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The NICE Guideline on ME/CFS: Diagnosis and Management [NG 206] Published 29 October 2021

  • This guideline covers diagnosing and managing myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome (ME/CFS) in children, young people and adults.
  • It aims to improve awareness and understanding about ME/CFS and when to suspect it, so that people are diagnosed earlier. It includes recommendations on diagnosis, assessment and care planning, safeguarding, access to care and managing ME/CFS and its symptoms.
  • These recommendations were developed based on evidence reviewed before the COVID-19 pandemic. We have not reviewed evidence on the effects of COVID-19, so it should not be assumed that these recommendations apply to people diagnosed with post-COVID-19 syndrome. NICE has produced a guideline on managing the long-term effects of COVID-19.


This guideline includes recommendations on:

  • suspecting ME/CFS and diagnosis
  • information and support, including advice when ME/CFS is suspected
  • assessment and care and support planning
  • safeguarding
  • access to care and support
  • managing ME/CFS
  • symptom management
  • flare-ups and relapse
  • care for people with severe or very severe ME/CFS.

Who is it for?

  • Health and social care professionals, including those working or providing input into educational and occupational health services
  • Commissioners
  • People with suspected or diagnosed ME/CFS, their families and carers and the public.

Guideline development process

How we develop NICE guidelines

  • This guideline was commissioned by NICE and developed at the National Guideline Centre which is hosted by the Royal College of Physicians.
  • This guideline updates and replaces NICE guideline CG53 (published August 2007).
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