What should you know about ME fatigue?

Fatigue is more than ordinary sleepiness: it may feel like reduced physical or mental capacity that does not resolve as expected with rest. In myalgic encephalomyelitis, people may describe worsening after exertion, unrefreshing sleep, concentration problems, dizziness or sensitivity to activity. Fatigue presents with many conditions, including anaemia, dehydration, COVID-19, coeliac disease, chronic kidney disease, burnout and alcohol use disorder, so the symptom alone cannot identify its cause.

A clinician asks when the problem began, what activity does to it, how sleep feels, and whether pain, fever, weight change, breathlessness or mood symptoms are present. They may review medicines and decide whether examination or tests are appropriate.

Book a GP appointment when fatigue persists, limits work or self-care, or follows an infection without improving. Keep an activity and symptom diary covering sleep, meals, hydration, exertion, recovery and dizziness. Use pacing: alternate essential tasks with rest, avoid repeatedly pushing through a crash, and adapt activity to what your body can tolerate. Regular fluids and balanced meals are sensible unless a clinician has given you restrictions.

Do not start supplements or restrictive diets as a substitute for assessment. Ask about medication effects and whether a blood test or other investigation is suitable.

Get urgent medical help for fatigue with chest pain, severe breathlessness, fainting, new confusion, one-sided weakness, black or bloody stools, or inability to stay awake. Seek prompt care for marked dehydration, persistent vomiting, a very high fever, or rapidly worsening weakness. Emergency symptoms should not be explained away as ME or simple tiredness.

What causes should we consider in my situation? Does my pattern suggest post-exertional worsening? Which activities should I prioritise, and how can I pace safely? Do my medicines, sleep or nutrition need review?