33:
520:" (PENE), which encompasses fatigability, symptoms worsening after exertion, exhaustion after exertion, a prolonged recovery from activity, and reduction of activities due to symptoms. The ICC definition describes severity levels: Mild ME is described as roughly a 50% in functioning compared to before the illness, moderate ME makes one mostly housebound, severe refers to mostly bed-bound, and a very severe being completely bed-bound and requiring care from others.
68:
1300:
Carruthers BM, van de Sande MI, De
Meirleir KL, Klimas NG, Broderick G, Mitchell T, Staines D, Powles AC, Speight N, Vallings R, Bateman L, Baumgarten-Austrheim B, Bell DS, Carlo-Stella N, Chia J, Darragh A, Jo D, Lewis D, Light AR, Marshall-Gradisbik S, Mena I, Mikovits JA, Miwa K, Murovska M, Pall
647:
The
National Institute for Health and Clinical Excellence (NICE) in England and Wales that in the absence of a biomarker, it is difficult to say one set of criteria is more valid than another. The quality can be assessed based on how the case definition was created. In particular, to what extend it
355:
The Oxford criteria differ from the Fukuda criteria in that mental fatigue is required and that symptoms that could be psychiatric in origin can count toward a diagnosis. Likewise, the Oxford criteria differs from the
Canadian consensus criteria by not excluding patients who may have a psychiatric
660:
An examination of the CDC 1994 criteria applied to several hundred patients found that the diagnosis could be strengthened by adding two new symptoms (anorexia and nausea) and eliminating three others (muscle weakness, joint pain, sleep disturbance). Other suggested improvements to the diagnostic
233:
A mental status examination to identify abnormalities in mood, intellectual function, memory, and personality. Particular attention should be directed toward current symptoms of depression or anxiety, self-destructive thoughts, and observable signs such as psychomotor retardation. Evidence of a
58:
is poorly understood, and it can be a difficult condition to diagnose because there is no standard test, many symptoms are non-specific, and because doctors and patients may be unfamiliar with post-exertional malaise. Subgroup analysis suggests that, depending on the applied definition, CFS may
405:
Unlike some criteria, the
Canadian consensus criteria exclude patients with symptoms of mental illness. This definition was updated in 2010 to provide greater specification to the original. Functional impairment must be below defined thresholds in two of the three designated subscales of the
240:
A minimum battery of laboratory screening tests, including complete blood count with leukocyte differential; erythrocyte sedimentation rate; serum levels of alanine aminotransferase, total protein, albumin, globulin, alkaline phosphatase, calcium, phosphorus, glucose, blood urea nitrogen,
229:
A thorough history that covers medical and psychosocial circumstances at the onset of fatigue; depression or other psychiatric disorders; episodes of medically unexplained symptoms; alcohol or other substance abuse; and current use of prescription and over-the-counter medications and food
557:
The CDC states that diagnostic tests should be directed to confirm or exclude other causes for fatigue and other symptoms. Further tests may be individually necessary to identify underlying or contributing conditions that require treatment. The following routine tests are recommended:
436:
These symptoms must have lasted at least 6 months. The London criteria also mention that other symptoms, including autonomic and immune symptoms, are common and may help confirm a diagnosis. In light of the advances in understanding of ME and CFS, the criteria for ME as described by
656:
A 2003 international CFS study group for the CDC found ambiguities in the CDC 1994 CFS research case definition which contribute to inconsistent case identification. Different self-reported causes of CFS are associated with significant differences in clinical measures and outcomes.
328:
The Oxford criteria were published in 1991 and include both CFS of unknown etiology and a subtype of CFS called post-infectious fatigue syndrome (PIFS), which "either follows an infection or is associated with a current infection." The Oxford criteria defines CFS as follows:
450:
The
International Consensus Criteria were based on the Canadian consensus criteria and developed by a group of 26 individuals from 13 countries and consisting of clinicians, researchers, teaching faculty, and an independent patient advocate. The ICC define the illness as:
528:
Several countries, including
Australia and the United Kingdom, have authored clinical guidelines that define ME/CFS based on some or all of the available diagnostic criteria. The 2021 UK NICE guideline requires all of the following symptoms:
1504:
Kennedy G, Abbot NC, Spence V, Underwood C, Belch JJ (February 2004). "The specificity of the CDC-1994 criteria for chronic fatigue syndrome: comparison of health status in three groups of patients who fulfill the criteria".
