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

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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: lilyxchu@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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(c) 2021 Mayo Clinic

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