Myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS) – Symptoms

The main symptom of myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS), is feeling extremely tired and generally unwell.

Symptoms vary from person to person, and the severity of symptoms can vary from day to day, or even within a day.

Extreme tiredness (fatigue)

The main symptom of ME/CFS is extreme physical and mental tiredness (fatigue) that does not go away with rest or sleep. This can make it difficult to carry out everyday tasks and activities.

Most people with ME/CFS describe their fatigue as overwhelming and a different type of tiredness from what they’ve experienced before.

Exercising usually makes the symptoms worse. Sometimes the effect is delayed and you’ll feel very tired a few hours after you’ve exercised, or even the next day.

Problems sleeping

Many people with ME/CFS also have problems with their sleep.

You may find that:

• you do not feel refreshed after sleeping – like you have not had a proper good night’s rest
• you keep waking up during sleep
• you feel stiff, tired or have flu-like symptoms when waking up
• you feel very tired and sleepy during the day

Problems with thinking, memory and concentration

If you have ME/CFS, it’s also common to have:

• problems remembering certain words, names or numbers
• difficulty concentrating or difficulty focusing on more than one thing at a time
• problems remembering things that happened recently
• being slow to speak or react to things

These problems are sometimes described “brain fog”.

Other symptoms

Other symptoms of ME/CFS can include:

• muscle or joint pain
• headaches
• a sore throat or sore glands that are not swollen
• flu-like symptoms
• feeling dizzy or sick
• fast or irregular heartbeats (heart palpitations)

Severity of symptoms

Most cases of ME/CFS are mild or moderate, but 1 in 4 people have severe symptoms. If your symptoms are severe, a specialist should be involved in your treatment.

ME/CFS symptoms can be considered:

• mild – you’re able to carry out everyday activities, such as work, studies or housework, but with difficulty; you may need to give up hobbies or social activities so you can rest in your spare time
• moderate – you may have difficulty moving around easily and problems carrying out daily activities; you may not be able to work or continue with your education and may need to rest often; and you may also have problems sleeping at night
• severe – you may only be able to do very basic daily tasks, such as brushing your teeth; you may be housebound or even bedbound and may need a wheelchair to get around; and you may also have difficulty concentrating, be sensitive to noise and light, and take a long time to recover after activities involving extra effort, such as leaving the house or talking for long periods
• very severe – you may have to spend all your time in bed resting and are fully dependent on carers; you may need help eating, washing and going to the toilet; you may be extremely sensitive to light and noise; you may be unable to swallow and need to be fed using a tube

There may be times when your symptoms get worse. These periods are known as relapses.

What else could it be?

The symptoms of ME/CFS are similar to those of other conditions.

If you think you may have ME/CFS it’s important to see a GP to make sure you get a correct diagnosis. A GP should also be able to refer you to a ME/CFS specialist if they think it would help you.

Page last reviewed: 29 October 2021
Next review due: 29 October 2024

Nausea or vomiting in adults

About this Symptom Checker

Nausea or vomiting in adults

Find possible causes of nausea or vomiting based on specific factors. Check one or more factors on this page that apply to your symptom.

Triggered or worsened by

• 
  Drinking alcohol




• 
  Eating certain foods

• 
  Stress




• 
  Travel or motion

Onset is

• 
  Intermittent or episodic




• 
  Recent (few hours)

• 
  Recent (hours to days)




• 
  Sudden (minutes to hours)