111:
They also note that for all symptoms except orthostatic intolerance, "frequency and severity of symptoms should be assessed," and that these symptoms should be present at least half the time with at least moderate severity.
935:
Fukuda K, Straus S, Hickie I, Sharpe M, Dobbins J, Komaroff A (15 December 1994). "The chronic fatigue syndrome: a comprehensive approach to its definition and study. International
Chronic Fatigue Syndrome Study Group".
669:
A new "empirical definition" of the CDC 1994 criteria was published in 2005. A 2009 evaluation of the 2005 empirical definition compared 27 patients with a prior diagnosis of CFS with 37 patients diagnosed with a
441:
and others were updated in 2009. These have been cited in articles and are being evaluated as of 2011, for example, in studies to ascertain differences between patients selected using different case definitions.
158:
The concurrent occurrence of four or more of the following symptoms, all of which must have persisted or recurred during six or more consecutive months of illness and must not have predated the fatigue:
1891:
422:
in all studies they funded until the mid-1990s. An incomplete version edited by Nick
Anderson (CEO of AFME) was published in a 1994 report. The London criteria require the following:
819:
Jason LA, Taylor RR, Kennedy CL, Song S, Johnson D, Torres S (September 2000). "Chronic fatigue syndrome: occupation, medical utilization, and subtypes in a community-based sample".
124:. The criteria were described as the most widely used diagnostic criteria for CFS in 2007. These criteria are sometimes called the "Fukuda definition" after the first author (
1628:
Reeves, William; Dieter Wagner; Rosane
Nisenbaum; James Jones; Brian Gurbaxani; Laura Solomon; Dimitris Papanicolaou; Elizabeth Unger; Suzanne Vernon; Christine Heim (2005).
1758:
1749:
55:
44:
1687:
Jason, Leonard A; Najar, Natasha; Porter, Nicole; Reh, Christy (2009). "Evaluating the
Centers for Disease Control's Empirical Chronic Fatigue Syndrome Case Definition".
222:
All other known causes of chronic fatigue must have been ruled out, specifically clinical depression, side effects of medication, eating disorders and substance abuse.
674:. The researchers reported that "38% of those with a diagnosis of a Major Depressive Disorder were misclassified as having CFS using the new CDC definition."
516:
Compared to the Canadian criteria, chronic fatigue is not required, and there is no requirement for symptoms to occur for 6 months. The main symptom is "
121:
1409:
Identifying and diagnosing ME/CFS: Myalgic encephalomyelitis (or encephalopathy) / chronic fatigue syndrome: diagnosis and management: Evidence review D
257:
The initial chronic fatigue syndrome definition was published in 1988. It is also called the "Holmes definition", after the manuscript's first author.
47:) vary. Different groups have produced sets of diagnostic criteria that share many similarities. The biggest differences between criteria are whether
84:
criteria come from the IOM's 2015 report on CFS, and the CDC currently uses this definition. The IOM criteria require the following three symptoms:
694:"Understanding History of Case Definitions and Criteria | Healthcare Providers | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) | CDC"
245:
Other diagnostic tests have no recognized value unless indicated on an individual basis to confirm or exclude a differential diagnosis, such as
1742:
554:
As there is no generally accepted test for chronic fatigue syndrome, diagnosis is based on symptoms, history, and ruling out other conditions.
517:
1540:
Komaroff AL; Fagioli LR; Geiger AM; et al. (January 1996). "An examination of the working case definition of chronic fatigue syndrome".
1417:
1250:"Contrasting case definitions for chronic fatigue syndrome, myalgic encephalomyelitis/chronic fatigue syndrome and myalgic encephalomyelitis"
893:
320:
To make a diagnosis, a patient must meet either 8 of the 11 symptom criteria, or 6 of the 11 symptom criteria and 2 of 3 physical criteria.
546:
Additionally, the symptoms must be present for at least 6 weeks in adults and 4 weeks in children, and not explained by another condition.
