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: Muscle
Decreasing muscle strength as we grow older – sarcopenia
I am in my mid sixties and have had moderate ME/CFS for about 20 years. Over the past year I've noticed a slow but steady decline in the muscle strength in my thigh muscles. This has reduced the distance I can comfortably walk and some difficulty in climbing stairs.
My GP was very good and in addition to doing a physical examination checked some blood tests – all of which were normal. He has told me that I probably have something called sarcopenia and that ME/CFS is exacerbating what can be a natural consequence of ageing.
My question is whether most people over the age of 60 who have ME/CFS are likely to experience a similar decline in muscle strength and whether there is anything that can be done to help.
Muscle twitching/fasciculations
Unlike some people with ME, I don’t have a big problem with muscle pain. But I do get muscle twitching, especially when I’m tired or going through a ‘bad patch’. The twitching not only affects the big muscles in my arms and legs – it sometimes affects muscles on the face and makes my eyelids twitch as well! Is this a recognized problem in ME? And is there anything I can do to relieve it?
Post-Viral Fatigue Syndrome, Myalgic Encephalomyelitis or Encephalopathy, Chronic Fatigue Syndrome, and Long Covid
Please can you define what PVFS, ME/CFS, and Long Covid mean. I am having difficulty determining if they are the same disease or different. Thank you!
Cardiopulmonary Exercise Testing (CPET)
Why aren’t the oxygen levels of ME sufferers routinely checked?
Polymyalgia
You don’t often cover more elderly people with ME/CFS – so I’d like to pass on a note of warning about a serious health condition that causes ME/CFS-like symptoms. My wife, who is in her early sixties, started to have really quite severe muscle and joint pains and in places – shoulders and hips – where she didn’t normally have pain. We put it down to ME/CFS to start with and so did the GP. But when the pain got worse, and painkillers weren’t working, the GP did some blood tests – one of which showed a high level of inflammation – and she was diagnosed with an inflammatory muscle condition called Polymyalgia. Is polymyalgia more common in people with ME/CFS? And is this something that should be ruled out in elderly people before a diagnosis of ME/CFS is being made?
Addison's Disease
I was interested to see the item on Addison’s disease in the Winter issue of ME Essential as I have a close friend with this rare disease and it obviously has some interesting symptom overlaps with ME/CFS. So is there any evidence that adrenal gland failure, and steroid hormone production, could also be involved in ME/CFS? If so, would it be worth looking at steroids as a possible form of treatment for ME/CFS?
Investigations: Hand Grip Strength
I was interested to read about the new research from the ME Biobank that looked at hand grip strength in people with ME. As this appears to be a good predictor of both loss of muscle strength and disease severity why isn’t it part of the examination protocol when doctors examine people with ME
Diagnosis: Blood Test
We keep hearing about different abnormalities that researchers are finding in the blood of people with ME and with brain scans. So why aren’t any of these tests, especially the new one from Professor Ron Davis’s group in America, being used by doctors to help confirm that someone has ME – or does not have ME?
Blood Flow: Oxygenation
I know there has been some interesting research involving neuroimaging studies and that this has demonstrated defects in blood flow to certain key parts of the brain. But does this research mean that people with ME/CFS have low levels of oxygen entering the brain? If so, does it also explain some of the key brain symptoms – cognitive dysfunction in particular? And could it lead to new forms of drug treatment?
Treatment: Hydrotherapy
My physiotherapist has suggested that I might like to use of the hydroils therapy pool at a local hospital.
I have been making fairly steady progress over the past year (with the occasional short relapses) and used to really enjoy swimming — something that I haven't done since becoming ill with ME three years ago.
The physio says that the changing facilities are good, the water is warm, the atmosphere is relaxed and nobody is encouraged to do anything that they do not feel comfortable with. So why not give it a try?
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).