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: Cancer
Symptoms – Abnormal red blood cells
After feeling more fatigued than usual, my GP arranged some blood tests – all of which were normal apart an abnormality with my red blood cells called macrocytosis. Can this can be caused by ME? I understand that there has been some research from New Zealand that found abnormally shaped red blood cells that impaired the blood flow in tiny capillaries.
Treatment: Bromelain
I have read several newspaper articles about the use of this natural plant-based treatment for pain relief, especially in arthritis and muscle soreness. But is there any evidence that it can help to reduce muscle pain in ME? Because none of the drug treatments that I have been prescribed by my GP have helped.
Septicaemia (Sepsis)
Could you say something about sepsis and ME? A friend of mine who has ME has been seriously ill in hospital with sepsis but is now back home again. The doctors say that she is going to need a prolonged period of recovery from the effects of sepsis. This has also caused a significant relapse of her ME. Are people with ME more at risk from developing sepsis if they just have a minor injury or infection? And is there anything we should be doing to reduce the risk of developing sepsis?
Genetic Predisposition: Hereditary
I am the only person in my family to have ME that I know of. But I’ve heard that people with ME quite often have another family member with the disease. Is this true? If so, can someone with ME transmit it to their children? And has any research been carried out into the genetics of ME?
Irritable Bowel Syndrome
Like many people with ME I also have irritable bowel syndrome (IBS). I have the MEA information leaflet on IBS and have had most of the treatments listed for my various bowel and stomach symptoms. But my symptoms are getting worse, especially the bloating, stomach pain and back pain. My fatigue levels have also increased. I am female, in my early 50s, and have had IBS symptoms for about three years. Do you have any other suggestions?
Treatment: Rituximab
Like everyone else, I was very disappointed to learn that the big clinical trial that had been carried out in Norway had failed to show any evidence of benefit for rituximab in ME/CFS. However, the doctors involved do not appear to have published a paper outlining what happened and explaining whether this is now the ‘end of the road’ for what appeared to be a very promising treatment that was actually aimed at the underlying disease process. Surely it would be a helpful to know why the trial failed and what lessons might be learnt.
Diet and Nutrition: The Ketogenic Diet
I have read some internet discussions involving people with ME who claim to be finding benefits from using what is called the ketogenic diet. This is based on the idea that it is beneficial to switch to fats as the primary source of energy. However, I understood that glucose was the best source of ‘food fuel’ that we have. Has any research has been done in this area? And is this safe if you have ME?
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).