There is no approved pharmacological treatment, therapy or cure for<unk>  although various drugs have been or are being investigated. A 2014 report prepared by the Agency for Healthcare Research and Quality stated that there are wide variations in patient management, that many receive a multifaceted approach to treatment, and that no medications have been approved by the U.S. Food and Drug Administration (FDA) for the treatment of ME/CFS, although several have been used off label. The report concluded that although counseling and graded exercise therapy (GET) have shown some benefits, these interventions have not been studied fully enough to recommend them for all persons affected. The report expressed concern that GET appears to be associated with worsening symptoms in some. The CDC no longer recommends these interventions, and there is some evidence of patient harm. The CDC guide for the management of<unk>  states that while there is no cure, a number of methods might improve symptoms. Treatment strategies for sleep problems, pain, (depression, stress, and anxiety) dizziness and lightheadedness (orthostatic Intolerance), and memory and concentration problems are enumerated. Other useful topics mentioned that patients and doctors might discuss include carefully monitoring and managing activity to avoid worsening of symptoms, counseling to cope with the impact the illness may have on quality of life, proper nutrition and nutritional supplements that may support better health, complementary therapies that might help increase energy or decrease pain. The United Kingdom's National Institute for Health and Clinical Excellence (NICE) 2021 guideline directed toward healthcare professionals and patients, specifies the need for shared decision-making between patients and medical care teams, and acknowledges the reality and impact of the condition and the symptoms. The NICE guideline covers diagnosis, illness management, and aspects of symptom management: diet, medications, coexisting conditions, flair-ups, and energy management. The guideline recognized symptoms of severe ME/CFS may be misunderstood as neglect or abuse, and recommends assessment for safeguarding of persons suspected of having ME/CFS be evaluated by professionals with experience and understanding of the illness. The guideline stated GET is not appropriate as a treatment for ME/CFS. CBT might be offered to help a person manage the difficulties of dealing with a chronic illness, not to cure the illness. Prior to publication of the NICE 2021 guideline, Andrew Goddard, president of the Royal College of Physicians stated there was concern NICE did not adequately consider the experts' support and evidence of the benefits of GET and CBT, and urged they be included in the guideline. Various ME/CFS patient groups disputed the benefits of the therapies, and stated that GET can make the illness more severe. Comorbid conditions can occur in<unk>  which may interact with and exacerbate the symptoms of<unk> . Appropriate medical intervention for these conditions may be beneficial. The most commonly diagnosed include: fibromyalgia, irritable bowel syndrome, depression, anxiety, as well as allergies and chemical sensitivities. Pacing Pacing, or activity management, is an illness management strategy based on the observation that symptoms tend to increase following mental or physical exertion, and was recommended for<unk>  in the 1980s. It is now commonly used as a management strategy in chronic illnesses and in chronic pain. Its two forms are: symptom-contingent pacing, where the decision to stop (and rest or change an activity) is determined by a self awareness of an exacerbation of symptoms; and time-contingent pacing, which is determined by a set schedule of activities that a patient estimates he or she is able to complete without triggering postexertional malaise (PEM). Thus, the principle behind pacing for<unk>  is to avoid overexertion and an exacerbation of symptoms. It is not aimed at treating the illness as a whole. Those whose illness appears stable may gradually increase activity and exercise levels, but according to the principle of pacing, must rest or reduce their activity levels if it becomes clear that they have exceeded their limits. Use of a heart-rate monitor with pacing to monitor and manage activity levels is recommended by a number of patient groups, and the CDC considers it useful for some individuals to help avoid post-exertional malaise. Energy envelope theory Energy envelope theory is considered to be consistent with pacing, and is a management strategy suggested in the 2011 international consensus criteria for ME, which referred to using an "energy bank budget". Energy envelope theory was devised by psychologist Leonard Jason, a former sufferer of<unk> . Energy envelope theory states that patients should stay within the envelope of energy available to them, and avoid pushing through, which will reduce the postexertional malaise "payback" caused by overexerting and may help them make "modest gains" in physical functioning. Several studies have found energy envelope theory to be a helpful management strategy, noting that it reduces symptoms and may increase the level of functioning in<unk> . Energy envelope theory does not recommend unilaterally increasing or decreasing activity and is not intended as a therapy or cure for<unk> . It has been promoted by various patient groups. Some patient groups recommend using a heart rate monitor to increase awareness of exertion, and allow patients to stay within their aerobic threshold envelope. Despite a number of studies showing positive results for energy envelope theory, randomized controlled trials are lacking. Exercise Stretching, movement therapies, and toning exercises are recommended for pain in patients with<unk> , and pain medication is also suggested. In many chronic illnesses, aerobic exercise is beneficial, but in<unk> , the CDC does not recommend it. The CDC states:Any activity or exercise plan for people with ME/CFS needs to be carefully designed with input from each patient. While vigorous aerobic exercise can be beneficial for many chronic illnesses, patients with ME/CFS do not tolerate such exercise routines. Standard exercise recommendations for healthy people can be harmful for patients with ME/CFS. However, it is important that patients with ME/CFS undertake activities that they can tolerate... Counseling The CDC states that counseling may help patients cope with pain caused by<unk> , and that talking with a professional counselor or therapist may help people to more effectively manage the symptoms that affect their quality of daily life. Nutrition A proper diet is a significant contributor to the health of any individual. Medical consultation about diet and supplements are recommended for persons with<unk> . Persons with<unk>  may benefit from a balanced diet and properly supervised administration of nutritional support if deficiencies are detected by medical testing. Risks of nutritional supplements include interactions with prescribed medications.
Chronic fatigue syndrome
Hypothyroidism
Cancer-related fatigue
Idiopathic chronic fatigue
Da Costa's syndrome  Da Costa's syndrome  1
Exercise addiction
Medication phobia
Generalized anxiety disorder