicine, Health &amp; Behavior | volume = | issue = | page = <br /> | date = 2017<br /> | pmid = <br /> | doi = 10.1080/21641846.2017.1362780<br /> }}<br /> &lt;/ref&gt;<br /> &lt;/references&gt;<br /> <br /> [[Category:Definitions]]<br /> [[Category:Diagnoses]]<br /> [[Category:Disease names]]</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Systemic_Exertion_Intolerance_Disease&diff=43166 2018-11-01T11:11:41Z

<p>MEcfsFMS:/* Centers for Disease Control and Prevention (CDC) website */ acronyms, little cleanup</p> <hr /> <div>'''Systemic Exertion Intolerance Disease''' (SEID) is the name and diagnostic criteria developed by the [[National Academy of Medicine]] (formerly the Institute of Medicine (IOM)) and published on February 10, 2015: ''Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness'' is also referred to as the [[Institute of Medicine report]]. <br /> <br /> SEID is accurately diagnosed when the most basic of its diagnostic criteria are met. It is also useful for a more severe presentation of the disease; symptom severity and other symptoms are outlined in the Institute of Medicine report. <br /> <br /> Adults can diagnosed at six months and pediatric cases are diagnosed at three months.<br /> [[File:Morgan Fairchild.png |300px|thumb|right|[[Morgan Fairchild]] is an [[United States|American]] actress of film and television. She was diagnosed with [[chronic fatigue syndrome]] (CFS) in 1989. On March 25, 2015, she gave a [https://www.youtube.com/watch?v=lWTF80daWtw speech] during the [[IOM]] briefing of the rollout of SEID where she says compared to others suffering with [[ME/CFS]] she has a mild case]]<br /> <br /> ==Authors==<br /> The committee on the Diagnostic Criteria for [[Myalgic Encephalomyelitis]]/[[Chronic Fatigue Syndrome]] ([[ME/CFS]]) consisted of [[Ellen Wright Clayton]], [[Margarita Alegría]], [[Lucinda Bateman]], [[Lily Chu]], [[Charles Cleeland]], [[Ronald Davis]], [[Betty Diamond]], [[Theodore Ganiats]], [[Betsy Keller]], [[Nancy Klimas]], [[A Martin Lerner]], [[Cynthia Mulrow]], [[Benjamin Natelson]], [[Peter Rowe]], and [[Michael Shelanski]].<br /> <br /> ==Development==<br /> In 2014, the [[U.S. Department of Health and Human Services]] (HHS), the [[National Institutes of Health]] (NIH), the [[Agency for Healthcare Research and Quality]] (AHRQ), the [[Centers for Disease Control &amp; Prevention]] (CDC), the [[Food and Drug Administration]] (FDA), and the [[Social Security Administration]] (SSA) asked the [[Institute of Medicine]] (IOM) to convene an expert committee to examine the evidence base for [[ME/CFS]]. In ''Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness'', the committee proposes new diagnostic criteria that will facilitate timely diagnosis and care and enhance understanding among health care providers and the public. These criteria, based on expert analysis and the most up-to-date scientific literature, are streamlined for practical use in the clinical setting. The IOM committee also recommends that the name of the disease be changed—from ME/CFS to systemic exertion intolerance disease (SEID)—to more accurately capture the central characteristics of the illness.&lt;ref&gt;{{Cite web|url=http://iom.nationalacademies.org/~/media/Files/Report%20Files/2015/MECFS/MECFScliniciansguide.pdf|title=Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome - Redefining an Illness|last=|first=|date=|website=nationalacademies.org|page=5|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt;<br /> <br /> '''The proposed name and acronym SEID is meant to hone in on key aspects of''' [[ME/CFS]]'''.''' '''''S'''ystemic'' would give credence to the disease being body wide. '''''E'''xertion '''I'''ntolerance'' would key doctors into understanding that the patient CANNOT tolerate exertion of any kind; physical, cognitive or emotional.&lt;ref&gt;{{Cite news|url=http://www.shoutoutaboutme.com/about-mecfs/seid-diagnostic-criteria-proposed/|title=NIH/IOM 2015 Definition (SEID)|last=Logan|first=Russell|date=Jan 3, 2015|work=Shoutout about ME|access-date=2018-09-03|archive-url=|archive-date=|dead-url=|language=en-us}}&lt;/ref&gt; (Intolerance is well understood in the medical field in that there is a medical problem. Other diseases, such as gluten intolerance, is a serious medical condition; gluten CAN NOT be consumed.) '''''D'''isease'' gave the self-explanatory label of being an organic biological disease.<br /> <br /> ==Diagnostic criteria==<br /> [[File:Rosa SEID.JPG|400px|thumb|right|Rosa age 25 in 1986, when she believes she would have met the SEID criteria developed in 2015. She became worse over the years and in 2003 was diagnosed and disabled with CFS. Rosa now meets the [[CCC]] criteria (with [[PEM]] &quot;option&quot;). ME/CFS onset was [[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome|age 17]] and [[fibromyalgia]] since puberty]]<br /> '''Diagnosis requires that the patient have the following three symptoms:'''<br /> <br /> 1. A substantial reduction or impairment in the ability to engage in pre-illness levels of occupational, educational, social, or personal activities, that persists for more than 6 months and is accompanied <br /> by [[fatigue]], which is often profound, is of new or definite onset (not lifelong), is not the result of ongoing excessive exertion, and is not substantially alleviated by rest, and<br /> <br /> 2. [[Post-exertional malaise]],* and<br /> <br /> 3. [[Unrefreshing sleep]]*<br /> <br /> '''At least one of the two following manifestations is also required:'''<br /> <br /> 1. [[Cognitive impairment]]* or<br /> <br /> 2. [[Orthostatic intolerance]]<br /> <br /> : * Frequency and severity of symptoms should be assessed. The diagnosis of ME/CFS (SEID) should be questioned if patients do not have these symptoms at least half of the time with moderate, substantial, or severe intensity.&lt;ref&gt;{{Cite web|url=http://iom.nationalacademies.org/~/media/Files/Report%20Files/2015/MECFS/MECFScliniciansguide.pdf|title=Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome - Redefining an Illness|last=|first=|date=2015|website=nationacademies.org|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt;<br /> <br /> ===Centers for Disease Control and Prevention (CDC) website===<br /> <br /> :Note: The name &quot;Systemic Exertion Intolerance Disease&quot; (SEID) has not been adopted but the new diagnostic criteria have been incorporated into the CDC's ME/CFS website under the tab [https://www.cdc.gov/me-cfs/healthcare-providers/diagnosis/iom-2015-diagnostic-criteria.html IOM 2015 Diagnostic Criteria].&lt;ref&gt;{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/diagnosis/iom-2015-diagnostic-criteria.html|title=IOM 2015 Diagnostic Criteria {{!}} Diagnosis {{!}} Healthcare Providers {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) {{!}} CDC|date=2018-07-10|website=www.cdc.gov|language=en-us|access-date=2018-09-03}}&lt;/ref&gt;<br /> <br /> == SEID vs Other criteria ==<br /> The SEID criteria are the most symptom liberal of the valid ''disease'' definition criteria. Other ME/CFS disease definition criteria include [[Fukuda criteria]], [[Canadian Consensus Criteria]] (CCC), and [[International Consensus Criteria]] (ICC).&lt;ref&gt;{{Cite journal|last=Chu|first=Lily|last2=Norris|first2=Jane L.|last3=Valencia|first3=Ian J.|last4=Montoya|first4=Jose G.|date=2017-03-13|title=Patients diagnosed with Myalgic encephalomyelitis/chronic fatigue syndrome also fit systemic exertion intolerance disease criteria|url=http://www.tandfonline.com/doi/abs/10.1080/21641846.2017.1299079?journalCode=rftg20|journal=Fatigue: Biomedicine, Health &amp; Behavior|language=en|volume=5|issue=2|pages=114–128|doi=10.1080/21641846.2017.1299079|issn=2164-1846}}&lt;/ref&gt; The IOM report calls for the &quot;retirement&quot; of the [[Oxford criteria]].&lt;ref&gt;{{Cite web|url=http://theargusreport.com/us-nih-report-calls-uk-definition-mecfs-scrapped/|title=US NIH Report Calls for UK Definition of ME/CFS to be Scrapped|last=Swift|first=Penny|date=|website=theargusreport.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-09-03}}&lt;/ref&gt;<br /> <br /> == Clinicians guide ==<br /> The [http://iom.nationalacademies.org/~/media/Files/Report%20Files/2015/MECFS/MECFScliniciansguide.pdf Report Guide for Clinicians] explains the core symptoms, additional symptoms, diagnostic criteria and more. (Feb 10, 2015)<br /> <br /> ===Centers for Disease Control and Prevention (CDC) website===<br /> <br /> : Note: This clinicians guide has been incorporated into the CDC's ME/CFS website under the tab [https://www.cdc.gov/me-cfs/healthcare-providers/index.html Information for Healthcare Providers] under the &quot;Resources&quot; heading with a page disclaimer: &quot;The findings and conclusions in these documents are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention (CDC).&quot;&lt;ref&gt;{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/index.html|title=Information for Healthcare Providers {{!}} ME/CFS {{!}} CDC|date=2018-07-10|website=www.cdc.gov|language=en-us|access-date=2018-09-03}}&lt;/ref&gt;<br /> <br /> == The Institute of Medicine report ==<br /> <br /> '''''Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness''''' <br /> <br /> ===Read the report===<br /> *[http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2015/MECFS/MECFS_KeyFacts.pdf Key facts] (two pages)<br /> *[http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2015/MECFS/MECFS_ReportBrief.pdf Report brief] (four pages)<br /> *[http://www.nationalacademies.org/hmd/Reports/2015/ME-CFS.aspx Download full report] (282 pages)<br /> *[http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2015/MECFS/MECFS_DiagnosticAlgorithm Diagnostic Algorithm Chart]<br /> *[http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2015/MECFS/MECFS_ProposedDiagnosticCriteria Proposed Diagnostic Criteria Chart]<br /> *[http://www.nap.edu/read/19012/chapter/1 Read the full 282 page report online]<br /> **[http://www.nap.edu/read/19012/chapter/1 Front matter]<br /> **[http://www.nap.edu/read/19012/chapter/2 Summary]<br /> **[http://www.nap.edu/read/19012/chapter/3 1. Introduction]<br /> **[http://www.nap.edu/read/19012/chapter/4 2. Background]<br /> **[http://www.nap.edu/read/19012/chapter/5 3. Current Case Definitions and Diagnostic Criteria, Terminology, and Symptom Constructs and Clusters]<br /> **[http://www.nap.edu/read/19012/chapter/6 4. Review of the Evidence on Major ME/CFS Symptoms and Manifestations]<br /> **[http://www.nap.edu/read/19012/chapter/7 5. Review of the Evidence on Other ME/CFS Symptoms and Manifestations]<br /> **[http://www.nap.edu/read/19012/chapter/8 6. Pediatric ME/CFS]<br /> **[http://www.nap.edu/read/19012/chapter/9 7. Recommendations]<br /> **[http://www.nap.edu/read/19012/chapter/10 8. Dissemination Strategy]<br /> **[http://www.nap.edu/read/19012/chapter/11 Public Session Agendas]<br /> **[http://www.nap.edu/read/19012/chapter/12 GRADE Grid Template]<br /> **[http://www.nap.edu/read/19012/chapter/13 Disability in ME/CFS]<br /> **[http://www.nap.edu/read/19012/chapter/14 Questionnaires and Tools That May Be Useful for Assessing ME/CFS Symptoms]<br /> **[http://www.nap.edu/read/19012/chapter/15 Biographical Sketches of Committee Members, Consultants, and Staff]<br /> <br /> <br /> [http://iom.nationalacademies.org/Reports/2015/ME-CFS.aspx &quot;Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness&quot; Official video presentation]<br /> <br /> == Videos ==<br /> *[[Beyond the Data – Chronic Fatigue Syndrome: Advancing Research and Clinical Education]]&lt;ref&gt;{{Cite web|url=https://www.me-pedia.org/wiki/Beyond_the_Data_%E2%80%93_Chronic_Fatigue_Syndrome:_Advancing_Research_and_Clinical_Education|title=Beyond the Data – Chronic Fatigue Syndrome: Advancing Research and Clinical Education - MEpedia|website=www.me-pedia.org|language=en|access-date=2018-09-03}}&lt;/ref&gt;<br /> :[[CDC]] Posted Video - Dr. [[John Iskander]] of CDC interviews Dr. [[Anthony Komaroff]] (Feb 17, 2016)<br /> <br /> *[https://www.youtube.com/watch?v=ZW2Tcsp75a0 SMCI IOM Briefing in Washington, D.C. Full Coverage]&lt;ref&gt;{{Cite web|url=https://www.youtube.com/watch?v=ZW2Tcsp75a0|title=SMCI IOM Briefing in Washington, D.C. Full Coverage|last=|first=|date=Mar 25, 2015|website=YouTube|publisher=SolveCFS|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt;<br /> :[[Carol Head]] of [[Solve ME/CFS]], Dr. [[Ellen Wright Clayton]] and [https://en.wikipedia.org/wiki/Morgan_Fairchild Morgan Fairchild]<br /> <br /> *[https://www.youtube.com/watch?v=X4Tnt2d-5S8 New Clinical Definitions for ME/CFS - Dr. Lucinda Bateman]&lt;ref&gt;{{Cite web|url=https://www.youtube.com/watch?v=X4Tnt2d-5S8|title=&quot;New Clinical Definitions for ME/CFS&quot; Dr. Lucinda Bateman|last=Bateman|first=Lucinda|date=Mar 8, 2015|website=YouTube|publisher=Bateman Horne Center|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt; <br /> :Dr. [[Lucinda Bateman]] of [[Bateman Horne Center]] discusses. (Mar 8, 2015)<br /> <br /> ==Notable studies==<br /> * 2015, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4556426/pdf/nihms699325.pdf Chronic Fatigue Syndrome versus Systemic Exertion Intolerance Disease]&lt;ref name=&quot;Jason, Sunn, 2015&quot; /&gt;<br /> <br /> *2017, [http://www.tandfonline.com/doi/full/10.1080/21641846.2017.1362750 Article commentary - Differences of opinion on systemic exercise intolerance disease are not ‘mistakes’: a rejoinder to Jason Sunnquist, Gleason and Fox]&lt;ref name=&quot;Chu, Valencia, Montoya, 2017&quot; /&gt;<br /> *2017, [http://www.tandfonline.com/doi/abs/10.1080/21641846.2017.1362780 Article commentary - Mistaken conclusions about systemic exercise intolerance disease being comparable to research case definitions of CFS: A rebuttal to Chu et al.]&lt;ref name=&quot;Jason, Sunnquist, Gleason, Fox, 2017&quot; /&gt;<br /> *2017, [http://www.tandfonline.com/doi/abs/10.1080/21641846.2017.1299079?journalCode=rftg20&amp; Patients diagnosed with Myalgic encephalomyelitis/chronic fatigue syndrome also fit systemic exertion intolerance disease criteria]&lt;ref name=&quot;Chu, 2017&quot; /&gt;<br /> <br /> ==In popular culture==<br /> A February 2016 comic strip referred to SEID and implied it is simply tiredness. ''See'': [[Blondie comic]]<br /> <br /> ==See also==<br /> * [[Chronic fatigue syndrome]]<br /> * [[ME/CFS]]<br /> * [[Myalgic encephalomyelitis]]<br /> <br /> *[[NIH Post-Infectious ME/CFS Study]] - [[SEID]] will be used in this study.&lt;ref&gt;{{Cite news|url=http://www.meaction.net/2016/02/09/positive-answers-to-initial-questions-re-nih-clinical-center-protocol/|title=Positive Answers to Initial Questions re NIH Clinical Center Protocol - #MEAction|last=Alexander Miller|first=Courtney|date=2016-02-09|work=#MEAction|access-date=2018-09-03|archive-url=|archive-date=|dead-url=|language=en-US}}&lt;/ref&gt;<br /> *[[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome]]<br /> *[[Severe and very severe ME]]<br /> <br /> ===Generally accepted criteria for diagnosing ME/CFS and ME ===<br /> *[[Canadian Consensus Criteria]] (CCC) - A diagnosis of moderate and severe forms of [[ME/CFS]] are accurately made using this criterion. Adults can be diagnosed at six months while pediatric cases are diagnosed at three months.<br /> <br /> *[[International Consensus Criteria]] (ICC)&lt;ref&gt;{{Cite journal|last=Carruthers|first=Bruce M.|author-link=Bruce Carruthers|last2=van de Sande|first2=Marjorie I.|author-link2=Marjorie van de Sande|last3=De Meirleir|first3=Kenny L.|author-link3=Kenny De Meirleir|last4=Klimas|first4=Nancy G.|author-link4=Nancy Klimas|last5=Broderick|first5=Gordon|author-link5=Gordon Broderick|last6=Mitchell|first6=Terry|author-link6=Terry Mitchell|last7=Staines|first7=Donald|author-link7=Donald Staines|last8=Powles|first8=A. C. Peter|author-link8=A C Peter Powles|last9=Speight|first9=Nigel|author-link9=Nigel Speight|last10=Vallings|first10=Rosamund|author-link10=Rosamund Vallings|last11=Bateman|first11=Lucinda|author-link11=Lucinda Bateman|last12=Baumgarten-Austrheim|first12=Barbara|author-link12=Barbara Baumgarten-Austrheim|last13=Bell|first13=David|author-link13=David Bell|last14=Carlo-Stella|first14=Nicoletta|author-link14=Nicoletta Carlo-Stella|last15=Chia|first15=John|author-link15=John Chia|last16=Darragh|first16=Austin|author-link16=Austin Darragh|last17=Jo|first17=Daehyun|author-link17=Daehyun Jo|last18=Lewis|first18=Donald|author-link18=Donald Lewis|last19=Light|first19=Alan|author-link19=Alan Light|last20=Marshall-Gradisnik|first20=Sonya|author-link20=Sonya Marshall-Gradisnik|last21=Mena|first21=Ismael|author-link21=Ismael Mena|last22=Mikovits|first22=Judy|author-link22=Judy Mikovits|last23=Miwa|first23=Kunihisa|author-link23=Kunihisa Miwa|last24=Murovska|first24=Modra|author-link24=Modra Murovska|last25=Pall|first25=Martin|author-link25=Martin Pall|last26=Stevens|first26=Staci|author-link26=Staci Stevens|date=2011-08-22|title=Myalgic encephalomyelitis: International Consensus Criteria|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2796.2011.02428.x|journal=Journal of Internal Medicine|language=en|volume=270|issue=4|pages=327–338|doi=10.1111/j.1365-2796.2011.02428.x|issn=0954-6820|pmc=3427890|pmid=21777306|via=}}&lt;/ref&gt; - This criterion will accurately diagnose [[myalgic encephalomyelitis]] (ME). There is no requirement that the individual have symptoms for a specified period of time for diagnosis, as opposed to [[Fukuda criteria|Fukuda]] and [[SEID]], which both require 6 months in adults.<br /> <br /> *Systemic Exertion Intolerance Disease (SEID) - ME/CFS (SEID) is accurately diagnosed when the basic criteria&lt;ref&gt;{{Cite web|url=https://www.me-pedia.org/wiki/Systemic_Exertion_Intolerance_Disease#Diagnostic_criteria|title=Systemic Exertion Intolerance Disease - MEpedia|website=www.me-pedia.org|language=en|access-date=2018-10-15}}&lt;/ref&gt; are met. The [[Institute of Medicine report]] as a whole is a comprehensive review of the medical literature available at time of publication (2015). Adults can be diagnosed at six months while pediatric cases are diagnosed at three months.<br /> <br /> ==Learn more==<br /> *2015, [https://www.newscientist.com/article/dn26945-chronic-fatigue-syndrome-gets-yet-another-name/ Chronic fatigue syndrome gets yet another name]&lt;ref&gt;{{Cite news|url=https://www.newscientist.com/article/dn26945-chronic-fatigue-syndrome-gets-yet-another-name/|title=Chronic fatigue syndrome gets yet another name|last=Coghlan|first=Andy|date=Feb 10, 2015|work=New Scientist|access-date=2018-09-03|archive-url=|archive-date=|dead-url=|language=en-US}}&lt;/ref&gt;<br /> *2015, [http://www.asianjournalofpsychiatry.com/article/S1876-2018(16)30248-9/abstract Systemic Exercise Intolerance Disease: What’s in a name?]&lt;ref&gt;{{Cite journal|last=Sen|first=Mahadev Singh|last2=Sahoo|first2=Swapnajeet|last3=Aggarwal|first3=Shivali|last4=Singh|first4=Shubh Mohan|date=2016|title=Systemic exercise intolerance disease: What’s in a name?|url=http://www.asianjournalofpsychiatry.com/article/S1876-2018(16)30248-9/abstract|journal=Asian Journal of Psychiatry|language=English|volume=22|pages=157–158|doi=10.1016/j.ajp.2016.06.003|issn=1876-2018|via=}}&lt;/ref&gt;<br /> *2018, [https://youtu.be/RC9TjgE_PlU?t=89 Diagnosis and Management of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome]&lt;ref&gt;{{Cite web|url=https://youtu.be/RC9TjgE_PlU?t=89|title=Diagnosis and Management of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome|last=Kaufman|first=David|date=Oct 16, 2018|website=YouTube|publisher=Unrest Film|archive-url=|archive-date=|dead-url=|access-date=|quote=Part of the Unrest Continuing Education module.}}&lt;/ref&gt; (Notes the IOM report's diagnostic criteria.)<br /> <br /> == References ==<br /> &lt;references&gt;<br /> &lt;ref name=&quot;Chu, 2017&quot;&gt;{{Citation<br /> | last1 = Chu | first1 = Lily | authorlink1 = Lily Chu<br /> | last2 = Norris | first2 = Jane | authorlink2 = Jane Norris<br /> | last3 = Valencia | first3 = Ian J. | authorlink3 = <br /> | last4 = Montoya | first4 = Jose G. | authorlink4 = Jose Montoya <br /> | title = Patients diagnosed with Myalgic encephalomyelitis/chronic fatigue syndrome also fit systemic exertion intolerance disease criteria<br /> | journal = Fatigue: Biomedicine, Health &amp; Behavior | volume = 5 | issue = | page = <br /> | date = 2017<br /> | doi = 10.1080/21641846.2017.1299079<br /> }}<br /> &lt;/ref&gt;<br /> &lt;ref name=&quot;Chu, Valencia, Montoya, 2017&quot;&gt;{{Citation<br /> | last1 = Chu | first1 = Lily | authorlink1 = Lily Chu<br /> | last2 = Valencia | first2 = Ian J. | authorlink2 = <br /> | last3 = Montoya | first3 = Jose G. | authorlink3 = Jose Montoya <br /> | title = Differences of opinion on systemic exercise intolerance disease are not ‘mistakes’: a rejoinder to Jason Sunnquist, Gleason and Fox<br /> | journal = Fatigue: Biomedicine, Health &amp; Behavior | volume = | issue = | page = <br /> | date = 2017<br /> | doi = 10.1080/21641846.2017.1362750<br /> }}<br /> &lt;/ref&gt;<br /> &lt;ref name=&quot;Jason, Sunn, 2015&quot;&gt;{{Citation<br /> | last1 = Jason | first1 = L.A. | authorlink1 = Leonard Jason<br /> | last2 = Sunnquist | first2 = M. | authorlink2 = Madison Sunnquist<br /> | last3 = Brown | first3 = A. | authorlink3 = <br /> | last4 = Newton | first4 = J.L. | authorlink4 = Julia Newton<br /> | last5 = Strand | first5 = E.B. | authorlink5 = Elin Strand<br /> | last6 = Vernon | first6 = S.D. | authorlink6 = Suzanne Vernon <br /> | title = Chronic fatigue syndrome versus systemic exertion intolerance disease<br /> | journal = Fatigue: Biomedicine, Health &amp; Behavior | volume = 3 | issue = 3 | page = 127-141<br /> | date = 2015<br /> | pmid = <br /> | doi = 10.1080/21641846.2015.1051291<br /> }}&lt;/ref&gt;<br /> &lt;ref name=&quot;Jason, Sunnquist, Gleason, Fox, 2017&quot;&gt;{{Citation<br /> | last1 = Jason | first1 = Leonard A. | authorlink1 = Leonard Jason<br /> | last2 = Sunnquist | first2 = Madison | authorlink2 = Madison Sunnquist<br /> | last3 = Gleason | first3 = Kristen | authorlink3 = Kristen Gleason<br /> | last4 = Fox | first4 = Pamela | authorlink4 = Pamela Fox<br /> | title = Mistaken conclusions about systemic exercise intolerance disease being comparable to research case definitions of CFS: A rebuttal to Chu et al.<br /> | journal = Fatigue: Biomedicine, Health &amp; Behavior | volume = | issue = | page = <br /> | date = 2017<br /> | pmid = <br /> | doi = 10.1080/21641846.2017.1362780<br /> }}<br /> &lt;/ref&gt;<br /> &lt;/references&gt;<br /> <br /> [[Category:Definitions]]<br /> [[Category:Diagnoses]]<br /> [[Category:Disease names]]</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Systemic_Exertion_Intolerance_Disease&diff=43165 2018-11-01T11:06:32Z