1365:"Recommendations | Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management | Guidance | NICE"
1073:
855:"IOM 2015 Diagnostic Criteria | Diagnosis | Healthcare Providers | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) | CDC"
1735:
1455:"Identification of ambiguities in the 1994 chronic fatigue syndrome research case definition and recommendations for resolution"
1824:
1226:
854:
513:
The ICC definition also notes that children may have somewhat different symptoms, and that symptoms tend to be more variable.
591:
234:
psychiatric or neurologic disorder requires that an appropriate psychiatric, psychological, or neurologic evaluation be done;
171:
severe enough to cause substantial reduction in previous levels of occupational, educational, social, or personal activities;
909:
1431:
1870:
81:
1159:
1160:"Myalgic encephalomyalitis/chronic fatigue syndrome: Clinical working definition, diagnostic and treatment protocols"
475:
Immune, gastrointestinal and genitourinary symptoms: patients must have at least one symptom in three of five areas:
1829:
1575:
King C, Jason LA (February 2005). "Improving the diagnostic criteria and procedures for chronic fatigue syndrome".
120:
The 1994 research guidelines were proposed by the "International Chronic Fatigue Syndrome Study Group", led by the
1364:
1036:
Holmes GP; Kaplan JE; Gantz NM; et al. (March 1988). "Chronic fatigue syndrome: a working case definition".
693:
671:
149:
results in substantial reduction in previous levels of occupational, educational, social, or personal activities.
17:
1860:
1865:
1782:
368:
and published by an international group of researchers in 2003. The requirements are summarized as follows:
105:
48:
32:
880:
1696:
1584:
636:
586:
1412:. NICE Evidence Reviews Collection. London: National Institute for Health and Care Excellence (NICE).
1727:
1349:
648:
represented a consensus process and involved stakeholders such as patients, doctors and researchers.
562:
1701:
1589:
617:
1714:
1610:
1070:
1061:
1015:
961:
801:
595:
246:
1200:
1392:
1819:
1669:
1651:
1602:
1557:
1522:
1486:
1423:
1413:
1332:
1279:
1123:
1053:
1007:
953:
889:
836:
793:
742:
495:
Energy production symptom: patients must have at least one symptom from any of the four lists
164:
949:
1777:
1706:
1659:
1641:
1594:
1549:
1514:
1476:
1466:
1322:
1314:
1269:
1261:
1174:
1135:
1113:
1105:
1045:
997:
945:
828:
783:
750:
732:
342:
The fatigue must have lasted for 6 months or longer, and be present at least 50% of the time
458:
Neurological symptoms: patients must have at least one symptom from one of the four lists:
241:
electrolytes, and creatinine; determination of thyroid-stimulating hormone; and urinalysis.
1077:
603:
128:) of the publication. The 1994 CDC criteria specify the following conditions must be met:
1630:"Chronic Fatigue Syndrome – A clinically empirical approach to its definition and study"
348:
Conditions known to cause severe fatigue and some mental conditions exclude a diagnosis.
1855:
1850:
1664:
1629:
1327:
1302:
1274:
1249:
1118:
1093:
755:
720:
576:
1553:
1481:
1454:
264:
Debilitating fatigue of new onset which interferes with the patient's daily activities
67:
1885:
1845:
1318:
1002:
985:
832:
438:
419:
365:
345:
Other symptoms are possible, such as muscle pain, mood problems, or sleep disturbance
168:
1718:
1614:
1598:
1518:
1065:
1019:
136:
Clinically evaluated, unexplained, persistent or relapsing chronic fatigue that is:
1234:
805:
580:
125:
965:
913:
1049:
882:
Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness
629:
621:
568:
187:
181:
174:
1407:
1109:
737:
1787:
1140:
788:
771:
719:
Davis, Hannah E.; McCorkell, Lisa; Vogel, Julia Moore; Topol, Eric J. (2023).
609:
352:
Post-infectious fatigue syndrome also requires evidence of a prior infection.
194:
1710:
1655:
1265:
746:
1248:
Jason, LA; Brown AA; Clyne E; Bartgis L; Evans M; Brown M. (December 2011).
