Introduction

Myalgic encephalomyelitis (ME) can affect every organ and function of the body. Here are some of its major symptoms:

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• Onset of severe, disabling fatigue that is new, persistent or recurrent, and is not alleviated by rest. In ME sufferers, the fatigue is a profound physiological exhaustion.

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• "Post Exertion Malaise" (PEM), also known as "Post Exertion Neuro-Immune Exhaustion" (PENE), is considered the hallmark symptom of ME. PEM occurs when fatigue and other symptoms worsen as a result of increased activity. The extent of this activity depends on the level of disability, and can involve exercise, socializing, cognitive activity, cleaning, walking, talking for too long, or as little as getting up to go to the bathroom. Patients often refer to a "crash" where they may become immobilized, even bedridden, for extended periods before the fatigue and other symptoms are even partially alleviated. PEM may last from a day or two, to many months.

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• Changes in sleep patterns. People with ME often complain of unrefreshing sleep, and experience disturbances in both quality and quantity of their sleep. Sleep apnea is also often present.

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• ME often causes cognitive function impairments such as short term memory disturbance, confusion and difficulty with thinking and concentration. The abilities to read, write, perform mathematical calculations, and clearly communicate can be affected.

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• Pain is often experienced in the muscles or joints and/or in the onset of headaches of a new type, pattern or severity.

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In addition to these major symptoms, people with ME experience, in varying degrees and combinations, a range of other symptoms related to irregularities in the functioning of the neurological, immune and endocrine systems. These can include:

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• problems with balance

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• orthostatic hypotension

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• hormone imbalances

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• chills and/or sweats

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• low grade fever or abnormal body temperature

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• heart rhythm irregularities

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• increased sensitivity to noise, light, odours

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• increased chemical sensitivity

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• gastrointestinal problems such as diarrhea, constipation, irritable bowel symptoms and abdominal pain

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• effective functions (emotions) can be altered and anxiety and mood changes may be severe, unprovoked and inappropriate. Depression may also occur, as a reaction to, rather than as a cause of ME.

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