<p>MEcfsFMS:/* Development */ acronyms</p> <hr /> <div>'''Systemic Exertion Intolerance Disease''' (SEID) is the name and diagnostic criteria developed by the [[National Academy of Medicine]] (formerly the Institute of Medicine (IOM)) and published on February 10, 2015: ''Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness'' is also referred to as the [[Institute of Medicine report]]. <br /> <br /> SEID is accurately diagnosed when the most basic of its diagnostic criteria are met. It is also useful for a more severe presentation of the disease; symptom severity and other symptoms are outlined in the Institute of Medicine report. <br /> <br /> Adults can diagnosed at six months and pediatric cases are diagnosed at three months.<br /> [[File:Morgan Fairchild.png |300px|thumb|right|[[Morgan Fairchild]] is an [[United States|American]] actress of film and television. She was diagnosed with [[chronic fatigue syndrome]] (CFS) in 1989. On March 25, 2015, she gave a [https://www.youtube.com/watch?v=lWTF80daWtw speech] during the [[IOM]] briefing of the rollout of SEID where she says compared to others suffering with [[ME/CFS]] she has a mild case]]<br /> <br /> ==Authors==<br /> The committee on the Diagnostic Criteria for [[Myalgic Encephalomyelitis]]/[[Chronic Fatigue Syndrome]] ([[ME/CFS]]) consisted of [[Ellen Wright Clayton]], [[Margarita Alegría]], [[Lucinda Bateman]], [[Lily Chu]], [[Charles Cleeland]], [[Ronald Davis]], [[Betty Diamond]], [[Theodore Ganiats]], [[Betsy Keller]], [[Nancy Klimas]], [[A Martin Lerner]], [[Cynthia Mulrow]], [[Benjamin Natelson]], [[Peter Rowe]], and [[Michael Shelanski]].<br /> <br /> ==Development==<br /> In 2014, the [[U.S. Department of Health and Human Services]] (HHS), the [[National Institutes of Health]] (NIH), the [[Agency for Healthcare Research and Quality]] (AHRQ), the [[Centers for Disease Control &amp; Prevention]] (CDC), the [[Food and Drug Administration]] (FDA), and the [[Social Security Administration]] (SSA) asked the [[Institute of Medicine]] (IOM) to convene an expert committee to examine the evidence base for [[ME/CFS]]. In ''Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness'', the committee proposes new diagnostic criteria that will facilitate timely diagnosis and care and enhance understanding among health care providers and the public. These criteria, based on expert analysis and the most up-to-date scientific literature, are streamlined for practical use in the clinical setting. The IOM committee also recommends that the name of the disease be changed—from ME/CFS to systemic exertion intolerance disease (SEID)—to more accurately capture the central characteristics of the illness.&lt;ref&gt;{{Cite web|url=http://iom.nationalacademies.org/~/media/Files/Report%20Files/2015/MECFS/MECFScliniciansguide.pdf|title=Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome - Redefining an Illness|last=|first=|date=|website=nationalacademies.org|page=5|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt;<br /> <br /> '''The proposed name and acronym SEID is meant to hone in on key aspects of''' [[ME/CFS]]'''.''' '''''S'''ystemic'' would give credence to the disease being body wide. '''''E'''xertion '''I'''ntolerance'' would key doctors into understanding that the patient CANNOT tolerate exertion of any kind; physical, cognitive or emotional.&lt;ref&gt;{{Cite news|url=http://www.shoutoutaboutme.com/about-mecfs/seid-diagnostic-criteria-proposed/|title=NIH/IOM 2015 Definition (SEID)|last=Logan|first=Russell|date=Jan 3, 2015|work=Shoutout about ME|access-date=2018-09-03|archive-url=|archive-date=|dead-url=|language=en-us}}&lt;/ref&gt; (Intolerance is well understood in the medical field in that there is a medical problem. Other diseases, such as gluten intolerance, is a serious medical condition; gluten CAN NOT be consumed.) '''''D'''isease'' gave the self-explanatory label of being an organic biological disease.<br /> <br /> ==Diagnostic criteria==<br /> [[File:Rosa SEID.JPG|400px|thumb|right|Rosa age 25 in 1986, when she believes she would have met the SEID criteria developed in 2015. She became worse over the years and in 2003 was diagnosed and disabled with CFS. Rosa now meets the [[CCC]] criteria (with [[PEM]] &quot;option&quot;). ME/CFS onset was [[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome|age 17]] and [[fibromyalgia]] since puberty]]<br /> '''Diagnosis requires that the patient have the following three symptoms:'''<br /> <br /> 1. A substantial reduction or impairment in the ability to engage in pre-illness levels of occupational, educational, social, or personal activities, that persists for more than 6 months and is accompanied <br /> by [[fatigue]], which is often profound, is of new or definite onset (not lifelong), is not the result of ongoing excessive exertion, and is not substantially alleviated by rest, and<br /> <br /> 2. [[Post-exertional malaise]],* and<br /> <br /> 3. [[Unrefreshing sleep]]*<br /> <br /> '''At least one of the two following manifestations is also required:'''<br /> <br /> 1. [[Cognitive impairment]]* or<br /> <br /> 2. [[Orthostatic intolerance]]<br /> <br /> : * Frequency and severity of symptoms should be assessed. The diagnosis of ME/CFS (SEID) should be questioned if patients do not have these symptoms at least half of the time with moderate, substantial, or severe intensity.&lt;ref&gt;{{Cite web|url=http://iom.nationalacademies.org/~/media/Files/Report%20Files/2015/MECFS/MECFScliniciansguide.pdf|title=Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome - Redefining an Illness|last=|first=|date=2015|website=nationacademies.org|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt;<br /> <br /> ===Centers for Disease Control and Prevention (CDC) website===<br /> <br /> :Note: The name Systemic Exertion Intolerance Disease (SEID) has not been adopted but the new diagnostic criteria have been incorporated into the [[Centers for Disease Control and Prevention]]'s ME/CFS website &quot;for informational purposes only&quot;&lt;ref&gt;{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/diagnosis/iom-2015-diagnostic-criteria.html|title=IOM 2015 Diagnostic Criteria {{!}} Diagnosis {{!}} Healthcare Providers {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) {{!}} CDC|date=2018-07-10|website=www.cdc.gov|language=en-us|access-date=2018-09-03}}&lt;/ref&gt; under the tab [https://www.cdc.gov/me-cfs/healthcare-providers/diagnosis/iom-2015-diagnostic-criteria.html IOM 2015 Diagnostic Criteria].&lt;ref&gt;{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/diagnosis/iom-2015-diagnostic-criteria.html|title=IOM 2015 Diagnostic Criteria {{!}} Diagnosis {{!}} Healthcare Providers {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) {{!}} CDC|date=2018-07-10|website=www.cdc.gov|language=en-us|access-date=2018-09-03}}&lt;/ref&gt;<br /> <br /> == SEID vs Other criteria ==<br /> The SEID criteria are the most symptom liberal of the valid ''disease'' definition criteria. Other ME/CFS disease definition criteria include [[Fukuda criteria]], [[Canadian Consensus Criteria]], and [[International Consensus Criteria]].&lt;ref&gt;{{Cite journal|last=Chu|first=Lily|last2=Norris|first2=Jane L.|last3=Valencia|first3=Ian J.|last4=Montoya|first4=Jose G.|date=2017-03-13|title=Patients diagnosed with Myalgic encephalomyelitis/chronic fatigue syndrome also fit systemic exertion intolerance disease criteria|url=http://www.tandfonline.com/doi/abs/10.1080/21641846.2017.1299079?journalCode=rftg20|journal=Fatigue: Biomedicine, Health &amp; Behavior|language=en|volume=5|issue=2|pages=114–128|doi=10.1080/21641846.2017.1299079|issn=2164-1846}}&lt;/ref&gt; The IOM report calls for the &quot;retirement&quot; of the [[Oxford criteria]].&lt;ref&gt;{{Cite web|url=http://theargusreport.com/us-nih-report-calls-uk-definition-mecfs-scrapped/|title=US NIH Report Calls for UK Definition of ME/CFS to be Scrapped|last=Swift|first=Penny|date=|website=theargusreport.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-09-03}}&lt;/ref&gt;<br /> <br /> == Clinicians guide ==<br /> The [http://iom.nationalacademies.org/~/media/Files/Report%20Files/2015/MECFS/MECFScliniciansguide.pdf Report Guide for Clinicians] explains the core symptoms, additional symptoms, diagnostic criteria and more. (Feb 10, 2015)<br /> <br /> ===Centers for Disease Control and Prevention (CDC) website===<br /> <br /> : Note: This clinicians guide has been incorporated into the CDC's ME/CFS website under the tab [https://www.cdc.gov/me-cfs/healthcare-providers/index.html Information for Healthcare Providers] under the &quot;Resources&quot; heading with a page disclaimer: &quot;The findings and conclusions in these documents are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention (CDC).&quot;&lt;ref&gt;{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/index.html|title=Information for Healthcare Providers {{!}} ME/CFS {{!}} CDC|date=2018-07-10|website=www.cdc.gov|language=en-us|access-date=2018-09-03}}&lt;/ref&gt;<br /> <br /> == The Institute of Medicine report ==<br /> <br /> '''''Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness''''' <br /> <br /> ===Read the report===<br /> *[http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2015/MECFS/MECFS_KeyFacts.pdf Key facts] (two pages)<br /> *[http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2015/MECFS/MECFS_ReportBrief.pdf Report brief] (four pages)<br /> *[http://www.nationalacademies.org/hmd/Reports/2015/ME-CFS.aspx Download full report] (282 pages)<br /> *[http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2015/MECFS/MECFS_DiagnosticAlgorithm Diagnostic Algorithm Chart]<br /> *[http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2015/MECFS/MECFS_ProposedDiagnosticCriteria Proposed Diagnostic Criteria Chart]<br /> *[http://www.nap.edu/read/19012/chapter/1 Read the full 282 page report online]<br /> **[http://www.nap.edu/read/19012/chapter/1 Front matter]<br /> **[http://www.nap.edu/read/19012/chapter/2 Summary]<br /> **[http://www.nap.edu/read/19012/chapter/3 1. Introduction]<br /> **[http://www.nap.edu/read/19012/chapter/4 2. Background]<br /> **[http://www.nap.edu/read/19012/chapter/5 3. Current Case Definitions and Diagnostic Criteria, Terminology, and Symptom Constructs and Clusters]<br /> **[http://www.nap.edu/read/19012/chapter/6 4. Review of the Evidence on Major ME/CFS Symptoms and Manifestations]<br /> **[http://www.nap.edu/read/19012/chapter/7 5. Review of the Evidence on Other ME/CFS Symptoms and Manifestations]<br /> **[http://www.nap.edu/read/19012/chapter/8 6. Pediatric ME/CFS]<br /> **[http://www.nap.edu/read/19012/chapter/9 7. Recommendations]<br /> **[http://www.nap.edu/read/19012/chapter/10 8. Dissemination Strategy]<br /> **[http://www.nap.edu/read/19012/chapter/11 Public Session Agendas]<br /> **[http://www.nap.edu/read/19012/chapter/12 GRADE Grid Template]<br /> **[http://www.nap.edu/read/19012/chapter/13 Disability in ME/CFS]<br /> **[http://www.nap.edu/read/19012/chapter/14 Questionnaires and Tools That May Be Useful for Assessing ME/CFS Symptoms]<br /> **[http://www.nap.edu/read/19012/chapter/15 Biographical Sketches of Committee Members, Consultants, and Staff]<br /> <br /> <br /> [http://iom.nationalacademies.org/Reports/2015/ME-CFS.aspx &quot;Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness&quot; Official video presentation]<br /> <br /> == Videos ==<br /> *[[Beyond the Data – Chronic Fatigue Syndrome: Advancing Research and Clinical Education]]&lt;ref&gt;{{Cite web|url=https://www.me-pedia.org/wiki/Beyond_the_Data_%E2%80%93_Chronic_Fatigue_Syndrome:_Advancing_Research_and_Clinical_Education|title=Beyond the Data – Chronic Fatigue Syndrome: Advancing Research and Clinical Education - MEpedia|website=www.me-pedia.org|language=en|access-date=2018-09-03}}&lt;/ref&gt;<br /> :[[CDC]] Posted Video - Dr. [[John Iskander]] of CDC interviews Dr. [[Anthony Komaroff]] (Feb 17, 2016)<br /> <br /> *[https://www.youtube.com/watch?v=ZW2Tcsp75a0 SMCI IOM Briefing in Washington, D.C. Full Coverage]&lt;ref&gt;{{Cite web|url=https://www.youtube.com/watch?v=ZW2Tcsp75a0|title=SMCI IOM Briefing in Washington, D.C. Full Coverage|last=|first=|date=Mar 25, 2015|website=YouTube|publisher=SolveCFS|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt;<br /> :[[Carol Head]] of [[Solve ME/CFS]], Dr. [[Ellen Wright Clayton]] and [https://en.wikipedia.org/wiki/Morgan_Fairchild Morgan Fairchild]<br /> <br /> *[https://www.youtube.com/watch?v=X4Tnt2d-5S8 New Clinical Definitions for ME/CFS - Dr. Lucinda Bateman]&lt;ref&gt;{{Cite web|url=https://www.youtube.com/watch?v=X4Tnt2d-5S8|title=&quot;New Clinical Definitions for ME/CFS&quot; Dr. Lucinda Bateman|last=Bateman|first=Lucinda|date=Mar 8, 2015|website=YouTube|publisher=Bateman Horne Center|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt; <br /> :Dr. [[Lucinda Bateman]] of [[Bateman Horne Center]] discusses. (Mar 8, 2015)<br /> <br /> ==Notable studies==<br /> * 2015, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4556426/pdf/nihms699325.pdf Chronic Fatigue Syndrome versus Systemic Exertion Intolerance Disease]&lt;ref name=&quot;Jason, Sunn, 2015&quot; /&gt;<br /> <br /> *2017, [http://www.tandfonline.com/doi/full/10.1080/21641846.2017.1362750 Article commentary - Differences of opinion on systemic exercise intolerance disease are not ‘mistakes’: a rejoinder to Jason Sunnquist, Gleason and Fox]&lt;ref name=&quot;Chu, Valencia, Montoya, 2017&quot; /&gt;<br /> *2017, [http://www.tandfonline.com/doi/abs/10.1080/21641846.2017.1362780 Article commentary - Mistaken conclusions about systemic exercise intolerance disease being comparable to research case definitions of CFS: A rebuttal to Chu et al.]&lt;ref name=&quot;Jason, Sunnquist, Gleason, Fox, 2017&quot; /&gt;<br /> *2017, [http://www.tandfonline.com/doi/abs/10.1080/21641846.2017.1299079?journalCode=rftg20&amp; Patients diagnosed with Myalgic encephalomyelitis/chronic fatigue syndrome also fit systemic exertion intolerance disease criteria]&lt;ref name=&quot;Chu, 2017&quot; /&gt;<br /> <br /> ==In popular culture==<br /> A February 2016 comic strip referred to Systemic Exertion Intolerance Disease and implied it is simply tiredness. ''See'': [[Blondie comic]]<br /> <br /> ==See also==<br /> * [[Chronic fatigue syndrome]]<br /> * [[ME/CFS]]<br /> * [[Myalgic encephalomyelitis]]<br /> <br /> *[[NIH Post-Infectious ME/CFS Study]] - [[SEID]] will be used in this study.&lt;ref&gt;{{Cite news|url=http://www.meaction.net/2016/02/09/positive-answers-to-initial-questions-re-nih-clinical-center-protocol/|title=Positive Answers to Initial Questions re NIH Clinical Center Protocol - #MEAction|last=Alexander Miller|first=Courtney|date=2016-02-09|work=#MEAction|access-date=2018-09-03|archive-url=|archive-date=|dead-url=|language=en-US}}&lt;/ref&gt;<br /> *[[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome]]<br /> *[[Severe and very severe ME]]<br /> <br /> ===Generally accepted criteria for diagnosing ME/CFS and ME ===<br /> *[[Canadian Consensus Criteria]] (CCC) - A diagnosis of moderate and severe forms of [[ME/CFS]] are accurately made using this criterion. Adults can be diagnosed at six months while pediatric cases are diagnosed at three months.<br /> <br /> *[[International Consensus Criteria]] (ICC)&lt;ref&gt;{{Cite journal|last=Carruthers|first=Bruce M.|author-link=Bruce Carruthers|last2=van de Sande|first2=Marjorie I.|author-link2=Marjorie van de Sande|last3=De Meirleir|first3=Kenny L.|author-link3=Kenny De Meirleir|last4=Klimas|first4=Nancy G.|author-link4=Nancy Klimas|last5=Broderick|first5=Gordon|author-link5=Gordon Broderick|last6=Mitchell|first6=Terry|author-link6=Terry Mitchell|last7=Staines|first7=Donald|author-link7=Donald Staines|last8=Powles|first8=A. C. Peter|author-link8=A C Peter Powles|last9=Speight|first9=Nigel|author-link9=Nigel Speight|last10=Vallings|first10=Rosamund|author-link10=Rosamund Vallings|last11=Bateman|first11=Lucinda|author-link11=Lucinda Bateman|last12=Baumgarten-Austrheim|first12=Barbara|author-link12=Barbara Baumgarten-Austrheim|last13=Bell|first13=David|author-link13=David Bell|last14=Carlo-Stella|first14=Nicoletta|author-link14=Nicoletta Carlo-Stella|last15=Chia|first15=John|author-link15=John Chia|last16=Darragh|first16=Austin|author-link16=Austin Darragh|last17=Jo|first17=Daehyun|author-link17=Daehyun Jo|last18=Lewis|first18=Donald|author-link18=Donald Lewis|last19=Light|first19=Alan|author-link19=Alan Light|last20=Marshall-Gradisnik|first20=Sonya|author-link20=Sonya Marshall-Gradisnik|last21=Mena|first21=Ismael|author-link21=Ismael Mena|last22=Mikovits|first22=Judy|author-link22=Judy Mikovits|last23=Miwa|first23=Kunihisa|author-link23=Kunihisa Miwa|last24=Murovska|first24=Modra|author-link24=Modra Murovska|last25=Pall|first25=Martin|author-link25=Martin Pall|last26=Stevens|first26=Staci|author-link26=Staci Stevens|date=2011-08-22|title=Myalgic encephalomyelitis: International Consensus Criteria|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2796.2011.02428.x|journal=Journal of Internal Medicine|language=en|volume=270|issue=4|pages=327–338|doi=10.1111/j.1365-2796.2011.02428.x|issn=0954-6820|pmc=3427890|pmid=21777306|via=}}&lt;/ref&gt; - This criterion will accurately diagnose [[myalgic encephalomyelitis]] (ME). There is no requirement that the individual have symptoms for a specified period of time for diagnosis, as opposed to [[Fukuda criteria|Fukuda]] and [[SEID]], which both require 6 months in adults.<br /> <br /> *Systemic Exertion Intolerance Disease (SEID) - ME/CFS (SEID) is accurately diagnosed when the basic criteria&lt;ref&gt;{{Cite web|url=https://www.me-pedia.org/wiki/Systemic_Exertion_Intolerance_Disease#Diagnostic_criteria|title=Systemic Exertion Intolerance Disease - MEpedia|website=www.me-pedia.org|language=en|access-date=2018-10-15}}&lt;/ref&gt; are met. The [[Institute of Medicine report]] as a whole is a comprehensive review of the medical literature available at time of publication (2015). Adults can be diagnosed at six months while pediatric cases are diagnosed at three months.<br /> <br /> ==Learn more==<br /> *2015, [https://www.newscientist.com/article/dn26945-chronic-fatigue-syndrome-gets-yet-another-name/ Chronic fatigue syndrome gets yet another name]&lt;ref&gt;{{Cite news|url=https://www.newscientist.com/article/dn26945-chronic-fatigue-syndrome-gets-yet-another-name/|title=Chronic fatigue syndrome gets yet another name|last=Coghlan|first=Andy|date=Feb 10, 2015|work=New Scientist|access-date=2018-09-03|archive-url=|archive-date=|dead-url=|language=en-US}}&lt;/ref&gt;<br /> *2015, [http://www.asianjournalofpsychiatry.com/article/S1876-2018(16)30248-9/abstract Systemic Exercise Intolerance Disease: What’s in a name?]&lt;ref&gt;{{Cite journal|last=Sen|first=Mahadev Singh|last2=Sahoo|first2=Swapnajeet|last3=Aggarwal|first3=Shivali|last4=Singh|first4=Shubh Mohan|date=2016|title=Systemic exercise intolerance disease: What’s in a name?|url=http://www.asianjournalofpsychiatry.com/article/S1876-2018(16)30248-9/abstract|journal=Asian Journal of Psychiatry|language=English|volume=22|pages=157–158|doi=10.1016/j.ajp.2016.06.003|issn=1876-2018|via=}}&lt;/ref&gt;<br /> *2018, [https://youtu.be/RC9TjgE_PlU?t=89 Diagnosis and Management of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome]&lt;ref&gt;{{Cite web|url=https://youtu.be/RC9TjgE_PlU?t=89|title=Diagnosis and Management of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome|last=Kaufman|first=David|date=Oct 16, 2018|website=YouTube|publisher=Unrest Film|archive-url=|archive-date=|dead-url=|access-date=|quote=Part of the Unrest Continuing Education module.}}&lt;/ref&gt; (Notes IOM report diagnostic criteria.)<br /> <br /> == References ==<br /> &lt;references&gt;<br /> &lt;ref name=&quot;Chu, 2017&quot;&gt;{{Citation<br /> | last1 = Chu | first1 = Lily | authorlink1 = Lily Chu<br /> | last2 = Norris | first2 = Jane | authorlink2 = Jane Norris<br /> | last3 = Valencia | first3 = Ian J. | authorlink3 = <br /> | last4 = Montoya | first4 = Jose G. | authorlink4 = Jose Montoya <br /> | title = Patients diagnosed with Myalgic encephalomyelitis/chronic fatigue syndrome also fit systemic exertion intolerance disease criteria<br /> | journal = Fatigue: Biomedicine, Health &amp; Behavior | volume = 5 | issue = | page = <br /> | date = 2017<br /> | doi = 10.1080/21641846.2017.1299079<br /> }}<br /> &lt;/ref&gt;<br /> &lt;ref name=&quot;Chu, Valencia, Montoya, 2017&quot;&gt;{{Citation<br /> | last1 = Chu | first1 = Lily | authorlink1 = Lily Chu<br /> | last2 = Valencia | first2 = Ian J. | authorlink2 = <br /> | last3 = Montoya | first3 = Jose G. | authorlink3 = Jose Montoya <br /> | title = Differences of opinion on systemic exercise intolerance disease are not ‘mistakes’: a rejoinder to Jason Sunnquist, Gleason and Fox<br /> | journal = Fatigue: Biomedicine, Health &amp; Behavior | volume = | issue = | page = <br /> | date = 2017<br /> | doi = 10.1080/21641846.2017.1362750<br /> }}<br /> &lt;/ref&gt;<br /> &lt;ref name=&quot;Jason, Sunn, 2015&quot;&gt;{{Citation<br /> | last1 = Jason | first1 = L.A. | authorlink1 = Leonard Jason<br /> | last2 = Sunnquist | first2 = M. | authorlink2 = Madison Sunnquist<br /> | last3 = Brown | first3 = A. | authorlink3 = <br /> | last4 = Newton | first4 = J.L. | authorlink4 = Julia Newton<br /> | last5 = Strand | first5 = E.B. | authorlink5 = Elin Strand<br /> | last6 = Vernon | first6 = S.D. | authorlink6 = Suzanne Vernon <br /> | title = Chronic fatigue syndrome versus systemic exertion intolerance disease<br /> | journal = Fatigue: Biomedicine, Health &amp; Behavior | volume = 3 | issue = 3 | page = 127-141<br /> | date = 2015<br /> | pmid = <br /> | doi = 10.1080/21641846.2015.1051291<br /> }}&lt;/ref&gt;<br /> &lt;ref name=&quot;Jason, Sunnquist, Gleason, Fox, 2017&quot;&gt;{{Citation<br /> | last1 = Jason | first1 = Leonard A. | authorlink1 = Leonard Jason<br /> | last2 = Sunnquist | first2 = Madison | authorlink2 = Madison Sunnquist<br /> | last3 = Gleason | first3 = Kristen | authorlink3 = Kristen Gleason<br /> | last4 = Fox | first4 = Pamela | authorlink4 = Pamela Fox<br /> | title = Mistaken conclusions about systemic exercise intolerance disease being comparable to research case definitions of CFS: A rebuttal to Chu et al.<br /> | journal = Fatigue: Biomedicine, Health &amp; Behavior | volume = | issue = | page = <br /> | date = 2017<br /> | pmid = <br /> | doi = 10.1080/21641846.2017.1362780<br /> }}<br /> &lt;/ref&gt;<br /> &lt;/references&gt;<br /> <br /> [[Category:Definitions]]<br /> [[Category:Diagnoses]]<br /> [[Category:Disease names]]</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Systemic_Exertion_Intolerance_Disease&diff=43164 2018-11-01T10:58:30Z

