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: Blood Pressure
Shakiness
I am hoping you can shed some light on two types of shakiness which I've had since a recent relapse of my ME.
Some days I start feeling shaky shortly after getting moving in the morning. It's like I've had a big dose of caffeine (which I definitely haven't) and at its worst my hands will be too shaky to do anything fiddly like sewing but resting is hard because I feel wired with it. It normally fades around the middle of the day. It's intermittent and there are no obvious triggers.
More difficult to describe is a sensation I get sometimes which is more disturbing. It's like an inner wobble, possibly centred around my abdomen. It comes and goes and tends to make me feel vaguely weak. It's possible that one trigger is doing too much but otherwise it's random and can disappear for weeks. I find it difficult because I don't know whether I should be resting more when I have this shakiness or trying to ignore it like a lot of other symptoms.
Steroid treatment – is it safe?
I’m having a lot of joint problems at the moment and my consultant wants to inject a steroid into the joint to reduce the inflammation and pain. I’m concerned that this could make my ME worse because I thought that people with ME shouldn’t be given steroids.
Symptoms: Balance
I developed ME a few years ago and have all of the main symptoms including occasional problems with balance or unsteadiness, especially when I’m tired. Over the past few months my balance/ unsteadiness has become more persistent. I’ve also had a couple of episodes when I’ve come off an escalator (which I no longer do) and nearly fallen over. My GP has checked me over (nothing abnormal was found) and prescribed a drug called Stugeron/ cinnarizine, which hasn’t really helped.
What else can I do? Just put up with it?
Symptom: Temperature Regulation (2)
I’ve always enjoyed a long soak in a hot bath, especially at the end of the day – and still do. But since developing ME/CFS I’ve found that I feel completely wiped out afterwards – as well as feeling more lightheaded and faint than usual. Is this something that could be related to ME/CFS, because it doesn’t appear to be listed as a symptom?
Non-Alcholic Fatty Liver Disease (NAFLD)
I’ve recently been feeling more fatigued than usual. I’ve also lost a bit of weight and had some tummy pains – which are higher up than the sort of spasmodic pain I sometimes get with my irritable bowel.
My GP did some blood tests – all of which were OK apart from some minor abnormalities in my liver function tests. To cut a long story short I then had a visit to hospital and an ultrasound scan of my liver. It turns out that I have what the hospital doctor calls a fatty liver. He says it’s a fairly common condition – especially if you have diabetes, high blood pressure or are overweight and possibly ME/CFS. Could this be connected to having ME/CFS as well? As I’ve only put on weight since developing the condition.
Management: Heart Health & ME/CFS
Can I ask what the advice is on heart health for people with ME? As most of us can’t exercise, how do we maintain a healthy cardiovascular system? Is a healthy diet enough?
Symptom: Palpitations
Like many people with ME I have occasional palpitations. Does this mean that I might have some form of underlying heart disease? Or is this just another part of having ME? And are there any drug treatments that might be helpful?
Septicaemia (Sepsis)
Could you say something about sepsis and ME? A friend of mine who has ME has been seriously ill in hospital with sepsis but is now back home again. The doctors say that she is going to need a prolonged period of recovery from the effects of sepsis. This has also caused a significant relapse of her ME. Are people with ME more at risk from developing sepsis if they just have a minor injury or infection? And is there anything we should be doing to reduce the risk of developing sepsis?
Dysautonomia: Orthostatic Intolerance (OI) and Postural Orthostatic Tachycardia Syndrome (PoTS)
I keep reading about orthostatic intolerance, PoTS and postural hypotension and how they can all be symptoms of ME/CFS. But what do all these medical terms mean? What is going wrong? And are all these symptoms and syndromes related to each other?
New Symptoms
I know that in addition to all the well-known symptoms associated with ME/CFS there are a considerable number of other symptoms that can sometimes occur. But when should I go and see my doctor if I develop a new symptom? Or when an existing symptom isn’t quite the same as it used to be? In my case I’ve always had a problem with balance and I know you have described this as ‘walking on rubber’ – which is exactly how it feels at times! However, I’m now having what are best described as occasional dizzy spells where I feel very “off balance”. I also suspect that my hearing isn’t quite as sharp as it used to be. I’ve mentioned this problem to my new GP, who checked my blood pressure, looked inside my ears and said it was probably caused by ME/CFS – but come back if things don’t improve! I don’t want to be seen as a hypochondriac, turning up at the doctors every time I don’t feel well. But at the same time, I don’t want to find that something important, or treatable, 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.
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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).