625:
200:
1673:
1646:
1606:
1526:
1490:
1471:
1427:
1336:
1283:
1182:
1011:
840:
797:
1561:
1178:
1127:
1057:
957:
1803:
1227:"Myalgic Encephalomyelitis (ME). Criteria and clinical guidelines 2014"
770:
Jason LA, Corradi K, Torres-Harding S, Taylor RR, King C (March 2005).
616:
In addition to the CDC's recommendation, the NICE guideline recommends
572:
59:
represent a variety of conditions rather than a single disease entity.
418:
The London Criteria were designed for research purposes and used by
306:
And three physical criteria that must be documented by a physician:
1092:
Sharpe MC; Archard LC; Banatvala JE; et al. (February 1991).
407:
207:
66:
31:
387:
At least one symptom from the lists for two of these categories:
1731:
1395:. Centers of Disease Control and Prevention. 27 January 2021.
1303:"Myalgic encephalomyelitis: International Consensus Criteria"
1094:"A report--chronic fatigue syndrome: guidelines for research"
1453:
Reeves WC; Lloyd A; Vernon SD; et al. (December 2003).
721:"Long COVID: major findings, mechanisms and recommendations"
1136:"Oxford criteria for the diagnosis of chronic fatigue syn"
51:(PEM) is required, and the number of symptoms needed.
410:
i.e. Vitality, Social Functioning, and Role-Physical.
432:
Fluctuating symptoms, usually in response to exertion
1838:
1812:
1796:
1765:
1201:"London Criteria for M.E. – for website discussion"
888:. National Academy of Medicine. 2015. p. 210.
643:
Diagnostic complications and suggested improvements
213:
post-exertional malaise lasting more than 24 hours.
1892:Myalgic encephalomyelitis/chronic fatigue syndrome
1759:Myalgic encephalomyelitis/chronic fatigue syndrome
1134:
624:tests, and mentions that blood tests for vitamins
364:The Canadian consensus criteria were initiated by
45:myalgic encephalomyelitis/chronic fatigue syndrome
772:"Chronic fatigue syndrome: the need for subtypes"
470:"Neurosensory, perceptual and motor disturbances"
140:of new or definite onset (has not been lifelong);
98:Also, at least one of the following is required:
18:Clinical descriptions of chronic fatigue syndrome
1295:
1293:
290:Fatigue after exercise lasting at least 24 hours
36:Chart comparing the different definitions of CFS
912:. National Institutes of Health. Archived from
455:"Postexertional neuroimmune exhaustion" or PENE
1387:
1385:
910:"About CFS: What is Chronic Fatigue Syndrome?"
661:criteria include the use of severity ratings.
401:Symptoms must be present for at least 6 months
384:Two or more neurological or cognitive symptoms
71:Chart from the CDC explaining the IOM criteria
1743:
1031:
1029:
267:Other fatiguing conditions must be eliminated
260:The Homes criteria require these two points:
8:
490:Sensitivity to food, medicines, or chemicals
429:Impaired short-term memory and concentration
146:is not substantially alleviated by rest; and
990:Acta Neurologica Scandinavica. Supplementum
1750:
1736:
1728:
986:"The chronic fatigue syndrome – an update"
122:Centers for Disease Control and Prevention
1700:
1663:
1645:
1588:
1480:
1470:
1326:
1273:
1117:
1087:
1085:
1001:
787:
754:
736:
979:
977:
975:
950:10.7326/0003-4819-121-12-199412150-00009
375:"Post-Exertional Malaise and/or Fatigue"
225:The clinical evaluation should include:
1406:National Guideline Centre (UK) (2021).
1254:Evaluation & the Health Professions
1153:
1151:
682:
1199:Shepherd, Charles (21 February 2011).
518:post-exertional neuroimmune exhaustion
302:A rapid onset over a few hours or days
143:is not the result of ongoing exertion;
88:Severe, disabling fatigue of new onset
1434:from the original on 19 February 2024
1359:
1357:
7:
1689:Journal of Disability Policy Studies
688:
686:
612:for blood cells, protein and glucose
203:of a new type, pattern, or severity;
1225:Howes, S; Goudsmit, E; Shepard, C.
1167:Journal of Chronic Fatigue Syndrome
1158:Carruthers BM; et al. (2003).