<p>MEcfsFMS:/* Diagnostic criteria */ x</p> <hr /> <div>'''Systemic Exertion Intolerance Disease''' (SEID) is the name and diagnostic criteria developed by the [[National Academy of Medicine]] (formerly the Institute of Medicine (IOM)) and published on February 10, 2015: ''Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness'' is also referred to as the [[Institute of Medicine report]]. <br /> <br /> SEID is accurately diagnosed when the most basic of its diagnostic criteria are met. It is also useful for a more severe presentation of the disease; symptom severity and other symptoms are outlined in the Institute of Medicine report. <br /> <br /> Adults can diagnosed at six months and pediatric cases are diagnosed at three months.<br /> [[File:Morgan Fairchild.png |300px|thumb|right|[[Morgan Fairchild]] is an [[United States|American]] actress of film and television. She was diagnosed with [[chronic fatigue syndrome]] (CFS) in 1989. On March 25, 2015, she gave a [https://www.youtube.com/watch?v=lWTF80daWtw speech] during the [[IOM]] briefing of the rollout of SEID where she says compared to others suffering with [[ME/CFS]] she has a mild case]]<br /> <br /> ==Authors==<br /> The committee on the Diagnostic Criteria for [[Myalgic Encephalomyelitis]]/[[Chronic Fatigue Syndrome]] ([[ME/CFS]]) consisted of [[Ellen Wright Clayton]], [[Margarita Alegría]], [[Lucinda Bateman]], [[Lily Chu]], [[Charles Cleeland]], [[Ronald Davis]], [[Betty Diamond]], [[Theodore Ganiats]], [[Betsy Keller]], [[Nancy Klimas]], [[A Martin Lerner]], [[Cynthia Mulrow]], [[Benjamin Natelson]], [[Peter Rowe]], and [[Michael Shelanski]].<br /> <br /> ==Development==<br /> In 2014, the [[U.S. Department of Health and Human Services]], the [[National Institutes of Health]], the [[Agency for Healthcare Research and Quality]], the [[Centers for Disease Control &amp; Prevention]], the [[Food and Drug Administration]], and the [[Social Security Administration]] asked the [[Institute of Medicine]] (IOM) to convene an expert committee to examine the evidence base for [[ME/CFS]]. In ''Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness'', the committee proposes new diagnostic criteria that will facilitate timely diagnosis and care and enhance understanding among health care providers and the public. These criteria, based on expert analysis and the most up-to-date scientific literature, are streamlined for practical use in the clinical setting. The IOM committee also recommends that the name of the disease be changed—from ME/CFS to systemic exertion intolerance disease (SEID)—to more accurately capture the central characteristics of the illness.&lt;ref&gt;{{Cite web|url=http://iom.nationalacademies.org/~/media/Files/Report%20Files/2015/MECFS/MECFScliniciansguide.pdf|title=Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome - Redefining an Illness|last=|first=|date=|website=nationalacademies.org|page=5|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt;<br /> <br /> '''The proposed name and acronym SEID is meant to hone in on key aspects of''' [[ME/CFS]]'''.''' '''''S'''ystemic'' would give credence to the disease being body wide. '''''E'''xertion '''I'''ntolerance'' would key doctors into understanding that the patient CANNOT tolerate exertion of any kind; physical, cognitive or emotional.&lt;ref&gt;{{Cite news|url=http://www.shoutoutaboutme.com/about-mecfs/seid-diagnostic-criteria-proposed/|title=NIH/IOM 2015 Definition (SEID)|last=Logan|first=Russell|date=Jan 3, 2015|work=Shoutout about ME|access-date=2018-09-03|archive-url=|archive-date=|dead-url=|language=en-us}}&lt;/ref&gt; (Intolerance is well understood in the medical field in that there is a medical problem. Other diseases, such as gluten intolerance, is a serious medical condition; gluten CAN NOT be consumed.) '''''D'''isease'' gave the self-explanatory label of being an organic biological disease.<br /> <br /> ==Diagnostic criteria==<br /> [[File:Rosa SEID.JPG|400px|thumb|right|Rosa age 25 in 1986, when she believes she would have met the SEID criteria developed in 2015. She became worse over the years and in 2003 was diagnosed and disabled with CFS. Rosa now meets the [[CCC]] criteria (with [[PEM]] &quot;option&quot;). ME/CFS onset was [[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome|age 17]] and [[fibromyalgia]] since puberty]]<br /> '''Diagnosis requires that the patient have the following three symptoms:'''<br /> <br /> 1. A substantial reduction or impairment in the ability to engage in pre-illness levels of occupational, educational, social, or personal activities, that persists for more than 6 months and is accompanied <br /> by [[fatigue]], which is often profound, is of new or definite onset (not lifelong), is not the result of ongoing excessive exertion, and is not substantially alleviated by rest, and<br /> <br /> 2. [[Post-exertional malaise]],* and<br /> <br /> 3. [[Unrefreshing sleep]]*<br /> <br /> '''At least one of the two following manifestations is also required:'''<br /> <br /> 1. [[Cognitive impairment]]* or<br /> <br /> 2. [[Orthostatic intolerance]]<br /> <br /> : * Frequency and severity of symptoms should be assessed. The diagnosis of ME/CFS (SEID) should be questioned if patients do not have these symptoms at least half of the time with moderate, substantial, or severe intensity.&lt;ref&gt;{{Cite web|url=http://iom.nationalacademies.org/~/media/Files/Report%20Files/2015/MECFS/MECFScliniciansguide.pdf|title=Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome - Redefining an Illness|last=|first=|date=2015|website=nationacademies.org|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt;<br /> <br /> ===Centers for Disease Control and Prevention (CDC) website===<br /> <br /> :Note: The name Systemic Exertion Intolerance Disease (SEID) has not been adopted but the new diagnostic criteria have been incorporated into the [[Centers for Disease Control and Prevention]]'s ME/CFS website &quot;for informational purposes only&quot;&lt;ref&gt;{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/diagnosis/iom-2015-diagnostic-criteria.html|title=IOM 2015 Diagnostic Criteria {{!}} Diagnosis {{!}} Healthcare Providers {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) {{!}} CDC|date=2018-07-10|website=www.cdc.gov|language=en-us|access-date=2018-09-03}}&lt;/ref&gt; under the tab [https://www.cdc.gov/me-cfs/healthcare-providers/diagnosis/iom-2015-diagnostic-criteria.html IOM 2015 Diagnostic Criteria].&lt;ref&gt;{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/diagnosis/iom-2015-diagnostic-criteria.html|title=IOM 2015 Diagnostic Criteria {{!}} Diagnosis {{!}} Healthcare Providers {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) {{!}} CDC|date=2018-07-10|website=www.cdc.gov|language=en-us|access-date=2018-09-03}}&lt;/ref&gt;<br /> <br /> == SEID vs Other criteria ==<br /> The SEID criteria are the most symptom liberal of the valid ''disease'' definition criteria. Other ME/CFS disease definition criteria include [[Fukuda criteria]], [[Canadian Consensus Criteria]], and [[International Consensus Criteria]].&lt;ref&gt;{{Cite journal|last=Chu|first=Lily|last2=Norris|first2=Jane L.|last3=Valencia|first3=Ian J.|last4=Montoya|first4=Jose G.|date=2017-03-13|title=Patients diagnosed with Myalgic encephalomyelitis/chronic fatigue syndrome also fit systemic exertion intolerance disease criteria|url=http://www.tandfonline.com/doi/abs/10.1080/21641846.2017.1299079?journalCode=rftg20|journal=Fatigue: Biomedicine, Health &amp; Behavior|language=en|volume=5|issue=2|pages=114–128|doi=10.1080/21641846.2017.1299079|issn=2164-1846}}&lt;/ref&gt; The IOM report calls for the &quot;retirement&quot; of the [[Oxford criteria]].&lt;ref&gt;{{Cite web|url=http://theargusreport.com/us-nih-report-calls-uk-definition-mecfs-scrapped/|title=US NIH Report Calls for UK Definition of ME/CFS to be Scrapped|last=Swift|first=Penny|date=|website=theargusreport.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-09-03}}&lt;/ref&gt;<br /> <br /> == Clinicians guide ==<br /> The [http://iom.nationalacademies.org/~/media/Files/Report%20Files/2015/MECFS/MECFScliniciansguide.pdf Report Guide for Clinicians] explains the core symptoms, additional symptoms, diagnostic criteria and more. (Feb 10, 2015)<br /> <br /> ===Centers for Disease Control and Prevention (CDC) website===<br /> <br /> : Note: This clinicians guide has been incorporated into the CDC's ME/CFS website under the tab [https://www.cdc.gov/me-cfs/healthcare-providers/index.html Information for Healthcare Providers] under the &quot;Resources&quot; heading with a page disclaimer: &quot;The findings and conclusions in these documents are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention (CDC).&quot;&lt;ref&gt;{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/index.html|title=Information for Healthcare Providers {{!}} ME/CFS {{!}} CDC|date=2018-07-10|website=www.cdc.gov|language=en-us|access-date=2018-09-03}}&lt;/ref&gt;<br /> <br /> == The Institute of Medicine report ==<br /> <br /> '''''Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness''''' <br /> <br /> ===Read the report===<br /> *[http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2015/MECFS/MECFS_KeyFacts.pdf Key facts] (two pages)<br /> *[http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2015/MECFS/MECFS_ReportBrief.pdf Report brief] (four pages)<br /> *[http://www.nationalacademies.org/hmd/Reports/2015/ME-CFS.aspx Download full report] (282 pages)<br /> *[http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2015/MECFS/MECFS_DiagnosticAlgorithm Diagnostic Algorithm Chart]<br /> *[http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2015/MECFS/MECFS_ProposedDiagnosticCriteria Proposed Diagnostic Criteria Chart]<br /> *[http://www.nap.edu/read/19012/chapter/1 Read the full 282 page report online]<br /> **[http://www.nap.edu/read/19012/chapter/1 Front matter]<br /> **[http://www.nap.edu/read/19012/chapter/2 Summary]<br /> **[http://www.nap.edu/read/19012/chapter/3 1. Introduction]<br /> **[http://www.nap.edu/read/19012/chapter/4 2. Background]<br /> **[http://www.nap.edu/read/19012/chapter/5 3. Current Case Definitions and Diagnostic Criteria, Terminology, and Symptom Constructs and Clusters]<br /> **[http://www.nap.edu/read/19012/chapter/6 4. Review of the Evidence on Major ME/CFS Symptoms and Manifestations]<br /> **[http://www.nap.edu/read/19012/chapter/7 5. Review of the Evidence on Other ME/CFS Symptoms and Manifestations]<br /> **[http://www.nap.edu/read/19012/chapter/8 6. Pediatric ME/CFS]<br /> **[http://www.nap.edu/read/19012/chapter/9 7. Recommendations]<br /> **[http://www.nap.edu/read/19012/chapter/10 8. Dissemination Strategy]<br /> **[http://www.nap.edu/read/19012/chapter/11 Public Session Agendas]<br /> **[http://www.nap.edu/read/19012/chapter/12 GRADE Grid Template]<br /> **[http://www.nap.edu/read/19012/chapter/13 Disability in ME/CFS]<br /> **[http://www.nap.edu/read/19012/chapter/14 Questionnaires and Tools That May Be Useful for Assessing ME/CFS Symptoms]<br /> **[http://www.nap.edu/read/19012/chapter/15 Biographical Sketches of Committee Members, Consultants, and Staff]<br /> <br /> <br /> [http://iom.nationalacademies.org/Reports/2015/ME-CFS.aspx &quot;Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness&quot; Official video presentation]<br /> <br /> == Videos ==<br /> *[[Beyond the Data – Chronic Fatigue Syndrome: Advancing Research and Clinical Education]]&lt;ref&gt;{{Cite web|url=https://www.me-pedia.org/wiki/Beyond_the_Data_%E2%80%93_Chronic_Fatigue_Syndrome:_Advancing_Research_and_Clinical_Education|title=Beyond the Data – Chronic Fatigue Syndrome: Advancing Research and Clinical Education - MEpedia|website=www.me-pedia.org|language=en|access-date=2018-09-03}}&lt;/ref&gt;<br /> :[[CDC]] Posted Video - Dr. [[John Iskander]] of CDC interviews Dr. [[Anthony Komaroff]] (Feb 17, 2016)<br /> <br /> *[https://www.youtube.com/watch?v=ZW2Tcsp75a0 SMCI IOM Briefing in Washington, D.C. Full Coverage]&lt;ref&gt;{{Cite web|url=https://www.youtube.com/watch?v=ZW2Tcsp75a0|title=SMCI IOM Briefing in Washington, D.C. Full Coverage|last=|first=|date=Mar 25, 2015|website=YouTube|publisher=SolveCFS|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt;<br /> :[[Carol Head]] of [[Solve ME/CFS]], Dr. [[Ellen Wright Clayton]] and [https://en.wikipedia.org/wiki/Morgan_Fairchild Morgan Fairchild]<br /> <br /> *[https://www.youtube.com/watch?v=X4Tnt2d-5S8 New Clinical Definitions for ME/CFS - Dr. Lucinda Bateman]&lt;ref&gt;{{Cite web|url=https://www.youtube.com/watch?v=X4Tnt2d-5S8|title=&quot;New Clinical Definitions for ME/CFS&quot; Dr. Lucinda Bateman|last=Bateman|first=Lucinda|date=Mar 8, 2015|website=YouTube|publisher=Bateman Horne Center|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt; <br /> :Dr. [[Lucinda Bateman]] of [[Bateman Horne Center]] discusses. (Mar 8, 2015)<br /> <br /> ==Notable studies==<br /> * 2015, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4556426/pdf/nihms699325.pdf Chronic Fatigue Syndrome versus Systemic Exertion Intolerance Disease]&lt;ref name=&quot;Jason, Sunn, 2015&quot; /&gt;<br /> <br /> *2017, [http://www.tandfonline.com/doi/full/10.1080/21641846.2017.1362750 Article commentary - Differences of opinion on systemic exercise intolerance disease are not ‘mistakes’: a rejoinder to Jason Sunnquist, Gleason and Fox]&lt;ref name=&quot;Chu, Valencia, Montoya, 2017&quot; /&gt;<br /> *2017, [http://www.tandfonline.com/doi/abs/10.1080/21641846.2017.1362780 Article commentary - Mistaken conclusions about systemic exercise intolerance disease being comparable to research case definitions of CFS: A rebuttal to Chu et al.]&lt;ref name=&quot;Jason, Sunnquist, Gleason, Fox, 2017&quot; /&gt;<br /> *2017, [http://www.tandfonline.com/doi/abs/10.1080/21641846.2017.1299079?journalCode=rftg20&amp; Patients diagnosed with Myalgic encephalomyelitis/chronic fatigue syndrome also fit systemic exertion intolerance disease criteria]&lt;ref name=&quot;Chu, 2017&quot; /&gt;<br /> <br /> ==In popular culture==<br /> A February 2016 comic strip referred to Systemic Exertion Intolerance Disease and implied it is simply tiredness. ''See'': [[Blondie comic]]<br /> <br /> ==See also==<br /> * [[Chronic fatigue syndrome]]<br /> * [[ME/CFS]]<br /> * [[Myalgic encephalomyelitis]]<br /> <br /> *[[NIH Post-Infectious ME/CFS Study]] - [[SEID]] will be used in this study.&lt;ref&gt;{{Cite news|url=http://www.meaction.net/2016/02/09/positive-answers-to-initial-questions-re-nih-clinical-center-protocol/|title=Positive Answers to Initial Questions re NIH Clinical Center Protocol - #MEAction|last=Alexander Miller|first=Courtney|date=2016-02-09|work=#MEAction|access-date=2018-09-03|archive-url=|archive-date=|dead-url=|language=en-US}}&lt;/ref&gt;<br /> *[[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome]]<br /> *[[Severe and very severe ME]]<br /> <br /> ===Generally accepted criteria for diagnosing ME/CFS and ME ===<br /> *[[Canadian Consensus Criteria]] (CCC) - A diagnosis of moderate and severe forms of [[ME/CFS]] are accurately made using this criterion. Adults can be diagnosed at six months while pediatric cases are diagnosed at three months.<br /> <br /> *[[International Consensus Criteria]] (ICC)&lt;ref&gt;{{Cite journal|last=Carruthers|first=Bruce M.|author-link=Bruce Carruthers|last2=van de Sande|first2=Marjorie I.|author-link2=Marjorie van de Sande|last3=De Meirleir|first3=Kenny L.|author-link3=Kenny De Meirleir|last4=Klimas|first4=Nancy G.|author-link4=Nancy Klimas|last5=Broderick|first5=Gordon|author-link5=Gordon Broderick|last6=Mitchell|first6=Terry|author-link6=Terry Mitchell|last7=Staines|first7=Donald|author-link7=Donald Staines|last8=Powles|first8=A. C. Peter|author-link8=A C Peter Powles|last9=Speight|first9=Nigel|author-link9=Nigel Speight|last10=Vallings|first10=Rosamund|author-link10=Rosamund Vallings|last11=Bateman|first11=Lucinda|author-link11=Lucinda Bateman|last12=Baumgarten-Austrheim|first12=Barbara|author-link12=Barbara Baumgarten-Austrheim|last13=Bell|first13=David|author-link13=David Bell|last14=Carlo-Stella|first14=Nicoletta|author-link14=Nicoletta Carlo-Stella|last15=Chia|first15=John|author-link15=John Chia|last16=Darragh|first16=Austin|author-link16=Austin Darragh|last17=Jo|first17=Daehyun|author-link17=Daehyun Jo|last18=Lewis|first18=Donald|author-link18=Donald Lewis|last19=Light|first19=Alan|author-link19=Alan Light|last20=Marshall-Gradisnik|first20=Sonya|author-link20=Sonya Marshall-Gradisnik|last21=Mena|first21=Ismael|author-link21=Ismael Mena|last22=Mikovits|first22=Judy|author-link22=Judy Mikovits|last23=Miwa|first23=Kunihisa|author-link23=Kunihisa Miwa|last24=Murovska|first24=Modra|author-link24=Modra Murovska|last25=Pall|first25=Martin|author-link25=Martin Pall|last26=Stevens|first26=Staci|author-link26=Staci Stevens|date=2011-08-22|title=Myalgic encephalomyelitis: International Consensus Criteria|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2796.2011.02428.x|journal=Journal of Internal Medicine|language=en|volume=270|issue=4|pages=327–338|doi=10.1111/j.1365-2796.2011.02428.x|issn=0954-6820|pmc=3427890|pmid=21777306|via=}}&lt;/ref&gt; - This criterion will accurately diagnose [[myalgic encephalomyelitis]] (ME). There is no requirement that the individual have symptoms for a specified period of time for diagnosis, as opposed to [[Fukuda criteria|Fukuda]] and [[SEID]], which both require 6 months in adults.<br /> <br /> *Systemic Exertion Intolerance Disease (SEID) - ME/CFS (SEID) is accurately diagnosed when the basic criteria&lt;ref&gt;{{Cite web|url=https://www.me-pedia.org/wiki/Systemic_Exertion_Intolerance_Disease#Diagnostic_criteria|title=Systemic Exertion Intolerance Disease - MEpedia|website=www.me-pedia.org|language=en|access-date=2018-10-15}}&lt;/ref&gt; are met. The [[Institute of Medicine report]] as a whole is a comprehensive review of the medical literature available at time of publication (2015). Adults can be diagnosed at six months while pediatric cases are diagnosed at three months.<br /> <br /> ==Learn more==<br /> *2015, [https://www.newscientist.com/article/dn26945-chronic-fatigue-syndrome-gets-yet-another-name/ Chronic fatigue syndrome gets yet another name]&lt;ref&gt;{{Cite news|url=https://www.newscientist.com/article/dn26945-chronic-fatigue-syndrome-gets-yet-another-name/|title=Chronic fatigue syndrome gets yet another name|last=Coghlan|first=Andy|date=Feb 10, 2015|work=New Scientist|access-date=2018-09-03|archive-url=|archive-date=|dead-url=|language=en-US}}&lt;/ref&gt;<br /> *2015, [http://www.asianjournalofpsychiatry.com/article/S1876-2018(16)30248-9/abstract Systemic Exercise Intolerance Disease: What’s in a name?]&lt;ref&gt;{{Cite journal|last=Sen|first=Mahadev Singh|last2=Sahoo|first2=Swapnajeet|last3=Aggarwal|first3=Shivali|last4=Singh|first4=Shubh Mohan|date=2016|title=Systemic exercise intolerance disease: What’s in a name?|url=http://www.asianjournalofpsychiatry.com/article/S1876-2018(16)30248-9/abstract|journal=Asian Journal of Psychiatry|language=English|volume=22|pages=157–158|doi=10.1016/j.ajp.2016.06.003|issn=1876-2018|via=}}&lt;/ref&gt;<br /> *2018, [https://youtu.be/RC9TjgE_PlU?t=89 Diagnosis and Management of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome]&lt;ref&gt;{{Cite web|url=https://youtu.be/RC9TjgE_PlU?t=89|title=Diagnosis and Management of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome|last=Kaufman|first=David|date=Oct 16, 2018|website=YouTube|publisher=Unrest Film|archive-url=|archive-date=|dead-url=|access-date=|quote=Part of the Unrest Continuing Education module.}}&lt;/ref&gt; (Notes IOM report diagnostic criteria.)<br /> <br /> == References ==<br /> &lt;references&gt;<br /> &lt;ref name=&quot;Chu, 2017&quot;&gt;{{Citation<br /> | last1 = Chu | first1 = Lily | authorlink1 = Lily Chu<br /> | last2 = Norris | first2 = Jane | authorlink2 = Jane Norris<br /> | last3 = Valencia | first3 = Ian J. | authorlink3 = <br /> | last4 = Montoya | first4 = Jose G. | authorlink4 = Jose Montoya <br /> | title = Patients diagnosed with Myalgic encephalomyelitis/chronic fatigue syndrome also fit systemic exertion intolerance disease criteria<br /> | journal = Fatigue: Biomedicine, Health &amp; Behavior | volume = 5 | issue = | page = <br /> | date = 2017<br /> | doi = 10.1080/21641846.2017.1299079<br /> }}<br /> &lt;/ref&gt;<br /> &lt;ref name=&quot;Chu, Valencia, Montoya, 2017&quot;&gt;{{Citation<br /> | last1 = Chu | first1 = Lily | authorlink1 = Lily Chu<br /> | last2 = Valencia | first2 = Ian J. | authorlink2 = <br /> | last3 = Montoya | first3 = Jose G. | authorlink3 = Jose Montoya <br /> | title = Differences of opinion on systemic exercise intolerance disease are not ‘mistakes’: a rejoinder to Jason Sunnquist, Gleason and Fox<br /> | journal = Fatigue: Biomedicine, Health &amp; Behavior | volume = | issue = | page = <br /> | date = 2017<br /> | doi = 10.1080/21641846.2017.1362750<br /> }}<br /> &lt;/ref&gt;<br /> &lt;ref name=&quot;Jason, Sunn, 2015&quot;&gt;{{Citation<br /> | last1 = Jason | first1 = L.A. | authorlink1 = Leonard Jason<br /> | last2 = Sunnquist | first2 = M. | authorlink2 = Madison Sunnquist<br /> | last3 = Brown | first3 = A. | authorlink3 = <br /> | last4 = Newton | first4 = J.L. | authorlink4 = Julia Newton<br /> | last5 = Strand | first5 = E.B. | authorlink5 = Elin Strand<br /> | last6 = Vernon | first6 = S.D. | authorlink6 = Suzanne Vernon <br /> | title = Chronic fatigue syndrome versus systemic exertion intolerance disease<br /> | journal = Fatigue: Biomedicine, Health &amp; Behavior | volume = 3 | issue = 3 | page = 127-141<br /> | date = 2015<br /> | pmid = <br /> | doi = 10.1080/21641846.2015.1051291<br /> }}&lt;/ref&gt;<br /> &lt;ref name=&quot;Jason, Sunnquist, Gleason, Fox, 2017&quot;&gt;{{Citation<br /> | last1 = Jason | first1 = Leonard A. | authorlink1 = Leonard Jason<br /> | last2 = Sunnquist | first2 = Madison | authorlink2 = Madison Sunnquist<br /> | last3 = Gleason | first3 = Kristen | authorlink3 = Kristen Gleason<br /> | last4 = Fox | first4 = Pamela | authorlink4 = Pamela Fox<br /> | title = Mistaken conclusions about systemic exercise intolerance disease being comparable to research case definitions of CFS: A rebuttal to Chu et al.<br /> | journal = Fatigue: Biomedicine, Health &amp; Behavior | volume = | issue = | page = <br /> | date = 2017<br /> | pmid = <br /> | doi = 10.1080/21641846.2017.1362780<br /> }}<br /> &lt;/ref&gt;<br /> &lt;/references&gt;<br /> <br /> [[Category:Definitions]]<br /> [[Category:Diagnoses]]<br /> [[Category:Disease names]]</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=MEpedia:Manual_of_style&diff=43080 2018-10-31T18:51:48Z

<p>MEcfsFMS:x</p> <hr /> <div>Writing articles on MEpedia requires familiarizing yourself with some of the basic formatting code used by MediaWiki, the software that powers both Wikipedia and MEpedia.<br /> <br /> A few key conventions:<br /> <br /> *'''Page titles and section headings''': Always capitalise the first letter of page titles and links, subsequent words must start with a lower case letter (eg &quot;Post-exertional malaise&quot;, &quot;Muscle fatigability&quot;) unless they are proper names (eg &quot;Royal Free Hospital&quot;, &quot;Nancy Klimas&quot;, &quot;United States&quot;) or acronyms (eg &quot;HHV-6&quot;, &quot;IL-7&quot;).<br /> <br /> *'''Use of plurals in titles''': Normal page articles should normally use the singular while category page articles should use the plural form.<br /> <br /> *'''Chronological order''': put oldest first, e.g., for Notable studies 2010 would go before 2018.<br /> <br /> *'''#MEAction colors''': [[File:style-guide-colors.jpg|thumb|float=&quot;right&quot;|width=&quot;450px&quot;|link=&quot;http://www.meaction.net/wp-content/uploads/2015/12/style-guide-colors.jpg&quot;]] red &lt;span style=&quot;color:{{MEActionRed}}&quot;&gt;#E7453A&lt;/span&gt;, blue &lt;span style=&quot;color:{{MEActionBlue}}&quot;&gt;#0BA7CD&lt;/span&gt;, light gray &lt;span style=&quot;color:{{MEActionGray}}&quot;&gt;#3B3E3F 50% fill - use rgba(59,62,63,0.5)&lt;/span&gt;, dark gray &lt;span style=&quot;color:{{MEActionDGray}}&quot;&gt;#3B3E3F&lt;/span&gt;, white #FFFFF, use templates for colors, e.g.:<br /> &lt;pre&gt;&lt;span style=&quot;color:{{MEActionRed}}&quot;&gt;This is red.&lt;/span&gt;<br /> &lt;span style=&quot;color:{{MEActionBlue}}&quot;&gt;This is blue.&lt;/span&gt;<br /> &lt;span style=&quot;color:{{MEActionGray}}&quot;&gt;This is (light) gray.&lt;/span&gt;<br /> &lt;span style=&quot;color:{{MEActionDGray}}&quot;&gt;This is dark gray.&lt;/span&gt;&lt;/pre&gt;<br /> <br /> ===Dates===<br /> &lt;span id=&quot;DATEUNIFY&quot;&gt;Dates should be in a consistent form and in US format: Jun 26, 2018; Jun 2018; or when the month is unknown, 2018. In citations, use Jun 26, 2018; Jun 2018; or when the month is unknown 2018.&lt;/span&gt;<br /> <br /> <br /> <br /> ==Related Articles==<br /> * [https://www.meaction.net/tools/branding/style-guide/ #MEAction branding]<br /> * [[mediawikiwiki:Help:Formatting|Formatting]] (e.g, bold, italics, bullets)<br /> * [[mediawikiwiki:Help:Links|Creating internal, external and transwiki links]]<br /> * Citations (guidelines to come...)<br /> * [[wikipedia:Wikipedia:Manual of Style|Wikipedia Manual of Style]]<br /> * [[wikipedia:Wikipedia:Stand-alone_lists#Chronological_ordering|Wikipedia: Chronological Order]]<br /> <br /> [[Category:MEpedia guidelines]]</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=MEpedia:Manual_of_style&diff=43076 2018-10-31T18:47:15Z

<p>MEcfsFMS:/* Dates */ US date format</p> <hr /> <div>Writing articles on MEpedia requires familiarizing yourself with some of the basic formatting code used by MediaWiki, the software that powers both Wikipedia and MEpedia.<br /> <br /> A few key conventions:<br /> <br /> *'''Page titles and section headings''': Always capitalise the first letter of page titles and links, subsequent words must start with a lower case letter (eg &quot;Post-exertional malaise&quot;, &quot;Muscle fatigability&quot;) unless they are proper names (eg &quot;Royal Free Hospital&quot;, &quot;Nancy Klimas&quot;, &quot;United States&quot;) or acronyms (eg &quot;HHV-6&quot;, &quot;IL-7&quot;).<br /> <br /> *'''Use of plurals in titles''': Normal page articles should normally use the singular while category page articles should use the plural form.<br /> <br /> *'''Chronological order''': put oldest first, e.g., for Notable studies 2010 would go before 2018.<br /> <br /> *'''#MEAction colors''': [[File:style-guide-colors.jpg|thumb|float=&quot;right&quot;|width=&quot;450px&quot;|link=&quot;http://www.meaction.net/wp-content/uploads/2015/12/style-guide-colors.jpg&quot;]] red &lt;span style=&quot;color:{{MEActionRed}}&quot;&gt;#E7453A&lt;/span&gt;, blue &lt;span style=&quot;color:{{MEActionBlue}}&quot;&gt;#0BA7CD&lt;/span&gt;, light gray &lt;span style=&quot;color:{{MEActionGray}}&quot;&gt;#3B3E3F 50% fill - use rgba(59,62,63,0.5)&lt;/span&gt;, dark gray &lt;span style=&quot;color:{{MEActionDGray}}&quot;&gt;#3B3E3F&lt;/span&gt;, white #FFFFF, use templates for colors, e.g.:<br /> &lt;pre&gt;&lt;span style=&quot;color:{{MEActionRed}}&quot;&gt;This is red.&lt;/span&gt;<br /> &lt;span style=&quot;color:{{MEActionBlue}}&quot;&gt;This is blue.&lt;/span&gt;<br /> &lt;span style=&quot;color:{{MEActionGray}}&quot;&gt;This is (light) gray.&lt;/span&gt;<br /> &lt;span style=&quot;color:{{MEActionDGray}}&quot;&gt;This is dark gray.&lt;/span&gt;&lt;/pre&gt;<br /> <br /> ===Dates===<br /> &lt;span id=&quot;DATEUNIFY&quot;&gt;Dates should be in a consistent form and in US format: Jun 26, 2018; Jun 2018; or when the month is unknown, 2018.&lt;/span&gt;<br /> <br /> In citations, use Jun 26, 2018; Jun 2018; or when the month is unknown 2018.<br /> <br /> ==Related Articles==<br /> * [https://www.meaction.net/tools/branding/style-guide/ #MEAction branding]<br /> * [[mediawikiwiki:Help:Formatting|Formatting]] (e.g, bold, italics, bullets)<br /> * [[mediawikiwiki:Help:Links|Creating internal, external and transwiki links]]<br /> * Citations (guidelines to come...)<br /> * [[wikipedia:Wikipedia:Manual of Style|Wikipedia Manual of Style]]<br /> * [[wikipedia:Wikipedia:Stand-alone_lists#Chronological_ordering|Wikipedia: Chronological Order]]<br /> <br /> [[Category:MEpedia guidelines]]</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=User_talk:Notjusttired&diff=43074 2018-10-31T18:43:26Z

<p>MEcfsFMS:/* MOS - Dates */</p> <hr /> <div><br /> == Priorities ==<br /> * Image copyrights to organize <br /> * Check copyrights on ICC and other files<br /> * Better symptom photos e.g. malaise, levels of fatigue and disability, symptoms <br /> * Infographics template - XMP CC info, large size, site name only in corner (font as wiki?)<br /> * Infographic &amp; poster creation <br /> * Dark / large skin option? As per migraine websites<br /> <br /> == Brain fog tasks ==<br /> * [[Articles that need an image or photo]]<br /> * [[Category:Articles with unsourced statements]]<br /> * [[Add source and copyright to existing images]]<br /> <br /> == Tips ==<br /> * [[Science Guidelines]]<br /> * [[Using the source_code editor]]<br /> * [[Power user/editor tips]]<br /> <br /> ==Welcome to MEpedia!==<br /> * [[How_to_contribute|How to contribute]]<br /> * If you need ideas of improvements to make to MEpedia, See [[MEpedia_suggestions|suggestions]]<br /> * [[Contents|MEpedia Contents]]<br /> <br /> * To create new page, use one an outline: [MEpedia_article_outlines]<br /> <br /> To see your contributions history, click Contributions in the top-right corner. To see recent contributions by others, click Recent Changes on the left. Not ready to edit pages, but want to suggest a change? On the page, just click Discussion, and write your suggestion there for others to see.|realName=Anonymous|name=Notjusttired}}<br /> <br /> == Random code==<br /> {{bar box<br /> |title=Chronic Fatigue Syndrome: Common Symptoms<br /> |titlebar=#DDD<br /> |left1='''Symptom'''<br /> |right2=%<br /> |width=400px<br /> |bars=<br /> {{bar pixel|Fatigue: persistent or relapsing|#0CBCBC|100}}<br /> {{bar pixel|Symptoms last over 6 months|#0CBCBC|100}}<br /> {{bar pixel|Significant reduction in activities|#0CBCBC|100}}<br /> {{bar pixel|Post-exertional malaise|#0CBCBC|96}}<br /> {{bar pixel|Memory &amp;amp; concentration probs|#0CBCBC|98}}<br /> {{bar pixel|Unrefreshing sleep|#0CBCBC|99}}<br /> {{bar pixel|Headaches - new or different|#0CBCBC|100}}<br /> {{bar pixel|Muscle pain (myalgia)|#0CBCBC|96}}<br /> {{bar pixel|Sore throat|#0CBCBC|81}}<br /> {{bar pixel|Joint pain (arthalgia)|#0CBCBC|86}}<br /> {{bar pixel|Lymph node pain|#0CBCBC|81}}<br /> |caption=Source: Jason et al.<br /> }}‎<br /> <br /> <br /> {{Bar chart<br /> | title = &lt;div style=&quot;font-size:1.4em; margin-bottom: 0.4em;&quot;&gt;Common Symptoms in Chronic Fatigue Syndrome&lt;/div&gt;<br /> | bar_width = 15<br /> | width = 30<br /> | width_units = em<br /> | label_type = Symptom<br /> | label1 = Fatigue - persist or relapsing*<br /> | label2 = Significant reduction in activities*<br /> | label3 = Symptoms last over 6 months*<br /> | label4 = Post-exertional malaise<br /> | label5 = Memory &amp;amp; concentration probs<br /> | label6 = Unrefreshing sleep<br /> | label7 = Headaches - new or different<br /> | label8 = Muscle pain (myalgia)<br /> | label9 = Sore throat<br /> | color = #0CBCBC<br /> | data_type = Mild to Severe&lt;br&gt; Symptom %<br /> | data_max = 101<br /> | data1 = 100<br /> | data2 = 100<br /> | data3 = 100<br /> | data4 = 96<br /> | data5 = 98<br /> | data6 = 99<br /> | data7 = 90<br /> | data8 = 96<br /> | data9 = 81<br /> | col2_data_type = Moderate to Severe&lt;br&gt; Symptom %<br /> | col2_data_max = 101<br /> | col2_data1 = 95<br /> | col2_data2 = 100<br /> | col2_data3 = 100<br /> | col2_data4 = 86<br /> | col2_data5 = 80<br /> | col2_data6 = 92<br /> | col2_data7 = 50<br /> | col2_data8 = 73<br /> | col2_data9 = 31<br /> |caption= '''Source: Jason et al.'''<br /> }}<br /> <br /> <br /> ===Messages ====<br /> Notjustired: [[Severe and very severe ME]] Chronological order goes from earliest to latest. Citations are not placed under the study and instead, they are cited. If details like pages are necessary, they can be entered into the citation. --[[User:MEcfsFMS|MEcfsFMS]] ([[User talk:MEcfsFMS|talk]]) 09:51, 20 October 2018 (EDT)<br /> <br /> Hi. Is that somewhere in the editorial standards? I don't remember reading it. I think it's important to add doi to citations of they aren't already in there. I will look at adding author links to the citations too. I created a talk page for the Severe ME image to discuss ideas.<br /> [[User:Notjusttired|notjusttired]] ([[User talk:Notjusttired|talk]]) 10:15, 20 October 2018 (EDT)<br /> <br /> :I put doi in and the PMID? But PMC causes an error and I don't think they have figured out why yet. Authors links don't get created and I thought they were in the &quot;Reference&quot; area.--[[User:MEcfsFMS|MEcfsFMS]] ([[User talk:MEcfsFMS|talk]]) 10:39, 20 October 2018 (EDT)<br /> <br /> :I see, if the citation automatically creates the citation, authors internal links are created. If they have to be manually input then it does not seem to create them.<br /> <br /> :That makes sense. I thought people had been spending ages manually adding them or copying and pasting the code for the most common ones. I normally automatically generate a citation, if it doesn't work I use another link or the doi, then replace the finished link with a full text link if necessary. Links from investinme and researchgate normally don't generate automatically so I use a PubMed link and overwrite the link only after the citation is generated.<br /> Could you update the [[Manual of style]] with anything else that isn't in there?<br /> I'll go back sort the citations I changed. [[User:Notjusttired|notjusttired]] ([[User talk:Notjusttired|talk]]) 10:53, 20 October 2018 (EDT)<br /> <br /> == MOS - Dates ==<br /> <br /> Hi Notjusttired:<br /> <br /> Somewhere at some point early on, I remember the date format was to be US, Jun 10, 2016, and not 10 Jun 2016. I can't remember where or when I read this but a few of us started changing dates in UK format and going forward we used US format. I think Jen had posted about it but I'm not sure. Also, we were to change any UK spellings to the US spelling unless it was a quote.--[[User:MEcfsFMS|MEcfsFMS]] ([[User talk:MEcfsFMS|talk]]) 14:26, 31 October 2018 (EDT)<br /> <br /> ty for letting me know, can you fix what I wrote on [[MOS]] - does the same apply to date in citations? Sometimes they cause an error so I presume I put them in as Jun, 28 2018 now?<br /> <br /> :Yes, that is how I write in the citations, but move the comma so it is Jun 28, 2018 or Jun 2018. I will change MOS.--[[User:MEcfsFMS|MEcfsFMS]] ([[User talk:MEcfsFMS|talk]]) 14:43, 31 October 2018 (EDT)</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=User_talk:Notjusttired&diff=43073 2018-10-31T18:43:05Z

