Other Conditions for Evaluation

Several conditions can cause symptoms that may resemble ME/CFS. If suggested by the history and physical examination, these conditions should be appropriately tested for, and treated if confirmed. Based on clinical presentation and history, these conditions could include:

• Any active medical condition that may explain the presence of fatigue such as untreated hypothyroidism (including Hashimoto’s disease), hyperthyroidism, diabetes mellitus, iron deficiency anemia, other treatable anemia, iron overload syndrome, adrenal insufficiency, Cushing’s syndrome, anorexia nervosa, or iatrogenic conditions such as side effects or interactions of medication(s) or supplements
• Rheumatological disorders (rheumatoid arthritis, lupus, polymyositis, polymyalgia rheumatica, Sjogren’s Syndrome, Ehlers Danlos Syndromes [Hypermobility type])
• Other heritable disorders of connective tissue (Marfan syndrome, Stickler syndrome, and others).
• Multiple sclerosis
• Celiac disease (Note: Patients with celiac disease can present without gastrointestinal symptoms)
• Immune disorders such as HIV/AIDS
• Sleep disorders, including obstructive sleep apnea
• Prior illnesses may relapse or may not have completely resolved during treatment. Examples are certain malignancies and leukemia, as well as infectious diseases such as tuberculosis and chronic hepatitis
• Active primary psychiatric disorders (e.g., eating disorders, alcohol or substance use disorder)

Disclaimer: The content of this ME/CFS website is for informational purposes only and does not represent a federal guideline or recommendation for the treatment of ME/CFS. The information provided on this website is not intended to be a substitute for the medical judgment of the healthcare provider and does not indicate an exclusive course of action or treatment.