List of symptoms in ME CFS

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The list of symptoms in ME CFS can be extensive and most patients will not have every symptom possible

A minimum list of core symptoms of chronic fatigue (CF); post-exertional malaise (PEM); unrefreshing sleep; cognitive impairment; and/or orthostatic intolerance (OI) can diagnose a person with Systemic Exertion Intolerance Disease (SEID), an ME/CFS definition. Other symptoms can be present but a diagnosis of the SEID criterion for ME/CFS requires less symptoms than the Canadian Consensus Criteria (CCC) or the International Consensus Criteria (ICC). The CCC is another ME/CFS definition which includes the core symptoms and neurological, autonomic, neuroendocrine, immune system, and myalgia  to meet its diagnostic criteria. The ICC is for diagnosing the neurological disease myalgic encephalomyelitis (ME) which was defined by the World Health Organization (WHO) in 1969.[1]

It includes the core symptoms and neurological, immune/gastrointestinal/genitourinary impairment, and energy metabolism/ion transport impairment.

Systemic Exertion Intolerance Disease (SEID) symptom list[edit | edit source]

These are the minimum of core symptoms necessary to be diagnosed with SEID, an ME/CFS criteria. Patients can have more symptoms[2] and they are outlined in the Institute of Medicine report.

These core symptoms are also part of the CCC and ICC criteria below. However, the CCC lists PEM as optional with Post-exertional fatigue. ICC refers to PEM as Postexertional neuroimmune exhaustion (PENE) and instead of CF the term "lack of stamina" is used. ME/CFS and ME patients will always have the core symptoms and the SEID diagnostic criteria can be used to diagnose these patients also. However, the SEID diagnostic criteria cannot speak to the number of symptoms and their severity all ME/CFS and ME patients experience. The IOM report authors who created the SEID diagnostic criteria did include some other symptoms in chapters 4 and 5.[3]

Core symptoms[edit | edit source]

and at least one of the following:



Pediatric[edit | edit source]

Pediatric cases have the same symptoms.[6] However, the CDC notes some differences: OI (dizziness and lightheadedness) is experienced more often making their other ME/CFS symptoms worse. Sleep problems may be harder to detect; they will experience insomnia, daytime sleepiness, and intense and vidid dreaming. Children and adolescents do not usually have muscle and joint pain but headaches and stomach pain are more common.[7] Dr. David Bell agrees the symptoms for children can be different noting abdominal pain is more common and in teens there can be facial flushing. Although children do not describe having PEM, a hallmark symptom used in diagnosing ME/CFS, they can experience a relapse from exertion, perhaps from just taking the school bus, having to spend prolonged periods in bed.[8]

Children, particularly adolescents, will more likely have an acute illness like the flu or mononucleosis as their onset.[9]

Canadian consensus criteria (CCC) symptom list[edit | edit source]

The Canadian Consensus Criteria (CCC), an ME/CFS criteria, includes a list of recognized signs and symptoms in the appendix. Only some of these symptoms within the categories below are needed to be diagnosed under the Canadian Consensus Criteria diagnostic criteria. PEM is an and/or option with post-exertional fatigue.[10] Pediatric cases have the same symptoms; please note the information for the "Pediatric" heading under "Systemic Exertion Intolerance Disease (SEID) symptom list" above.

Cognitive[edit | edit source]

Motor (movement) and balance[edit | edit source]

Sleep disruption[edit | edit source]

Visual and auditory[edit | edit source]

Neuropsychological[edit | edit source]

Immune system[edit | edit source]

Reproductive[edit | edit source]

  • PMS or irregular menstrual cycles

Respiratory (breathing)[edit | edit source]

  • exertional dyspnea (short of breath)

Urinary[edit | edit source]

Circulatory[edit | edit source]

Digestive[edit | edit source]

  • lump in throat

Neuroendocrine[edit | edit source]

Musculoskeletal[edit | edit source]

Neurological (nervous system)[edit | edit source]

Sensory[edit | edit source]

International consensus criteria (ICC) symptom list[edit | edit source]

The International Consensus Criteria (ICC) will diagnose myalgic encephalomyelitis (ME). See the International Consensus Criteria diagnostic criteria for diagnostic guidance. Not every symptom listed is necessary to diagnose ME but having symptoms within categories is necessary. The ICC refers to "lack of stamina" instead of CF.

Post-exertional Neuroimmune Exhaustion (PENE)[edit | edit source]

Previously known as Post-exertional malaise. This cardinal feature is a pathological inability to produce sufficient energy on demand with prominent symptoms primarily in the neuroimmune regions. Characteristics are:

  • Marked, rapid physical and/or cognitive fatigability in response to exertion, which may be minimal such as activities of daily living or simple mental tasks, can be debilitating and cause a relapse.
  • Post-exertional symptom exacerbation: e.g. acute flu-like symptoms, pain and worsening of other symptoms.
  • Post-exertional exhaustion may occur immediately after activity or be delayed by hours or days.
  • Recovery period is prolonged, usually taking 24 hours or longer. A relapse can last days, weeks or longer.
  • Low threshold of physical and mental fatigability (lack of stamina) results in a substantial reduction in pre-illness activity level.