<p>MEcfsFMS:/* MOS - Dates */</p> <hr /> <div><br /> == Priorities ==<br /> * Image copyrights to organize <br /> * Check copyrights on ICC and other files<br /> * Better symptom photos e.g. malaise, levels of fatigue and disability, symptoms <br /> * Infographics template - XMP CC info, large size, site name only in corner (font as wiki?)<br /> * Infographic &amp; poster creation <br /> * Dark / large skin option? As per migraine websites<br /> <br /> == Brain fog tasks ==<br /> * [[Articles that need an image or photo]]<br /> * [[Category:Articles with unsourced statements]]<br /> * [[Add source and copyright to existing images]]<br /> <br /> == Tips ==<br /> * [[Science Guidelines]]<br /> * [[Using the source_code editor]]<br /> * [[Power user/editor tips]]<br /> <br /> ==Welcome to MEpedia!==<br /> * [[How_to_contribute|How to contribute]]<br /> * If you need ideas of improvements to make to MEpedia, See [[MEpedia_suggestions|suggestions]]<br /> * [[Contents|MEpedia Contents]]<br /> <br /> * To create new page, use one an outline: [MEpedia_article_outlines]<br /> <br /> To see your contributions history, click Contributions in the top-right corner. To see recent contributions by others, click Recent Changes on the left. Not ready to edit pages, but want to suggest a change? On the page, just click Discussion, and write your suggestion there for others to see.|realName=Anonymous|name=Notjusttired}}<br /> <br /> == Random code==<br /> {{bar box<br /> |title=Chronic Fatigue Syndrome: Common Symptoms<br /> |titlebar=#DDD<br /> |left1='''Symptom'''<br /> |right2=%<br /> |width=400px<br /> |bars=<br /> {{bar pixel|Fatigue: persistent or relapsing|#0CBCBC|100}}<br /> {{bar pixel|Symptoms last over 6 months|#0CBCBC|100}}<br /> {{bar pixel|Significant reduction in activities|#0CBCBC|100}}<br /> {{bar pixel|Post-exertional malaise|#0CBCBC|96}}<br /> {{bar pixel|Memory &amp;amp; concentration probs|#0CBCBC|98}}<br /> {{bar pixel|Unrefreshing sleep|#0CBCBC|99}}<br /> {{bar pixel|Headaches - new or different|#0CBCBC|100}}<br /> {{bar pixel|Muscle pain (myalgia)|#0CBCBC|96}}<br /> {{bar pixel|Sore throat|#0CBCBC|81}}<br /> {{bar pixel|Joint pain (arthalgia)|#0CBCBC|86}}<br /> {{bar pixel|Lymph node pain|#0CBCBC|81}}<br /> |caption=Source: Jason et al.<br /> }}‎<br /> <br /> <br /> {{Bar chart<br /> | title = &lt;div style=&quot;font-size:1.4em; margin-bottom: 0.4em;&quot;&gt;Common Symptoms in Chronic Fatigue Syndrome&lt;/div&gt;<br /> | bar_width = 15<br /> | width = 30<br /> | width_units = em<br /> | label_type = Symptom<br /> | label1 = Fatigue - persist or relapsing*<br /> | label2 = Significant reduction in activities*<br /> | label3 = Symptoms last over 6 months*<br /> | label4 = Post-exertional malaise<br /> | label5 = Memory &amp;amp; concentration probs<br /> | label6 = Unrefreshing sleep<br /> | label7 = Headaches - new or different<br /> | label8 = Muscle pain (myalgia)<br /> | label9 = Sore throat<br /> | color = #0CBCBC<br /> | data_type = Mild to Severe&lt;br&gt; Symptom %<br /> | data_max = 101<br /> | data1 = 100<br /> | data2 = 100<br /> | data3 = 100<br /> | data4 = 96<br /> | data5 = 98<br /> | data6 = 99<br /> | data7 = 90<br /> | data8 = 96<br /> | data9 = 81<br /> | col2_data_type = Moderate to Severe&lt;br&gt; Symptom %<br /> | col2_data_max = 101<br /> | col2_data1 = 95<br /> | col2_data2 = 100<br /> | col2_data3 = 100<br /> | col2_data4 = 86<br /> | col2_data5 = 80<br /> | col2_data6 = 92<br /> | col2_data7 = 50<br /> | col2_data8 = 73<br /> | col2_data9 = 31<br /> |caption= '''Source: Jason et al.'''<br /> }}<br /> <br /> <br /> ===Messages ====<br /> Notjustired: [[Severe and very severe ME]] Chronological order goes from earliest to latest. Citations are not placed under the study and instead, they are cited. If details like pages are necessary, they can be entered into the citation. --[[User:MEcfsFMS|MEcfsFMS]] ([[User talk:MEcfsFMS|talk]]) 09:51, 20 October 2018 (EDT)<br /> <br /> Hi. Is that somewhere in the editorial standards? I don't remember reading it. I think it's important to add doi to citations of they aren't already in there. I will look at adding author links to the citations too. I created a talk page for the Severe ME image to discuss ideas.<br /> [[User:Notjusttired|notjusttired]] ([[User talk:Notjusttired|talk]]) 10:15, 20 October 2018 (EDT)<br /> <br /> :I put doi in and the PMID? But PMC causes an error and I don't think they have figured out why yet. Authors links don't get created and I thought they were in the &quot;Reference&quot; area.--[[User:MEcfsFMS|MEcfsFMS]] ([[User talk:MEcfsFMS|talk]]) 10:39, 20 October 2018 (EDT)<br /> <br /> :I see, if the citation automatically creates the citation, authors internal links are created. If they have to be manually input then it does not seem to create them.<br /> <br /> :That makes sense. I thought people had been spending ages manually adding them or copying and pasting the code for the most common ones. I normally automatically generate a citation, if it doesn't work I use another link or the doi, then replace the finished link with a full text link if necessary. Links from investinme and researchgate normally don't generate automatically so I use a PubMed link and overwrite the link only after the citation is generated.<br /> Could you update the [[Manual of style]] with anything else that isn't in there?<br /> I'll go back sort the citations I changed. [[User:Notjusttired|notjusttired]] ([[User talk:Notjusttired|talk]]) 10:53, 20 October 2018 (EDT)<br /> <br /> == MOS - Dates ==<br /> <br /> Hi Notjusttired:<br /> <br /> Somewhere at some point early on, I remember the date format was to be US, Jun 10, 2016, and not 10 Jun 2016. I can't remember where or when I read this but a few of us started changing dates in UK format and going forward we used US format. I think Jen had posted about it but I'm not sure. Also, we were to change any UK spellings to the US spelling unless it was a quote.--[[User:MEcfsFMS|MEcfsFMS]] ([[User talk:MEcfsFMS|talk]]) 14:26, 31 October 2018 (EDT)<br /> <br /> ty for letting me know, can you fix what I wrote on [[MOS]] - does the same apply to date in citations? Sometimes they cause an error so I presume I put them in as Jun, 28 2018 now?<br /> <br /> :Yes, that is how I write in the citations, but move the comma so it is Jun 28, 2018 or Jun 2018.</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=User_talk:Notjusttired&diff=43069 2018-10-31T18:26:09Z

<p>MEcfsFMS:/* MOS - Dates */ new section</p> <hr /> <div><br /> == Priorities ==<br /> * Image copyrights to organize <br /> * Check copyrights on ICC and other files<br /> * Better symptom photos e.g. malaise, levels of fatigue and disability, symptoms <br /> * Infographics template - XMP CC info, large size, site name only in corner (font as wiki?)<br /> * Infographic &amp; poster creation <br /> * Dark / large skin option? As per migraine websites<br /> <br /> == Brain fog tasks ==<br /> * [[Articles that need an image or photo]]<br /> * [[Category:Articles with unsourced statements]]<br /> * [[Add source and copyright to existing images]]<br /> <br /> == Tips ==<br /> * [[Science Guidelines]]<br /> * [[Using the source_code editor]]<br /> * [[Power user/editor tips]]<br /> <br /> ==Welcome to MEpedia!==<br /> * [[How_to_contribute|How to contribute]]<br /> * If you need ideas of improvements to make to MEpedia, See [[MEpedia_suggestions|suggestions]]<br /> * [[Contents|MEpedia Contents]]<br /> <br /> * To create new page, use one an outline: [MEpedia_article_outlines]<br /> <br /> To see your contributions history, click Contributions in the top-right corner. To see recent contributions by others, click Recent Changes on the left. Not ready to edit pages, but want to suggest a change? On the page, just click Discussion, and write your suggestion there for others to see.|realName=Anonymous|name=Notjusttired}}<br /> <br /> == Random code==<br /> {{bar box<br /> |title=Chronic Fatigue Syndrome: Common Symptoms<br /> |titlebar=#DDD<br /> |left1='''Symptom'''<br /> |right2=%<br /> |width=400px<br /> |bars=<br /> {{bar pixel|Fatigue: persistent or relapsing|#0CBCBC|100}}<br /> {{bar pixel|Symptoms last over 6 months|#0CBCBC|100}}<br /> {{bar pixel|Significant reduction in activities|#0CBCBC|100}}<br /> {{bar pixel|Post-exertional malaise|#0CBCBC|96}}<br /> {{bar pixel|Memory &amp;amp; concentration probs|#0CBCBC|98}}<br /> {{bar pixel|Unrefreshing sleep|#0CBCBC|99}}<br /> {{bar pixel|Headaches - new or different|#0CBCBC|100}}<br /> {{bar pixel|Muscle pain (myalgia)|#0CBCBC|96}}<br /> {{bar pixel|Sore throat|#0CBCBC|81}}<br /> {{bar pixel|Joint pain (arthalgia)|#0CBCBC|86}}<br /> {{bar pixel|Lymph node pain|#0CBCBC|81}}<br /> |caption=Source: Jason et al.<br /> }}‎<br /> <br /> <br /> {{Bar chart<br /> | title = &lt;div style=&quot;font-size:1.4em; margin-bottom: 0.4em;&quot;&gt;Common Symptoms in Chronic Fatigue Syndrome&lt;/div&gt;<br /> | bar_width = 15<br /> | width = 30<br /> | width_units = em<br /> | label_type = Symptom<br /> | label1 = Fatigue - persist or relapsing*<br /> | label2 = Significant reduction in activities*<br /> | label3 = Symptoms last over 6 months*<br /> | label4 = Post-exertional malaise<br /> | label5 = Memory &amp;amp; concentration probs<br /> | label6 = Unrefreshing sleep<br /> | label7 = Headaches - new or different<br /> | label8 = Muscle pain (myalgia)<br /> | label9 = Sore throat<br /> | color = #0CBCBC<br /> | data_type = Mild to Severe&lt;br&gt; Symptom %<br /> | data_max = 101<br /> | data1 = 100<br /> | data2 = 100<br /> | data3 = 100<br /> | data4 = 96<br /> | data5 = 98<br /> | data6 = 99<br /> | data7 = 90<br /> | data8 = 96<br /> | data9 = 81<br /> | col2_data_type = Moderate to Severe&lt;br&gt; Symptom %<br /> | col2_data_max = 101<br /> | col2_data1 = 95<br /> | col2_data2 = 100<br /> | col2_data3 = 100<br /> | col2_data4 = 86<br /> | col2_data5 = 80<br /> | col2_data6 = 92<br /> | col2_data7 = 50<br /> | col2_data8 = 73<br /> | col2_data9 = 31<br /> |caption= '''Source: Jason et al.'''<br /> }}<br /> <br /> <br /> ===Messages ====<br /> Notjustired: [[Severe and very severe ME]] Chronological order goes from earliest to latest. Citations are not placed under the study and instead, they are cited. If details like pages are necessary, they can be entered into the citation. --[[User:MEcfsFMS|MEcfsFMS]] ([[User talk:MEcfsFMS|talk]]) 09:51, 20 October 2018 (EDT)<br /> <br /> Hi. Is that somewhere in the editorial standards? I don't remember reading it. I think it's important to add doi to citations of they aren't already in there. I will look at adding author links to the citations too. I created a talk page for the Severe ME image to discuss ideas.<br /> [[User:Notjusttired|notjusttired]] ([[User talk:Notjusttired|talk]]) 10:15, 20 October 2018 (EDT)<br /> <br /> :I put doi in and the PMID? But PMC causes an error and I don't think they have figured out why yet. Authors links don't get created and I thought they were in the &quot;Reference&quot; area.--[[User:MEcfsFMS|MEcfsFMS]] ([[User talk:MEcfsFMS|talk]]) 10:39, 20 October 2018 (EDT)<br /> <br /> :I see, if the citation automatically creates the citation, authors internal links are created. If they have to be manually input then it does not seem to create them.<br /> <br /> :That makes sense. I thought people had been spending ages manually adding them or copying and pasting the code for the most common ones. I normally automatically generate a citation, if it doesn't work I use another link or the doi, then replace the finished link with a full text link if necessary. Links from investinme and researchgate normally don't generate automatically so I use a PubMed link and overwrite the link only after the citation is generated.<br /> Could you update the [[Manual of style]] with anything else that isn't in there?<br /> I'll go back sort the citations I changed. [[User:Notjusttired|notjusttired]] ([[User talk:Notjusttired|talk]]) 10:53, 20 October 2018 (EDT)<br /> <br /> == MOS - Dates ==<br /> <br /> Hi Notjusttired:<br /> <br /> Somewhere at some point early on, I remember the date format was to be US, Jun 10, 2016, and not 10 Jun 2016. I can't remember where or when I read this but a few of us started changing dates in UK format and going forward we used US format. I think Jen had posted about it but I'm not sure. Also, we were to change any UK spellings to the US spelling unless it was a quote.--[[User:MEcfsFMS|MEcfsFMS]] ([[User talk:MEcfsFMS|talk]]) 14:26, 31 October 2018 (EDT)</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Carol_Monaghan&diff=42991 2018-10-30T20:37:19Z

<p>MEcfsFMS:/* Media */ citation info</p> <hr /> <div>[[File:Carol Monaghan.jpg|right|200px]]<br /> '''Carol Monaghan''' MP is a Scottish National Party member of the [[UK]] Parliament.<br /> <br /> ==Parliamentary debates and business==<br /> Carol Monaghan MP has led two UK Parliamentary debates in Westminster. <br /> <br /> <br /> * Feb 20, 2018, ''PACE trial and its effect on people with ME'' [[PACE trial#Second Parliamentary debate on PACE Trial|Parliamentary debate on PACE Trial]]<br /> :*''PACE Trial: People with ME'' [https://hansard.parliament.uk/commons/2018-02-20/debates/990746C7-9010-4566-940D-249F5026FF73/PACETrialPeopleWithME (TRANSCRIPT)]&lt;ref&gt;{{Cite web|url=https://hansard.parliament.uk/commons/2018-02-20/debates/990746C7-9010-4566-940D-249F5026FF73/PACETrialPeopleWithME|title=PACE Trial: People with ME - Hansard|last=|first=|date=Feb 20, 2018|website=hansard.parliament.uk|series=Volume 636|publisher=UK Parliament Hansard|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-10-29}}&lt;/ref&gt;<br /> <br /> ::<br /> {{Quote2|I think that when the full details of the trial become known, it will be considered one of the biggest medical scandals of the 21st century.&lt;sup&gt;1&lt;/sup&gt;|Carol Monaghan|''PACE Trial: People with ME'', House of Commons Hansard Debate, Feb 20, 2018}}<br /> <br /> * Jun 21, 2018, ''M.E. Treatment and Research'' [[UK Parliament Grand Committee Room debate 21st June 2018|UK Parliament Grand Committee Room debate]]<br /> * Oct 30, 2018, ''Backbench Business Committee'' - EXTRACT[https://parliamentlive.tv/event/index/0666480c-4fb5-443f-87bc-e295dabc0e58?in=14:42:55&amp;out=14:53:00 (Video)]&lt;ref&gt;{{Cite web|url=https://parliamentlive.tv/event/index/0666480c-4fb5-443f-87bc-e295dabc0e58?in=14:42:55&amp;out=14:53:00|title=Backbench Business Committee - EXTRACT|last=Monaghan|first=Carol|last2=Morgan|first2=Nicky|date=Oct 30, 2018|website=parliamentlive.tv|archive-url=|archive-date=|dead-url=|access-date=2018-10-30|last3=Hopkins|first3=Kelvin|last4=Pound|first4=Steve}}&lt;/ref&gt;<br /> <br /> ==Talks and interviews==<br /> * May 21, 2018, Episode 3 of [[The ME Show]]<br /> <br /> ==Awards==<br /> * Jul 6, 2018, [https://www.facebook.com/CarolMonaghanSNP/photos/a.603087106485156.1073741828.602811439846056/1548871901906667/?type=3&amp;theater Campaigner of the Week]&lt;ref&gt;{{Cite web|url=https://www.facebook.com/CarolMonaghanSNP/photos/a.603087106485156.1073741828.602811439846056/1548871901906667/?type=3&amp;theater|title=Carol Monaghan - MP for Glasgow North West|last=|first=|date=July 6, 2018|website=www.facebook.com|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-10-29|publisher=The House (Print)|via=FaceBook - Carol Monaghan - MP for Glasgow North West}}&lt;/ref&gt;<br /> <br /> ==Media==<br /> * Jun 18, 2018, [https://www.politicshome.com/news/uk/health-and-care/illnesstreatments/house/house-magazine/96009/carol-monaghan-we-must-change 'Carol Monaghan: We must change perceptions of the debilitating illness ME']&lt;ref&gt;{{Cite news|url=https://www.politicshome.com/news/uk/health-and-care/illnesstreatments/house/house-magazine/96009/carol-monaghan-we-must-change|title=Carol Monaghan: We must change perceptions of the debilitating illness ME|last=|date=2018-06-18|work=PoliticsHome.com|access-date=2018-10-29|language=en|first=|archive-url=|archive-date=|dead-url=|publisher=The House}}&lt;/ref&gt;<br /> <br /> ==Online presence==<br /> * [https://twitter.com/CMonaghanSNP Twitter]<br /> * [https://www.facebook.com/CarolMonaghanSNP Facebook]<br /> * [http://www.carol.monaghan.scot Website]<br /> <br /> ==Learn more==<br /> *[https://en.wikipedia.org/wiki/Carol_Monaghan Wikipedia - Carol Monaghan MP]<br /> <br /> ==See also==<br /> <br /> ==References==<br /> &lt;references /&gt;<br /> <br /> [[Category:Advocates or allies]]<br /> [[Category:United Kingdom politicians]]<br /> [[Category:Politicians]]<br /> [[Category:United Kingdom Members of Parliament]]</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Carol_Monaghan&diff=42989 2018-10-30T20:31:58Z

<p>MEcfsFMS:/* Awards */ cleanup</p> <hr /> <div>[[File:Carol Monaghan.jpg|right|200px]]<br /> '''Carol Monaghan''' MP is a Scottish National Party member of the [[UK]] Parliament.<br /> <br /> ==Parliamentary debates and business==<br /> Carol Monaghan MP has led two UK Parliamentary debates in Westminster. <br /> <br /> <br /> * Feb 20, 2018, ''PACE trial and its effect on people with ME'' [[PACE trial#Second Parliamentary debate on PACE Trial|Parliamentary debate on PACE Trial]]<br /> :*''PACE Trial: People with ME'' [https://hansard.parliament.uk/commons/2018-02-20/debates/990746C7-9010-4566-940D-249F5026FF73/PACETrialPeopleWithME (TRANSCRIPT)]&lt;ref&gt;{{Cite web|url=https://hansard.parliament.uk/commons/2018-02-20/debates/990746C7-9010-4566-940D-249F5026FF73/PACETrialPeopleWithME|title=PACE Trial: People with ME - Hansard|last=|first=|date=Feb 20, 2018|website=hansard.parliament.uk|series=Volume 636|publisher=UK Parliament Hansard|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-10-29}}&lt;/ref&gt;<br /> <br /> ::<br /> {{Quote2|I think that when the full details of the trial become known, it will be considered one of the biggest medical scandals of the 21st century.&lt;sup&gt;1&lt;/sup&gt;|Carol Monaghan|''PACE Trial: People with ME'', House of Commons Hansard Debate, Feb 20, 2018}}<br /> <br /> * Jun 21, 2018, ''M.E. Treatment and Research'' [[UK Parliament Grand Committee Room debate 21st June 2018|UK Parliament Grand Committee Room debate]]<br /> * Oct 30, 2018, ''Backbench Business Committee'' - EXTRACT[https://parliamentlive.tv/event/index/0666480c-4fb5-443f-87bc-e295dabc0e58?in=14:42:55&amp;out=14:53:00 (Video)]&lt;ref&gt;{{Cite web|url=https://parliamentlive.tv/event/index/0666480c-4fb5-443f-87bc-e295dabc0e58?in=14:42:55&amp;out=14:53:00|title=Backbench Business Committee - EXTRACT|last=Monaghan|first=Carol|last2=Morgan|first2=Nicky|date=Oct 30, 2018|website=parliamentlive.tv|archive-url=|archive-date=|dead-url=|access-date=2018-10-30|last3=Hopkins|first3=Kelvin|last4=Pound|first4=Steve}}&lt;/ref&gt;<br /> <br /> ==Talks and interviews==<br /> * May 21, 2018, Episode 3 of [[The ME Show]]<br /> <br /> ==Awards==<br /> * Jul 6, 2018, [https://www.facebook.com/CarolMonaghanSNP/photos/a.603087106485156.1073741828.602811439846056/1548871901906667/?type=3&amp;theater Campaigner of the Week] by ''[[wikipedia:The_House_(magazine)|The House]]'' (magazine)&lt;ref&gt;{{Cite web|url=https://www.facebook.com/CarolMonaghanSNP/photos/a.603087106485156.1073741828.602811439846056/1548871901906667/?type=3&amp;theater|title=Carol Monaghan - MP for Glasgow North West|last=|first=|date=July 6, 2018|website=www.facebook.com|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-10-29}}&lt;/ref&gt;<br /> <br /> ==Media==<br /> * Jun 18, 2018, The House Parliament's Magazine [https://www.politicshome.com/news/uk/health-and-care/illnesstreatments/house/house-magazine/96009/carol-monaghan-we-must-change 'Carol Monaghan: We must change perceptions of the debilitating illness ME']&lt;ref&gt;{{Cite news|url=https://www.politicshome.com/news/uk/health-and-care/illnesstreatments/house/house-magazine/96009/carol-monaghan-we-must-change|title=Carol Monaghan: We must change perceptions of the debilitating illness ME|last=PoliticsHome.com|date=2018-06-18|work=PoliticsHome.com|access-date=2018-10-29|language=en}}&lt;/ref&gt;<br /> <br /> ==Online presence==<br /> * [https://twitter.com/CMonaghanSNP Twitter]<br /> * [https://www.facebook.com/CarolMonaghanSNP Facebook]<br /> * [http://www.carol.monaghan.scot Website]<br /> <br /> ==Learn more==<br /> *[https://en.wikipedia.org/wiki/Carol_Monaghan Wikipedia - Carol Monaghan MP]<br /> <br /> ==See also==<br /> <br /> ==References==<br /> &lt;references /&gt;<br /> <br /> [[Category:Advocates or allies]]<br /> [[Category:United Kingdom politicians]]<br /> [[Category:Politicians]]<br /> [[Category:United Kingdom Members of Parliament]]</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Carol_Monaghan&diff=42988 2018-10-30T20:24:53Z

<p>MEcfsFMS:/* Awards */ x</p> <hr /> <div>[[File:Carol Monaghan.jpg|right|200px]]<br /> '''Carol Monaghan''' MP is a Scottish National Party member of the [[UK]] Parliament.<br /> <br /> ==Parliamentary debates and business==<br /> Carol Monaghan MP has led two UK Parliamentary debates in Westminster. <br /> <br /> <br /> * Feb 20, 2018, ''PACE trial and its effect on people with ME'' [[PACE trial#Second Parliamentary debate on PACE Trial|Parliamentary debate on PACE Trial]]<br /> :*''PACE Trial: People with ME'' [https://hansard.parliament.uk/commons/2018-02-20/debates/990746C7-9010-4566-940D-249F5026FF73/PACETrialPeopleWithME (TRANSCRIPT)]&lt;ref&gt;{{Cite web|url=https://hansard.parliament.uk/commons/2018-02-20/debates/990746C7-9010-4566-940D-249F5026FF73/PACETrialPeopleWithME|title=PACE Trial: People with ME - Hansard|last=|first=|date=Feb 20, 2018|website=hansard.parliament.uk|series=Volume 636|publisher=UK Parliament Hansard|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-10-29}}&lt;/ref&gt;<br /> <br /> ::<br /> {{Quote2|I think that when the full details of the trial become known, it will be considered one of the biggest medical scandals of the 21st century.&lt;sup&gt;1&lt;/sup&gt;|Carol Monaghan|''PACE Trial: People with ME'', House of Commons Hansard Debate, Feb 20, 2018}}<br /> <br /> * Jun 21, 2018, ''M.E. Treatment and Research'' [[UK Parliament Grand Committee Room debate 21st June 2018|UK Parliament Grand Committee Room debate]]<br /> * Oct 30, 2018, ''Backbench Business Committee'' - EXTRACT[https://parliamentlive.tv/event/index/0666480c-4fb5-443f-87bc-e295dabc0e58?in=14:42:55&amp;out=14:53:00 (Video)]&lt;ref&gt;{{Cite web|url=https://parliamentlive.tv/event/index/0666480c-4fb5-443f-87bc-e295dabc0e58?in=14:42:55&amp;out=14:53:00|title=Backbench Business Committee - EXTRACT|last=Monaghan|first=Carol|last2=Morgan|first2=Nicky|date=Oct 30, 2018|website=parliamentlive.tv|archive-url=|archive-date=|dead-url=|access-date=2018-10-30|last3=Hopkins|first3=Kelvin|last4=Pound|first4=Steve}}&lt;/ref&gt;<br /> <br /> ==Talks and interviews==<br /> * May 21, 2018, Episode 3 of [[The ME Show]]<br /> <br /> ==Awards==<br /> * Jul 6, 2018, Campaigner of the Week by [https://en.wikipedia.org/wiki/The_House_(magazine) ''The House Magazine'']&lt;ref&gt;{{Cite web|url=https://www.facebook.com/CarolMonaghanSNP/photos/a.603087106485156.1073741828.602811439846056/1548871901906667/?type=3&amp;theater|title=Carol Monaghan - MP for Glasgow North West|last=|first=|date=July 6, 2018|website=www.facebook.com|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-10-29}}&lt;/ref&gt;<br /> <br /> ==Media==<br /> * Jun 18, 2018, The House Parliament's Magazine [https://www.politicshome.com/news/uk/health-and-care/illnesstreatments/house/house-magazine/96009/carol-monaghan-we-must-change 'Carol Monaghan: We must change perceptions of the debilitating illness ME']&lt;ref&gt;{{Cite news|url=https://www.politicshome.com/news/uk/health-and-care/illnesstreatments/house/house-magazine/96009/carol-monaghan-we-must-change|title=Carol Monaghan: We must change perceptions of the debilitating illness ME|last=PoliticsHome.com|date=2018-06-18|work=PoliticsHome.com|access-date=2018-10-29|language=en}}&lt;/ref&gt;<br /> <br /> ==Online presence==<br /> * [https://twitter.com/CMonaghanSNP Twitter]<br /> * [https://www.facebook.com/CarolMonaghanSNP Facebook]<br /> * [http://www.carol.monaghan.scot Website]<br /> <br /> ==Learn more==<br /> *[https://en.wikipedia.org/wiki/Carol_Monaghan Wikipedia - Carol Monaghan MP]<br /> <br /> ==See also==<br /> <br /> ==References==<br /> &lt;references /&gt;<br /> <br /> [[Category:Advocates or allies]]<br /> [[Category:United Kingdom politicians]]<br /> [[Category:Politicians]]<br /> [[Category:United Kingdom Members of Parliament]]</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Carol_Monaghan&diff=42987 2018-10-30T20:22:38Z

