Healthcare provider education:
ME Introduction & diagnosis
Getting started
Canadian Consensus Criteria for diagnosis ME
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See pages 22 and 23 for Diagnostic Protocol
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(from BC Women's Hospital Complex Chronic Diseases Program)
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Introduction and Diagnosis
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The Diagnosis and Managment of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome
(12 minute introductory video from MEAction)
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ME and Long-COVID
Please read more on this emerging topic, and refer to above diagnosis and symptom support material as required.
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To provide you with a starting point, here are several important references.
A note of CAUTION around the use of FCEs for diagnosing ME/CFS
From the BC Women’s CCDP (Complex Chronic Diseases Program)
Functional Capacity Evaluations or FCEs are not recommended for people with ME/CFS.
Many patients with ME/CFS
are unable to complete the test
“FCEs typically track reports of the individual’s pain but often do not track fatigue as a limiting symptom and fatigue is the primary symptom of ME/CFS.
This may result in the FCE provider simply stating that the individual self-limited their efforts and interpreting this as invalid effort.”
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The test may not work
The results of FCEs are likely incorrect or invalid (will significantly overestimate functioning) in people with ME/CFS.
The test may cause a crash
The test itself poses a serious risk of triggering PEM (post exertional malaise, or a worsening of symptoms immediately or 12-48 hours after exertion), that may not be evident for a day or more, and therefore may not come to the attention of the FCE provider or diagnosing physician.
The test may contribute to
permanent worsening of the illness
Triggering PEM can cause an immediate crash and triggering PEM too hard or too often may lead to a permanent or long-term worsening of ME/CFS.
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These conclustions should apply equally to those with Long-COVID who exhibit exercise intolerance and PEM.
ME early diagnosis
A number of research articles outline the importance of early diagnosis. However, many patients report it taking years to receive an ME diagnosis.
Early recognition and diagnosis is critical to better care, can lessen the impact of the illness and may improve prognosis.
Related articles
Rowe, P. et al. (2017).
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Diagnosing and Treating ME/CFS
Click here for the complete guide for diagnosis and treatment of ME from the US ME/CFS Clinician Coalition.
ME common comorbidities
There are a number of conditions that can commonly occur at the same time as ME.
The Canadian Consensus Criteria, used to diagnose ME, recognizes the following comorbidities for ME/CFS: fibromyalgia, myofascial pain syndrome (MPS), temporomandibular joint syndrome (TMJ), irritable bowel syndrome (IBS), interstitial cystitis, Raynaud's phenomenon, prolapsed mitral valve, migraine, allergies, multiple chemical sensitivities (MCS), Hashimoto's thyroiditis, and sicca syndrome (Sjögren's syndrome).
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Additional common co-conditions are: postural tachycardia syndrome (or POTS) and other dysautonomia disorders, mast cell activation syndrome, Ehlers-Danlos syndrome, and a variety of autoimmune diseases.
More research is needed to understand how these conditions are related.
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Additional video information
Myalgic Encephalomyelitis -
Diagnosis, Management and Current Research
An educational webinar featuring Dr. Nina Muirhead, Dr. Lucinda Bateman, Dr. Luis Nacul and Patient Voice Hilary Robertson. This webinar was developed in partnership by the ME|FM Society of BC and ICanCME to develop a webinar for the Federation of Medical Women in Canada (September, 2021).
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A 1.25 hour video.
Improving the way medical providers understand, diagnose, and treat ME/CFS and Fibromyalgia is critical to progress and a primary focus of the Bateman Horne Center (2017).
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A 1-hour video.
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Diagnosis and Management of ME,
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Current and Upcoming Research (2021).
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A 1-hour CIHR-IMHA webinar.
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Paediatrics
N.I.C.E. Guidelines: evidence-based recommendations for diagnosis and management of ME/CFS (2021)
In October 2021, The National (UK) Institute for Health and Care Excellence (NICE) produced an updated review of the evidence for ME/CFS care.
Other Resources
Other resources
MEPedia Primer for Doctors and Researchers
A wiki resource for health care professionals on ME/CFS.
ME/CFS Clinician Coalition
Succinct and easy navigation to clinical resources/support.