Autism and ME/CFS

Well said. I too don't understand why people anyone would think the two are linked in any meaningful way.
oh I do.

Some of the cognitive issues can cause 'social' issues, difficulties in comprehending others, difficulty in expression of various things.

To the lay person that sounds like 'autism', and TBF before ME I could cope a lot better, ME has made certain aspects of my ASD more expressed, left me with less to work with to 'compensate'.

When my ME is 'bad', amongst other things, I go from a 'high functioning' person with ASD to someone who is unable to deal with others, or various aspects of the environment, effectively.

So, whilst I agree that there is probably no meaningful link between ASD and ME, ME makes my ASD much more so, it can turn me from ASD to 'autistic'.
 
Hello

I see scatterings of conversations around this topic here but couldn't find a single thread which dealt with this overall assertion. That ME is late onset ASD and that PEM and autistic overload may be related. Naviaux seems to be the touch point, but I am asking regarding the overall topic including his thinking, but not just his.

It makes experiential sense to me, but recent discussion showed Gulf War Syndrome and ME PEM to be qualitatively similar but neurologically different. It may also just be the result of overlapping Venn diagrams of symptoms, comorbidities and comorbidities of comorbidities. Correlation is not causation, Christmas cards do not cause Christmas. Causation may appear backwards after a few cycles. Or they may merely be correlated with another cause

But I'm so curious about the assertion, esp in view of nascent microbiomal evidence re ASD. I'd love to see this idea dissected by people who can say more than me on it.

Some subjective narrative: https://www.syndromea.org/2018/10/29/autism-and-chronic-fatigue-syndrome/

Some tentative similarities:

Reduced HRV and HF HRV in people with autism: https://www.ncbi.nlm.nih.gov/m/pubmed/30972967/

Autonomic underarousal: https://www.ncbi.nlm.nih.gov/m/pubmed/28006949/

Low cortisol, sleep disruptions and maybe overarousal: https://www.ncbi.nlm.nih.gov/m/pubmed/30896090/

General
https://www.omf.ngo/2017/10/19/treating-autism-and-mecfs-could-one-drug-do-both/

Apologies if I missed where a previous thread became more general to this topic.

I am not really sure what you are trying to say here but if it’s autism and ME being connected and you can get late onset Autism, then no that is not possible. I have worked with children with Autism for the last 14 years and I also have a child with Autism. Autism is something I know a lot about through experience and training. People with Autism have a social, communication and understanding difficulties. They see the world very different to everyone else. There are various degrees of Autism, on the milder end it’s barely noticeable to those that know nothing about it, although it may be noticed that those that have it maybe a little different from there peers. They are very good with numbers and anything scientific, like ICT. Those that can learn who are really clever are often referred to as higher functioning Autism.

Those that are more severe, can still be classed as higher functioning Autism if they can speak and learn. But they very often represent the same difficulties as someone with very severe Autism. Like change, social aspects of understanding etc. They often have huge meltdowns when there is a change in their routine or they don’t understand the world around them. They usually have sensory impairment which maybe sound, lights or smells, sometimes it can be all 3. My son used to have a huge meltdown down if I took him to a supermarket because of his sensory impairment and if there were loads of people around. He couldn’t cope in situations like that. My daughter said to me, in describing my sons understanding issue, that he understands facts but not all the bits in between.

Those with very severe Autism often don’t talk, they have severe behavioural issues with all the above.

To me and everyone I know who has loads of experience with Autism, there can be no link between ME and Autism. Autism is what you are born with and is genetic in a lot of cases. There is so much more to Autism than I have said. I hope I have made sense lol.

Edit: what I will say though, is like all other illnesses, if you have an illness that have similar symptoms to Autism, then they will feed into each other and make it worse and challenging.

Edit 2: just to understand a little more about how it happens, in one of our training sessions we watched a video clip of what happens to the brain with someone with Autism. When a baby is born and the baby goes through different milestones of development, the connections in the brain don’t connect up where they should. That’s why it’s very difficult to detect those that have it on the milder scale before the age of 5, sometimes longer. In my sons case we knew early on when he was 18mths that he wasn’t developing in the same way as his peers and had been through the system since then to find out what was wrong with him. All they found was he had no u derstanding of the world around him. But even then he was 9 before he got official diagnosis of Autism.
 
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I seem to recall, from the time of the MMR debate, discussion of a particular form of autism referred to as regressive autism, or something of that sort, which fuelled the controversy. One wonders whether some might see similarities between that particular form and a form of ME.
 
I seem to recall, from the time of the MMR debate, discussion of a particular form of autism referred to as regressive autism, or something of that sort, which fuelled the controversy. One wonders whether some might see similarities between that particular form and a form of ME.

What a lot of people don’t understand is that it’s more common than not for that to happen with a child with autism. It’s not that they lose their speech, they often don’t see a need to talk in a lot of cases or it’s because of their social communication difficulties. They get locked into their own world because it’s where they feel safe. As time goes on sometimes they regain some speech or not at all. They do learn other ways to communicate though, either through Makaton, a form or sign language that is used with speech, or PECS, a visual communication used through symbols.
 
Merged thread

This is a rather comprehensive Wikipedia style article describing the overlap between autism and ME/CFS

https://neurodivergentinsights.com/blog/autism-and-health-issues?format=amp

Generally I spend most of my days horizontal, lots of naps and a brain on idle. I'm on a trip from west coast Canada to Europe. I didn't sleep "overnight" on the plane so was awake for 24 hours. Today my brain is active, alive and racing with ideas and connections like the good old days.