<p>MEcfsFMS:/* Parliamentary debates */ x</p> <hr /> <div>[[File:Carol Monaghan.jpg|right|200px]]<br /> '''Carol Monaghan''' MP is a Scottish National Party member of the [[UK]] Parliament.<br /> <br /> ==Parliamentary debates and business==<br /> Carol Monaghan MP has led two UK Parliamentary debates in Westminster. <br /> <br /> <br /> * Feb 20, 2018, ''PACE trial and its effect on people with ME'' [[PACE trial#Second Parliamentary debate on PACE Trial|Parliamentary debate on PACE Trial]]<br /> :*''PACE Trial: People with ME'' [https://hansard.parliament.uk/commons/2018-02-20/debates/990746C7-9010-4566-940D-249F5026FF73/PACETrialPeopleWithME (TRANSCRIPT)]&lt;ref&gt;{{Cite web|url=https://hansard.parliament.uk/commons/2018-02-20/debates/990746C7-9010-4566-940D-249F5026FF73/PACETrialPeopleWithME|title=PACE Trial: People with ME - Hansard|last=|first=|date=Feb 20, 2018|website=hansard.parliament.uk|series=Volume 636|publisher=UK Parliament Hansard|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-10-29}}&lt;/ref&gt;<br /> <br /> ::<br /> {{Quote2|I think that when the full details of the trial become known, it will be considered one of the biggest medical scandals of the 21st century.&lt;sup&gt;1&lt;/sup&gt;|Carol Monaghan|''PACE Trial: People with ME'', House of Commons Hansard Debate, Feb 20, 2018}}<br /> <br /> * Jun 21, 2018, ''M.E. Treatment and Research'' [[UK Parliament Grand Committee Room debate 21st June 2018|UK Parliament Grand Committee Room debate]]<br /> * Oct 30, 2018, ''Backbench Business Committee'' - EXTRACT[https://parliamentlive.tv/event/index/0666480c-4fb5-443f-87bc-e295dabc0e58?in=14:42:55&amp;out=14:53:00 (Video)]&lt;ref&gt;{{Cite web|url=https://parliamentlive.tv/event/index/0666480c-4fb5-443f-87bc-e295dabc0e58?in=14:42:55&amp;out=14:53:00|title=Backbench Business Committee - EXTRACT|last=Monaghan|first=Carol|last2=Morgan|first2=Nicky|date=Oct 30, 2018|website=parliamentlive.tv|archive-url=|archive-date=|dead-url=|access-date=2018-10-30|last3=Hopkins|first3=Kelvin|last4=Pound|first4=Steve}}&lt;/ref&gt;<br /> <br /> ==Talks and interviews==<br /> * May 21, 2018, Episode 3 of [[The ME Show]]<br /> <br /> ==Awards==<br /> * Jul 6, 2018, Campaigner of the Week by [https://en.wikipedia.org/wiki/The_House_(magazine) The House Magazine]&lt;ref&gt;{{Cite web|url=https://www.facebook.com/CarolMonaghanSNP/photos/a.603087106485156.1073741828.602811439846056/1548871901906667/?type=3&amp;theater|title=Carol Monaghan - MP for Glasgow North West|last=|first=|date=July 6, 2018|website=www.facebook.com|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-10-29}}&lt;/ref&gt;<br /> <br /> ==Media==<br /> * Jun 18, 2018, The House Parliament's Magazine [https://www.politicshome.com/news/uk/health-and-care/illnesstreatments/house/house-magazine/96009/carol-monaghan-we-must-change 'Carol Monaghan: We must change perceptions of the debilitating illness ME']&lt;ref&gt;{{Cite news|url=https://www.politicshome.com/news/uk/health-and-care/illnesstreatments/house/house-magazine/96009/carol-monaghan-we-must-change|title=Carol Monaghan: We must change perceptions of the debilitating illness ME|last=PoliticsHome.com|date=2018-06-18|work=PoliticsHome.com|access-date=2018-10-29|language=en}}&lt;/ref&gt;<br /> <br /> ==Online presence==<br /> * [https://twitter.com/CMonaghanSNP Twitter]<br /> * [https://www.facebook.com/CarolMonaghanSNP Facebook]<br /> * [http://www.carol.monaghan.scot Website]<br /> <br /> ==Learn more==<br /> *[https://en.wikipedia.org/wiki/Carol_Monaghan Wikipedia - Carol Monaghan MP]<br /> <br /> ==See also==<br /> <br /> ==References==<br /> &lt;references /&gt;<br /> <br /> [[Category:Advocates or allies]]<br /> [[Category:United Kingdom politicians]]<br /> [[Category:Politicians]]<br /> [[Category:United Kingdom Members of Parliament]]</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Kelvin_Hopkins&diff=42986 2018-10-30T20:16:19Z

<p>MEcfsFMS:/* Parliamentary Questions */ video and heading</p> <hr /> <div>[[File:MP Kelvin Hopkins.jpg |200px|thumb|right|Source:www.labour.org.uk]] <br /> '''Kelvin Peter Hopkins''' is a Labour Member of UK Parliament for Luton North since 1997.&lt;ref&gt;[http://kelvinhopkinsmp.com/ KelvinHopkinsMP.com]&lt;/ref&gt;<br /> <br /> == Parliamentary debates and business ==<br /> * Oct 30, 2018, ''Backbench Business Committee'' - EXTRACT[https://parliamentlive.tv/event/index/0666480c-4fb5-443f-87bc-e295dabc0e58?in=14:42:55&amp;out=14:53:00 (Video)]&lt;ref&gt;{{Cite web|url=https://parliamentlive.tv/event/index/0666480c-4fb5-443f-87bc-e295dabc0e58?in=14:42:55&amp;out=14:53:00|title=Backbench Business Committee - EXTRACT|last=Monaghan|first=Carol|last2=Morgan|first2=Nicky|date=Oct 30, 2018|website=parliamentlive.tv|archive-url=|archive-date=|dead-url=|access-date=2018-10-30|last3=Hopkins|first3=Kelvin|last4=Pound|first4=Steve}}&lt;/ref&gt;<br /> <br /> == Parliamentary Questions ==<br /> *Nov 22, 2016: [http://www.parliament.uk/business/publications/written-questions-answers-statements/written-questions-answers/?page=1&amp;max=20&amp;questiontype=AllQuestions&amp;house=commons%2clords&amp;member=2&amp;keywords=Chronic%2cFatigue%2cSyndrome Written questions and answers - www.parliament.uk]<br /> <br /> :MP Hopkins asked 7 questions about [[ME/CFS]] research and treatment recommendations of the Secretary of State Health and Secretary of State for Business, Energy and Industrial Strategy. He is questioning as to whether there was fraudulent activity of the [[PACE trial]] and whether those involved should receive public funding into ME/CFS research in the future. He wants [[NICE]] guideline recommendations for the treatment of ME/CFS changed and [[GET]] and [[CBT]] recommendations removed.<br /> <br /> :These questions were recorded on November 22, 2016 with five answered on November 25, 2016. &lt;ref&gt;[https://www.change.org/p/opposing-mega-a-vote-of-no-confidence-in-mega-research-for-me-cfs/u/18598481 Parliamentary Questions asked by MP Kelvin Hopkins - Change.org Opposing MEGA: A Vote of No Confidence in MEGA Research]&lt;/ref&gt;<br /> <br /> == References ==<br /> <br /> [[Category:Advocates or allies]]<br /> [[Category:British advocates or allies]]<br /> [[Category:United Kingdom politicians]]<br /> [[Category:Politicians]]<br /> [[Category:United Kingdom Members of Parliament]]<br /> &lt;references /&gt;</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Carol_Monaghan&diff=42985 2018-10-30T20:04:28Z

<p>MEcfsFMS:/* Parliamentary debates */ citation info</p> <hr /> <div>[[File:Carol Monaghan.jpg|right|200px]]<br /> '''Carol Monaghan''' MP is a Scottish National Party member of the [[UK]] Parliament.<br /> <br /> ==Parliamentary debates==<br /> Carol Monaghan MP has led two UK Parliamentary debates in Westminster. <br /> <br /> <br /> * Feb 20, 2018, ''PACE trial and its effect on people with ME'' [[PACE trial#Second Parliamentary debate on PACE Trial|Parliamentary debate on PACE Trial]]<br /> :*''PACE Trial: People with ME'' [https://hansard.parliament.uk/commons/2018-02-20/debates/990746C7-9010-4566-940D-249F5026FF73/PACETrialPeopleWithME (TRANSCRIPT)]&lt;ref&gt;{{Cite web|url=https://hansard.parliament.uk/commons/2018-02-20/debates/990746C7-9010-4566-940D-249F5026FF73/PACETrialPeopleWithME|title=PACE Trial: People with ME - Hansard|last=|first=|date=Feb 20, 2018|website=hansard.parliament.uk|series=Volume 636|publisher=UK Parliament Hansard|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-10-29}}&lt;/ref&gt;<br /> <br /> ::<br /> {{Quote2|I think that when the full details of the trial become known, it will be considered one of the biggest medical scandals of the 21st century.&lt;sup&gt;1&lt;/sup&gt;|Carol Monaghan|''PACE Trial: People with ME'', House of Commons Hansard Debate, Feb 20, 2018}}<br /> <br /> * Jun 21, 2018, ''M.E. Treatment and Research'' [[UK Parliament Grand Committee Room debate 21st June 2018|UK Parliament Grand Committee Room debate]]<br /> * Oct 30, 2018, ''Backbench Business Committee'' - EXTRACT[https://parliamentlive.tv/event/index/0666480c-4fb5-443f-87bc-e295dabc0e58?in=14:42:55&amp;out=14:53:00 (Video)]&lt;ref&gt;{{Cite web|url=https://parliamentlive.tv/event/index/0666480c-4fb5-443f-87bc-e295dabc0e58?in=14:42:55&amp;out=14:53:00|title=Backbench Business Committee - EXTRACT|last=Monaghan|first=Carol|last2=Morgan|first2=Nicky|date=Oct 30, 2018|website=parliamentlive.tv|archive-url=|archive-date=|dead-url=|access-date=2018-10-30|last3=Hopkins|first3=Kelvin|last4=Pound|first4=Steve}}&lt;/ref&gt;<br /> <br /> ==Talks and interviews==<br /> * May 21, 2018, Episode 3 of [[The ME Show]]<br /> <br /> ==Awards==<br /> * Jul 6, 2018, Campaigner of the Week by [https://en.wikipedia.org/wiki/The_House_(magazine) The House Magazine]&lt;ref&gt;{{Cite web|url=https://www.facebook.com/CarolMonaghanSNP/photos/a.603087106485156.1073741828.602811439846056/1548871901906667/?type=3&amp;theater|title=Carol Monaghan - MP for Glasgow North West|last=|first=|date=July 6, 2018|website=www.facebook.com|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-10-29}}&lt;/ref&gt;<br /> <br /> ==Media==<br /> * Jun 18, 2018, The House Parliament's Magazine [https://www.politicshome.com/news/uk/health-and-care/illnesstreatments/house/house-magazine/96009/carol-monaghan-we-must-change 'Carol Monaghan: We must change perceptions of the debilitating illness ME']&lt;ref&gt;{{Cite news|url=https://www.politicshome.com/news/uk/health-and-care/illnesstreatments/house/house-magazine/96009/carol-monaghan-we-must-change|title=Carol Monaghan: We must change perceptions of the debilitating illness ME|last=PoliticsHome.com|date=2018-06-18|work=PoliticsHome.com|access-date=2018-10-29|language=en}}&lt;/ref&gt;<br /> <br /> ==Online presence==<br /> * [https://twitter.com/CMonaghanSNP Twitter]<br /> * [https://www.facebook.com/CarolMonaghanSNP Facebook]<br /> * [http://www.carol.monaghan.scot Website]<br /> <br /> ==Learn more==<br /> *[https://en.wikipedia.org/wiki/Carol_Monaghan Wikipedia - Carol Monaghan MP]<br /> <br /> ==See also==<br /> <br /> ==References==<br /> &lt;references /&gt;<br /> <br /> [[Category:Advocates or allies]]<br /> [[Category:United Kingdom politicians]]<br /> [[Category:Politicians]]<br /> [[Category:United Kingdom Members of Parliament]]</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Carol_Monaghan&diff=42984 2018-10-30T20:01:17Z

<p>MEcfsFMS:/* Parliamentary debates */ added parliament video</p> <hr /> <div>[[File:Carol Monaghan.jpg|right|200px]]<br /> '''Carol Monaghan''' MP is a Scottish National Party member of the [[UK]] Parliament.<br /> <br /> ==Parliamentary debates==<br /> Carol Monaghan MP has led two UK Parliamentary debates in Westminster. <br /> <br /> <br /> * Feb 20, 2018, ''PACE trial and its effect on people with ME'' [[PACE trial#Second Parliamentary debate on PACE Trial|Parliamentary debate on PACE Trial]]<br /> :*''PACE Trial: People with ME'' [https://hansard.parliament.uk/commons/2018-02-20/debates/990746C7-9010-4566-940D-249F5026FF73/PACETrialPeopleWithME (TRANSCRIPT)]&lt;ref&gt;{{Cite web|url=https://hansard.parliament.uk/commons/2018-02-20/debates/990746C7-9010-4566-940D-249F5026FF73/PACETrialPeopleWithME|title=PACE Trial: People with ME - Hansard|last=|first=|date=Feb 20, 2018|website=hansard.parliament.uk|series=Volume 636|publisher=UK Parliament Hansard|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-10-29}}&lt;/ref&gt;<br /> <br /> ::<br /> {{Quote2|I think that when the full details of the trial become known, it will be considered one of the biggest medical scandals of the 21st century.&lt;sup&gt;1&lt;/sup&gt;|Carol Monaghan|''PACE Trial: People with ME'', House of Commons Hansard Debate, Feb 20, 2018}}<br /> <br /> * Jun 21, 2018, ''M.E. Treatment and Research'' [[UK Parliament Grand Committee Room debate 21st June 2018|UK Parliament Grand Committee Room debate]]<br /> * Oct 30, 2018, ''Backbench Business Committee'' - EXTRACT[https://parliamentlive.tv/event/index/0666480c-4fb5-443f-87bc-e295dabc0e58?in=14:42:55&amp;out=14:53:00 (Video)]<br /> <br /> ==Talks and interviews==<br /> <br /> May 21, 2018, Episode 3 of [[The ME Show]]<br /> <br /> ==Awards==<br /> <br /> Jul 6, 2018, Campaigner of the Week by [https://en.wikipedia.org/wiki/The_House_(magazine) The House Magazine]&lt;ref&gt;{{Cite web|url=https://www.facebook.com/CarolMonaghanSNP/photos/a.603087106485156.1073741828.602811439846056/1548871901906667/?type=3&amp;theater|title=Carol Monaghan - MP for Glasgow North West|last=|first=|date=July 6, 2018|website=www.facebook.com|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-10-29}}&lt;/ref&gt;<br /> <br /> ==Media==<br /> <br /> Jun 18, 2018, The House Parliament's Magazine <br /> [https://www.politicshome.com/news/uk/health-and-care/illnesstreatments/house/house-magazine/96009/carol-monaghan-we-must-change 'Carol Monaghan: We must change perceptions of the debilitating illness ME']&lt;ref&gt;{{Cite news|url=https://www.politicshome.com/news/uk/health-and-care/illnesstreatments/house/house-magazine/96009/carol-monaghan-we-must-change|title=Carol Monaghan: We must change perceptions of the debilitating illness ME|last=PoliticsHome.com|date=2018-06-18|work=PoliticsHome.com|access-date=2018-10-29|language=en}}&lt;/ref&gt;<br /> <br /> ==Online presence==<br /> * [https://twitter.com/CMonaghanSNP Twitter]<br /> * [https://www.facebook.com/CarolMonaghanSNP Facebook]<br /> * [http://www.carol.monaghan.scot Website]<br /> <br /> ==Learn more==<br /> *[https://en.wikipedia.org/wiki/Carol_Monaghan Wikipedia - Carol Monaghan MP]<br /> <br /> ==See also==<br /> <br /> ==References==<br /> &lt;references /&gt;<br /> <br /> [[Category:Advocates or allies]]<br /> [[Category:United Kingdom politicians]]<br /> [[Category:Politicians]]<br /> [[Category:United Kingdom Members of Parliament]]</div>

MEcfsFMS https://me-pedia.org/w/index.php?title=Fibromyalgia&diff=42974 2018-10-30T14:55:30Z