539:Unrefreshing and/or disturbed sleep
197:without joint swelling or redness;
25:
271:They define 11 symptom criteria:
1319:10.1111/j.1365-2796.2011.02428.x
1003:10.1111/j.1600-0404.2007.00840.x
833:10.1097/00005053-200009000-00002
446:International Consensus Criteria
339:The fatigue must be debilitating
333:Fatigue must be the main symptom
237:A thorough physical examination;
1599:10.1016/j.biopsycho.2004.03.015
1519:10.1016/j.annepidem.2003.10.004
665:CDC "Empirical definition" 2005
41:Clinical descriptions of ME/CFS
27:Case definitions of the illness
1301:ML, Stevens S (October 2011).
592:Erythrocyte sedimentation rate
336:There must be a definite onset
1:
1871:Whittemore Peterson Institute
1554:10.1016/S0002-9343(96)90012-1
481:Gets sick from viruses easily
426:Fatigue triggered by exercise
91:Post-exertional malaise (PEM)
1350:Australian Guidelines (2002)
287:Muscle discomfort or myalgia
180:tender cervical or axillary
163:self-reported impairment in
1050:10.7326/0003-4819-108-3-387
725:Nature Reviews Microbiology
635:, infectious diseases, and
507:Intolerance of heat or cold
408:Short Form 36 Health Survey
360:Canadian consensus criteria
1908:
1110:10.1177/014107689108400224
738:10.1038/s41579-022-00846-2
484:Gastro-intestinal symptoms
461:Neurocognitive impairments
789:10.1007/s11065-005-3588-2
672:Major Depressive Disorder
504:Temperature dysregulation
1861:Open Medicine Foundation
1711:10.1177/1044207308325995
1266:10.1177/0163278711424281
1076:29 November 2009 at the
313:Nonexudative pharyngitis
1866:Solve ME/CFS Initiative
1783:Post-exertional malaise
536:Post-exertional malaise
498:Cardiovascular symptoms
393:Neuroendocrine symptoms
299:Hypersomnia or insomnia
154:Additional requirements
106:Orthostatic intolerance
49:post-exertional malaise
1647:10.1186/1741-7015-3-19
1472:10.1186/1472-6963-3-25
587:Thyroid function tests
583:, and protein levels).
542:Cognitive difficulties
487:Genitourinary symptoms
72:
37:
1773:Clinical descriptions
1393:"Diagnosis of ME/CFS"
1179:10.1300/J092v11n01_02
637:adrenal insufficiency
70:
35:
1188:on 16 December 2008.
563:Complete blood count
533:Debilitating fatigue
501:Respiratory symptoms
324:Oxford 1991 criteria
275:Mild fever or chills
102:Cognitive impairment
1813:Society and history
1459:BMC Health Serv Res
916:on 16 February 2013
639:may be warranted.
524:National guidelines
94:Unrefreshing sleep.
56:pathology of ME/CFS
1205:The ME Association
984:Wyller VB (2007).
821:J. Nerv. Ment. Dis
700:. 19 November 2019
596:C-Reactive protein
390:Autonomic symptoms
316:Tender lymph nodes
247:multiple sclerosis
73:
38:
1879:
1878:
1419:978-1-4731-4221-3
895:978-0-309-31689-7
567:Blood chemistry (
478:Flu-like symptoms
467:Sleep disturbance
378:Sleep dysfunction
253:CDC 1988 criteria
218:Final requirement
165:short-term memory
116:CDC 1994 criteria
76:2015 IOM criteria
16:(Redirected from
1899:
1830:Notable patients
1752:
1745:
1738:
1729:
1723:
1722:
1704:
1684:
1678:
1677:
1667:
1649:
1625:
1619:
1618:
1592:
1572:
1566:
1565:
1537:
1531:
1530:
1501:
1495:
1494:
1484:
1474:
1450:
1444:
1443:
1441:
1439:
1403:
1397:
1396:
1389:
1380:
1379:
1377:
1375:
1361:
1352:
1347:
1341:
1340:
1330:
1297:
1288:
1287:
1277:
1245:
1239:
1238:
1237:on 14 July 2014.
