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: Appetite
CBD oil for pain relief
I keep reading about people with ME/CFS who are using cannabis oil (CBD oil) for pain relief – with varying degrees of benefit. My GP said that he isn’t allowed to prescribe cannabis oil for pain relief and he wasn’t convinced by the claims that are being made. So is there any evidence that CBD oil can help with pain relief? And given the link to cannabis is it safe to try if you have ME/CFS?
Loss of appetite
I’m not sure if I ought to be worried about my recent loss of appetite – because this means that I’m starting to lose a bit of excess weight. However, this illness imposes far too many restrictions on what I can do already and I normally enjoy my food.
I haven’t been to see my GP because she’s not really interested in ME.
Is there a good tonic you could recommend? And is there a reason why people with ME sometimes lose their appetite?
Hyperparathyroidism
Many symptoms of Hyperparathyroidism are similar to ME/CFS and Fibromyalgia. Would a GP be able to recognise hyperparathyroidism and what are the treatment options?
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?
Treatment: Thiamine
There are “medical people” on the internet claiming that high doses of a supplement called thiamine are a safe and effective new treatment for ME. What is thiamine? Is there any evidence to support this claim? And could taking high doses of thiamine cause any harm?
Aetiology: Immune System
I keep seeing references to ‘low level immune system activation’ being an important research finding in ME/CFS. But what does this mean in language that I can understand?
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?
Rheumatoid Arthritis
I’ve always had occasional joint pains since developing ME/CFS three years ago but they are definitely getting more frequent and painful. As both my mum and aunt have rheumatoid arthritis, I’m worried that I may also be developing arthritis. My GP isn’t too concerned as there isn’t any swelling or signs of inflammation, but I’m still not happy. What is the difference between joint pains in ME/CFS and true arthritic joint pain?
Diet and Nutrition: Malnutrition
I ask because there is a great deal of positive discussion on internet forums about the benefits of unproven special diets, restrictive and exclusion diets, and dietary supplements. At the same time, very little attention is paid to the dangers of cutting out or reducing the intake of specific food groups such as dairy or wheat. And people with more severe ME may have significant problems in obtaining groceries, preparing meals and even eating a full meal. All of which could be having an adverse effect on their overall health. So, do we need to start looking at diet and nutritional status in ME from both a clinical and research point of view?
Treatment: Drugs and Weight Gain
Although taking a low dose amitriptyline has been very useful in reducing some of my pain and helping to correct my very erratic sleep pattern (frequent wakening during the night) I’ve put on a considerable amount of weight since taking this drug. My GP says that weight gain is a well recognised side-effect with this type of drug and that it can also occur with other drugs that are used for pain relief. I know from talking to other people with ME that weight gain can be a major problem with some drug treatments for ME. But why is this so? And are there any solutions?
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 an HCP you can sign-up here to receive ME Medical magazine (people with ME/CFS can also nominate their HCP by completing the sign-up form).