<p>MEcfsFMS:/* Brain and spinal cord research */ citation</p> <hr /> <div>[[Fibromyalgia]] (FM/FMS) is a chronic disorder characterized by widespread [[musculoskeletal]] pain, [[fatigue]], and tenderness in localized areas. [[Pain]] is widespread, on both sides of the body, and above and below the waist.<br /> <br /> Sufferers are fatigued and tired even when sleeping for long periods of time, and sleep is often disrupted by pain. Many FM sufferers have [[Sleep dysfunction|sleep disorders]] like [https://en.wikipedia.org/wiki/Sleep_apnea sleep apnea] and [[restless leg syndrome|restless legs syndrome]]. [[Cognitive impairment]], when one cannot focus or pay attention and the patient has difficulty concentrating on mental tasks, is known by FM sufferers as &quot;[[fibro fog]]&quot;.&lt;ref name=&quot;:17&quot;&gt;{{Cite news|url=https://www.verywellhealth.com/brain-fibro-fog-causes-symptoms-possible-treatment-716014|title=What Is Fibro Fog and ME/CFS Brain Fog?|last=Dellwo|first=Adrienne|date=|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt; Some experience [[depression]], [[headache]]s, and lower [[abdominal pain]] or [[wikipedia:Cramp|cramping]]. Other symptoms include [[Paresthesia|tingling]] or [[numbness]] in hands and feet, pain in jaw and disorders of the jaw such as [[temporomandibular joint disorder|temporomandibular joint disorder]] (TMJ/TMD), [[Menstrual cycle#Health effects in other conditions|menstrual cycle]] cramps, and [[digestive problems]] like i[[Irritable bowel syndrome|rritable bowel syndrome]] (IBS).&lt;ref name=&quot;:26&quot;&gt;{{Cite news|url=https://www.webmd.com/fibromyalgia/guide/fibromyalgia-symptoms#1|title=Fibromyalgia Symptoms|work=WebMD|access-date=2018-08-09|language=en-US}}&lt;/ref&gt;&lt;ref name=&quot;:27&quot;&gt;{{Cite news|url=https://www.mayoclinic.org/diseases-conditions/fibromyalgia/symptoms-causes/syc-20354780|title=Fibromyalgia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-09|language=en}}&lt;/ref&gt; <br /> <br /> The [[wikipedia:American_College_of_Rheumatology|American College of Rheumatology]] (ACR) created and updates the diagnostic criteria for fibromyalgia.&lt;ref name=&quot;:12&quot; /&gt;&lt;ref name=&quot;:13&quot; /&gt; ''See:'' [[Fibromyalgia#Diagnosis|Fibromyalgia (''Diagnosis'' section)]].<br /> <br /> [[File:Fibro_Tender_Points.png|400px|thumb|right|1990 ACR Diagnostic Criteria: 18 &lt;u&gt;Tender Points&lt;/u&gt;]]<br /> [[File:Fibro_Widespread_Pain.png|400px|thumb|right|2010 ACR Preliminatry Diagnostic Criteria: '''Wisedpread Pain Index (WPI'''), 19 &lt;u&gt;Tender Point Areas&lt;/u&gt;]]<br /> <br /> ==Prevalence==<br /> FM is the second most common [https://en.wikipedia.org/wiki/Rheumatism rheumatic disorder] behind [[wikipedia:Osteoarthritis|osteoarthritis]] and is &quot;now considered to be a lifelong [[central nervous system]] disorder.&quot;&lt;ref&gt;{{Cite news|url=https://naidw.org/blog/members-myblogs/fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder|title=Fibromyalgia now considered as a lifelong central nervous system disorder|work=NAIDW.org®|access-date=2018-08-09|language=en-gb}}&lt;/ref&gt; An estimated 10 million people in the US and 3-6% of the world population have fibromyalgia. It is seen in women, men, children, and all ethnic groups. It is often seen in families and diagnosed between the ages of 20 to 50 years; incidence increases with age.&lt;ref&gt;{{Cite news|url=http://www.fmaware.org/about-fibromyalgia/prevalence/|title=Prevalence - National Fibromyalgia Association (NFA)|work=National Fibromyalgia Association (NFA)|access-date=2018-08-09|language=en-US}}&lt;/ref&gt;<br /> <br /> FM has a female:male 7:1 ratio under the ''American College of Rheumatology (ACR) 1990 Diagnostic Criteria'' and 2:1 when the ''ACR 2010 Preliminary Diagnostic Criteria'' is used.&lt;ref&gt;{{Cite journal|last=Boomershine|first=Chad|date=Nov 4, 2017|title=Fibromyalgia: Practice Essentials, Background, Pathophysiology|url=http://emedicine.medscape.com/article/329838-overview#a5|journal=Medscape|volume=|pages=|via=|publisher=|editor-last=Diamond|editor-first=Herbert|at=Sex-related differences in incidence}}&lt;/ref&gt; ''See'': [[Fibromyalgia#American College of Rheumatology (ACR) Criteria|Fibromyalgia (''American College of Rheumatology (ACR) Criteria'' section)]]. A September 2018, Wolfe et al study ''Fibromyalgia diagnosis and biased assessment: Sex, prevalence and bias''&lt;ref name=&quot;:28&quot; /&gt; found fewer women and more men are diagnosed under the 2010/11 criteria (this criterion further updated in 2016&lt;ref&gt;{{Cite journal|date=2016-12-01|title=2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria|url=https://www.sciencedirect.com/science/article/pii/S0049017216302086|journal=Seminars in Arthritis and Rheumatism|language=en|volume=46|issue=3|pages=319–329|doi=10.1016/j.semarthrit.2016.08.012|issn=0049-0172}}&lt;/ref&gt;). They found the ratio is F/M 1.5:1.&lt;ref name=&quot;:28&quot;&gt;{{Cite journal|last=Wolfe|first=Frederick|last2=Walitt|first2=Brian|last3=Perrot|first3=Serge|last4=Rasker|first4=Johannes J.|last5=Häuser|first5=Winfried|date=2018-09-13|title=Fibromyalgia diagnosis and biased assessment: Sex, prevalence and bias|url=https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0203755|journal=PLOS ONE|language=en|volume=13|issue=9|pages=e0203755|doi=10.1371/journal.pone.0203755|issn=1932-6203|pmc=|pmid=30212526|via=}}&lt;/ref&gt;&lt;blockquote&gt;What we did not find in our unbiased CritFM samples was 9:1 female to male fibromyalgia ratios that are widely described by expert sources [11–13]. We believe that such findings only occur in the presence of selection bias or biased ascertainment.&lt;ref name=&quot;:28&quot; /&gt;&lt;/blockquote&gt;&lt;blockquote&gt;As unbiased epidemiological studies show only a small increase in the female to male sex ratio (~1.5:1) as opposed to the observed ratio in clinical studies of 9:1, we believe that the over-identification of fibromyalgia in women and the consequent under-identification of men is the result of bias.&lt;ref name=&quot;:28&quot; /&gt;&lt;/blockquote&gt;<br /> ==Fibromyalgia in ME/CFS==<br /> Dr. [[Jarred Younger]] has said that many patients that meet the criteria for FM also meet criteria for [[chronic fatigue syndrome]] (CFS) but the reverse is not necessarily true as a lot of people with [[CFS]] do not have [[chronic pain]].&lt;ref&gt;{{Cite web|url=https://www.youtube.com/watch?v=wJB95m4FLa0#t=57m27s|title=Webinar with Jarred Younger, Ph.D.|last=Younger|first=Jared|date=May 20, 2016|website=YouTube|at=57:27|via=|archive-url=|archive-date=|dead-url=|access-date=|publisher=SolveCFS|type=Video}}&lt;/ref&gt; However, the [[Canadian Consensus Criteria]] (CCC) requires the symptom of pain to diagnose [[ME/CFS|Myalgic Encephalomyelitis/Chronic Fatigue Syndrome]] (ME/CFS).&lt;ref name=&quot;Carruthers, 2003&quot;&gt;{{Citation<br /> | last1 = Carruthers | first1 = Bruce M. | authorlink1 = Bruce Carruthers <br /> | last2 = Jain | first2 = Anil Kumar | authorlink2 = Anil Kumar Jain<br /> | last3 = De Meirleir | first3 = Kenny L. | authorlink3 = Kenny De Meirleir<br /> | last4 = Peterson | first4 = Daniel L. | authorlink4 = Daniel Peterson<br /> | last5 = Klimas | first5 = Nancy G. | authorlink5 = Nancy Klimas<br /> | last6 = Lerner | first6 = A. Martin | authorlink6 = Martin Lerner<br /> | last7 = Bested | first7 = Alison C. | authorlink7 = Alison Bested<br /> | last8 = Flor-Henry | first8 = Pierre | authorlink8 = Pierre Flor-Henry <br /> | last9 = Joshi | first9 = Pradip | authorlink9 = Pradip Joshi<br /> | last10 = Powles | first10 = A C Peter | authorlink10 = A C Peter Powles<br /> | last11 = Sherkey | first11 = Jeffrey A. | authorlink11 = Jeffrey Sherkey<br /> | last12 = van de Sande | first12 = Marjorie I. | authorlink12 = Marjorie van de Sande<br /> | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols<br /> | journal = Journal of Chronic Fatigue Syndrome | volume = 11 | issue = 2 | page = 7-115<br /> | date = 2003<br /> | pmid = <br /> | doi = 10.1300/J092v11n01_02<br /> | url = http://phoenixrising.me/wp-content/uploads/Canadian-definition.pdf<br /> }}&lt;/ref&gt;&lt;ref&gt;{{Cite web|url=https://www.me-pedia.org/wiki/Canadian_Consensus_Criteria|title=Canadian Consensus Criteria - MEpedia|website=www.me-pedia.org|language=en|access-date=2018-10-04}}&lt;/ref&gt; It is the pattern (on both sides of the body, and above and below the waist) of chronic widespread musculoskeletal pain (involving [[muscle]], cartilage, ligaments, and connective tissue) in FM that sets it apart from other diseases that have pain; it also causes [[cognitive symptoms]] and [[unrefreshing sleep]].&lt;ref name=&quot;:17&quot; /&gt;&lt;ref name=&quot;:26&quot; /&gt;&lt;ref name=&quot;:27&quot; /&gt;<br /> <br /> &quot;The most common overlapping condition with [[ME/CFS]] is fibromyalgia.&quot;&lt;ref name=&quot;:30&quot;&gt;{{Cite web|url=https://ammes.org/overlapping-conditions/|title=Overlapping Conditions - American Myalgic Encephalomyelitis and Chronic Fatigue Syndrome Society|last=|first=|date=|website=ammes.org|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-12}}&lt;/ref&gt;&lt;ref name=&quot;:31&quot;&gt;{{Cite journal|last=Jason|first=Leonard|last2=Taylor|first2=R.R.|last3=Kennedy|first3=C.L.|last4=Song|first4=S|last5=Johnson|first5=D|last6=Torres|first6=S.R.|date=2001-01-01|title=Chronic fatigue syndrome: Comorbidity with fibromyalgia and psychiatric illness|url=https://www.researchgate.net/publication/285787383_Chronic_fatigue_syndrome_Comorbidity_with_fibromyalgia_and_psychiatric_illness|journal=Medicine and Psychiatry|volume=4|pages=29–34}}&lt;/ref&gt;<br /> <br /> ==Health complications==<br /> FM is not a [https://en.wikipedia.org/wiki/Progressive_disease progressive disease] but according to Dr. Dan Clauw the &quot;slow gradual worsening of chronic pain patients over time is due to downstream consequences of poorly controlled pain and other symptoms, wherein individuals then progressively get less active, sleep worse, are under more stress and unknowingly develop bad habits which worsen pain and other symptoms.&quot;&lt;ref&gt;{{Cite news|url=http://nationalpainreport.com/ask-the-dctors-is-fibromyalgia-progressive-8831105.html|title=Ask the Doctors: Is Fibromyalgia Progressive?|date=2016-08-09|work=National Pain Report|access-date=2018-08-09|language=en-US}}&lt;/ref&gt;<br /> <br /> *[https://www.sharecare.com/health/fibromyalgia-effects Fibromyalgia Complications]&lt;ref name=&quot;:19&quot; /&gt;<br /> <br /> :&lt;blockquote&gt;People who have fibromyalgia frequently complain of a variety of symptoms that affect other parts of the body. Many people complain of [[gastrointestinal]] issues and restless legs syndrome (RLS). Additionally, the [[chronic pain]] and discomfort of fibromyalgia may lead to [[depression]].&lt;ref name=&quot;:19&quot;&gt;{{Cite news|url=https://www.sharecare.com/health/fibromyalgia-effects|title=Fibromyalgia Complications - Fibromyalgia - Joint Health|work=Sharecare|access-date=2018-08-09|language=en}}&lt;/ref&gt;&lt;/blockquote&gt;<br /> <br /> *[https://www.sharecare.com/health/fibromyalgia-effects/can-fibromyalgia-cause-medical-conditions Can fibromyalgia cause other medical conditions?]&lt;ref name=&quot;:20&quot; /&gt;<br /> <br /> :&lt;blockquote&gt;Fibromyalgia is not known to cause other medical conditions. However, people who have fibromyalgia seem to be at high risk for developing other painful conditions, including [https://en.wikipedia.org/wiki/Osteoarthritis osteoarthritis] (the common type of arthritis caused by wear and tear on the joints) as well as other related conditions, such as [[rheumatoid arthritis]], [[lupus]], and [https://en.wikipedia.org/wiki/Ankylosing_spondylitis ankylosing spondylitis]. Also, people with fibromyalgia are frequently diagnosed with chronic fatigue syndrome, irritable bowel syndrome (IBS), and temporomandibular joint (TMJ) disorder.&lt;ref name=&quot;:20&quot;&gt;{{Cite web|url=https://www.sharecare.com/health/fibromyalgia-effects/can-fibromyalgia-cause-medical-conditions|title=Can fibromyalgia cause other medical conditions? {{!}} Fibromyalgia Complications|last=Honor Society of Nursing|first=|date=|website=Sharecare|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}&lt;/ref&gt;&lt;/blockquote&gt;<br /> <br /> ==Risk factors==<br /> [[Lupus]] and [[rheumatoid arthritis]] (RA) are risk factors in developing FM. Car accidents, [[post-traumatic stress disorder]] (PTSD), [https://en.wikipedia.org/wiki/Repetitive_strain_injury repetitive injuries], illness such as a [https://en.wikipedia.org/wiki/Viral_disease viral infection], [https://en.wikipedia.org/wiki/Family_history_(medicine) family history], and [https://en.wikipedia.org/wiki/Obesity obesity] have all been linked to FM.&lt;ref&gt;{{Cite web|url=https://www.cdc.gov/arthritis/basics/fibromyalgia.htm|title=Fibromyalgia {{!}} Arthritis {{!}} CDC|date=2018-04-03|website=www.cdc.gov|language=en-us|access-date=2018-08-09}}&lt;/ref&gt;&lt;ref&gt;{{Cite news|url=https://www.niams.nih.gov/health_info/Fibromyalgia/|title=Fibromyalgia What Causes it?|last=Director|first=Nancy Garrick, Deputy|date=2017-04-05|work=National Institute of Arthritis and Musculoskeletal and Skin Diseases|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}&lt;/ref&gt;&lt;ref&gt;{{Cite news|url=http://www.prohealth.com/library/showarticle.cfm?libid=22315|title=When Fibromyalgia Is More than Pain - Prohealth|date=2016-01-08|work=Prohealth|access-date=2018-08-09|language=en-US}}&lt;/ref&gt;<br /> <br /> ==Diagnosis==<br /> [https://www.verywellhealth.com/what-are-fibromyalgia-tender-points-189768 Tender points], not [https://en.wikipedia.org/wiki/Myofascial_trigger_point trigger points], are used to diagnose fibromyalgia.&lt;ref&gt;{{Cite web|url=http://www.healthcentral.com/chronic-pain/c/662034/176031/fibromyalgia-trigger/|title=The Difference Between Fibromyalgia Tender Points and Myofascial Trigger Points - Chronic Pain {{!}} HealthCentral|last=Cooper|first=Celeste|date=May 8, 2015|website=www.healthcentral.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}&lt;/ref&gt; Tender points will be above and below the waist and on both sides of the body. (See: Illustrations of the 1990 and 2010 American College of Rheumatology (ACR) Criteria depicting tender points near the top of this page.) It is important to check for other conditions that could be causing pain such as hypothyroidism, rheumatoid arthritis or lupus, osteoarthritis, ankylosing spondylitis, and [[wikipedia:Polymyalgia_rheumatica|polymyalgia rheumatica]].&lt;ref&gt;{{Cite news|url=https://www.webmd.com/fibromyalgia/guide/fibromyalgia-diagnosis-and-misdiagnosis#1|title=How Is Fibromyalgia Diagnosed?|work=WebMD|access-date=2018-08-12|language=en-US}}&lt;/ref&gt;<br /> <br /> ===United States===<br /> ==== American College of Rheumatology (ACR) Criteria ====<br /> <br /> =====1990 ACR criteria=====<br /> <br /> *1990, [http://www.rheumatology.org/Portals/0/Files/1990_Criteria_for_Classification_Fibro.pdf The American College Of Rheumatology 1990 Criteria For The Classification Of Fibromyalgia]&lt;ref name=&quot;:12&quot;&gt;{{Cite web|url=https://www.rheumatology.org/Portals/0/Files/1990_Criteria_for_Classification_Fibro.pdf|title=The American College of Rheumatology Criteria for the Classification of Fibromyalgia|last=Wolfe|first=Frederick|last2=Smythe|first2=Hugh|date=1990|website=rheumatology.org|publisher=|others=Abeles, Micha; Clark, Patricia; Fam, Adel; Farber, Stephen; Fiechtner, Justus; Franklin, Michael; Gatter, Robert; Hamaty, Daniel; Lessard, James; Lightbroun, Alan; Masi, Alfonse; McCain, Glenn; Reynolds, W. John; Romano, Thomas; Russell, Jon; Sheon, Robert|archive-url=|archive-date=|dead-url=|access-date=|last3=Yunus|first3=Muhammad|last4=Bennett|first4=Robert|last5=Bombardier|first5=Claire|last6=Goldenberg|first6=Don|last7=Tugwell|first7=Peter|last8=Campbell|first8=Stephen}}&lt;/ref&gt; &quot;American College of Rheumatology guidelines suggest that people with fibromyalgia have pain in at least 11 of these tender points when a doctor applies a certain amount of pressure.&quot;&lt;ref&gt;{{Cite news|url=http://www.health.com/health/gallery/0,,20345635,00.html|title=18 Points Used to Diagnose Fibromyalgia|last=|first=|date=Feb 4, 2011|work=Health.com|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}&lt;/ref&gt;&lt;ref&gt;{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}&lt;/ref&gt;<br /> <br /> =====2010 ACR criteria=====<br /> <br /> *2010, The [https://www.fibroknowledge.com/site/acr-2010 2010 American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia: Overview]&lt;ref name=&quot;:13&quot;&gt;{{Cite web|url=https://www.fibroknowledge.com/sites/default/files/downloads/file/2010_ACR_CRITERIA.pdf|title=American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia|last=|first=|date=2010|website=fibroknowledge.com|type=PDF|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt; was proposed and modified in 2011&lt;ref&gt;{{Cite news|url=http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria|title=New and Modified Fibromyalgia Diagnostic Criteria|last=Garg|first=Neha|date=Feb 9, 2012|work=Rheumatology Network|access-date=Aug 9, 2017|archive-url=|archive-date=|dead-url=|last2=Deodhar|first2=Atul}}&lt;/ref&gt; with the modification being validated in 2013 and published in 2014.&lt;ref&gt;{{Cite journal|last=Bennett|first=Robert M.|last2=Friend|first2=Ronald|last3=Marcus|first3=Dawn|last4=Bernstein|first4=Cheryl|last5=Han|first5=Bobby Kwanghoon|last6=Yachoui|first6=Ralph|last7=Deodhar|first7=Atul|last8=Kaell|first8=Alan|last9=Bonafede|first9=Peter|date=2014|title=Criteria for the diagnosis of fibromyalgia: validation of the modified 2010 preliminary American College of Rheumatology criteria and the development of alternative criteria|url=https://www.ncbi.nlm.nih.gov/pubmed/24497443|journal=Arthritis Care &amp; Research|volume=66|issue=9|pages=1364–1373|doi=10.1002/acr.22301|issn=2151-4658|pmid=24497443|via=}}&lt;/ref&gt; September of 2016, another revision has been made.&lt;ref name=&quot;:14&quot;&gt;{{Cite news|url=http://acrabstracts.org/abstract/2016-revisions-to-the-20102011-fibromyalgia-diagnostic-criteria/|title=2016 Revisions to the 2010/2011 Fibromyalgia Diagnostic Criteria - ACR Meeting Abstracts|last=|first=|date=Sep 28, 2016|work=ACR Meeting Abstracts|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}&lt;/ref&gt; <br /> <br /> :Men do not seem to form the tender points needed for diagnosis under the 1990 criteria,&lt;ref&gt;{{Cite news|url=http://www.webmd.com/fibromyalgia/features/how-fibromyalgia-affects-men#2|title=How Fibromyalgia Affects Men: Symptoms and Diagnosis|work=WebMD|access-date=2018-08-09|language=en-US}}&lt;/ref&gt; the 2010 proposed criteria diagnoses more men with a F/M ratio of 2:1.&lt;ref&gt;{{Cite journal|last=Boomershine|first=Chad|date=Nov 4, 2017|title=Fibromyalgia: Practice Essentials, Background, Pathophysiology|url=http://emedicine.medscape.com/article/329838-overview#a5|journal=Medscape|volume=|pages=|via=}}&lt;/ref&gt;<br /> :Tender points were used to diagnose with the 1990 criteria, however &quot;considerable skill is needed to correctly check for a patient’s tender points (i.e., digital palpation that is done with certain amount of applied pressure), yet this technique is not typically taught at most medical schools.&quot;&lt;ref name=&quot;:0&quot;&gt;{{Cite web|url=https://www.masscfids.org/8-resource-library/diagnosis/266-tender-points-might-no-longer-be-used-for-diagnosis-of-fibromyalgia#2|title=Tender Points might no longer be used for diagnosis of Fibromyalgia|last=Proskauer|first=Charmian|date=Feb 5, 2011|website=www.masscfids.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}&lt;/ref&gt;<br /> :The new standards were designed to:<br /> :*eliminate the use of a tender point examination<br /> :*include a severity scale by which to identify and measure characteristic FM symptoms<br /> :*utilize an index by which to rate pain&lt;ref name=&quot;:0&quot; /&gt; <br /> <br /> There are 19 &lt;u&gt;tender point areas&lt;/u&gt; in the widespread pain index '''(WPI)''', whereas the 1990 criteria had 18 &lt;u&gt;tender points&lt;/u&gt;.&lt;ref name=&quot;:0&quot; /&gt;&lt;ref&gt;{{Cite news|url=https://www.verywellhealth.com/what-are-fibromyalgia-tender-points-189768|title=Why Tender Points Are No Longer Used to Diagnose Fibromyalgia|last=Eustice|first=Carol|date=Oct 3, 2018|work=Verywell Health|access-date=2018-10-04|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt;<br /> <br /> ====== Widespread pain index and Symptom severity ======<br /> <br /> <br /> The '''Widespread Pain Index (WPI)''' and '''Symptom Severity''' '''(SS)''' is explained in the study ''Fibromyalgia Syndrome: An Overview of Pathophysiology, Diagnosis and Management''.&lt;ref name=&quot;:21&quot; /&gt; <br /> [[File:Widespread Pain Index Areas with numbers.svg|200px|thumb|right|'''WPI''' 19 areas of pain. Count 1 point for each area of pain&lt;ref name=&quot;:21&quot; /&gt;]]<br /> &lt;blockquote&gt;In place of the tender point count, patients (or their physician) may endorse 19 body regions in which pain has been experienced during the past week. One point is given for each area, so the score is between 0-19. This number is referred to as the '''Widespread Pain Index (WPI)''' and it is one of the two required scores needed for a doctor to make a diagnosis of fibromyalgia.&lt;/blockquote&gt;&lt;blockquote&gt;The second part of the score required to assess the diagnosis of fibromyalgia involves the evaluation of a person's symptoms. The patient ranks specific symptoms on a scale of 0-3. These symptoms include: [[Fatigue]], [[Unrefreshing sleep|Waking unrefreshed]], [[Cognitive dysfunction|Cognitive symptoms]], Somatic (physical) symptoms in general (such as [[headache]], [[wikipedia:Weakness|weakness]], [[Gastrointestinal system|bowel problems]], [[nausea]], [[dizziness]], [[numbness]] / [[Paresthesia|tingling]], [[hair loss]]). The numbers assigned to each are added up, for a total of 0-12.&lt;/blockquote&gt;&lt;blockquote&gt;The diagnosis is based on both the '''WPI''' score and the '''SS''' score either:&lt;/blockquote&gt;<br /> :::&lt;blockquote&gt;'''WPI''' of at least 7 and '''SS''' scale score of at least 5, '''OR'''&lt;/blockquote&gt;<br /> :::&lt;blockquote&gt;'''WPI''' of 4-6&lt;ref name=&quot;:14&quot; /&gt; and '''SS''' scale score of at least 9.&lt;ref name=&quot;:21&quot; /&gt;&lt;/blockquote&gt;<br /> <br /> [[File:WPI SS Fibro.JPG|600px|thumb|center|Table 2: '''SS''' scale score. Add a 4th column for Somatic (physical) symptoms in general (such as headache, weakness, bowel problems, nausea, dizziness, numbness/tingling, hair loss). The patient ranks specific symptoms on a scale of 0-3. The numbers assigned to each are added up, for a total of 0-12.&lt;ref name=&quot;:21&quot; /&gt; ]]<br /> <br /> <br /> The [[Social Security Administration]] (SSA) accepts a diagnosis of fibromyalgia with the 1990 or 2010 ACR criteria.&lt;ref&gt;{{Cite web|url=https://www.ssa.gov/OP_Home/rulings/di/01/SSR2012-02-di-01.html|title=Social Security Ruling: SSR 12-2p|last=ORDP,OPPS|first=|date=Jul 25, 2012|website=www.ssa.gov|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}&lt;/ref&gt; See the [[Fibromyalgia disability process]] page.<br /> <br /> === Sleep study ===<br /> [[Sleep dysfunction]] is often involved in fibromyalgia. Treating a sleep disorder can help with fibromyalgia symptoms. A diagnosed sleep disorder is also helpful if one needs to file for disability.<br /> <br /> *[https://www.verywellhealth.com/sleep-study-fibromyalgia-cfs-716054 Getting a Sleep Study with Fibromyalgia or Chronic Fatigue Syndrome]&lt;ref&gt;{{Cite news|url=https://www.verywellhealth.com/sleep-study-fibromyalgia-cfs-716054|title=Getting a Sleep Study with Fibromyalgia or Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 15, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt;<br /> <br /> *[http://www.sciencedaily.com/releases/2008/09/080903134311.htm What A Sleep Study Can Reveal About Fibromyalgia]&lt;ref&gt;{{Cite news|url=https://www.sciencedaily.com/releases/2008/09/080903134311.htm|title=What A Sleep Study Can Reveal About Fibromyalgia|work=ScienceDaily|access-date=2018-08-09|language=en}}&lt;/ref&gt;<br /> <br /> *[http://linkis.com/nationalpainreport.com/lzYea Fibromyalgia Sufferers Have Difficulty Maintaining Continuous Sleep, Study Says]&lt;ref&gt;{{Cite news|url=http://linkis.com/nationalpainreport.com/lzYea|title=Fibromyalgia Sufferers Have Difficulty Maintaining Continuous Sleep, Study Says|last=|first=|date=Mar 25, 2016|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}&lt;/ref&gt;<br /> <br /> === ICD Diagnostic code===<br /> '''ICD-10'''<br /> <br /> The [[World Health Organization]] (WHO) International Classification of Diseases (ICD) lists fibromyalgia as a &quot;disease of the [[musculoskeletal system]] and connective tissue&quot;, under the code M79.7 (WHO ICD-10 Version: 016).&lt;ref name=&quot;:24&quot;&gt;{{Cite web|url=http://apps.who.int/classifications/icd10/browse/2016/en#/M79.7|title=ICD-10 Version:2016|last=|first=|date=2016|website=apps.who.int|at=M79.7 Fibromyalgia|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-09-15}}&lt;/ref&gt;<br /> <br /> *'''M79.7 Fibromyalgia'''<br /> ::Fibromyositis<br /> ::Fibrositis<br /> ::Myofibrositis&lt;ref name=&quot;:24&quot; /&gt;<br /> <br /> In 2015, the [[United States]] finally adopted ICD-10 and Fibromyalgia as a diagnosis.&lt;ref&gt;{{Cite web|url=http://www.icd10data.com/ICD10CM/Codes/M00-M99/M70-M79/M79-/M79.7|title=2018 ICD-10-CM Diagnosis Code M79.7: Fibromyalgia|website=www.icd10data.com|language=en|access-date=2018-08-09|date=|last=World Health Organisation|first=|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt; &lt;ref&gt;{{Cite news|url=http://nationalpainreport.com/the-health-care-industry-finally-recognizes-fibromyalgia-8827637.html|title=The Health Care Industry Finally Recognizes Fibromyalgia|last=Liptan|first=Ginevra|date=2015-09-30|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}&lt;/ref&gt;<br /> <br /> '''ICD-11 (2019)'''<br /> <br /> [https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/849253504 ICD-11] (2019) has diagnostic code ''MG30.1 Chronic widespread pain''.&lt;ref name=&quot;:18&quot;&gt;{{Cite web|url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/849253504|title=ICD-11 - Mortality and Morbidity Statistics|website=icd.who.int|language=en|access-date=2018-08-09}}&lt;/ref&gt; <br /> <br /> *'''MG30.01 Chronic widespread pain'''<br /> <br /> '''Parent'''<br /> ::MG30.0 Chronic primary pain<br /> <br /> '''Description'''<br /> &lt;blockquote&gt;Chronic widespread pain (CWP) is diffuse pain in at least 4 of 5 body regions and is associated with significant emotional distress (anxiety, anger/frustration or depressed mood) or functional disability (interference in daily life activities and reduced participation in social roles) [1]. CWP is multifactorial: biological, psychological and social factors contribute to the pain syndrome. The diagnosis is appropriate when the pain is not directly attributable to a nociceptive process in these regions and there are features consistent with nociplastic pain [2] and identified psychological and social contributors.&lt;ref name=&quot;:18&quot; /&gt;&lt;/blockquote&gt;<br /> <br /> '''Inclusions'''<br /> :*Fibromyalgia<br /> '''Exclusions'''<br /> :*Acute pain (MG31)&lt;ref name=&quot;:18&quot; /&gt;<br /> <br /> ==Pathophysiology==<br /> &quot;Fibromyalgia (FM) is a chronic pain disorder with unknown etiology and unclear pathophysiology. There is no evidence that a single event “causes” FM. Rather, many physical and/or emotional stressors may trigger or aggravate symptoms. These have included certain infections, such as a viral illness or [[Lyme disease]], as well as emotional or physical trauma.&quot;&lt;ref&gt;{{Cite web|url=https://www.uptodate.com/contents/pathogenesis-of-fibromyalgia#!|title=UpToDate|last=Goldenberg|first=Don L|date=|website=www.uptodate.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}&lt;/ref&gt; The widespread pain is severe, debilitating, and abnormal in processing its pain. There is also [[Sleep dysfunction|sleep disturbance]] and fatigue. Cause or causes are unproven.&lt;ref&gt;{{Cite news|url=https://www.omf.ngo/what-is-mecfs-old/fibromyalgia/|title=What is Fibromyalgia? {{!}} Open Medicine Foundation|work=Open Medicine Foundation|access-date=2018-08-09|language=en-US}}&lt;/ref&gt;<br /> <br /> *May 2012, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394355/ Fibromyalgia Syndrome: An Overview of Pathophysiology, Diagnosis and Management]&lt;ref name=&quot;:21&quot;&gt;{{Cite journal|last=Jahan|first=Firdous|last2=Nanji|first2=Kashmira|last3=Qidwai|first3=Waris|last4=Qasim|first4=Rizwan|date=2012|title=Fibromyalgia Syndrome: An Overview of Pathophysiology, Diagnosis and Management|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394355/|journal=Oman Medical Journal|volume=27|issue=3|pages=192–195|doi=10.5001/omj.2012.44|issn=1999-768X|pmc=|pmid=22811766|via=}}&lt;/ref&gt; ''See'' Table 1: &quot;Conditions associated with fibromyalgia.&quot; Musculoskeletal, genitourianry, gastro intestinal, and miscellaneous conditions often exist among fibromyalgia patients.<br /> <br /> &lt;blockquote&gt;Pathophysiology: Although the etiology remains unclear, characteristic alterations in the [[Sleep dysfunction|pattern of sleep]] and changes in neuroendocrine transmitters such as [[serotonin]], substance P, growth hormone and [[cortisol]] suggest that regulation of the [[Autonomic nervous system|autonomic]] and neuro-endocrine system appears to be the basis of the syndrome. Fibromyalgia is not a life-threatening, deforming, or [https://en.wikipedia.org/wiki/Progressive_disease progressive disease]. [[Anxiety]] and [[depression]] are the most common association. Aberrant pain processing, which can result in [[chronic pain]], may be the result of several interplaying mechanisms. [[Central sensitization]], blunting of inhibitory pain pathways and alterations in [[neurotransmitters]] lead to aberrant neuro-chemical processing of sensory signals in the CNS, thus lowering the threshold of pain and amplification of normal sensory signals causing constant pain.