Medical Matters > Management: Fitness

ME Essential Winter 2021

Question

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?

Answer

That’s a really good question because regular aerobic/oxygen requiring exercise such as brisk walking, running or cycling is one of the most important ways of improving your circulation and keeping your heart healthy. But this type of exercise isn’t something that someone with ME/CFS can consider until they have made a significant and sustained degree of improvement. Having said that there are plenty of things that everyone with ME/CFS can do to try and keep their hearts healthy:

  • Have your blood pressure checked. If this is significantly elevated (= hypertension) there are drugs that can help to bring it back to a more normal level. Having a blood pressure check is particularly important if there is any family history of heart disease. However, it’s worth noting that low blood pressure (= hypotension) sometimes occurs in ME/CFS and this is generally regarded to be good for heart health – even though it may exacerbate orthostatic intolerance (= difficulty in remaining standing) and cause symptoms such as feeling faint on standing up
  • Have your blood cholesterol level checked and, if it is raised, bring it down with a low-fat diet and possibly a cholesterol-lowering drug. However, care needs to be taken with the use of cholesterol lowering drugs called statins – as these drugs can cause muscle damage as a side-effect
  • Stop smoking
  • Avoid drinking alcohol to excess – this should not be a problem if you have ME/CFS because alcohol intolerance is a common symptom in ME/CFS
  • Reduce your intake of caffeine containing drinks – because caffeine can trigger palpitations and heart rhythm disturbances
  • Have a well-balanced healthy diet that contains plenty of fruit and vegetables. Eat more fibre from a variety of sources – wholemeal bread, bran, oats, potatoes with skins on – and at least one portion of oily fish, which is rich in Omega-3 fatty acids, each week. Or you could take an Omega-3 supplement.
  • Eat less fat and switch to lower-fat dairy products. Salt intake should be no more than 6gms a day – unless this forms part of the management of low blood pressure. NB: Increasing fibre intake can increase irritable bowel symptoms – so this may not be an option for everyone.
  • Lose weight if necessary
  • Look after your teeth and gums with regular dental checks – as there is evidence that chronic gum disease (i.e sore swollen gums) is a risk factor for heart disease.
  • Deal with stress – if this is occurring.

If you do experience any symptoms that suggest the possibility of heart disease – chest pains on exertion, palpitations, ankle swelling – please see your GP who can carry out a basic heart examination and arrange for some heart monitoring (ECG) tests if necessary.

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MEDICAL DISCLAIMER

Medical Matters is for information purposes only. The answers provided by Dr Shepherd and the ME Association’s other expert advisers should not be construed as medical advice. We recommend that any information you deem relevant is discussed with your GP as soon as possible. It is important to obtain advice from a GP who is in charge of your clinical care, who knows you well, and who can consider other likely causes for symptoms. Seek personalised medical advice whenever a new symptom arises, or an existing symptom worsens. Don't assume that new or worsened symptoms are a result of having ME/CFS.

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