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: Weight
‘Clean food’
Three years ago I asked my previous GP practise for a consultation with their dietitian. They refused.
I changed to a much better practice seven months ago, but I would prefer not to deal with them on this matter as they are all completely ignorant about ME.
I was vegetarian for 29 years and transitioned to a vegan lifestyle 11 months ago. I’m convinced that it is the best I can do for my body as every animal product causes inflammation. And I’m definitely feeling the benefit of clean food.
Some specific advice with regard to the implications for ME would be much appreciated.
Overweight – so clinic referral is refused
Like many people with ME I have put on quite a lot of weight. I am very aware of all the other health problems that this could cause.
So I was surprised to find that when my GP contacted out local ME/CFS clinic for a referral to help me with management this was refused because they will not see people who have a high BMI/are significantly overweight.
This is not fair and seems to be discriminatory.
Worried about weight loss
I’ve read on the internet that one of the many symptoms of ME is weight loss. My weight has dropped from about 11 stone to just over 9.5 stone over the past six months. I have a reasonable appetite and eat a fairly normal diet. I don’t have any stomach or bowel problems. The fact that I’ve lost quite a bit of weight doesn’t really bother me but why does this occur in ME?
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?
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?
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?
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.
Mental Health: Depression
Like many other people with ME/CFS, I often feel fed up and frustrated by all the restrictions this illness imposes on my life. But I don’t feel depressed. I now have a new bright GP who thinks I am depressed and he wants me to try a course of antidepressants – to see if they make me feel happier! I know I would feel happier if I just felt well again. But I’m not convinced that I need antidepressants to do so!
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.
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 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).