Accompanied by

• 
  Abdominal bloating or swelling




• 
  Abdominal pain, discomfort or cramps




• 
  Anxiety




• 
  Black or bloody stools




• 
  Chest pain or tightness




• 
  Constipation




• 
  Diarrhea




• 
  Difficulty breathing

• 
  Dizziness or fainting




• 
  Feeling of fullness after eating small amounts of food




• 
  Fever




• 
  Headache




• 
  Heartburn




• 
  Irregular or rapid heartbeat




• 
  Sweating




• 
  Unintended weight loss

1. Walls RM, et al. , eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Accessed Oct. 30, 2017.
2. Palmer J, et al. Abdominal pain mimics. Emergency Medicine Clinics of North America. 2016;34:409.
3. UpToDate. https://www.uptodate.com/contents/search. Accessed Oct. 30, 2017.
4. Zeiter D. Abdominal pain in children. Pediatric Clinics of North America. 2017;64:525.
5. Palmer J, et al. Abdominal pain mimics. Emergency Medicine Clinics of North America. 2016;34:409.
6. Feldman M, et al. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. https://www.clinicalkey.com. Accessed Oct. 30, 2017.
7. Merck Manual Professional Version. https://www.merckmanuals.com/professional. Accessed Oct. 30, 2017.
8. AskMayoExpert. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2017.
9. Kliegman RM, et al. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, Pa.: Elsevier; 2016. https://www.clinicalkey.com. Accessed Nov. 2, 2017.
10. Zitelli BJ, et al., eds. Zitelli and Davis’ Atlas of Pediatric Physical Diagnosis. Philadelphia, Pa.: Elsevier; 2017. https://www.clinicalkey.com. Accessed Nov. 11, 2017.
11. Ferri FF. Ferri’s Clinical Advisor 2018. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Accessed Nov. 11, 2017.
12. Muncie HL, et al. Dizziness: Approach to evaluation and management. American Family Physician. 2017;95:154.
13. American College of Emergency Physicians. https://www.acep.org. Accessed Nov. 11, 2017.
14. U.S. Food and Drug Administration. http://www.fda.gov. Accessed Nov. 11, 2017.
15. Schmitt BD. Fever. In: Pediatric Telephone Protocols: Office Version 15th ed. Elk Grove Village, Ill.: American Academy of Pediatrics; 2015.
16. Mannenbach MS (expert opinion). Mayo Clinic, Rochester, Minn. June 14, 2017.
17. Goyal DG (expert opinion). Mayo Clinic, Rochester, Minn. June 14, 2017.
18. Hoecker JL (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 28, 2017.
19. American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org. Accessed Nov. 20, 2017.
20. Petty RE, et al., eds. Textbook of Pediatric Rheumatology. 7th ed. Philadelphia, Pa.: Elsevier; 2016. https://www.clinicalkey.com. Accessed Nov. 20, 2017.
21. Elsevier Point of Care. https://www.clinicalkey.com.  Accessed Nov. 20, 2017.
22. Kasper DL, et al., eds. Harrison’s Principles of Internal Medicine. 19th ed. New York, N.Y.: McGraw-Hill Education; 2015. http://accessmedicine.mhmedical.com. Accessed Nov. 20, 2017.
23. Wein AJ, et al., eds. Campbell-Walsh Urology. 11th ed. Philadelphia, Pa.: Elsevier; 2016. https://www.clinicalkey.com.. Accessed Dec. 2, 2017.
24. National Eye Institute. https://nei.nih.gov. Accessed Dec. 5, 2017.
25. Wilkinson JM (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 8, 2017.

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Symptoms: veil before the eyes, temporary loss of visual acuity, sand in the eyes, tension in the eyes, tired eyes, dizziness, headache, heaviness in the head, objects blur, cannot focus on the object, everything floats before the eyes, feeling of sand in the eyes , intraocular pressure. Our patients often experience one or another problem in the eye area, or vision problems. At …

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Symptoms: prolonged fever, temperature 37, progressive increase in body temperature, palpitations, clouding, loss of consciousness, nausea, weakness, convulsions, heaviness in the head, headache, feeling hot, feeling cold, chills, excruciating thirst, increased nervous excitability , irritability, neurosis, hallucinations, pale skin, redness of the skin, insomnia, shortness of breath, excessive sweating, chest pain, abdominal pain. Subfebrile temperature is elevated …

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Symptoms of meteorological dependence: meteorological sensitivity, reaction to weather changes, magnetic storms, headache, changes in blood pressure. Causes of meteorological dependence Meteorological dependence is a deterioration in well-being during fluctuations in meteorological factors. It is manifested by an inadequate response of the body to changes in atmospheric pressure, temperature and humidity, wind speed, and magnetic storms. Weather-dependent people suffer more during the off-season (March-April, October-November) and are more difficult to tolerate acclimatization …

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Causes of pain in the lower abdomen – symptoms, diagnosis, treatment at NCC No. 2 (Central Clinical Hospital of the Russian Academy of Sciences)
Weak, moderate or severe pain in the lower abdomen in women, the causes of which may be different, is a very common complaint from numerous patients, both very young and elderly.

In some cases, these are, albeit unpleasant, but variants of the norm that do not indicate any pathologies. But, often they are one of the symptoms of a large list of diseases. First of all, gynecological health is under suspicion, although pain can also occur for reasons of a different nature. In any case, you need the help of specialists who will identify the source of the disease state.

Types of pain in the lower abdomen

The nature of pain can be different:

• pull;
• stabbing;
• aching;
• cramping;
• expanding;
• blunt;
• cutting;
• herpes;
• burning, as if burning from the inside.

Unpleasant sensations can begin abruptly and intensely, grow gradually, disturb on the right, left or in the middle, radiate to the lower back and other areas. It can last for several minutes or days, stop periodically or disturb constantly.

The causes of pain in the lower abdomen in women can be divided into several main categories:

other pathologies and conditions.

In choosing specific research methods, making a correct diagnosis, it is of great importance to clarify the nature, duration, and intensity of pain. By studying the symptoms, doctors can suggest a specific disease and outline the necessary direction in the examination of the patient.

