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 Test
Blood tests: Low Neutrophil count
As I’ve been feeling more fatigued than usual, my GP arranged some routine blood tests.
Everything was normal – apart from having a low neutrophil count. My GP didn’t seem too worried and is going to repeat the test.
What are neutrophils and can ME cause them to decrease?
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?
Low sodium levels – Hyponatraemia
I’ve been feeling generally unwell and more fatigued – mentally and physically, for the past few months.
My GP ordered some routine blood tests – all of which were normal apart from having a slightly lower than normal level of sodium in the blood. My GP isn’t too concerned and is going to repeat the blood test. Could a low sodium level be caused by having ME?
Symptoms: Cognitive Dysfunction
I know that cognitive dysfunction/’brain fog’ is one of the key symptoms of ME/CFS and that it can vary in severity – just like most other ME/CFS symptoms. But I’m concerned about what seems to be a slow and progressive worsening in the problems I have with memory, concentration, mixing up words and the ability to process information. I’ve also noticed that my memory for events in the past is now being affected. Otherwise, most of my other ME/CFS symptoms are fairly stable. But the frustration with not being able to properly function mentally is starting to make me feel depressed.
I went to see my GP a few months ago, and he felt that my cognitive problems were probably ‘just another part of having ME/CFS’. So is this sort of progressive decline in mental functioning something that other people with ME/CFS report and just have to live with?
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.
Treatment: Vitamin D
Can Vitamin D help people with ME/CFS and are we more susceptible to Vitamin D deficiency?
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
The 2021 NICE Guideline ME/CFS: Drug Treatments
Comparing some of the recommendations on the use of specific drugs in the new NICE guideline to those in the previous 2007 NICE guideline, I see that melatonin is no longer given a possible recommendation for sleep disturbance in the 2021 guideline and the “do not use” instruction in the 2007 guideline no longer applies to antiviral drugs, fludrocortisone, steroids and thyroxine.
Does this mean that doctors can no longer prescribe melatonin but that they can now prescribe amphetamines, antiviral drugs, steroids, etc for people with ME?
Diagnosis: Buspirone Challenge Test
I didn’t think there was a blood test for ME. However, my doctor wants to arrange for me to have what is called a buspirone challenge test. If this test can be used to confirm a diagnosis of ME, why isn’t it being used more widely?
Investigations: Magnetic Resonance Imaging (MRI)
I have been referred to a neurologist who has arranged for me to have an MRI scan. This will involve the use of a dye/contrast agent called gadolinium. Is this a safe procedure to have for people with ME/CFS? Can it be used to confirm a diagnosis of ME? And can MRI brain scans cause any adverse reactions?
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:
- Review the free information in the What is ME/CFS? section of the website, and the free Covid-19 and Long Covid information in the website shop.
- Review the largest range of literature covering all aspects of living with ME/CFS. Download detailed information about symptoms, diagnosis, management, co-mordities, employment, education, related health conditions, The 2021 NICE Clinical Guideline, welfare benefits etc.
- Join the ME Association as a member and you'll receive the highly-rated ME Essential magazine, and you can ask questions of the charity’s expert advisers including Dr Shepherd.
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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).
