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: Hypothyroidism
Symptoms: Gradual deterioration
I’m in my late forties and have had ME for over 10 years. For the past few years it has been fairly stable with occasional exacerbations, normally when I get an infection. But I’ve recently noticed a gradual deterioration in almost all of my ME symptoms. I don’t have any new or unusual symptoms and there are no obvious reasons for this deterioration in health – infection, stress etc. I’m reluctant to see my GP – who knows very little about ME – but I am starting to feel concerned.
Blood sugars: Hypoglycaemia
I sometimes have acute and short lived episodes involving symptoms that are found with low blood sugar: feeling weak and dizzy, looking pale, sweating, increased pulse rate, blurred vision and confusion.
I’ve read on the internet that one of the symptoms of ME can be episodes of low blood sugar (hypoglycaemia). However, I cannot find hypoglycaemia being listed in any of the official diagnostic criteria for ME/CFS, or in the symptom list in the MEA purple book.
As my brother is diabetic, I’ve been checking my blood sugar levels at these times and found them to be low. My GP said he didn’t know if this could be related to ME/CFS and has arranged for me to see an endocrinologist (hormone specialist) for further assessment.
Please could you clarify if there is a link between ME/CFS and low blood sugar. If so, what is the best form of treatment? I should add that I have a healthy balanced diet with no food restrictions.
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.
Symptoms: Pins and Needles
I’m in my early forties and have had moderate ME/CFS for about 5 years. I have all the usual symptoms but I now have a new and rather distressing sensation in my arms and sometimes in my legs. It is very similar to the ‘pins and needles’ sensation you can get when your legs have been crossed for too long. These abnormal sensations come and go and don’t seem to be triggered by anything in particular. Is this yet another symptom of ME/CFS? Or do I need to go and see my doctor?
Symptoms: Cognitive Dysfunction
I know that cognitive dysfunction/’brain fog’ is one of the key symptoms of ME/CFS and that it can vary in severity – just like most other ME/CFS symptoms. But I’m concerned about what seems to be a slow and progressive worsening in the problems I have with memory, concentration, mixing up words and the ability to process information. I’ve also noticed that my memory for events in the past is now being affected. Otherwise, most of my other ME/CFS symptoms are fairly stable. But the frustration with not being able to properly function mentally is starting to make me feel depressed.
I went to see my GP a few months ago, and he felt that my cognitive problems were probably ‘just another part of having ME/CFS’. So is this sort of progressive decline in mental functioning something that other people with ME/CFS report and just have to live with?
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.
New Symptoms
I know that in addition to all the well-known symptoms associated with ME/CFS there are a considerable number of other symptoms that can sometimes occur. But when should I go and see my doctor if I develop a new symptom? Or when an existing symptom isn’t quite the same as it used to be? In my case I’ve always had a problem with balance and I know you have described this as ‘walking on rubber’ – which is exactly how it feels at times! However, I’m now having what are best described as occasional dizzy spells where I feel very “off balance”. I also suspect that my hearing isn’t quite as sharp as it used to be. I’ve mentioned this problem to my new GP, who checked my blood pressure, looked inside my ears and said it was probably caused by ME/CFS – but come back if things don’t improve! I don’t want to be seen as a hypochondriac, turning up at the doctors every time I don’t feel well. But at the same time, I don’t want to find that something important, or treatable, is being missed.
Symptom: Cold Extremities
Like most people with ME/CFS I‘m very sensitive to changes in temperature and find the cold winter weather is very difficult to deal with. So do you have any tips on keeping warm when it gets really cold?
Idiopathic Chronic Fatigue
What is the difference between chronic fatigue and ME/CFS? A friend of mine has been told by her doctor that she has something called idiopathic chronic fatigue. But I know that she has very similar symptoms to ME/CFS.
Prognosis: Progressive
I’m in my late forties and have had ME for over 10 years. For the past few years it has been fairly stable with occasional exacerbations, normally when I get an infection. But I’ve recently noticed a gradual deterioration in almost all of my ME symptoms. I don’t have any new or unusual symptoms and there are no obvious reasons for this deterioration in health – infection, stress etc. I’m reluctant to see my GP – who knows very little about ME – but I am starting to feel concerned.
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).
