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: Muscle Weakness

Decreasing muscle strength as we grow older – sarcopenia

ME Essential Summer 2025

I am in my mid sixties and have had moderate ME/CFS for about 20 years. Over the past year I've noticed a slow but steady decline in the muscle strength in my thigh muscles. This has reduced the distance I can comfortably walk and some difficulty in climbing stairs.

My GP was very good and in addition to doing a physical examination checked some blood tests – all of which were normal. He has told me that I probably have something called sarcopenia and that ME/CFS is exacerbating what can be a natural consequence of ageing.

My question is whether most people over the age of 60 who have ME/CFS are likely to experience a similar decline in muscle strength and whether there is anything that can be done to help.

10 KEY FACTS: THE THYROID GLAND AND THYROID FUNCTION TESTS IN RELATION TO ME/CFS

ME Essential Winter 2025

What is low thyroid function/hypothyroidism and how do the symptoms overlap with ME/CFS?

Does ME involve spinal cord inflammation?

ME Essential Autumn 2024

Earlier this year, I suddenly developed severe back pain, loss of balance and was unable to walk in a straight line. I was sent to casualty where I had a CT and MRI scan. I was then diagnosed as having severe spinal inflammation.

The MEA purple book states that there is no evidence of brain or spinal inflammation (= encephalomyelitis) in ME/CFS.

But are we missing something here? Could symptoms such as back pain, poor coordination and abnormal sensations that are commonly reported in ME be caused by inflammation in the spinal nerves?

Hyperparathyroidism

ME Essential Spring 2023

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

ME Essential Winter 2023

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?

Post-Viral Fatigue Syndrome, Myalgic Encephalomyelitis or Encephalopathy, Chronic Fatigue Syndrome, and Long Covid

ME Essential Winter 2022

Please can you define what PVFS, ME/CFS, and Long Covid mean. I am having difficulty determining if they are the same disease or different. Thank you!

Treatment: Low Dose Steroids

ME Essential Autumn 2022

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?

Sjögren’s Syndrome

ME Essential Spring 2021

I know that joint pains sometimes occur in ME/CFS and this is a symptom that I’ve occasionally had over many years – but without any swelling, redness or deformity occurring. But I’ve also developed more persistent joint pain, dry eyes and my fatigue levels are considerably worse. My GP is questioning whether I might now have a condition cause Sjögren’s Syndrome which he says can sometimes be misdiagnosed as ME/CFS. But can it co-exist with ME/CFS?

Addison's Disease

ME Essential Summer 2020

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?

Treatment: Tryptophan

ME Essential Spring 2020

I’ve read that taking a tryptophan supplement is helpful for people with ME. Is this true? And are there any side-effects?

Charles Shepherd

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