&lt;ref name=&quot;:21&quot; /&gt;&lt;/blockquote&gt;<br /> <br /> &lt;blockquote&gt;The frequent co-morbidity of fibromyalgia with mood disorders suggests a major role for the stress response and for neuroendocrine abnormalities. The [[hypothalamic pituitary axis]] (HPA) is a critical component of the stress-adaptation response. In FMS, stress adaptation response is disturbed leading to stress induce symptoms. Psychiatric co-morbidity has been associated with FMS and needs to be identified during the consultation process, as this requires special consideration during treatment.&lt;ref name=&quot;:21&quot; /&gt;&lt;/blockquote&gt;<br /> <br /> *May 2018, [https://www.chiropractic.ca/wp-content/uploads/2018/05/107243-2_Chiro_62_1d_Bourgaize.pdf A comparison of the clinical manifestation and pathophysiology of myofascial pain syndrome and fibromyalgia: implications for differential diagnosis and management]&lt;ref&gt;{{Cite journal|last=Bourgaize|first=Sheryl|last2=Newton|first2=Genevieve|last3=Kumbhare|first3=Dinesh|last4=Srbely|first4=John|date=2018|title=A comparison of the clinical manifestation and pathophysiology of myofascial pain syndrome and fibromyalgia: implications for differential diagnosis and management (Table 1).|url=https://www.chiropractic.ca/wp-content/uploads/2018/05/107243-2_Chiro_62_1d_Bourgaize.pdf|format=PDF|journal=Journal of the Canadian Chiropractic Assoc.|volume=|pages=26-41|at=|via=|page=}}&lt;/ref&gt; ''See'' Table 1 &quot;Summary of the pathophysiology of fibromyalgia and myofascial pain syndrome.&quot; pg. 29 (pg. 4 of PDF) <br /> <br /> *Jun 2018, [https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0198625 SNPs in inflammatory genes ''CCL11'', ''CCL4'' and ''MEFV'' in a fibromyalgia family study]&lt;ref&gt;{{Cite journal|last=Zhang|first=Zhifang|last2=Feng|first2=Jinong|last3=Mao|first3=Allen|last4=Le|first4=Keith|last5=Placa|first5=Deirdre La|last6=Wu|first6=Xiwei|last7=Longmate|first7=Jeffrey|last8=Marek|first8=Claudia|last9=Amand|first9=R. Paul St|date=2018-06-21|title=SNPs in inflammatory genes CCL11, CCL4 and MEFV in a fibromyalgia family study|url=http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0198625|journal=PLOS ONE|language=en|volume=13|issue=6|pages=e0198625|doi=10.1371/journal.pone.0198625|issn=1932-6203|pmid=29927949|via=}}&lt;/ref&gt;&lt;ref&gt;{{Cite news|url=https://fibromyalgianewstoday.com/2018/07/03/immune-system-may-play-role-fibromyalgia-study/|title=Fibromyalgia May Be Linked to Immune System, Study Suggests|last=Inacio|first=Patricia|date=2018-07-03|work=Fibromyalgia News Today|access-date=2018-08-22|archive-url=|archive-date=|dead-url=|language=en-US}}&lt;/ref&gt;<br /> <br /> &lt;blockquote&gt;SNPs with significant TDTs were found in 36% of the cohort for CCL11 and 12% for MEFV, along with a protein variant in CCL4 (41%) that affects CCR5 down-regulation, supporting an immune involvement for FM.&lt;/blockquote&gt;<br /> <br /> *Jul 2018, [https://fibromyalgianewstoday.com/2018/07/31/primary-secondary-fibromyalgia-share-similar-symptom-burden-study/ Primary and Secondary Fibromyalgia Share Same Symptom Burden, Study Suggests]&lt;ref name=&quot;:22&quot;&gt;{{Cite news|url=https://fibromyalgianewstoday.com/2018/07/31/primary-secondary-fibromyalgia-share-similar-symptom-burden-study/|title=Primary, Secondary Fibromyalgia Share Same Symptom Burden, Study Says|last=Carvalho|first=John|date=2018-07-31|work=Fibromyalgia News Today|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}&lt;/ref&gt;<br /> <br /> &lt;blockquote&gt;Fibromyalgia can be considered either primary, or dominant, also known as idiopathic fibromyalgia, or secondary. In the primary form, the causes of the disorder are unknown, but in secondary fibromyalgia, the disorder usually occurs alongside other debilitating medical conditions, such as rheumatoid arthritis (RA), lupus, and multiple sclerosis.&lt;ref name=&quot;:22&quot; /&gt;&lt;/blockquote&gt;<br /> <br /> ===Immune system research===<br /> <br /> Dr. [[Jarred Younger]] believes an overactive [[immune system]] is the cause and will be conducting a study to test this hypothesis.&lt;ref&gt;{{Cite news|url=http://nationalpainreport.com/new-uab-study-could-radically-change-fibromyalgia-treatment-as-we-know-it-8833437.html|title=New UAB Study Could Radically Change Fibromyalgia Treatment As We Know It|last=Gregory Burch|first=Donna|date=2017-04-24|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}&lt;/ref&gt;&lt;ref&gt;{{Cite web|url=https://www.youtube.com/watch?v=8e5xKX036bE|title=Testing the fibromyalgia immune system with lipopolysaccharide (LPS)|last=Younger|first=Jarred|date=May 24, 2017|website=YouTube|archive-url=|archive-date=|dead-url=|access-date=|via=Younger Lab}}&lt;/ref&gt; An overactive immune system can cause [[inflammation]] and [[chronic pain]].&lt;ref&gt;{{Cite news|url=https://www.epainassist.com/autoimmune/what-is-overactive-immune-system|title=What is Overactive Immune System{{!}}Causes{{!}}Symptoms{{!}}Treatment|last=Kerkar|first=Pramod|date=2016-09-29|work=ePainAssist|access-date=2018-10-04|archive-url=|archive-date=|dead-url=|language=en-gb}}&lt;/ref&gt;&lt;ref&gt;{{Cite news|url=https://www.webmd.com/a-to-z-guides/autoimmune-diseases|title=Autoimmune Diseases|work=WebMD|access-date=2018-10-04|language=en-US}}&lt;/ref&gt;<br /> <br /> Dr. William Pridgen's research of [[HSV-1]] (cold sore virus) as being involved in FM has conducted a successful Phase III clinical trial, which had been fast-tracked by the [[Food and Drug Administration]] (FDA), of a combination drug that suppresses this virus and also helps with pain. ''See'': [https://www.me-pedia.org/wiki/Fibromyalgia_drugs#Drug_trials Fibromyalgia drugs (''Drug trials: IMC-1'')].&lt;ref&gt;{{Cite web|url=https://www.me-pedia.org/wiki/Fibromyalgia_drugs#Drug_trials|title=Fibromyalgia drugs - MEpedia|last=|first=|date=|website=www.me-pedia.org|at=Drug trials: IMC-1|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-09-01}}&lt;/ref&gt; <br /> <br /> EpicGenetics has a blood test that is identifying the presence of specific white blood cell abnormalities of patients diagnosed with FM and has partnered with two universities to offer [[wikipedia:Exome_sequencing|whole exome sequencing]] free of charge to those who test positive with their [http://fmtest.com/ FM/a® test].&lt;ref&gt;{{Cite news|url=http://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical|title=EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches|last=|first=|date=Apr 19, 2017|work=|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}&lt;/ref&gt; Concerns have been raised in regards to the FM/a® EpicGenetics Blood Test.&lt;ref&gt;{{Cite web|url=http://www.fmperplex.com/2013/02/25/junk-science-junk-ethics/|title=Junk Science – Junk Ethics – The Fibromyalgia Perplex|last=Wolfe|first=Fred|date=Feb 25, 2013|website=www.fmperplex.com|language=en-US|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}&lt;/ref&gt; <br /> <br /> On September 5th, 2018, EpicGenetics announced that [http://www.massgeneral.org/ Massachusetts General Hospital] received approval from the FDA to test the [[wikipedia:BCG_vaccine|Bacille Calmette-Guerin (BCG) vaccine]] (an old Tuberculosis vaccine) on patients that tested positive with its FM/a® test.&lt;ref&gt;{{Cite news|url=http://nationalpainreport.com/can-an-existing-vaccine-help-treat-fibromyalgia-8837139.html|title=Can an Existing Vaccine Help Treat Fibromyalgia?|last=Coghlan|first=Ed|date=2018-09-05|work=National Pain Report|access-date=2018-09-10|archive-url=|archive-date=|dead-url=|language=en-US}}&lt;/ref&gt;&lt;ref&gt;{{Cite web|url=https://www.celestecooper.com/2018/07/the-fma-blood-test-and-participation-in.html#.Wz4nxdJKjIU|title=The FM/a® Blood Test and Participation in Fibromyalgia Vaccine Study|last=Cooper|first=Celeste|date=Jul 5, 2018|website=www.celestecooper.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}&lt;/ref&gt; &lt;ref&gt;{{Cite news|url=http://www.prohealth.com/library/showArticle.cfm?libid=30644|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}&lt;/ref&gt;&lt;ref&gt;{{Cite news|url=https://www.prohealth.com/library/century-old-vaccine-gives-new-hope-to-fibromyalgia-community-42689#comment-2286|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|at=See Comments Section: CDW12 says: June 26, 2018 at 2:05 pm|language=en-US}}&lt;/ref&gt;&lt;ref&gt;{{Cite news|url=http://www.prohealth.com/library/showArticle.cfm?libid=30644|title=Century-old Vaccine Gives New Hope to Fibromyalgia Community - Prohealth|last=Gregory Burch|first=Donna|date=2017-08-14|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}&lt;/ref&gt; <br /> <br /> Recognizing FM may involved activation of the immune system researchers performed exome sequencing on chemokine genes in a region of chromosome 17 identified in a genome-wide family association study. There conclusion: &quot;SNPs with significant TDTs were found in 36% of the cohort for ''CCL11'' and 12% for ''MEFV'', along with a protein variant in CCL4 (41%) that affects CCR5 down-regulation, supporting an immune involvement for FM.&quot;&lt;ref name=&quot;:42&quot;&gt;{{Cite journal|last=Zhang|first=Zhifang|last2=Feng|first2=Jinong|last3=Mao|first3=Allen|last4=Le|first4=Keith|last5=Placa|first5=Deirdre La|last6=Wu|first6=Xiwei|last7=Longmate|first7=Jeffrey|last8=Marek|first8=Claudia|last9=Amand|first9=R. Paul St|date=2018-06-21|title=SNPs in inflammatory genes CCL11, CCL4 and MEFV in a fibromyalgia family study|url=http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0198625|journal=PLOS ONE|language=en|volume=13|issue=6|pages=e0198625|doi=10.1371/journal.pone.0198625|issn=1932-6203|pmid=29927949|via=}}&lt;/ref&gt; <br /> <br /> === Brain and spinal cord research ===<br /> Various types of [[brain imaging]] are being used to research FM. (''See'': [[Fibromyalgia notable studies]] for images.)<br /> <br /> In 2002, an fMRI study conducted by Richard Gracely and Daniel Claw found people with fibromyalgia &quot;have measurable pain signals in their brains, from a gentle finger squeeze that barely feels unpleasant to people without the disease.&quot;&lt;ref&gt;{{Cite web|url=https://www.sciencedaily.com/releases/2002/06/020607073056.htm|title=Fibromyalgia Pain Isn't All In Patient's Heads, New Brain Study Finds|last=|first=|date=Jun 7, 2002|website=sciencedaily.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}&lt;/ref&gt; A 2007 study by Borsook et al., ''Neuroimaging revolutionizes therapeutic approaches to chronic pain'' found decreased [[gray matter]] density relative to controls in [[cingulate cortex]] (CC), medial [[prefrontal cortex]] (Med. PFC), [[parahippocampal gyrus]] (PHG) and [[insula]].&lt;ref name=&quot;:03&quot;&gt;{{Cite journal|last=Borsook|first=David|last2=Moulton|first2=Eric A|last3=Schmidt|first3=Karl F|last4=Becerra|first4=Lino R|date=2007-09-11|title=Neuroimaging Revolutionizes Therapeutic Approaches to Chronic Pain|url=https://link.springer.com/article/10.1186/1744-8069-3-25|journal=Molecular Pain|language=en|volume=3|issue=1|pages=1744–8069-3-25|doi=10.1186/1744-8069-3-25|issn=1744-8069|pmid=17848191|via=}}&lt;/ref&gt; In 2015, Loggia et al. imaged [[neuroinflammation]] due to [[Glial cell|glial]] activation using [https://www.itnonline.com/article/mrpet-ultimate-imaging-hybrid MR/PET imaging]&lt;ref&gt;{{Cite news|url=https://www.itnonline.com/article/mrpet-ultimate-imaging-hybrid|title=MR/PET: The Ultimate Imaging Hybrid|last=Ros|first=Pablo R.|date=2012-05-29|work=Imaging Technology News|access-date=2018-10-30|archive-url=|archive-date=|dead-url=|language=en}}&lt;/ref&gt;.&lt;ref&gt;{{Cite journal|last=Loggia|first=Marco L.|last2=Chonde|first2=Daniel B.|last3=Akeju|first3=Oluwaseun|last4=Arabasz|first4=Grae|last5=Catana|first5=Ciprian|last6=Edwards|first6=Robert R.|last7=Hill|first7=Elena|last8=Hsu|first8=Shirley|last9=Izquierdo-Garcia|first9=David|date=2015-01-08|title=Evidence for brain glial activation in chronic pain patients|url=https://academic.oup.com/brain/article/138/3/604/333527?searchresult=1|journal=Brain|language=en|volume=138|issue=3|pages=604–615|doi=10.1093/brain/awu377|issn=1460-2156}}&lt;/ref&gt; In 2017, López-Solà et al. identified three [[brain]] patterns based on [[Functional magnetic resonance imaging|fMRI]] responses to pressure pain and non-painful multisensory stimulation. &quot;These patterns, taken together, discriminate FM from matched healthy controls with 92% sensitivity and 94% specificity.&quot;&lt;ref name=&quot;:34&quot;&gt;{{Cite journal|last=López-Solà|first=Marina|last2=Woo|first2=Choong-Wan|last3=Pujol|first3=Jesus|last4=Deus|first4=Joan|last5=Harrison|first5=Ben J.|last6=Monfort|first6=Jordi|last7=Wager|first7=Tor D.|date=2017|title=Towards a neurophysiological signature for fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pubmed/27583567|journal=Pain|volume=158|issue=1|pages=34–47|doi=10.1097/j.pain.0000000000000707|issn=1872-6623|pmid=27583567|via=}}&lt;/ref&gt; In 2018, Albrecht et al used PET scans to document glial activation.&lt;ref name=&quot;:52&quot;&gt;{{Cite journal|last=Albrecht|first=Daniel S.|last2=Forsberg|first2=Anton|last3=Sandstrom|first3=Angelica|last4=Bergan|first4=Courtney|last5=Kadetoff|first5=Diana|last6=Protsenko|first6=Ekaterina|last7=Lampa|first7=Jon|last8=Lee|first8=Yvonne C.|last9=Höglundi|first9=Caroline Olgart|date=2018-09-14|others=Catana, Ciprian; Cervenka, Simon; Akeju, Oluwaseun; Lekander, Mats; Cohen, George; Halldin, Christer; Taylor, Norman; Kim, Minhae; Hooker, Jacob M.; Loggia, Marco L.|title=Brain glial activation in fibromyalgia – A multi-site positron emission tomography investigation|url=https://www.sciencedirect.com/science/article/pii/S0889159118302423|journal=Brain, Behavior, and Immunity|language=en|volume=|pages=|doi=10.1016/j.bbi.2018.09.018|issn=0889-1591|via=}}&lt;/ref&gt; Also in 2018, Martucci et al. found unbalanced activity between the ventral and dorsal cervical [[spinal cord]]. Ventral neural processes were increased and dorsal neural processes were decreased which may reflect the presence of [[central sensitization]] contributing to [[fatigue]] and other bodily symptoms in fibromyalgia.&lt;ref&gt;{{Cite journal|last=Martucci|first=Katherine T|last2=Weber|first2=Kenneth A|last3=Mackey|first3=Sean C|date=2018-10-03|title=Altered Cervical Spinal Cord Resting State Activity in Fibromyalgia|url=https://onlinelibrary.wiley.com/doi/abs/10.1002/art.40746|journal=Arthritis &amp; Rheumatology|language=en|doi=10.1002/art.40746|issn=2326-5191}}&lt;/ref&gt; <br /> <br /> == Comorbidities, overlapping conditions, and common symptoms ==<br /> [[File:Fibromyalgia and comorbid conditions.JPG|700px|thumb|center|Comorbid conditions of fibromyalgia (FM) are ME/CFS which is the most common; autoimmune diseases; migraines; multiple chemical sensitivities (MCS); and orthostatic intolerance (OI) / postural orthostatic tachycardia syndrome (POTS).&lt;ref name=&quot;:30&quot; /&gt;&lt;ref name=&quot;:31&quot; /&gt;&lt;ref name=&quot;:33&quot;&gt;{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-comorbid-overlapping-conditions-716184|title=Illness That Come Along with Fibromyalgia &amp; Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 26, 2018|work=Verywell Health|access-date=2018-08-19|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt;&lt;ref name=&quot;:21&quot; /&gt; Overlapping conditions are depression and anxiety; digestive conditions, menstrual problems; Gulf War Illness (GWI); nervous system disorders; low blood pressure (Low BP); other pain conditions and migraines; and sleep dysfunction/disturbance&lt;ref name=&quot;:30&quot; /&gt; &lt;ref name=&quot;:33&quot; /&gt;&lt;ref name=&quot;:21&quot; /&gt;]]<br /> <br /> *[[Allodynia]]<br /> ** [http://chronicfatigue.about.com/od/glossary/g/allodynia.htm Allodynia: A Rare &amp; Distinct Type of Pain in Fibromyalgia &amp; ME/CFS]&lt;ref name=&quot;:1&quot;&gt;{{Cite news|url=https://www.verywellhealth.com/allodynia-definition-and-types-fibromyalgia-715929|title=Allodynia: A Rare &amp; Distinct Type of Pain in Fibromyalgia &amp; ME/CFS|last=Dellwo|first=Adrienne|date=Feb 23, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt; Types of Allodynia: Tactile; Mechanical; and Thermal. &quot;Type of pain, generally on the skin, that's caused by something that wouldn't normally cause pain.&quot;&lt;ref name=&quot;:1&quot; /&gt; <br /> *[[Autoimmune disease]]&lt;nowiki/&gt;s &quot;Research suggests that RA and other inflammatory diseases may somehow increase the risk for fibromyalgia.&quot;&lt;ref&gt;{{Cite news|url=https://www.health.com/health/gallery/0,,20520705,00.html#restless-legs-0|title=7 Conditions Linked to Fibromyalgia|work=Health.com|access-date=2018-08-19|language=en}}&lt;/ref&gt;<br /> <br /> *[[Body temperature]] (''See:'' [[small fiber peripheral neuropathy]] for temperature sensitivity; burning, tingling, and prickling due to [[paresthesia]]; [[numbness]]; [[Dry eye syndrome|dry eyes]] and [[dry mouth]]; and more.)&lt;ref&gt;{{Cite news|url=https://www.verywellhealth.com/small-fiber-neuropathy-may-cause-fibromyalgia-pain-3972935|title=Does Fibromyalgia Come From Small Nerves in Your Skin?|last=Dellwo|first=Adrienne|date=Feb 23, 2018|work=Verywell Health|access-date=2018-10-04|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt;&lt;ref&gt;{{Cite news|url=https://www.verywellhealth.com/neuropathy-in-fibromyalgia-cfs-3973033|title=Does Your Pain Come From Damage to Small Nerves?|last=Dellwo|first=Adrienne|date=Feb 1, 2018|work=Verywell Health|access-date=2018-10-04|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt;&lt;ref name=&quot;:02&quot;&gt;{{Cite news|url=https://www.healthline.com/health/small-fiber-neuropathy#symptoms|title=Small Fiber Neuropathy: Symptoms, Treatment, Causes, and More|last=Vandergriendt|first=Carly|date=Jan 4, 2018|work=Healthline|access-date=2018-10-04|archive-url=|archive-date=|dead-url=|last2=Weatherspoon|first2=Deborah|language=en}}&lt;/ref&gt;&lt;ref&gt;{{Cite news|url=https://www.webmd.com/brain/understanding-peripheral-neuropathy-basics#3|title=Peripheral Neuropathy -- Symptoms, Types, and Causes of Peripheral Neuropathy|last=|first=|date=|work=WebMD|access-date=2018-10-04|archive-url=|archive-date=|dead-url=|page=3|language=en-US}}&lt;/ref&gt;<br /> **[https://www.verywell.com/temperature-sensitivity-in-fibromyalgia-and-mecfs-716025 Temperature Sensitivity in Fibromyalgia &amp; Chronic Fatigue Syndrome]&lt;ref name=&quot;:2&quot;&gt;{{Cite news|url=https://www.verywellhealth.com/temperature-sensitivity-in-fibromyalgia-and-mecfs-716025|title=Temperature Sensitivity in Fibromyalgia &amp; ME/CFS|last=Dellwo|first=Adrienne|date=Mar 15, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt; <br /> <br /> &lt;blockquote&gt;When you're exposed to heat, does it feel like you're burning up? Does it seem impossible for you to cool off? Or maybe it's cold that bothers you, chilling you to the bone, leaving you unable to warm up? Or are you one of those people with fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS) who is cold all the time, or hot all the time, or alternately hot or cold while out of sync with the environment?&lt;ref name=&quot;:2&quot; /&gt;&lt;/blockquote&gt;<br /> <br /> [[File:Costal cartilages.JPG|200px|thumb|left|Costochondritis is inflammation of the costal cartilages (shown in red) causing chest and ribcage pain]]<br /> <br /> :* [https://www.verywell.com/costochondritis-in-fibromyalgia-716178 Costochondritis in Fibromyalgia]&lt;ref name=&quot;:10&quot;&gt;{{Cite news|url=https://www.verywellhealth.com/costochondritis-in-fibromyalgia-716178|title=Costochondritis Chest Pain in Fibromyalgia|last=Dellow|first=Adrienne|date=Feb 14, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt;&lt;ref&gt;{{Cite journal|date=2018-05-25|title=Costochondritis|url=https://en.wikipedia.org/w/index.php?title=Costochondritis&amp;oldid=842926736|journal=Wikipedia|language=en}}&lt;/ref&gt; <br /> &lt;blockquote&gt;Costochondritis is inflammation of the cartilage that connects your ribs to your breastbone. Depending on how much inflammation there is, it can range from mildly annoying to intensely painful. People sometimes describe the pain as stabbing, aching, or burning.&lt;/blockquote&gt;<br /> <br /> &lt;blockquote&gt;Costochondritis can make you think you're having heart problems, which is a scary thing. Even though costochondritis is common, you should get medical attention if you have unexplained chest pain. You don't want to assume that it's FMS-related and end up with permanent heart damage or worse.&lt;/blockquote&gt;<br /> <br /> &lt;blockquote&gt;The pain can radiate to your shoulder and arms as well (another way the condition mimics a heart attack). Sometimes the pain is accompanied by redness and/or swelling in the most painful areas. When that's the case, it's called Tietze's Syndrome.&lt;ref name=&quot;:10&quot; /&gt;&lt;/blockquote&gt;<br /> <br /> <br /> <br /> * [[Depression]] and [[Anxiety]]<br /> <br /> Fibromyalgia sufferers are &quot;up to three times more likely to have depression at the time of their diagnosis than someone without fibromyalgia.&quot;&lt;ref&gt;{{Cite news|url=https://www.webmd.com/fibromyalgia/fibromyalgia-and-depression#1|title=Fibromyalgia and Depression|work=WebMD|access-date=2018-08-19|language=en-US}}&lt;/ref&gt; Up to 20 percent of Fibromyalgia patients will have either depression or anxiety.&lt;ref&gt;{{Cite web|url=https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/fibromyalgia|title=Fibromyalgia {{!}} Anxiety and Depression Association of America, ADAA|website=adaa.org|language=en|access-date=2018-08-19}}&lt;/ref&gt;<br /> <br /> *[[Fibro fog]] and [[Cognitive dysfunction]]<br /> <br /> :*[http://www.news-medical.net/health/What-is-Fibro-Fog-Fibromyalgia-and-Cognitive-Dysfunction.aspx What is Fibro Fog? - Fibromyalgia and Cognitive Dysfunction]&lt;ref name=&quot;:3&quot;&gt;{{Cite news|url=https://www.news-medical.net/health/What-is-Fibro-Fog-Fibromyalgia-and-Cognitive-Dysfunction.aspx|title=What is Fibro Fog? - Fibromyalgia and Cognitive Dysfunction|last=Mandal|first=Ananya|date=2013-06-03|work=News-Medical.net|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}&lt;/ref&gt; 'Mental confusion along with difficulty in concentration and loss of memory is often termed “[[fibro fog]]&quot;'.&lt;ref name=&quot;:3&quot; /&gt;<br /> <br /> :* [https://www.verywellhealth.com/brain-fibro-fog-causes-symptoms-possible-treatment-716014 What Is Fibro Fog and ME/CFS Brain Fog?]&lt;ref name=&quot;:17&quot; /&gt;<br /> :* [https://fibromyalgianewstoday.com/2018/03/21/fibromyalgia-cognitive-dysfunction-study-identifies-main-types/ Study Identifies the Types of Cognitive Dysfunction That Are Most Prevalent in Fibromyalgia]&lt;ref&gt;{{Cite news|url=https://fibromyalgianewstoday.com/2018/03/21/fibromyalgia-cognitive-dysfunction-study-identifies-main-types/|title=Fibromyalgia Study Identifies Main Types of Patients' Cognitive Dysfunction|last=Pena|first=Ana|date=2018-03-21|work=Fibromyalgia News Today|access-date=2018-08-28|archive-url=|archive-date=|dead-url=|language=en-US}}&lt;/ref&gt;<br /> <br /> *[[Gastrointestinal system]]<br /> **[[Irritable bowel syndrome]]: [http://chronicfatigue.about.com/od/whyfmscfsarelinked/a/IBS.htm Irritable Bowel Syndrome in Fibromyalgia &amp; Chronic Fatigue Syndrome - Why Do They Go Together?]&lt;ref name=&quot;:4&quot;&gt;{{Cite news|url=https://www.verywellhealth.com/irritable-bowel-syndrome-in-fibromyalgia-cfs-716167|title=Irritable Bowel Syndrome in Fibromyalgia &amp; ME/CFS|last=Dellwo|first=Adrienne|date=Jan 28, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt; <br /> <br /> :&lt;blockquote&gt;Fibromyalgia, chronic fatigue syndrome and irritable bowel syndrome (IBS) frequently go together. No one really knows why, but we do know that all three conditions can include imbalances of serotonin -- although in fibromyalgia (FMS) and Chronic Fatigue Syndrome (CFS or ME/CFS) it's an imbalance in the brain, while with IBS it's in the gut.&lt;ref name=&quot;:4&quot; /&gt;&lt;/blockquote&gt;<br /> * [[Gulf War Illness]] <br /> **[https://www.publichealth.va.gov/exposures/gulfwar/fibromyalgia.asp Fibromyalgia in Gulf War Veterans]&lt;ref&gt;{{Cite web|url=https://www.publichealth.va.gov/exposures/gulfwar/fibromyalgia.asp|title=Fibromyalgia in Gulf War Veterans - Public Health|last=Administration|first=US Department of Veterans Affairs, Veterans Health|website=www.publichealth.va.gov|language=en|access-date=2018-08-19}}&lt;/ref&gt; GWI increases risk of developing fibromyalgia.<br /> <br /> *[https://en.wikipedia.org/wiki/Interstitial_cystitis Interstitial Cystitis]&lt;ref&gt;{{Cite journal|date=2018-07-11|title=Interstitial cystitis|url=https://en.wikipedia.org/w/index.php?title=Interstitial_cystitis&amp;oldid=849828657|journal=Wikipedia|language=en}}&lt;/ref&gt; (Painful bladder) <br /> **[https://www.verywellhealth.com/chronic-fatigue-syndrome-interstitial-cystitis-716168 Fibromyalgia, Chronic Fatigue Syndrome &amp; Interstitial Cystitis]&lt;ref name=&quot;:5&quot;&gt;{{Cite news|url=https://www.verywellhealth.com/chronic-fatigue-syndrome-interstitial-cystitis-716168|title=Fibromyalgia, Chronic Fatigue Syndrome &amp; Interstitial Cystitis|last=Dellwo|first=Adrienne|date=Feb 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt; &quot;Fibromyalgia, chronic fatigue syndrome and interstitial cystitis (IC) -- a painful bladder condition -- frequently occur together. Women may be up to 10 times more likely than men to develop it.&quot;&lt;ref name=&quot;:5&quot; /&gt;<br /> **[[pubmed:20719340|Interstitial cystitis/painful bladder syndrome and associated medical conditions with an emphasis on irritable bowel syndrome, fibromyalgia and chronic fatigue syndrome.]]&lt;ref&gt;{{Cite journal|last=Nickel|first=J. Curtis|last2=Tripp|first2=Dean A.|last3=Pontari|first3=Michel|last4=Moldwin|first4=Robert|last5=Mayer|first5=Robert|last6=Carr|first6=Lesley K.|last7=Doggweiler|first7=Ragi|last8=Yang|first8=Claire C.|last9=Mishra|first9=Nagendra|date=2010|title=Interstitial cystitis/painful bladder syndrome and associated medical conditions with an emphasis on irritable bowel syndrome, fibromyalgia and chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/20719340|journal=The Journal of Urology|volume=184|issue=4|pages=1358–1363|doi=10.1016/j.juro.2010.06.005|issn=1527-3792|pmid=20719340|via=}}&lt;/ref&gt;<br /> <br /> *Language Impairment<br /> **[[Word-finding problems]] <br /> :*[https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024 Language Impairment in Fibromyalgia and Chronic Fatigue Syndrome Impaired Language in Fibromyalgia &amp; Chronic Fatigue Syndrome]&lt;ref name=&quot;:6&quot; /&gt; &quot;Searching their brains for simple words that they just can't remember. On other occasions, individuals with these diagnoses may find it hard to write or even understand language.&quot;&lt;ref name=&quot;:6&quot;&gt;{{Cite news|url=https://www.verywellhealth.com/language-impairment-in-fibromyalgia-cfs-716024|title=Language Impairment in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 12, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt; <br /> <br /> :*&quot;The diagnosis of [[Aphasia]] is a condition that robs you of the ability to communicate. It can affect your ability to speak, write and understand language, both verbal and written&quot;&lt;ref&gt;{{Cite news|url=http://www.mayoclinic.org/diseases-conditions/aphasia/basics/definition/con-20027061|title=Aphasia - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-09|language=en}}&lt;/ref&gt; but with [[dysphasia]] you will have those symptoms and trouble listening and doing numeral calculations.&lt;ref&gt;{{Cite web|url=http://www.ayushveda.com/healthcare/dysphasia.htm|title=Dysphasia - Causes, Symptoms &amp; Treatment|website=www.ayushveda.com|access-date=2018-08-09}}&lt;/ref&gt; ''See also'': [[Dyscalculia]].<br /> * [[ME/CFS]] <br /> :*[https://www.verywellhealth.com/fibromyalgia-comorbid-overlapping-conditions-716184 Comorbid Conditions in Fibromyalgia &amp; Chronic Fatigue Syndrome]&lt;ref&gt;{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-comorbid-overlapping-conditions-716184|title=Illness That Come Along with Fibromyalgia &amp; Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 26, 2018|work=Verywell Health|access-date=2018-08-19|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt;<br /> * [[Migraine]] <br /> :*[https://migrainecenters.com/blog/migraines-and-fibromyalgia/ Migraines and Fibromyalgia]&lt;ref name=&quot;:32&quot; /&gt; <br /> &lt;blockquote&gt;Both fibromyalgia and migraine may reflect problems in the brain’s pain processing center. It is believed that both conditions are caused by excitation of the nervous system or an over-response to stimuli. Stress is usually cited as a trigger for both migraine and fibromyalgia attacks.&lt;ref name=&quot;:32&quot;&gt;{{Cite news|url=https://migrainecenters.com/blog/migraines-and-fibromyalgia/|title=Migraines and Fibromyalgia - Migraine Centers|date=2016-05-06|work=Migraine Centers|access-date=2018-08-19|language=en-US}}&lt;/ref&gt;&lt;/blockquote&gt;<br /> * [[Multiple chemical sensitivity|Multiple Chemical Sensitivity]] (MCS) It is thought that both Fibromyalgia and MCS are [[Central sensitization|central sensitivity]] syndromes.&lt;ref&gt;{{Cite news|url=https://www.verywellhealth.com/chemical-sensitivity-in-fibromyalgia-716170|title=Multiple Chemical Sensitivity in Fibromyalgia &amp; ME/CFS|last=Dellwo|first=Adrienne|date=Jul 23, 2018|work=Verywell Health|access-date=2018-08-19|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt;<br /> <br /> *OBGYN<br /> **[https://www.verywellhealth.com/menstrual-periods-and-fibromyalgia-715596 Menstrual Periods with Fibromyalgia: Personal Stories]&lt;ref&gt;{{Cite news|url=https://www.verywellhealth.com/menstrual-periods-and-fibromyalgia-715596|title=Menstrual Periods with Fibromyalgia: Personal Stories|last=Dellwo|first=Adrienne|date=May 18, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt;<br /> **[https://www.verywellhealth.com/fibromyalgia-tied-to-hysterectomy-gynecologic-disease-715626 Fibromyalgia Tied to Hysterectomy, Gynecologic Disease].&lt;ref name=&quot;:7&quot; /&gt;<br /> :&lt;blockquote&gt;You may have heard about a possible link between gynecologic surgery (such as a hysterectomy) and the development of fibromyalgia, and doctors have long suspected that fibromyalgia has strong hormonal ties and triggers. This does not seem surprising as we've long suspected a link between endocrine disorders, gynecological conditions, and autoimmune conditions.