Neurological[edit | edit source]

Neurocognitive Impairments

Difficulty processing information: slowed thought, impaired concentration, e.g. confusion, disorientation, cognitive overload, difficulty with making decisions, slowed speech, acquired or exertional dyslexia

Short-term memory loss: e.g. difficulty remembering what one wanted to say, what one was saying, retrieving words, recalling information, poor working memory Pain

Headaches: e.g. chronic, generalized headaches often involve aching of the eyes, behind the eyes or back of the head that may be associated with cervical muscle tension; migraine; tension headaches

Significant pain can be experienced in muscles, muscle-tendon junctions, joints, abdomen or chest. It is non-inflammatory in nature and often migrates. e.g. generalized hyperalgesia, widespread pain (may meet fibromyalgia criteria), myofascial or radiating pain Sleep disturbances

Neurosensory, Perceptual and Motor Disturbances

Neurosensory and perceptual: e.g. inability to focus vision, sensitivity to light, noise, vibration, odor sensitivities, taste and touch; impaired depth perception.

Motor: e.g. muscle weakness, twitching, poor coordination, feeling unsteady on feet, ataxia.

Immune, Gastro-intestinal and Genitourinary[edit | edit source]

Susceptibility to viral infections with prolonged recovery periods.

Energy Metabolism/Ion Transportation[edit | edit source]


Children's symptoms[edit | edit source]


See also[edit | edit source]

Learn more[edit | edit source]

  • IOM report - Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

References[edit | edit source]

  1. World Health Organization (1969). International Classification of Diseases (PDF). 2 (Eighth revision ed.). Geneva: WHO. p. 173. Encephalomyelitis (chronic),
    (myalgic, benign) 323
  2. "5". Read "Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness" at National Academy of Medicine. 2015. p. 141. 
  3. "4 and 5". Read "Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness" at National Academy of Medicine. 2015. 
  4. "Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness - Diagnostic Algorithm". 2015. 
  5. "Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome - Redefining an Illness" (PDF). 2015. 
  6. "6". Read "Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness" at National Academies of Medicine. 2015. p. 181. 
  7. "Symptoms and Diagnosis of ME/CFS in Children | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) | CDC". Jan 18, 2019. Retrieved Jan 29, 2019. 
  8. "ME/CFS in Children - by David S. Bell, MD | Open Medicine Foundation". Open Medicine Foundation. Jun 25, 2016. Retrieved Aug 11, 2018. 
  9. "Symptoms and Diagnosis of ME/CFS in Children | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) | CDC". Jan 18, 2019. Retrieved Jan 29, 2019. 
  10. "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Clinical Case Definition and Guidelines for Medical Practitioners - An Overview fo the Canadian Consensus Document" (PDF). p. 4. Physical or mental exertion often causes debilitating malaise and/or fatigue, generalized pain, deterioration of cognitive functions, and worsening of other symptoms that may occur immediately after activity or be delayed. Patients experience rapid muscle fatigue and lack endurance. 
  11. Carruthers, Bruce M.; Jain, Anil Kumar; De Meirleir, Kenny L.; Peterson, Daniel L.; Klimas, Nancy G.; Lerner, A. Martin; Bested, Alison C.; Flor-Henry, Pierre; Joshi, Pradip; Powles, A C Peter; Sherkey, Jeffrey A.; van de Sande, Marjorie I. (2003), "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols" (PDF), Journal of Chronic Fatigue Syndrome, 11 (2): 7-115, doi:10.1300/J092v11n01_02 
  12. Carruthers, Bruce M.; van de Sande, Marjorie I.; De Meirleir, Kenny L.; Klimas, Nancy G.; Broderick, Gordon; Mitchell, Terry; Staines, Donald; Powles, A. C. Peter; Speight, Nigel; Vallings, Rosamund; Bateman, Lucinda; Baumgarten-Austrheim, Barbara; Bell, David; Carlo-Stella, Nicoletta; Chia, John; Darragh, Austin; Jo, Daehyun; Lewis, Donald; Light, Alan; Marshall-Gradisnik, Sonya; Mena, Ismael; Mikovits, Judy; Miwa, Kunihisa; Murovska, Modra; Pall, Martin; Stevens, Staci (Aug 22, 2011). "Myalgic encephalomyelitis: International Consensus Criteria". Journal of Internal Medicine. 270 (4): 327–338. doi:10.1111/j.1365-2796.2011.02428.x. ISSN 0954-6820. PMC 3427890Freely accessible. PMID 21777306. 
  13. 13.013.1 Carruthers, BM; van de Sande, MI; De Meirleir, KL; Klimas, NG; Broderick, G; Mitchell, T; Staines, D; Powles, ACP; Speight, N; Vallings, R; Bateman, L; Bell, DS; Carlo-Stella, N; Chia, J; Darragh, A; Gerken, A; Jo, D; Lewis, DP; Light, AR; Light, KC; Marshall-Gradisnik, S; McLaren-Howard, J; Mena, I; Miwa, K; Murovska, M; Stevens, SR (2012), Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners (PDF), ISBN 978-0-9739335-3-6 

The information provided at this site is not intended to diagnose or treat any illness.
From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history.