MEDICAL MATTERS
- Medical Matters features questions asked by Members of the ME Association on health-related topics.
- Dr Charles Shepherd and the ME Association's other advisers answer these questions by sharing their expert knowledge.
- Medical Matters is based on the popular ‘Ask the Doctor’ series in ME Essential magazine.
- It is a free resource that supplements the detailed information contained in the full range of literature that can be found in the website shop.
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Questions in the Category: GP
Diagnosing ME in a teenager
My 13-year-old daughter had a very nasty flu-like infection about two months ago. Our GP thought she might have had glandular fever but a blood test was negative.
Since then she has continued to have severe fatigue, post-exertional malaise (PEM), brain fog, frequent headaches and unrefreshing sleep. She has tried to return to school on two occasions but this has not been successful. Not surprisingly, she is getting upset at remaining so unwell and losing contact with her friends.
Our GP is very reluctant to make a diagnosis of ME/CFS in such a young person and says that it’s probably just ‘post-viral fatigue’. However, he has offered to refer her to a paediatrician if she continues to remain unwell. Could this be ME/CFS?
Diagnosing ME/CFS
I have had ME-type symptoms for well over a year following a viral infection. Unfortunately, my GP says that he doesn’t feel confident to make a diagnosis as he knows almost nothing about this illness. I have now been referred to a local ME/CFS service but find that this service does not diagnose ME. Why is this?
Can nimodipine be used to treat ME/CFS?
I know that nimodipine, a drug that dilates blood vessels, has been used by some doctors in the past to treat ME but this no longer appears to be the case. In view of some of the recent research into both ME/CFS and Long Covid, which indicates that part of the problem may involve reduced blood supply to the brain, I wonder whether this is a drug that we should be looking at again.
Can HIV/AIDS be misdiagnosed as ME/CFS?
I've been diagnosed with ME by my GP after having several months of fatigue, enlarged glands, night sweats and flu-like symptoms. A friend says that HIV/AIDS can cause very similar symptoms in the early stages and that I probably ought to have an HIV blood test – which hasn't been done as far as I know.
Having had several sexual partners, some casual, in the past, I suppose I could be at risk. Unfortunately, this isn't the sort of medical query that I can discuss with my GP because he is a family friend.
Antidepressant withdrawal
I've been taking an antidepressant drug called Prozac for a period of depression for much of the past year. My depressive symptoms have now cleared up. My GP is keen for me to remain on the drug for a period after the depression has cleared and then stop taking it. However, I've heard that it's not sensible to suddenly stop taking this type of antidepressant. Is this correct?
Biomedical research
How can we ensure that important biomedical research information about the cause and treatment of ME/CFS is getting through to policy makers and health professionals so that people are treated correctly?
What is graded activity?
Although I have a firm diagnosis of ME, I am thinking about asking my GP to refer me to the local ME/CFS clinic for some further help with management because my GP is very honest and says she “doesn’t know very much about how to manage people with ME”.
Having looked at the website for the local ME/CFS service, I’m a bit concerned because it seems to place quite a lot of emphasis on social and psychological support and also refers to a graded activity programme.
So what is graded activity? And is it the same as graded exercise therapy?
Medical Disclosure
I have quite severe ME/CFS and am currently unable to work. However, my wife has a well-paid job and we are probably going to have to move house to another part of the country later in the year. As this may involve taking out some new insurance cover can I check what the position is regarding the disclosure of my medical information to an insurance company? Whilst I can understand why an insurance company would find it helpful to know about someone’s state of health, I am concerned about the accuracy of the information that my GP may be asked to provide – as he takes a rather sceptical view of ME/CFS and I very rarely see him.
The 2021 NICE Guideline ME/CFS: Primary Care
I asked my GP if she was aware of the new NICE guideline on ME/CFS and whether she had read it. The answer was a very firm no and she explained that all doctors are suffering from information overload. So they can’t keep up-to-date with all the new NICE guidelines that appear.
Is there any way in which we could actually get our doctors to read this important new information?
Symptoms: Joint Pain and Irritable Bowel
I know that in addition to all the classic diagnostic symptoms of ME there are a considerable number of other symptoms that can sometimes occur. But should we always go and see our GP every time a new symptom appears? Or when an existing symptom changes character or gets significantly worse? In my case, after several years of having ME, I’ve now developed intermittent joint pains (without any swelling or redness) and bowel symptoms (mainly loose motions with occasional stomach cramps and bloating) that sound like irritable bowel syndrome. I haven’t yet mentioned these symptoms to my new GP – who tends to blame everything on ME! I don’t want to be seen as a hypochondriac, turning up at the doctors every time I don’t feel well. At the same time, I don’t want to find that a new and treatable medical condition is being missed
Dr Charles Shepherd
Dr Shepherd has been Trustee and Hon. Medical Adviser to the ME Association for more than 40 years. He is integral to the charity's activities and provides information and support based on his professional knowledge, personal experience as a doctor with ME/CFS, and the understanding gained from helping many thousands of people with the condition. He was a member of the comittee responsible for the 2021 NICE Clinical Guideline and is a recognised expert on ME/CFS in the UK. His knowledge extends to Post-Viral Fatigue Syndromes (PVFS), Myalgic Encephalopathy/Encephalomyelitis (ME), Chronic Fatigue Syndrome (CFS), and Post-Acute Sequelae of SARS-CoV-2 infection (PASC) or Long Covid.
If you have questions about ME/CFS or Long Covid, you can:
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Medical Matters is based on the popular ‘Ask the Doctor‘ series featured in the highly-regarded member’s magazine, ME Essential, and in the healthcare professional magazine, ME Medical. Both are produced by the ME Association and published as hard-copy magazines every 3 months and sent to members and healthcare professionals by post to home or business addresses.
If you are a Health Care Professional you can sign-up to receive ME Medical magazine (people with ME/CFS can also nominate their HCP by completing the sign-up form).