Underuse of Pharmacologic Therapies for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Before Specialist Evaluation, 2026, Grach et al

[Utsikt]

And reading here I get the impression that PEM is an extremely variable category, such that it may be unwise to extrapolate from one case to another. We can advise people that others' experience is that pushing through is, in the long term, a bad idea. But if that gets enshrined in some stereotyped concept of PEM, bogus theorising and ungrounded treatments tend to rapidly follow. So we end up with these complicated recipes for energy management that just wear people out writing diaries for.

We’re kind of dealing with this in Norway at the moment. The BPS people are really pushing the «PEM is normal» narrative, based on e.g. the DSQ.

But at the same time, «figuring out what works for you» is the mantra of the alternativ industry, so it’s difficult to get the point across that trying pacing is okay, but suggesting treatment X isn’t. They don’t seem to understand the difference between management and treatment.

I am getting a bit irritated by people giving seminars and discussing policy at meetings talking about 'pem' as a word the rhymes with 'them'. It seems a relatively new habit. My suspicion is that folklorisation will tend to rapidly follow, just like 'nets' for neutrophil DNA extrusions.

It has always been pronounced like that in Norway. It don’t think it makes much of a difference. But I do worry about the lack of an understanding of what «PEM» means to the speaker and reader. We’ve seem this kind of issue recently with the DSQ v2.

 

[rvallee]

We’re kind of dealing with this in Norway at the moment. The BPS people are really pushing the «PEM is normal» narrative, based on e.g. the DSQ.

They're pretending it's DOMS and we're just confused/stupid?

It's not as if PEM is defined as an abnormal reaction, or anything like that, which would explicitly exclude this as being normal. Good grief it's like we're dealing with children who think they're so smart because you told them to go to bed and they're eating bread in the kitchen like the joke from the Simpsons. "But you said go to bread, bread, I'm eating bred" with a shit-eating grin.

Actually it's kind of like "the card says moops" (taken from Seinfeld, a common reactionary argumentative trope) except they put the error there themselves.

 

[Utsikt]

They're pretending it's DOMS and we're just confused/stupid?

They are just following what Jason & Co says..

 

[Dolphin]

Mayo Clinic study details set of options family medicine physicians may consider to treat ME/CFS and long covid

U.S. prevalence of chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME), a multisystem neurologic disease and debilitating chronic condition, averaged 1 million to 2.5 million before the COVID-19 pandemic. Incidence rates are now reported to be 15 times greater, related...

www.eurekalert.org

News Release 26-May-2026

Mayo Clinic study details set of options family medicine physicians may consider to treat ME/CFS and long covid​

Peer-Reviewed Publication
American Academy of Family Physicians


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Original Research

Mayo Clinic Study Details Set of Options Family Medicine Physicians May Consider to Treat ME/CFS and Long Covid

Background: U.S. prevalence of chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME), a multisystem neurologic disease and debilitating chronic condition, averaged 1 million to 2.5 million before the COVID-19 pandemic. Incidence rates are now reported to be 15 times greater, related at least in part to long COVID. This retrospective chart review analyzed records of medications and supplements tried before specialty consultation from 571 adults with ME/CFS seen at a Mayo Clinic specialty clinic from 2018 to 2022.

What This Study Found: Medications used commonly for pain, impaired sleep, and mood disorders were the ones most often prescribed before consultation. Medications that have been suggested for core symptoms of ME/CFS, such as fatigue, brain fog, postexertional malaise, orthostatic intolerance, or allergy/inflammation, had less often been tried. Most (72%) of the individuals used at least one supplement.

Implications: The findings suggest potentially helpful medications used by ME/CFS specialists, most of which are well known and used in primary care for other diagnoses, may be under utilized to treat ME/CFS in primary care. To help clinicians navigate available options, researchers created two tables with medications and supplements that ME/CFS specialists commonly discuss with patients in the clinic, organized by symptom category, along with a summary of the current evidence for each.

Underuse of Pharmacologic Therapies for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Before Specialist Evaluation

Corresponding author: Stephanie L. Grach, MD, MS, et al

Department of Internal Medicine, Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota

PERMANENT LINK - Will become active after 5 p.m. ET on 05/26/26

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Journal​

The Annals of Family Medicine

Article Title​

Mayo Clinic Study Details Set of Options Family Medicine Physicians May Consider to Treat ME/CFS and Long Covid

Article Publication Date​

26-May-2026