How can you tell if you have ME, or chronic fatigue syndrome?

If you’re experiencing fatigue and wondering if you have chronic fatigue syndrome, you’ve come to the right place.

Chronic fatigue syndrome (CFS) is also called myalgic encephalomyelitis (ME). It’s a long-term health condition affecting around 250,000 people in the United Kingdom alone. 

The symptoms vary between individuals, but extreme fatigue is the most common one.

Doctors and scientists are still working to determine what causes ME/CFS, and how best to diagnose and treat it.

In this article, we’ll describe the symptoms of ME/CFS and how doctors reach a diagnosis. Along the way, we’ll look at some experimental tests that scientists are still investigating. 

We’ll also explore the approaches to treating this chronic condition, and which lifestyle changes can help manage the symptoms.

What are the symptoms of ME/CFS?

The main symptoms of ME/CFS are:

• Extreme tiredness (fatigue) that makes everyday tasks challenging.

• Changes in sleep patterns, which may involve getting too much or too little sleep, or feeling like you haven’t had a proper night’s sleep. 

• Cognitive changes, which can include poor concentration, memory problems and brain fog. 

These ME/CFS symptoms tend to get worse following mental or physical activity. This is called post-exertional malaise, and it can last for days or even weeks.

It’s important to note that the symptoms above are also associated with a wide range of other health conditions. This is one reason why diagnosing ME/CFS is challenging.

How do doctors diagnose ME/CFS?

Currently, no blood tests can point to ME/CFS because there are no known ‘disease markers.’ In other words, no compounds in the body can reliably indicate this condition. 

Instead, doctors start by asking for detailed descriptions of your symptoms. Their questions will cover fatigue, sleep, changes in thinking and other aspects of your health. Specifically, they might ask:

• Do you feel better after sleeping or resting?

• What makes your symptoms worse? 

• What happens when you push yourself to do activities that are hard?

• Are you able to think as clearly as you did before becoming ill?

• Do you have any other health conditions, like allergies?

• What medications are you taking?

• Do close family members have any chronic health conditions?

Doctors might also ask about other symptoms that are common in people with ME/CFS, such as:

• a sore throat

• headaches

• joint or muscle pain

According to guidelines from the National Institute for Health and Care Excellence (NICE), a doctor might consider an ME/CFS diagnosis when a person meets all three of these criteria:

1. They’ve experienced extreme fatigue, sleep problems, cognitive changes and post-exertional malaise for at least 6 weeks.

2. They struggle to engage in work, education, social or personal activities.

3. Their symptoms can’t be explained by other health conditions.

As the third point suggests, doctors then need to rule out other possible causes of the symptoms.

For instance, fatigue can be a sign of:

• a sleep disorder, like sleep apnea

• anaemia

• diabetes

• an underactive thyroid

• mental health conditions, such as depression or anxiety

• Lyme disease

So, before they diagnose ME/CFS, the doctor will order a range of tests to check for other health conditions. 

Experimental diagnostic tests

As we’ve seen, there are no diagnostic tests for ME/CFS specifically. Still, scientists continue to search for markers of this illness, and they’ve arrived at some experimental tests for this condition.

Some tests that might eventually prove helpful in diagnosing ME/CFS include:

• Single-cell Raman profiles: This involves using scanning technology that provides a molecular ‘fingerprint’ of single cells.

• Measuring neuroinflammation: Researchers are investigating whether people with ME/CFS have unique levels of inflammatory markers called cytokines in their brains.

• Nanoelectronics: This new technique can directly measure biomolecular interactions in response to stressors.

• Mitochondrial function: Some experts believe that mitochondria – the powerhouses of the cell – may be involved in ME/CFS. So, measuring their function might, one day, help diagnose the condition.

How do you treat ME/CFS?

There’s currently no cure for ME/CFS. So, treatments focus on addressing the symptoms. 

Not everyone responds in the same way to these treatments. For instance, some people benefit from exercise, some don’t, and it may even make ME/CFS symptoms worse.

Because of these differing responses, doctors generally tailor the treatment plan for each person, depending in part on their symptoms. 

An ME/CFS treatment plan may involve:

• Energy management: Experts can offer guidance about how best to use your energy and avoid making the symptoms worse. This may involve pacing: breaking down activities into more manageable blocks and taking rests in between.

• Cognitive behavioural therapy (CBT): This talking therapy can help manage symptoms related to mental and emotional health by changing patterns of thoughts and behaviours. CBT doesn’t reduce the symptoms, but it helps people live with them.

• Certain medicines: These can relieve pain, improve sleep and ease depression. These drugs don’t tackle ME/CFS itself, but they can help reduce some of its most challenging symptoms.

Lifestyle changes for people with ME/CFS

When you have ME/CFS, there can be periods when symptoms get better or worse. Overall, it’s important to adapt your daily routines and activities in the long run. Below are some areas where adjustments can be useful.

Diet: As with every other facet of our health, eating well can help.

Specifically, research suggests that certain nutrient deficiencies might make ME/CFS symptoms worse. So, it’s a good idea to have a well-rounded, nutrient-dense diet.

There’s also some evidence that certain elimination diets, microbiome therapies and dietary supplements may help with this condition. Consider meeting with a dietitian to discuss your options.

Meditation and mindfulness: These techniques can help manage pain for some people with ME/CFS. 

Sleep: Many people with this condition struggle to fall asleep, have difficulty staying asleep, have unrefreshing sleep or sleep for long periods.

Your doctor will likely offer guidance about developing healthy sleep routines. They may recommend not sleeping during the day or using breathing exercises to help you sleep better at night.

Spacing out activities: Planning your day so you get enough rest between tasks and events can reduce the risk of post-exertional malaise.

Summary

ME/CFS is a long-term condition characterised by extreme fatigue, sleep problems and cognitive changes.

Currently, doctors diagnose it by carefully considering your symptoms and ruling out other health conditions.

While there’s no cure for ME/CFS, certain lifestyle strategies can help you manage the symptoms. These can include having a healthy diet, spacing out activities and taking certain medications.

If you believe that you may have ME/CFS, speak with your doctor.

To learn more about healthy lifestyle topics, visit Symprove’s Gut Hub.

Sources

A nanoelectronics-blood-based diagnostic biomarker for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). PNAS. (2019). Link.

Chronic fatigue syndrome (CFS): Suggestions for a nutritional treatment in the therapeutic approach. Biomedicine & Pharmacotherapy. (2019). Link.

Developing a blood cell-based diagnostic test for myalgic encephalomyelitis/chronic fatigue syndrome using peripheral blood mononuclear cells. Advanced Science. (2023). Link.

Diagnosing ME/CFS. (2024). Link.

Dietary and nutrition interventions for the therapeutic treatment of chronic fatigue syndrome/myalgic encephalomyelitis: A systematic review. Journal of Human Nutrition and Dietetics. (2017). Link. 

Dietary supplementation for fatigue symptoms in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) — a systematic review. Nutrients. (2025). Link. 

European Network on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (EUROMENE): Expert consensus on the diagnosis, service provision, and care of people with ME/CFS in Europe. Medicinia. (2021). Link. 

Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: Diagnosis and management. (2021). Link.

Neuroinflammation and cytokines in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): A critical review of research methods. Frontiers in Neurology. (2019). Link.

Pacing and energy management. (n.d.). Link.

Prevalence of ME/CFS in the UK — summary. (2024). Link.

The potential therapeutic approaches targeting gut health in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): A narrative review. Journal of Translational Medicine. (2025). Link. 

The role of mitochondria in ME/CFS: A perspective. Fatigue: Biomedicine, Health & Behavior. (2018). Link.