Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Myalgic encephalomyelitis (ME), commonly referred to as chronic fatigue syndrome (CFS), is a complex disorder characterized by unexplained and persistent fatigue lasting longer than six months. It is estimated that ME/CFS affects between 1–2.4 million people in the US. Symptoms can include memory loss or the inability to concentrate, mild fever, sore throat, tender lymph nodes, headaches, non-restorative sleep and depression. These symptoms overlap a wide range of medical conditions commonly associated with ME/CFS including anemia, anxiety, autoimmune diseases, depression, endocrine disorders, fibromyalgia, hypothyroidism, mononucleosis, sleep apnea and persistent viral or bacterial infections.

Fatigue is one of the most common complaints in primary care, with up to 33% of patients complaining about long-lasting exhaustion and tiredness. For one third of these patients, the etiology of this fatigue cannot be identified.

ME/CFS Profile

Patients with ME/CFS often have persistent, severe fatigue that cannot be explained fully by an underlying condition, and diagnosis of ME/CFS is essential in the treatment a patient’s condition. BioReference offers a ME/CFS profile that includes first- and second-line testing to detect the presence of markers and antibodies associated with autoimmune diseases, Lyme disease, hypothyroidism and viral infections.

To rule out underlying diseases, the profile provides clinical data that can confirm or exclude common disorders and diseases that present with similar symptoms. The ME/CFS Testing Profile includes markers for:

Connective Tissue Disease

First-line testing for ANA. If results are abnormal, second-line testing includes dsDNA RF, anti-SSA, anti-SSB, anti-Sm/RnP, anti-CCP and histone IgG.

Lyme Disease

First-line testing for Lyme disease Ab, Total. If results are abnormal, second-line testing includes Lyme disease IgM. If positive, test will reflex to Western Blot for Lyme confirmation.

Thyroid Disease

First-line testing for Free T4, Total T4 and TSH. If results are abnormal, second-line testing includes anti-microsomal Ab and thyroglobulin Ab.

Viral Infection

First-line testing for EBV: IgG, IgM (Capsid, Nuclear Antigen and Early Antigen), CMV: IgG, IgM, CBC and hsCRP.

Anemia

If CBC shows anemia, second-line testing includes retic count, ret-Hgb, ferritin, folic acid, vitamin B12, erythropoietin, iron, iron % sat and TIBC.

Test Benefits

The BioReference ME/CFS Profile has a range of benefits, including:

  • Identification of underlying symptoms or diseases leading to more targeted treatment and/or guidance for specialist referrals.
  • First- and second-line testing of relevant markers reduces unnecessary tests and leads to faster diagnosis of disease.
  • Treatment management tools (such as previous test results and highlighted abnormalities on the test report) promote patient engagement and treatment compliance.

Patient Considerations

Medical conditions commonly associated with ME/CFS symptoms include anemia, anxiety, autoimmune diseases, depression, endocrine disorders, fibromyalgia, hypothyroidism, mononucleosis, sleep apnea, and persistent viral or bacterial infections. Those with persistent fatigue lasting longer than six months where another underlying cause of symptoms cannot be identified should be considered for testing.

People of every age can be afflicted by ME/CFS, but research suggests that prevalence is highest in people in their 40s and 50s. Studies have found that four out of five people with ME/ CFS are women, although women do not appear to have more severe symptoms than men with the disorder.

By ruling out the conditions commonly associated with persistent fatigue, you can get your patient on the path to proper diagnosis of ME/CFS. Please speak with your sales representative or call our customer service team for ordering information or additional resources.

Full test information can also be found using the Test Directory.

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