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.
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Questions in the Category: Alcohol
Gilbert's Syndrome
A few months ago I noticed that the whites of my eyes had turned slightly yellow. It turned out that I had a mild episode of jaundice. My GP was a bit mystified – so I was sent to see a liver specialist who diagnosed a condition called Gilbert’s Syndrome. The specialist said it was nothing to worry about. However, as he had seen other people with ME/CFS with the same condition, he wondered whether there may be a link. Is this so?
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.
Osteoporosis
I have several family members who have developed osteoporosis (thinning of the bones) in later life – some of whom have had nasty fractures as a result – and I understand that people with ME may be at increased risk of developing osteoporosis.
Why is this? Is there anything we can do to reduce this happening? And is there any treatment for osteoporosis?
Management: Fitness
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?
Symptom: Palpitations
Like many people with ME I have occasional palpitations. Does this mean that I might have some form of underlying heart disease? Or is this just another part of having ME? And are there any drug treatments that might be helpful?
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?
Symptom: Alcohol Intolerance
Like most people with ME/CFS, I quickly found that alcohol makes me feel much worse and avoided drinking any alcohol since my illness started. I’ve been lucky and made some significant improvement over the past few years. A few weeks ago, I was invited to a big family social event and was persuaded to have a small glass of wine – which I have always enjoyed. To my surprise, it didn’t have the same adverse effect as it did in the past and since then I’ve enjoyed an occasional small glass of wine. Why does alcohol have such an adverse effect on ME/CFS? Has any research been carried out into why alcohol intolerance occurs in ME/CFS? And is it safe to start having an occasional drink of alcohol if you can cope with it again?
Diet and Nutrition: Restrictive Diets
All kinds of strange and restrictive diets are recommended for people with ME/CFS. I know of people who have cut out loads of different food groups, especially dairy, gluten and meat. Some of them have lost weight and made themselves worse as a result. So is there any evidence that any of these restrictive diets can be helpful? And what are the potential problems?
Symptom: Tremor
I understand that a tremor, or shaking in the hands, sometimes occurs in ME/CFS. But it could also be a sign of Parkinson’s disease. I’m in my mid fifties and have had moderate ME/CFS for about five years. It is fairly stable but the tremor, which is in both hands and tends to be more noticeable when I’m fatigued, has only been present for a few weeks. Should I see my GP?
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).
Please note: The answers comprising Medical Matters were accurate at the time of printing. A publication date accompanies all listed entries. We will endeavour to keep Medical Matters updated as information changes, but if you would like to comment, please email: meconnect@meassociation.org.uk
MEDICAL DISCLAIMER
Information provided by The ME Association should not be construed as medical advice. Don't assume any new or worsened symptoms are simply the result of having ME/CFS or Long Covid. We recommend that any information you deem relevant is discussed with your NHS GP as soon as possible. It is important that you seek personalised medical advice from the GP who is in charge of your care and who knows you well.