People with ME/CFS frequently report digestive symptoms alongside fatigue, brain fog and Post-Exertional Malaise (PEM). Bloating, abdominal discomfort, constipation, diarrhoea, nausea and food intolerance can become significant problems. So why does this happen? The answer may partly involve the complex communication between the digestive system, immune system, nervous system and the trillions of microorganisms living in the gut. This is often called the gut-brain axis. As an

People with ME/CFS often experience a wide range of symptoms that can involve several body systems. Fatigue, brain fog, sleep problems, dizziness, headaches, gastrointestinal symptoms and sensitivity to foods or medications may occur together. One condition that is increasingly discussed in this context is Mast Cell Activation Syndrome (MCAS). As an ME/CFS specialist, I am sometimes asked whether MCAS could explain symptoms that occur alongside ME/CFS, whether the two conditi

Living with ME/CFS can make working difficult in ways that are not always obvious to employers, colleagues or even healthcare professionals who are unfamiliar with the condition. Someone may look well but have significant limitations caused by fatigue, cognitive symptoms, dizziness or Post-Exertional Malaise (PEM). For some people, a clear medical report can help explain these difficulties and provide evidence for workplace adjustments, occupational health assessments, disabi

If you are living with ME/CFS and struggling to work because of fatigue, brain fog, Post-Exertional Malaise (PEM) or other symptoms, you may need medical evidence to explain how your condition affects your ability to work. A common question is: “Can I get a private ME/CFS fit note online?” The answer is sometimes yes, but there are important distinctions between an official fit note, private medical evidence and a medical report. The right option depends on your circumstances

Acupuncture treatment for fibromyalgia Fibromyalgia is a long-term condition associated with widespread pain, fatigue, poor sleep and increased sensitivity to physical and sensory stimuli. For some people, symptoms can be severe and may overlap with ME/CFS, particularly when fatigue and Post-Exertional Malaise (PEM) are prominent. A question I am increasingly asked as an ME/CFS specialist and clinician working with people with fibromyalgia is: can acupuncture actually help? A

Low-dose naltrexone (LDN) has attracted considerable interest among people living with fibromyalgia, ME/CFS and other chronic pain conditions. Some patients report improvements in pain, fatigue, sleep or brain fog, while others notice little or no benefit. So what does the latest research actually tell us? A new exploratory analysis of the FINAL randomised controlled trial, published in 2026, has looked specifically at whether individual symptoms of fibromyalgia respond to lo

Brain fog and sensitivity to sound are surprisingly common in people living with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), Long COVID and some people with fibromyalgia. For some, ordinary background noise can become exhausting. A conversation, television, traffic or several people speaking at once may suddenly feel overwhelming. These symptoms can be particularly difficult to understand because routine neurological examinations and standard blood tests may

Have you ever stood up and suddenly felt dizzy, light-headed, shaky, weak, or as though your heart is racing? For people living with ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome), this can be surprisingly common. Some people find that simply standing in a queue, taking a shower, cooking a meal, or having a conversation while upright can leave them feeling unwell. This is often related to something called orthostatic intolerance — difficulty tolerating being upri

Long COVID vs ME/CFS Since the COVID-19 pandemic, doctors have seen many people who continue to experience disabling symptoms long after the initial infection has resolved. At the same time, awareness of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) has increased significantly. One of the biggest questions patients ask is: "Do I have Long COVID or ME/CFS?" The answer is not always straightforward. Increasingly, research and clinical practice suggest that these c

For people living with severe ME/CFS, accessing healthcare and social care can be extremely difficult. Leaving the house may cause a significant worsening of symptoms, and even a short journey can trigger Post-Exertional Malaise (PEM). For some people, travel to an appointment may be impossible altogether. As an ME/CFS specialist, I regularly see how important it is for services to understand the difference between ordinary tiredness and the disabling symptoms of ME/CFS. In s

For many years, people living with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) have asked the same question: Why does this illness happen? Researchers have made progress, but many important questions remain unanswered. A major new UK research project called SequenceME hopes to help answer some of those questions. Building on the earlier DecodeME study, researchers will analyse the DNA of thousands of people with ME/CFS to better understand the biological cause

Living with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) can make working incredibly challenging. Many people with ME/CFS want to remain employed, but symptoms often fluctuate from day to day. One of the biggest reasons for this is Post-Exertional Malaise (PEM), the hallmark symptom of ME/CFS that can cause a significant worsening of symptoms after physical, mental, or emotional activity. As an ME/CFS specialist, I regularly help patients understand how their i

Many people living with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) describe the same frustrating experience: they know something is seriously wrong, but they struggle to be believed or supported. If your GP has dismissed your symptoms, suggested that you simply need to exercise more, or seems unfamiliar with the latest guidance, you are not alone. As an ME/CFS specialist, I regularly meet patients who have spent months or even years searching for answers befo

Brain fog is one of the most frustrating symptoms experienced by people with ME/CFS, Long COVID and fibromyalgia. Many patients describe feeling as though they are "thinking through treacle"—finding it difficult to concentrate, remember information, process conversations, or make decisions. As an ME/CFS specialist, one question I am increasingly asked is whether resonance frequency breathing can improve brain fog. The technique has become popular on social media and wellness

Hyperbaric Oxygen Therapy (HBOT) has attracted growing interest among people living with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), Long COVID, fibromyalgia, and post-viral fatigue. As an ME/CFS specialist, I am often asked whether HBOT is an effective treatment and whether it is worth considering. The short answer is that HBOT is an interesting area of research, but the evidence is still developing. Some studies have shown promising results, while others hi

Many people living with ME/CFS ask the same question: “Are there any supplements that can help my symptoms?” As an ME/CFS specialist, I regularly discuss supplements with patients during assessment and follow-up consultations. People often arrive with lists of vitamins, minerals, and nutritional products they have seen recommended online. Some report benefits, while others have spent significant amounts of money without noticing any improvement. The truth is that supplements

Many people diagnosed with ME/CFS ask the same question: What is actually causing this illness? The honest answer is that researchers still do not have one single explanation. But over the last few years, especially with increased interest in Long COVID research, scientists have made important progress. As an ME/CFS specialist and online ME/CFS doctor, one of the most common misconceptions I hear is that ME/CFS is simply “being tired.” Modern research increasingly suggests so

If you live with ME/CFS, one of the hardest parts is often not just the symptoms themselves — it is trying to explain them to other people. Many people with ME/CFS tell me the same thing: “People can’t understand me. I look normal, they think I just feel tired.” Unfortunately, tiredness is only a small part of the picture. As an ME/CFS specialist, one of the most important things I discuss during consultations is how patients can explain their illness in a way that others can

Living with ongoing fatigue can be frustrating, frightening, and isolating. Many people spend months or even years searching for answers before receiving a diagnosis such as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). One phrase patients often hear is that “ME/CFS is a diagnosis of exclusion.” But what does that actually mean? As an experienced ME/CFS specialist, I often explain that diagnosing ME/CFS is not simply about identifying tiredness. Fatigue can hav

Many people living with ME/CFS spend years being misunderstood. Friends, employers, and even healthcare professionals may wrongly assume the illness is “just tiredness” or caused by stress. In reality, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a serious, complex medical condition that can significantly affect daily life. Major health organisations, including the CDC and NICE, recognise ME/CFS as a biological illness that affects multiple body systems. As