[CFS-L] New American ME/CFS Guidelines (text)

[Dr. Marc-Alexander Fluks]

Source: Mayo Clinic Proceedings
Preprint
Date: August 25, 2021
URL:
https://www.mayoclinicproceedings.org/article/S0025-6196(21)00513-9/fulltext


Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Essentials of
diagnosis and management
-----------------------------------------------------------------
Lucinda Bateman(1), Alison C. Bested(2), Hector F. Bonilla(3), Bela
V. Chheda(4), Lily Chu(5,*) Jennifer M. Curtin(4), Tania T. Dempsey
(6), Mary E. Dimmock(7), Theresa G. Dowell(8), Donna Felsenstein(9),
David L. Kaufman(4), Nancy G. Klimas(10), Anthony L. Komaroff(11),
Charles W. Lapp(12), Susan M. Levine(13), Jose G. Montoya(14),
Benjamin H. Natelson(15), Daniel L. Peterson(16), Richard N. Podell
(17), Irma R. Rey(10), Ilene S. Ruhoy(18), Maria A. Vera-Nunez(19),
Brayden P. Yellman(1)
1 Bateman Horne Center of Excellence, Salt Lake City, UT
2 Integrative Medicine, Dr Kiran C. Patel College of Osteopathic
Medicine,
Nova Southeastern University, Fort Lauderdale, FL
3 Infectious Diseases and Geographic Medicine, Stanford University
School
of Medicine, Palo Alto, CA
4 Center for Complex Diseases, Mountain View, CA
5 Independent Consultant, 16 Lorton Ave, Unit 4, Burlingame, CA 94010.
6 AIM Center for Personalized Medicine, Purchase, NY
7 Independent Consultant, Waterford, CT
8 Four Peaks Healthcare Associates, Flagstaff, AZ
9 Infectious Diseases, Massachusetts General Hospital, Harvard Medical
School, Boston
10 Institute for Neuro Immune Medicine, Dr Kiran C. Patel College of
Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL
11 Brigham and Women's Hospital and Harvard Medical School, Boston, MA
12 Hunter-Hopkins Center PLLC, Charlotte, NC
13 Private Practice, New York, NY
14 Dr Jack S. Remington Laboratory for Specialty Diagnostics, Palo Alto
Medical Foundation Research Institute, Palo Alto, CA
15 Pain & Fatigue Study Center, Icahn School of Medicine at Mount Sinai,
New York, NY
16 Sierra Internal Medicine, Incline Village, NV
17 Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ
18 Neurology, Chiari/EDS Center, Mount Sinai South Nassau, Oceanside, NY
19 Private Practice, Charleston, SC
* Corresponding author. Email: lily...@gmail.com


Abstract

Despite myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)
affecting millions of people worldwide, many clinicians lack the
knowledge to appropriately diagnose or manage ME/CFS. Unfortunately,
clinical guidance has been scarce, obsolete, or potentially harmful.
Consequently, up to 91% of patients in the United States remain
undiagnosed, and those diagnosed often receive inappropriate treatment.
These problems are of increasing importance because after acute
COVID-19, a significant percentage of people remain ill for many months
with an illness similar to ME/CFS. In 2015, the US National Academy of
Medicine published new evidence-based clinical diagnostic criteria that
have been adopted by the US Centers for Disease Control and Prevention.
Furthermore, the United States and other governments as well as major
health care organizations have recently withdrawn graded exercise and
cognitive-behavioral therapy as the treatment of choice for patients
with ME/CFS. Recently, 21 clinicians specializing in ME/CFS convened to
discuss best clinical practices for adults affected by ME/CFS. This
article summarizes their top recommendations for generalist and
specialist health care providers based on recent scientific progress and
decades of clinical experience. There are many steps that clinicians can
take to improve the health, function, and quality of life of those with
ME/CFS, including those in whom ME/CFS develops after COVID-19. Patients
with a lingering illness that follows acute COVID-19 who do not fully
meet criteria for ME/CFS may also benefit from these approaches.

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