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: Diabetes
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: Gradual deterioration
I’m in my late forties and have had ME for over 10 years. For the past few years it has been fairly stable with occasional exacerbations, normally when I get an infection. But I’ve recently noticed a gradual deterioration in almost all of my ME symptoms. I don’t have any new or unusual symptoms and there are no obvious reasons for this deterioration in health – infection, stress etc. I’m reluctant to see my GP – who knows very little about ME – but I am starting to feel concerned.
Blood sugars: Hypoglycaemia
I sometimes have acute and short lived episodes involving symptoms that are found with low blood sugar: feeling weak and dizzy, looking pale, sweating, increased pulse rate, blurred vision and confusion.
I’ve read on the internet that one of the symptoms of ME can be episodes of low blood sugar (hypoglycaemia). However, I cannot find hypoglycaemia being listed in any of the official diagnostic criteria for ME/CFS, or in the symptom list in the MEA purple book.
As my brother is diabetic, I’ve been checking my blood sugar levels at these times and found them to be low. My GP said he didn’t know if this could be related to ME/CFS and has arranged for me to see an endocrinologist (hormone specialist) for further assessment.
Please could you clarify if there is a link between ME/CFS and low blood sugar. If so, what is the best form of treatment? I should add that I have a healthy balanced diet with no food restrictions.
Treatment: Hyperbaric Oxygen Therapy (HBOT)
Has there ever been a clinical trial to assess the use to hyperbaric oxygen (HBO) in ME? I know that HBO is being used by people with multiple sclerosis as well as ME – so it seems that there are positive effects in the case of neurological diseases. I’ve also read that a clinical trial involving people with Long Covid has found some beneficial effects.
Treatment: Low Dose Steroids
I’m having joint problems at the moment and my consultant wants to inject a steroid into the joint to calm things down. I’m concerned that this could make my ME/CFS worse because I thought that people with ME/CFS should not take steroids. What do you suggest I do?
Symptoms: Overactive Bladder (OAB)
I’m female, in my early forties, and have had moderate ME/CFS for about five years. More recently, I've been having a number of bladder symptoms – in particular a frequent and sudden urge to pass what are only quite small amounts of urine. I am also having to go to the bathroom on several occasions during the night.
My doctor thought I might have cystitis – even though I don’t have any pain. However, there were no signs of infection on repeated urine tests. My GP now says that I probably have an “overactive bladder”, and that while there are drugs that can definitely help to calm down an irritable bladder they can cause side-effects, including drowsiness.
Is having an overactive bladder more common in ME/CFS? And is there any other form of treatment – as this is causing me a lot of distress and restricting what I’m able to do outside the house.
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.
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?
Diabetes
Knowing that lack of exercise and weight gain are two things that increase the risk of developing type 2 diabetes, is this type of diabetes more common in people with ME? I ask because I noticed I was getting thirsty, drinking more water than usual, and was also passing urine more frequently. I went to see my GP for some blood and urine tests and she confirmed that I had developed type 2 (non insulin requiring) diabetes. The good news is that a change in diet and weight loss are definitely bringing things under control and it doesn’t look as though I am going to need treating with drugs.
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.
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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).