&lt;ref name=&quot;:7&quot;&gt;{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-tied-to-hysterectomy-gynecologic-disease-715626|title=Fibromyalgia Tied to Hysterectomy, Gynecologic Disease|last=Dellwo|first=Adrienne|date=Feb 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt;&lt;/blockquote&gt;<br /> <br /> *[[Orthostatic intolerance]] (OI) and [[Postural orthostatic tachycardia syndrome]] (POTS)&lt;ref&gt;{{Cite journal|last=Yun|first=Dong Joo|last2=Choi|first2=Han Na|last3=Oh|first3=Gun-Sei|date=2013|title=A Case of Postural Orthostatic Tachycardia Syndrome Associated with Migraine and Fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3710947/|journal=The Korean Journal of Pain|volume=26|issue=3|pages=303–306|doi=10.3344/kjp.2013.26.3.303|issn=2005-9159|pmid=23862007|via=}}&lt;/ref&gt;<br /> <br /> :*[http://drlapp.com/wp-content/uploads/TTT_symptoms.pdf Symptoms Predict the Outcome of Tilt Table Testing in CFS/ME/FM]&lt;ref&gt;{{Cite web|url=http://drlapp.com/wp-content/uploads/TTT_symptoms.pdf|title=Symptoms Predict the Outcome of Tilt Table Testing in CFS/ME/FM|last=Lapp|first=Charles W.|last2=Black|first2=Laura|date=|website=drlapp.com|archive-url=|archive-date=|dead-url=|access-date=|last3=Smith|first3=Rebekah S.}}&lt;/ref&gt; (PDF) Symptoms can include low blood pressure and/or sudden high blood pressure, dizziness, fainting.<br /> <br /> :*[https://www.healthrising.org/blog/2017/09/21/fibromyalgia-problems-standing-orthostatic-intolerance/ An Overlooked Issue in Fibromyalgia? Study Highlights Problems Standing (Orthostatic Intolerance)]&lt;ref&gt;{{Cite news|url=https://www.healthrising.org/blog/2017/09/21/fibromyalgia-problems-standing-orthostatic-intolerance/|title=An Overlooked Issue in Fibromyalgia? Study Highlights Orthostatic Intolerance - Problems Standing - Health Rising|last=Johnson|first=Cort|date=2017-09-21|work=Health Rising|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}&lt;/ref&gt;<br /> <br /> *[[Sleep dysfunction]]<br /> **[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648619/ Sleep is associated with task-negative brain activity in fibromyalgia participants with comorbid chronic insomnia]&lt;ref name=&quot;:23&quot;&gt;{{Cite journal|last=Vatthauer|first=Karlyn E|last2=Craggs|first2=Jason G|last3=Robinson|first3=Michael E|last4=Staud|first4=Roland|last5=Berry|first5=Richard B|last6=Perlstein|first6=William M|last7=McCrae|first7=Christina S|date=2015-11-12|title=Sleep is associated with task-negative brain activity in fibromyalgia participants with comorbid chronic insomnia|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648619/|journal=Journal of Pain Research|volume=8|pages=819–827|doi=10.2147/JPR.S87501|issn=1178-7090|pmc=|pmid=26648751|via=}}&lt;/ref&gt;<br /> <br /> :&lt;blockquote&gt;The present results of this study suggest that long-term, comorbid pain and sleep disturbance may be associated with increased activation in core default mode brain areas that is above and beyond long-term pain disturbance alone.&lt;ref name=&quot;:23&quot; /&gt;&lt;/blockquote&gt;<br /> <br /> :*[http://www.prohealth.com/library/showarticle.cfm?libid=22344 Fibromyalgia and Sleep]&lt;ref name=&quot;:8&quot;&gt;{{Cite news|url=https://www.prohealth.com/library/fibromyalgia-and-sleep-38954|title=Fibromyalgia and Sleep - Prohealth|date=2016-01-11|work=Prohealth|access-date=2018-08-09|language=en-US}}&lt;/ref&gt; &quot;Most people with fibromyalgia have an associated sleep disorder that makes it difficult for them to get the deep, restorative sleep they need.&quot;&lt;ref name=&quot;:8&quot; /&gt;<br /> <br /> [[File:Skull_diagram.png|350px|thumb|right|The [[wikipedia:Temporomandibular_joint#Disorders|temporomandibular joint]] is the joint between the mandible (light blue) and the temporal bone (orange) of the skull]]<br /> * [[Temporomandibular joint disorder]] (TMJ/TMD) <br /> <br /> :* [https://www.sciencedirect.com/science/article/pii/S2255502114001758 Temporomandibular disorders in fibromyalgia syndrome: a short-communication]&lt;ref&gt;{{Cite journal|last=Soares Gui|first=Maisa|last2=Pimentel|first2=Marcele Jardim|last3=Rizzatti-Barbosa|first3=C'elia Marisa|date=2015-03-01|title=Temporomandibular disorders in fibromyalgia syndrome: a short-communication|url=https://www.sciencedirect.com/science/article/pii/S2255502114001758|journal=Revista Brasileira de Reumatologia (English Edition)|language=en|volume=55|issue=2|pages=189–194|doi=10.1016/j.rbre.2014.07.004|issn=2255-5021|via=ScienceDirect}}&lt;/ref&gt;&lt;ref&gt;{{Cite news|url=https://www.whitesmilesforlife.com/blog/study-probes-pain-link-between-tmj-fibromyalgia/|title=Study Probes Pain Link Between TMJ, Fibromyalgia|date=2016-05-03|work=Kent E. White, DDS|access-date=2018-08-19|language=en-US}}&lt;/ref&gt;<br /> <br /> :Other than headaches, the symptoms are quite distinct from symptoms of FMS and ME/CFS.<br /> <br /> ::They include:<br /> ::*Jaw pain<br /> ::*Discomfort or difficulty chewing<br /> ::*Painful clicking in the jaw<br /> ::*Difficulty opening or closing the mouth<br /> ::*Headaches<br /> ::*Locking jaw<br /> ::*Teeth that don't come together properly&lt;ref&gt;{{Cite news|url=https://www.verywellhealth.com/tmj-in-fibromyalgia-chronic-fatigue-syndrome-716175|title=TMJ in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Mar 31, 2018|work=Verywell Health|access-date=2018-08-22|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt;<br /> <br /> <br /> *[[Thyroid disease]]<br /> **[https://www.verywellhealth.com/relationship-between-cfs-fibromyalgia-and-aitd-3231677 Chronic Fatigue Syndrome, Fibromyalgia, and Autoimmune Thyroid Disease]&lt;ref name=&quot;:9&quot;&gt;{{Cite news|url=https://www.verywellhealth.com/relationship-between-cfs-fibromyalgia-and-aitd-3231677|title=A Comparison of Chronic Fatigue, Fibromyalgia, and Thyroid Disease|last=Shomon|first=Mary|date=Feb 21, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt; <br /> <br /> :&lt;blockquote&gt;People with Hashimoto's autoimmune thyroid disease often experience significant fatigue and body aches. While these symptoms are common in Hashimoto's, they can also be markers of other diseases, like chronic fatigue syndrome or fibromyalgia.&lt;ref name=&quot;:9&quot; /&gt;&lt;/blockquote&gt;<br /> <br /> *Other symptoms<br /> **[http://chronicfatigue.about.com/od/whatisfibromyalgia/a/fibrosymptoms.htm Symptoms of Fibromyalgia]&lt;ref&gt;{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-symptoms-716139|title=Symptoms of Fibromyalgia|last=Dellwo|first=Adrienne|date=May 16, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt; (On all the many symptoms and conditions of and related to fibromyalgia.)<br /> **''Fibromyalgia Syndrome: An Overview of Pathophysiology, Diagnosis and Management'' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394355/ Conditions associated with fibromyalgia. (Table 1)]&lt;ref name=&quot;:21&quot; /&gt;<br /> <br /> ==Treatment==<br /> <br /> ===United States===<br /> '''Rheumatology and primary care providers: Diagnosing and treatment'''<br /> <br /> *2012, [https://www.mayoclinicproceedings.org/article/S0025-6196(12)00299-6/abstract A Framework for Fibromyalgia Management for Primary Care Providers]&lt;ref&gt;{{Cite journal|last=Arnold|first=Lesley M.|last2=Clauw|first2=Daniel J.|last3=Dunegan|first3=L. Jean|last4=Turk|first4=Dennis C.|date=2012|title=A Framework for Fibromyalgia Management for Primary Care Providers|url=https://www.mayoclinicproceedings.org/article/S0025-6196(12)00299-6/abstract|journal=Mayo Clinic Proceedings|language=English|volume=87|issue=5|pages=488–496|doi=10.1016/j.mayocp.2012.02.010|issn=0025-6196|via=}}&lt;/ref&gt; Rheumatologists stopped treating fibromyalgia patients and primary care providers began treatment managment although rheumatologists are most often the specialist to diagnose. (Please see [http://me-pedia.org/wiki/Fibromyalgia#Disability disability] heading about ''primary provider'' and ''specialists'' for disability cases.)<br /> <br /> === Drugs ===<br /> <br /> {{Main article |page_name = Fibromyalgia drugs}}<br /> <br /> === Therapies ===<br /> <br /> ==== Exercise ====<br /> ''Please Note'': These recommendations are for fibromyalgia patients and '''not''' [[ME/CFS]] sufferers due to it's hallmark symptom of [[post-exertional malaise]].<br /> [[File:Warm water exercise.JPG|200px|thumb|left|Warm water exercise is best for fibromyalgia. Start slow and don't push through the pain&lt;ref name=&quot;:11&quot; /&gt;]]<br /> <br /> *[https://www.verywellhealth.com/warm-water-exercise-for-fibromyalgia-716059 Warm Water Exercise for Fibromyalgia]&lt;ref name=&quot;:11&quot;&gt;{{Cite news|url=http://chronicfatigue.about.com/od/treatingfmscfs/a/warmwaterFMS.htm|title=Warm Water Exercise for Fibromyalgia|last=Dellwo|first=Adrienne|date=Nov 19, 2017|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt;&lt;ref&gt;{{Cite journal|last=Munguía-Izquierdo|first=D.|last2=Legaz-Arrese|first2=A.|date=2007|title=Exercise in warm water decreases pain and improves cognitive function in middle-aged women with fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pubmed/18173915|journal=Clinical and Experimental Rheumatology|volume=25|issue=6|pages=823–830|issn=0392-856X|pmid=18173915|via=}}&lt;/ref&gt;&lt;ref&gt;{{Cite news|url=https://www.prohealth.com/fibromyalgia/library/aquatic-exercise-training-fibromyalgia-85081?utm_campaign=Social%20Media%20-%20Fibromyalgia&amp;utm_content=76595810&amp;utm_medium=social&amp;utm_source=twitter|title=Aquatic exercise training for fibromyalgia. - Prohealth|date=2018-08-29|work=Prohealth|access-date=2018-09-01|language=en-US}}&lt;/ref&gt;&lt;ref&gt;{{Cite journal|last=Bidonde|first=Julia|last2=Busch|first2=Angela J.|last3=Webber|first3=Sandra C.|last4=Schachter|first4=Candice L.|last5=Danyliw|first5=Adrienne|last6=Overend|first6=Tom J.|last7=Richards|first7=Rachel S.|last8=Rader|first8=Tamara|date=2014-10-28|title=Aquatic exercise training for fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pubmed/25350761|journal=The Cochrane Database of Systematic Reviews|issue=10|pages=CD011336|doi=10.1002/14651858.CD011336|issn=1469-493X|pmid=25350761}}&lt;/ref&gt;<br /> <br /> &lt;blockquote&gt;A warm-water pool is good for therapy because cold water can make muscles tense up. It's especially important in FMS because many people with the condition are intolerant of cold. A warm-water pool is one that's kept around 89.6 degrees Fahrenheit (32 Celsius), which is several degrees warmer than most heated pools.&lt;ref name=&quot;:11&quot; /&gt;&lt;/blockquote&gt;<br /> <br /> * Moderate aerobic exercise and weights with six to eight reps and then a day or two of rest in between. Do not start a program if you are in a flare.&lt;ref&gt;{{Cite web|url=http://www.arthritis.org/living-with-arthritis/tools-resources/expert-q-a/fibromyalgia-questions/fibromyalgia-exercise.php|title=Fibromyalgia Exercise {{!}} Exercising with Fibromyalgia|last=Ronenn|first=Roubenoff|date=|website=www.arthritis.org|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}&lt;/ref&gt;<br /> <br /> *[https://www.youtube.com/watch?v=BauJYuJwFsI Easy fibromyalgia exercises and motivation to keep you healthy!]&lt;ref&gt;{{Cite web|url=https://www.youtube.com/watch?v=BauJYuJwFsI|title=Easy Fibromyalgia exercises and motivation to keep you healthy!|last=Suarez|first=Eric|date=Jun 21, 2011|website=YouTube|archive-url=|archive-date=|dead-url=|access-date=Aug 9, 2018}}&lt;/ref&gt; Video<br /> <br /> *[http://chronicfatigue.about.com/od/whatisfibromyalgia/a/Fibromyalgia-Myth-Vs-Fact.htm Fibromyalgia Myth vs. Fact]&lt;ref name=&quot;:15&quot;&gt;{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-myth-vs-fact-716131|title=Fibromyalgia: What's Myth, What's Fact?|last=Dellwo|first=Adrienne|date=Jun 8, 2016|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|at=Myth #3 People With Fibromyalgia Need More Exercise}}&lt;/ref&gt; Heading: ''Myth #3: People With Fibromyalgia Need More Exercise''. Appropriate exercise, which each patient needs to gauge for themselves.&lt;ref name=&quot;:15&quot; /&gt;<br /> <br /> ==== Massage ====<br /> <br /> *2014, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930706/ Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials]&lt;ref&gt;{{Cite journal|last=Li|first=Yan-hui|last2=Wang|first2=Feng-yun|last3=Feng|first3=Chun-qing|last4=Yang|first4=Xia-feng|last5=Sun|first5=Yi-hua|date=2014-02-20|title=Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930706/|journal=PLoS ONE|volume=9|issue=2|doi=10.1371/journal.pone.0089304|issn=1932-6203|pmc=|pmid=24586677|pages=|via=}}&lt;/ref&gt;<br /> <br /> *2016, [http://chronicfatigue.about.com/od/alternativetreatments/a/bodywork.htm Massage, Rolfing &amp; Other Bodywork - Are They Effective Fibromyalgia &amp; Chronic Fatigue Syndrome Treatments?]&lt;ref&gt;{{Cite news|url=https://www.verywellhealth.com/massage-rolfing-other-bodywork-715645|title=Massage, Rolfing, Reiki: Do They Work for Fibromyalgia &amp; ME/CFS?|last=Dellwo|first=Adrienne|date=Aug 10, 2017|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt;<br /> <br /> ==== Acupuncture ====<br /> <br /> *2004, [[U.S. Department of Health and Human Services]] (HHS) and [https://en.wikipedia.org/wiki/Centers_for_Medicare_and_Medicaid_Services Centers for Medicare and Medicaid Services] (CMS) ruled April 16, 2004, a noncoverage determination for acupuncture.&lt;ref&gt;{{Cite web|url=https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R11NCD.pdf|title=CMS Manual System Pub. 100-03 Medicare National Coverage Determinations|last=|first=|date=Apr 16, 2004|website=CMS.gov|format=PDF|archive-url=|archive-date=|dead-url=|access-date=}}&lt;/ref&gt;<br /> <br /> *2005, [http://acupunctureschoolonline.com/acupuncture-good-for-fibromyalgia.html Acupuncture Good for Fibromyalgia?] &lt;ref name=&quot;:16&quot;&gt;{{Cite web|url=http://acupunctureschoolonline.com/acupuncture-good-for-fibromyalgia.html|title=Acupuncture Good for Fibromyalgia?|last=|first=|date=Oct 2, 2012|website=Acupuncture School Online|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}&lt;/ref&gt; &quot;Acupuncture gave no significant pain relief to fibromyalgia patients.&quot;&lt;ref name=&quot;:16&quot; /&gt;<br /> <br /> *2016, [http://www.sciencedirect.com/science/article/pii/S2095496416602352 Short-term complementary and alternative medicine on quality of life in women with fibromyalgia] &lt;ref name=&quot;:25&quot;&gt;{{Cite journal|date=2016-01-01|title=Short-term complementary and alternative medicine on quality of life in women with fibromyalgia|url=https://www.sciencedirect.com/science/article/pii/S2095496416602352|journal=Journal of Integrative Medicine|language=en|volume=14|issue=1|pages=29–35|doi=10.1016/S2095-4964(16)60235-2|issn=2095-4964}}&lt;/ref&gt; &quot;There was no significant improvement in pain or reduction of tender points in any of the groups studied, at the end of the 8th session.&quot;&lt;ref name=&quot;:25&quot; /&gt; <br /> <br /> *2016, [https://fibromyalgianewstoday.com/2016/02/01/acupuncture-does-not-reduce-pain-for-women-with-fibromyalgia/ Acupuncture Does Not Appear to Relieve Pain in Fibromyalgia Patients]&lt;ref&gt;{{Cite news|url=https://fibromyalgianewstoday.com/2016/02/01/acupuncture-does-not-reduce-pain-for-women-with-fibromyalgia/|title=Acupuncture Does Not Appear to Relieve Pain in Fibromyalgia Patients - Fibromyalgia News Today|last=Semedo|first=Daniela|date=2016-02-01|work=Fibromyalgia News Today|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}&lt;/ref&gt;<br /> <br /> == Disability ==<br /> {{Main article |page_name = Fibromyalgia disability process}}<br /> <br /> == Notable studies ==<br /> {{Main article |page_name = Fibromyalgia notable studies}}<br /> <br /> == Controversy ==<br /> === Dr. Frederick Wolfe ===<br /> Dr. [http://rheummd.org/members/fwolfe Frederick Wolfe], the director of the [https://www.arthritis-research.org/ National Databank for Rheumatic Diseases] and the lead author of the 1990 paper that first defined the diagnostic guidelines for fibromyalgia, says he has become cynical and discouraged about the diagnosis. He now considers the condition a physical response to stress, depression, and economic and social anxiety.&lt;ref&gt;{{Cite news|url=http://www.nytimes.com/2008/01/14/health/14pain.html?_r=0|title=Drug Approved. Is Disease Real?|last=Berenson|first=Alex|date=Jan 14, 2008|work=The Wall Street Journal|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}&lt;/ref&gt;&lt;ref&gt;{{Cite journal|last=Wolfe|first=Frederick|last2=Walitt|first2=Brian|date=2016|title=Fibromyalgia: A Short Commentary|url=http://headache.imedpub.com/fibromyalgia-a-short-commentary.pdf|journal=Journal of Headache &amp; Pain Management|volume=1|issue=No. 3:27|pages=|via=iMedPubJournals}}&lt;/ref&gt;&lt;ref&gt;{{Cite news|url=https://www.news-medical.net/news/20130322/Fibromyalgia-an-interview-with-Dr-Frederick-Wolfe-University-of-Kansas-School-of-Medicine.aspx|title=Fibromyalgia: an interview with Dr Frederick Wolfe, University of Kansas School of Medicine|last=Cashin-Garbutt|first=April|date=2013-03-22|work=News-Medical.net|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}&lt;/ref&gt;<br /> <br /> === Fibromyalgia vs Chiari malformation ===<br /> Some individuals diagnosed with FMS were undergoing surgery for [[chiari malformation]] (CM). These are two separate conditions; FMS cannot be resolved by undergoing a risky CM surgery. <br /> <br /> *2011, [https://www.ncbi.nlm.nih.gov/pubmed/21135714 Is Chiari I malformation associated with fibromyalgia?]&lt;ref&gt;{{Cite journal|last=Watson|first=Nathaniel F.|last2=Buchwald|first2=Dedra|last3=Goldberg|first3=Jack|last4=Maravilla|first4=Kenneth R.|last5=Noonan|first5=Carolyn|last6=Guan|first6=Qingyan|last7=Ellenbogen|first7=Richard G.|date=2011|title=Is Chiari I malformation associated with fibromyalgia?|url=https://www.ncbi.nlm.nih.gov/pubmed/21135714|journal=Neurosurgery|volume=68|issue=2|pages=443–448; discussion 448–449|doi=10.1227/NEU.0b013e3182039a31|issn=1524-4040|pmid=21135714|via=}}&lt;/ref&gt;<br /> ::Conclusion: Most patients with FM do not have [[CIM]] pathology. Future studies should focus on dynamic neuroimaging of craniocervical neuroanatomy in patients with FM.<br /> *2015, [https://www.massmecfs.org/resource-library/9-treatment/172-cfidsfm-and-chiari-malformation-surgery CFS/FM and Chiari Malformation Surgery]&lt;ref&gt;{{Cite web|url=https://www.massmecfs.org/resource-library/9-treatment/172-cfidsfm-and-chiari-malformation-surgery|title=CFS/FM and Chiari Malformation Surgery|last=Casanova|first=Ken|date=Nov 15, 2015|website=www.massmecfs.org|language=en-GB|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}&lt;/ref&gt;<br /> <br /> ==See also==<br /> *[[Fibromyalgia disability process]]<br /> * [[Fibromyalgia drugs]]<br /> * [[Fibromyalgia notable studies]]<br /> * [[Influenza vaccine]]<br /> *[[Lady Gaga]]<br /> <br /> == Learn more ==<br /> *[https://www.s4me.info/forums/fibromyalgia-and-connective-tissue-disorders.35/ Forum: Fibromyalgia and Connective Tissue Disorders] at [[Science for ME]]<br /> *[[Verywell FMS/CFS]]<br /> <br /> === Ongoing process of diagnosing and categorizing ===<br /> <br /> *2014, [http://www.medpagetoday.com/Rheumatology/Fibromyalgia/49114 Lyme Disease, Fibromyalgia Link Evaporates]&lt;ref&gt;{{Cite news|url=https://www.medpagetoday.com/Rheumatology/Fibromyalgia/49114|title=Lyme Disease, Fibromylagia Link Evaporates|last=Kuznar|first=Wayne|date=2014-12-14|work=|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}&lt;/ref&gt; (See also: [[Chronic lyme disease]]) <br /> <br /> *2015, [http://www.news-medical.net/news/20150518/Fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder.aspx Fibromyalgia now considered as a lifelong central nervous system disorder]&lt;ref&gt;{{Cite news|url=https://www.news-medical.net/news/20150518/Fibromyalgia-now-considered-as-a-lifelong-central-nervous-system-disorder.aspx|title=Fibromyalgia now considered as a lifelong central nervous system disorder|date=2015-05-18|work=News-Medical.net|access-date=2018-08-09|language=en}}&lt;/ref&gt; <br /> <br /> *2015, [http://nationalpainreport.com/foundation-of-fibromyalgia-is-altered-central-nervous-system-new-study-validates-8827896.html Foundation of Fibromyalgia Is Altered Central Nervous System, New Study Validates]&lt;ref&gt;{{Cite news|url=http://nationalpainreport.com/foundation-of-fibromyalgia-is-altered-central-nervous-system-new-study-validates-8827896.html|title=Foundation of Fibromyalgia Is Altered Central Nervous System, New Study Validates|date=2015-10-24|work=National Pain Report|access-date=2018-08-09|language=en-US}}&lt;/ref&gt;<br /> <br /> *2015, ''Question:'' [http://fmcfstriggerpoints.blogspot.com/2015/09/is-fibromyalgia-psychosomatic-illness.html 'Is Fibromyalgia a Psychosomatic Illness?'] ''Answer:'' &quot;Fibromyalgia is NOT a psychosomatic illness.&quot;&lt;ref&gt;{{Cite web|url=http://fmcfstriggerpoints.blogspot.com/2015/09/is-fibromyalgia-psychosomatic-illness.html|title=Is Fibromyalgia a Psychosomatic Illness? Med Student Asks Celeste Cooper|last=Cooper|first=Celeste|date=Sep 4, 2015|website=fmcfstriggerpoints.blogspot.com|archive-url=|archive-date=|dead-url=|access-date=2018-09-15}}&lt;/ref&gt;<br /> <br /> *2016, [http://fibromyalgianewstoday.com/2016/09/09/fibromyalgia-diagnosis-using-noninvasive-eye-examination Diagnosing Fibromyalgia May Be Possible Using Noninvasive Eye Examination]&lt;ref&gt;{{Cite news|url=https://fibromyalgianewstoday.com/2016/09/09/fibromyalgia-diagnosis-using-noninvasive-eye-examination|title=Diagnosing Fibromyalgia May Be Possible with Noninvasive Eye Exam|date=2016-09-09|work=Fibromyalgia News Today|access-date=2018-08-09|language=en-US}}&lt;/ref&gt;<br /> <br /> *2016, [https://www.verywellhealth.com/microglia-in-fibromyalgia-chronic-fatigue-syndrome-3862780 Microglia in Fibromyalgia &amp; Chronic Fatigue Syndrome]&lt;ref&gt;{{Cite news|url=https://www.verywellhealth.com/microglia-in-fibromyalgia-chronic-fatigue-syndrome-3862780|title=Microglia in Fibromyalgia and Chronic Fatigue Syndrome|last=Dellwo|first=Adrienne|date=Feb 21, 2018|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt;<br /> <br /> *2016, [http://simmaronresearch.com/2016/03/are-chronic-fatigue-syndrome-mecfs-and-fibromyalgia-immune-exhaustion-disorders/ Are Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia Immune Exhaustion Disorders?]&lt;ref&gt;{{Cite news|url=http://simmaronresearch.com/2016/03/are-chronic-fatigue-syndrome-mecfs-and-fibromyalgia-immune-exhaustion-disorders/|title=Are Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia Immune Exhaustion Disorders? - Simmaron Research|date=2016-03-21|work=Simmaron Research|access-date=2018-08-09|language=en-US}}&lt;/ref&gt;<br /> <br /> *2016, [https://consultqd.clevelandclinic.org/2016/03/why-fibromyalgia-is-neuropathic/?utm_campaign=qd+tweets&amp;utm_medium=social&amp;utm_source=twitter&amp;utm_content=160308+fibromyalgia+neuropathic&amp;dynid=twitter-_-qd+tweets-_-social-_-social-_-160308+fibromyalgia+neuropathic Why Fibromyalgia Is Neuropathic]&lt;ref&gt;{{Cite news|url=https://consultqd.clevelandclinic.org/why-fibromyalgia-is-neuropathic/?utm_campaign=qd+tweets&amp;utm_medium=social&amp;utm_source=twitter&amp;utm_content=160308+fibromyalgia+neuropathic&amp;dynid=twitter-_-qd+tweets-_-social-_-social-_-160308+fibromyalgia+neuropathic|title=Why Fibromyalgia Is Neuropathic|date=2016-03-08|work=Consult QD|access-date=2018-08-09|language=en-US}}&lt;/ref&gt;<br /> <br /> *2017, [http://nationalpainreport.com/study-reveals-new-treatment-target-for-fibromyalgia-inflammation-in-the-brain-8833354.html Study Reveals New Treatment Target for Fibromyalgia: Inflammation in the Brain]&lt;ref&gt;{{Cite news|url=http://nationalpainreport.com/study-reveals-new-treatment-target-for-fibromyalgia-inflammation-in-the-brain-8833354.html|title=Study Reveals New Treatment Target for Fibromyalgia: Inflammation in the Brain|last=Liptan|first=Ginevra|date=2017-04-11|work=National Pain Report|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}&lt;/ref&gt; <br /> *2017, [https://qz.com/1349854/ai-can-spot-the-pain-from-a-disease-some-doctors-still-think-is-fake/?mc_cid=669d3db241&amp;mc_eid=c75cd86947 AI can spot the pain from a disease some doctors still think is fake]&lt;ref&gt;{{Cite news|url=https://qz.com/1349854/ai-can-spot-the-pain-from-a-disease-some-doctors-still-think-is-fake/?mc_cid=669d3db241&amp;mc_eid=c75cd86947|title=AI can spot the pain from a disease some doctors still think is fake|last=Goldhill|first=Olivia|date=Aug 9, 2018|work=Quartz|access-date=2018-08-15|archive-url=|archive-date=|dead-url=|language=en-US}}&lt;/ref&gt;<br /> *2018, [https://www.verywellhealth.com/fibromyalgia-pain-physiological-evidence-716141 Understanding the Pathophysiology of Fibromyalgia]&lt;ref&gt;{{Cite news|url=https://www.verywellhealth.com/fibromyalgia-pain-physiological-evidence-716141|title=What Is the Pathophysiology of Fibromyalgia?|last=Dellwo|first=Adrienne|date=Sep 18, 2018|work=Verywell Health|access-date=2018-09-19|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt;<br /> <br /> === Blood tests ===<br /> <br /> *2013, [http://nationalpainreport.com/new-fibromyalgia-blood-test-is-99-accurate-8821072.html New Fibromyalgia Blood Test is 99% Accurate]&lt;ref&gt;{{Cite news|url=http://nationalpainreport.com/new-fibromyalgia-blood-test-is-99-accurate-8821072.html|title=New Fibromyalgia Blood Test is 99% Accurate|date=2013-07-31|work=National Pain Report|access-date=2018-08-09|language=en-US}}&lt;/ref&gt;<br /> <br /> *2014, [http://www.prohealth.com/library/showarticle.cfm?libid=18837 Pridgen Reports Fibromyalgia Antiviral Trial Results “Very Positive”: Predicts New Approach Will Be “Game-Changer”]&lt;ref&gt;{{Cite news|url=https://www.prohealth.com/library/pridgen-reports-fibromyalgia-antiviral-trial-results-very-positive-predicts-new-approach-will-be-game-changer-32620|title=Pridgen Reports Fibromyalgia Antiviral Trial Results “Very Positive”: Predicts New Approach Will Be “Game-Changer”|last=|first=|date=2014-03-25|work=Prohealth|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}&lt;/ref&gt;<br /> <br /> *2016, [https://www.celestecooper.com/2016/05/blood-test-for-fibromyalgia-fma-test-is.html Blood Test for Fibromyalgia: FM/a Test Ⓡ is now available, Q&amp;A]&lt;ref&gt;{{Cite web|url=https://www.celestecooper.com/2016/05/blood-test-for-fibromyalgia-fma-test-is.html|title=Blood Test for Fibromyalgia: FM/a Test ® Is Real, Q&amp;A|last=Cooper|first=Celeste|date=May 3, 2016|website=www.celestecooper.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}&lt;/ref&gt;<br /> <br /> *2016, [http://www.liveinsurancenews.com/fibromyalgia-blood-testing-covered-rising-number-insurance-companies/ Fibromyalgia blood testing covered by rising number of insurance companies]&lt;ref&gt;{{Cite news|url=http://www.liveinsurancenews.com/fibromyalgia-blood-testing-covered-rising-number-insurance-companies/|title=Fibromyalgia blood testing covered more of insurance companies|last=Campbell|first=Julie|date=2016-04-08|work=Live Insurance News|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en-US}}&lt;/ref&gt;<br /> <br /> *2017, [http://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches]&lt;ref&gt;{{Cite news|url=https://www.businesswire.com/news/home/20170419005324/en/EpicGenetics-Assistance-Leading-Medical-Centers-Expands-Clinical|title=EpicGenetics, with the Assistance of Leading Medical Centers, Expands Clinical Study of FM/a® Test to Diagnose Fibromyalgia, Identify Genetic Markers Unique to the Disorder and Explore Direct Treatment Approaches|last=|first=|date=Apr 19, 2017|work=Business Wire|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}&lt;/ref&gt;<br /> <br /> === Brain scans ===<br /> <br /> *2002, [http://www.anapsid.org/cnd/diagnosis/brainpain.html Fibromyalgia Pain Isn't All In Patient's Heads, New Brain Study Finds]&lt;ref&gt;{{Cite web|url=http://www.anapsid.org/cnd/diagnosis/brainpain.html|title=Fibromyalgia Pain Isn't All In Patient's Heads, New Brain Study Finds|last=Kaplan|first=Melissa|date=Jan 1, 2014|website=www.anapsid.org|publisher=ANAPSID|via=Chronic Neuroimmune Diseases|archive-url=|archive-date=|dead-url=|access-date=2018-08-09}}&lt;/ref&gt;<br /> <br /> *2012, [https://www.sciencedaily.com/releases/2012/11/121111153426.htm Fibromyalgia and the brain: New clues reveal how pain and therapies are processed]&lt;ref&gt;{{Cite news|url=https://www.sciencedaily.com/releases/2012/11/121111153426.htm|title=Fibromyalgia and the brain: New clues reveal how pain and therapies are processed|last=|first=|date=Nov 11, 2012|work=ScienceDaily|access-date=2018-08-09|archive-url=|archive-date=|dead-url=|language=en}}&lt;/ref&gt;<br /> <br /> *2015, [https://www.verywellhealth.com/how-lyrica-changes-the-fibromyalgia-brain-715767 How Lyrica Changes the Fibromyalgia Brain]&lt;ref&gt;{{Cite news|url=https://www.verywellhealth.com/how-lyrica-changes-the-fibromyalgia-brain-715767|title=How Lyrica Changes the Fibromyalgia Brain|last=Dellwo|first=Adrienne|date=Apr 30, 2016|work=Verywell Health|access-date=2018-08-09|archive-url=|archive-date=|dead-url=}}&lt;/ref&gt;<br /> *2018, [https://ki.se/en/news/people-with-fibromyalgia-have-inflammation-of-the-brain People with fibromyalgia have inflammation of the brain]&lt;ref&gt;{{Cite web|url=https://ki.se/en/news/people-with-fibromyalgia-have-inflammation-of-the-brain|title=People with fibromyalgia have inflammation of the brain|last=|first=|date=Sep 25, 2018|website=ki.se|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-09-26}}&lt;/ref&gt;<br /> *2018, [https://fibromyalgianewstoday.com/2018/10/11/brain-inflammation-imaged-first-time-fibromyalgia-patients-study/ Brain Inflammation Imaged for First Time in Fibromyalgia Patients, Study Reports]&lt;ref&gt;{{Cite news|url=https://fibromyalgianewstoday.com/2018/10/11/brain-inflammation-imaged-first-time-fibromyalgia-patients-study/|title=In Fibromyalgia Patients, Brain Inflammation Imaged for First Time in Study|last=Inacio|first=Patricia|date=2018-10-11|work=Fibromyalgia News Today|access-date=2018-10-30|archive-url=|archive-date=|dead-url=|language=en-US}}&lt;/ref&gt;<br /> <br /> ==References==<br /> &lt;references /&gt;<br /> <br /> [[Category:Diagnoses]]<br /> [[Category:Comorbidities]]</div>

MEcfsFMS