Lower abdominal pain in women: physiological causes

In this case, pain is associated with physiological changes occurring in the body. They can occur at different stages of the menstrual cycle, early pregnancy, be observed during hormonal changes (including during menopause).

Shortly after fertilization, a woman may feel a pulling pain. This is due to the introduction of the egg into the endometrium of the uterus, the integrity of which is violated. As the fetus grows, the internal organs move, which sometimes provokes severe discomfort.

Many girls experience severe pain during ovulation in the lower abdomen, the causes of which are hidden in the hormonal changes that occur due to the rupture of the follicle and the release of the egg. Often they are accompanied by other symptoms:

• breast hypersensitivity;
• nausea;
• weakness, drowsiness;
• sudden changes in emotional state;
• puffiness;
• bloating.

Before menstruation, pain is also a frequent companion of many women. If the patient is examined, she does not have any pathologies and unpleasant sensations do not interfere with her usual way of life, then such manifestations fit into the normal range. When the pain is intense and provokes a serious deterioration in the general condition, dysmenorrhea (algomenorrhea) is usually diagnosed.

Pathologies of the reproductive system

There are many causes of pain associated with gynecological problems. Among the most common:

• Endometritis. It is characterized by inflammation of the endometrium, which can be acute or chronic. Often accompanied by a violation of the menstrual cycle, spotting, uterine bleeding, pulling pains.
• Adnexitis. Inflammation of the uterine appendages is one of the most common diseases in gynecological practice. In addition to pain (may be in one side or spread to the entire lower abdomen), patients experience signs of intoxication and fever. The disease is caused by bacteria, viruses or fungi.
• Endometriosis. In this disease, the cells of the uterus grow and are outside of it. Accompanied by pain during urination, defecation, sexual intercourse and just with sudden movements, heavy bleeding during menstruation. Regardless of the cycle, brownish discharge is noted.
• Uterine fibroids, which are usually characterized by dull pain in the pelvic region. Cysts, other benign, as well as malignant formations can cause discomfort of varying intensity, spasms.
• Spikes. May be the result of inflammation in the genital organs, varicose and other diseases. Complications during pregnancy. These include spontaneous abortion, placental abruption and other pathologies. In such cases, the pain is sudden and sharp, accompanied by the release of blood from the genitals.

Separately, it is worth focusing on sexual infections – mycoplasmosis, gonorrhea, chlamydia, trichomoniasis and other diseases. They affect the reproductive organs, causing pain, copious vaginal discharge of a pathogenic nature, burning, itching and are fraught with complications if left untreated.

Pain on the right and left

In some cases, patients complain of pain in a specific localization. There may be pain in the lower abdomen in a woman on the right due to a right-sided lesion of the uterine appendages of an inflammatory nature (adnexitis, salpingo-oophoritis), spasm of the ileum, and tumor formations. Also in this place is the caecum, which has a vermiform process – the appendix. In case of its inflammation, appendicitis develops and the patient needs emergency care.

The most common causes of pain in the left lower abdomen in women are secondary inflammation of the appendages, spasm of the sigmoid colon, a tumor process, and ulcerative colitis. Sometimes the problem can be associated with disorders in the joints of the spine and their tissues, herniated disc, sciatica.

Disorders in the functioning of the organs of the urinary system

Cystitis is one of the most common causes of aching pain in women. The bladder can become inflamed after a banal hypothermia. Cramping during urination, false and frequent urges are a characteristic symptomatology of this disease. Other frequently diagnosed pathologies of the urinary system include pyelonephritis and urethritis, in which case discomfort is disturbed not only in the lower abdomen, but also in the back (especially in the lumbar region).

With pain that is dull in nature and occurs in the area above the pubis, bladder polyps can be assumed.

Digestive problems

It can also hurt in the lower abdomen due to problems with the intestines, existing diseases of different parts of the digestive system:

• Poisoning of low-quality food contaminated with bacteria. For example, with shigellosis, echirichiosis and other infections, the pain is paroxysmal and pronounced.
• Hernias of inguinal, spigelian and white lines. When they are infringed, acute pain occurs in the abdominal cavity.
• Pancreatitis. With inflammation of the pancreas, the left side of the lower abdomen and chest hurts, jaundice may occur.
• Intestinal colic. It is characterized by spasm of the large or small intestine. Able to be the result of helminthic invasion, food poisoning, severe stress.
• Cholecystitis. When the outflow of bile is disturbed, the risk of developing inflammation of the gallbladder is high. In this case, the pain spreads to the right side, shoulder or shoulder blade.

If the pain is accompanied by diarrhea or constipation, discoloration of the feces, the appearance of blood or mucus in the stool, bloating, nausea, vomiting, frequent urge to empty the bowels, chills or fever, the cause of such symptoms may be a disorder of the digestive function, diseases of the organs GIT.