A severe lack of sleep often works well for me to temporarily banish my ME/CFS symptoms for quite a while. I wonder about the connection to the initial short term immune system response.
 
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I have both diagnoses and have wondered whether my ME/CFS might have been misdiagnosed autism. I ended up rejecting this idea.

Autism is associated with autistic burnout which has not been studied much. Autistic burnout is attributed to "chronic life stress and a mismatch of expectations and abilities without adequate supports." I experienced something that fits this definition of autistic burnout but it was the result of years of trying to maintain normal life and continuing to relapse and having what is best described as PEM, and being misunderstood as not disabled. This led to years of nearly complete withdrawal from life where I had no interest in even trying and had no faith in interacting with anyone any more (because outside pressure from other people had caused the problem).

I suspect autism might be associated with a lot of problems that tend to be underestimated because people think in terms of a simple stereotype of autism of poor social skills that doesn't include debilitating fatigue, cognitive impairment, and other symptoms that are common in chronic illnesses.

I have higher physical function than most ME/CFS patients but also suffer what is best described as PEM. I need the ME/CFS diagnosis to make sense of what I'm experiencing and knowing how to manage it.

There was this study that reported a "higher risk of chronic disabling fatigue for children with neurodivergent traits, likely linked to higher levels of inflammation"
https://orca.cardiff.ac.uk/id/eprint/170644/

I remember that the FOXP4 gene has been linked to both long covid and autism.

Perhaps autism increases the risk of ME/CFS. @Chris Ponting can DecodeME tell us anything about this?
 
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I was late realized at 63. I agree that one of the defining differences between the two is PEM, which I've never seen mentioned with autism.

In my case, the realization about autism came when I asked myself why I was so insistent/consistent about exhausting myself with exercise routines when it was very clear they resulted in PEM.

On the other hand, those same usually aerobic routines are the only times I feel good, which I attribute to increased blood flow to the brain.
 
Can you describe it?
I had unrefreshing sleep, brain fog, my eyes would sting from lack of sleep. I became a very light sleeper, with smaller noises being enough to wake me up. I developed synaesthesia and started to feel physically hit by certain sounds. The more I was exposed to an offending sound or smell, the more painful it became, I haven't fully returned to baseline over a decade later. At school I had a high IQ and good memory but over the years my cognitive faculties diminished, I had to drop out of college despite having great potential. I struggled with my special skills (I was originally talented at music but burnout diminished my skills). I remember becoming impulsive.

At the time I didn't have a word for burnout, I just called it tiredness because poor sleep made it worse and I thought everybody experienced sleep deprivation as Autistic Burnout.
 
In Dissecting the genetic complexity of myalgic encephalomyelitis/chronic fatigue syndrome via deep learning-powered genome analysis (2025, Preprint: MedRxiv) —

Most prominently, this set of synaptic genes is implicated in attention deficit hyperactivity disorder (ADHD) and autistic spectrum disorder (ASD) (Wikipathways WP5420). Indeed the entire set of ME/CFS genes is significantly enriched in this pathway (P = 3.9 x 10-10 , two-sided Fisher’s exact test). A shared genetic basis between ME/CFS and ADHD/ASD suggests that these two disorders may have shared aspects of molecular dysfunction. It is intriguing that the typical age of onset of ADHD/ASD is in childhood whereas ME/CFS typically manifests in adolescence or adulthood. If both disorders share a related mechanism then perhaps they are age-specific manifestations of a similar underlying process.
 
As someone currently on several years long waiting lists for a very late diagnosis for autism and ADHD, I strongly suspect that my developing ME/CFS after experiencing life threatening health issues and a life time of depression, has a lot to do with living without diagnoses and spending a lifetime trying to fit in and meet neurotypical standards

In Dissecting the genetic complexity of myalgic encephalomyelitis/chronic fatigue syndrome via deep learning-powered genome analysis (2025, Preprint: MedRxiv) —

A shared genetic basis between ME/CFS and ADHD/ASD suggests that these two disorders may have shared aspects of molecular dysfunction. It is intriguing that the typical age of onset of ADHD/ASD is in childhood whereas ME/CFS typically manifests in adolescence or adulthood. If both disorders share a related mechanism then perhaps they are age-specific manifestations of a similar underlying process.

I swore very loudly on reading this..I am getting really sick of the absolute lack of systemic curiosity and funding for research on any of these issues and having to randomly fall over significant answers on the internet.
 
I need the ME/CFS diagnosis to make sense of what I'm experiencing and knowing how to manage

Yes. This.Thank you for elucidating this so clearly.

I have had someone say to me that I am pathologising normal experiences, whereas actually what I'm trying to do is this, to seek out diagnoses to make sense of my experiences and symptoms and figure out how to manage them - especially with a dwindling supply of energy.
 
I have been wondering about the possibility of some common element to ASD and ME/CFS for a while but ASD is more common in boys. I think maybe there is a link but it is an indirect one and that it interacts with something that confers female bias for ME/CFS.
 
mTOR overactivity has been proposed to be relevant to both autism and ME/CFS.

Loss of mTOR‐dependent autophagy causes autistic‐like synaptic pruning deficits in the brain.
 
Is it though, or is it an historical massive under diagnosis in women?

The information I have seen suggests that there may well a diagnostic ascertainment factor but that may reduce the ratio from 4 to 2 in favour of boys. Why would autism be massively under diagnosed in women and not in ME/CFS? We might just about claim that autism had a ratio nearer 1 but that is still in contrast to a 3:1 for women to men for ME/CFS.
 
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