1233:. Archived from
1222:
1216:
1215:
1213:
1211:
1196:
1190:
1189:
1187:
1181:. Archived from
1164:
1155:
1146:
1144:
1138:
1131:
1121:
1089:
1080:
1069:
1038:Ann. Intern. Med
1033:
1024:
1023:
1005:
981:
970:
969:
932:
926:
925:
923:
921:
906:
900:
899:
887:
877:
871:
870:
868:
866:
851:
845:
844:
816:
810:
809:
791:
776:Neuropsychol Rev
767:
761:
760:
758:
740:
716:
710:
709:
707:
705:
690:
281:Sore lymph nodes
132:Primary symptoms
21:
1907:
1906:
1902:
1901:
1900:
1898:
1897:
1896:
1882:
1881:
1880:
1875:
1834:
1808:
1792:
1761:
1756:
1726:
1702:10.1.1.508.1082
1686:
1685:
1681:
1627:
1626:
1622:
1590:10.1.1.595.4767
1574:
1573:
1569:
1539:
1538:
1534:
1503:
1502:
1498:
1452:
1451:
1447:
1437:
1435:
1420:
1405:
1404:
1400:
1391:
1390:
1383:
1373:
1371:
1369:www.nice.org.uk
1363:
1362:
1355:
1348:
1344:
1299:
1298:
1291:
1247:
1246:
1242:
1224:
1223:
1219:
1209:
1207:
1198:
1197:
1193:
1185:
1162:
1157:
1156:
1149:
1133:
1091:
1090:
1083:
1078:Wayback Machine
1035:
1034:
1027:
983:
982:
973:
934:
933:
929:
919:
917:
908:
907:
903:
896:
885:
879:
878:
874:
864:
862:
861:. 27 April 2021
853:
852:
848:
818:
817:
813:
769:
768:
764:
718:
717:
713:
703:
701:
692:
691:
684:
680:
667:
654:
645:
633:
622:creatine kinase
552:
526:
448:
416:
414:London criteria
396:Immune symptoms
362:
326:
310:Low-grade fever
284:Muscle weakness
255:
118:
78:
65:
28:
23:
22:
15:
12:
11:
5:
1905:
1903:
1895:
1894:
1884:
1883:
1877:
1876:
1874:
1873:
1868:
1863:
1858:
1856:ME Research UK
1853:
1851:ME Association
1848:
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1836:
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1833:
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1822:
1816:
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1806:
1800:
1798:
1794:
1793:
1791:
1790:
1785:
1780:
1775:
1769:
1767:
1766:Medical issues
1763:
1762:
1757:
1755:
1754:
1747:
1740:
1732:
1725:
1724:
1679:
1620:
1567:
1532:
1496:
1445:
1418:
1398:
1381:
1353:
1342:
1289:
1260:(3): 280–304.
1240:
1231:Axford's Abode
1217:
1191:
1147:
1081:
1025:
971:
944:(12): 953–59.
938:Ann Intern Med
927:
901:
894:
872:
846:
811:
762:
731:(3): 133–146.
711:
681:
679:
676:
666:
663:
653:
650:
644:
641:
631:
614:
613:
607:
604:Celiac disease
601:
598:
589:
584:
577:renal function
565:
551:
548:
544:
543:
540:
537:
534:
525:
522:
511:
510:
509:
508:
505:
502:
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479:
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456:
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430:
427:
415:
412:
403:
402:
399:
398:
397:
394:
391:
385:
382:
379:
376:
373:
372:Severe fatigue
361:
358:
350:
349:
346:
343:
340:
337:
334:
325:
322:
318:
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314:
311:
304:
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297:
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291:
288:
285:
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279:
276:
269:
268:
265:
254:
251:
243:
242:
238:
235:
231:
220:
219:
215:
214:
211:
204:
198:
191:
185:
178:
172:
156:
155:
151:
150:
147:
144:
141:
134:
133:
117:
114:
109:
108:
103:
96:
95:
92:
89:
77:
74:
64:
61:
26:
24:
14:
13:
10:
9:
6:
4:
3:
2:
1904:
1893:
1890:
1889:
1887:
1872:
1869:
1867:
1864:
1862:
1859:
1857:
1854:
1852:
1849:
1847:
1846:Action for ME
1844:
1843:
1841:
1839:Organizations
1837:
1831:
1828:
1826:
1825:Controversies
1823:
1821:
1818:
1817:
1815:
1811:
1805:
1802:
1801:
1799:
1795:
1789:
1786:
1784:
1781:
1779:
1776:
1774:
1771:
1770:
1768:
1764:
1760:
1753:
1748:
1746:
1741:
1739:
1734:
1733:
1730:
1720:
1716:
1712:
1708:
1703:
1698:
1695:(2): 93–100.
