Question

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.

Answer

Sue Luscombe, Hon Diet & Nutrition Adviser to the ME Association, says…

GPs have clearly-defined criteria for referral to dietitians in the NHS. They recommend referring people with ME, who have significant unwanted weight loss to poor appetite and intake, for nutritional assessment and support; IBS symptoms that have not improved through first line treatment, to help with gut symptoms; those with restricted diets, and at risk of malnutrition; and for those with severe and very severe ME.

In some areas, GPs also refer for weight management although this is reducing as there are now many national programmes to support weight goals. There’s very little research on diet and ME and hence evidence.

In 2021 NICE updated their guidance of evidence based practice in ME including nutrition and diet. A summary of these guidelines is in the British Dietetic Association (BDA) Food Facts on ME/CFS and also in the MEA information on diet and nutrition. NICE does not recommend ‘clean’ eating for ME.

• BDA Food Facts on ME/CFS

• Diet and Nutrition (Free MEA booklet)

Finally I would highly recommend the information from the Vegan Society especially on B12 recommendations as the only reliable source of B12 for vegans is from fortified foods or supplements.