1694:
1690:
1683:
1680:
1675:
1671:
1666:
1661:
1657:
1653:
1648:
1643:
1639:
1635:
1631:
1624:
1621:
1616:
1612:
1608:
1604:
1600:
1596:
1591:
1586:
1583:(2): 87–106.
1582:
1578:
1571:
1568:
1563:
1559:
1555:
1551:
1547:
1543:
1536:
1533:
1528:
1524:
1520:
1516:
1513:(2): 95–100.
1512:
1508:
1507:Ann Epidemiol
1500:
1497:
1492:
1488:
1483:
1478:
1473:
1468:
1464:
1460:
1456:
1449:
1446:
1433:
1429:
1425:
1421:
1415:
1411:
1410:
1402:
1399:
1394:
1388:
1386:
1382:
1370:
1366:
1360:
1358:
1354:
1351:
1346:
1343:
1338:
1334:
1329:
1324:
1320:
1316:
1313:(4): 327–38.
1312:
1308:
1304:
1296:
1294:
1290:
1285:
1281:
1276:
1271:
1267:
1263:
1259:
1255:
1251:
1244:
1241:
1236:
1232:
1228:
1221:
1218:
1206:
1202:
1195:
1192:
1184:
1180:
1176:
1172:
1168:
1161:
1154:
1152:
1148:
1142:
1137:
1129:
1125:
1120:
1115:
1111:
1107:
1104:(2): 118–21.
1103:
1099:
1095:
1088:
1086:
1082:
1079:
1075:
1072:
1067:
1063:
1059:
1055:
1051:
1047:
1044:(3): 387–89.
1043:
1039:
1032:
1030:
1026:
1021:
1017:
1013:
1009:
1004:
999:
995:
991:
987:
980:
978:
976:
972:
967:
963:
959:
955:
951:
947:
943:
939:
931:
928:
915:
911:
905:
902:
897:
891:
884:
883:
876:
873:
860:
856:
850:
847:
842:
838:
834:
830:
827:(9): 568–76.
826:
822:
815:
812:
807:
803:
799:
795:
790:
785:
781:
777:
773:
766:
763:
757:
752:
748:
744:
739:
734:
730:
726:
722:
715:
712:
699:
695:
689:
687:
683:
677:
675:
673:
664:
662:
658:
651:
649:
642:
640:
638:
634:
627:
623:
619:
611:
608:
605:
602:
599:
597:
593:
590:
588:
585:
582:
581:liver enzymes
578:
574:
570:
566:
564:
561:
560:
559:
555:
549:
547:
541:
538:
535:
532:
531:
530:
523:
521:
519:
514:
506:
503:
500:
497:
496:
494:
489:
486:
483:
480:
477:
476:
474:
469:
466:
463:
460:
459:
457:
454:
453:
452:
445:
443:
440:
431:
428:
425:
424:
423:
421:
420:Action for ME
413:
411:
409:
400:
395:
392:
389:
388:
386:
383:
380:
377:
374:
371:
370:
369:
367:
366:Health Canada
359:
357:
353:
347:
344:
341:
338:
335:
332:
331:
330:
323:
321:
315:
312:
309:
308:
307:
301:
298:
295:
292:
289:
286:
283:
280:
277:
274:
273:
272:
266:
263:
262:
261:
258:
252:
250:
248:
239:
236:
232:
228:
227:
226:
223:
217:
216:
212:
209:
206:unrefreshing
205:
202:
199:
196:
192:
189:
186:
183:
179:
176:
173:
170:
169:concentration
166:
162:
161:
160:
153:
152:
148:
145:
142:
139:
138:
137:
131:
130:
129:
127:
123:
115:
113:
107:
104:
101:
100:
99:
93:
90:
87:
86:
85:
83:
75:
69:
62:
60:
57:
52:
50:
46:
42:
34:
30:
19:
1772:
1692:
1688:
1682:
1637:
1634:BMC Medicine
1633:
1623:
1580:
1577:Biol Psychol
1576:
1570:
1548:(1): 56–64.
1545:
1541:
1535:
1510:
1506:
1499:
1462:
1458:
1448:
1438:23 September
1436:. Retrieved
1408:
1401:
1372:. Retrieved
1368:
1345:
1310:
1307:J Intern Med
1306:
1257:
1253:
1243:
1235:the original
1230:
1220:
1208:. Retrieved
1204:
1194:
1183:the original
1170:
1166:
1132:Synopsis by
1101:
1097:
1041:
1037:
993:
989:
941:
937:
930:
918:. Retrieved
914:the original
904:
881:
875:
863:. Retrieved
858:
849:
824:
820:
814:
782:(1): 29–58.
779:
775:
765:
728:
724:
714:
702:. Retrieved
697:
668:
659:
655:
646:
615:
569:electrolytes
556:
553:
545:
527:
515:
512:
449:
435:
417:
404:
363:
354:
351:
327:
319:
305:
270:
259:
256:
244:
230:supplements;
224:
221:
157:
135:
126:Keiji Fukuda
119:
110:
97:
79:
53:
40:
39:
29:
1173:(1): 7–36.
1098:J R Soc Med
859:www.cdc.gov
698:www.cdc.gov
356:condition.
278:Sore throat
188:muscle pain
182:lymph nodes
175:sore throat
63:Definitions
1788:2-day CPET
1542:Am. J. Med
1141:GPnotebook
678:References
610:Urinalysis
600:Iron tests
594:(ESR) and
296:Joint pain
195:joint pain
1778:Treatment
1697:CiteSeerX
1656:1741-7015
1585:CiteSeerX
1465:(1): 25.
747:1740-1534
606:screening
293:Headaches
201:headaches
1886:Category
1804:DecodeME
1797:Research
1719:71852821
1674:16356178
1615:12601890
1607:15450690
1527:15018881
1491:14702202
1432:Archived
1428:35438857
1337:21777306
1284:22158691
1074:Archived
1066:42395288
1020:11247547
1012:17419822
996:: 7–14.
841:11009329
798:15929497
652:CDC 1994
1820:History
1665:1334212
1562:8579088
1328:3427890
1275:3658447
1128:1999813
1119:1293107
1071:Details
1058:2829679
958:7978722
920:27 June
806:8153255
756:9839201
573:glucose
550:Testing
381:Myalgia
1717:
1699:
1672:
1662:
1654:
1640:: 19.
1613:
1605:
1587:
1560:
1525:
1489:
1482:317472
1479:
1426:
1416:
1374:3 July
1335:
1325:
1282:
1272:
1210:4 July
1126:
1116:
1064:
1056:
1018:
1010:
966:510735
964:
956:
892:
865:3 July
839:
804:
796:
753:
745:
704:3 July
439:Ramsay
193:multi-
1715:S2CID
1611:S2CID
1186:(PDF)
1163:(PDF)
1062:S2CID
1016:S2CID
962:S2CID
886:(PDF)
802:S2CID
618:HbA1c
208:sleep
1670:PMID
1652:ISSN
1603:PMID
1558:PMID
1523:PMID
1487:PMID
1440:2023
1424:PMID
1414:ISBN
1376:2022
1333:PMID
1280:PMID
1212:2022
1124:PMID
1054:PMID
1008:PMID
954:PMID
922:2009
890:ISBN
867:2022
837:PMID
794:PMID
743:ISSN
706:2022
628:and
620:and
464:Pain
80:The
54:The
1707:doi
1660:PMC
1642:doi
1595:doi
1550:doi
1546:100
1515:doi
1477:PMC
1467:doi
1323:PMC
1315:doi
1311:270
1270:PMC
1262:doi
1175:doi
1114:PMC
1106:doi
1046:doi
1042:108
998:doi
994:187
946:doi
942:121
829:doi
825:188
784:doi
751:PMC
733:doi
167:or
82:IOM
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