Freelance Writing Jobs | Today's Articles | Sign In

What Kind of a Specialist to See For CFS/ME?

Different Types of Doctors Can Help with Diagnosis and Treatment

Mar 3, 2009 Maija Haavisto

Neurologist, cardiologist, endocrinologist or perhaps an infection specialist? Who should diagnose and treat chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME)?

One of the problems with chronic fatigue syndrome/myalgic encephalomyelitis is that even though it is primarily a neurological illness, it can affect just about all bodily systems. It is best to see a CFS/ME specialist, but often this isn't possible for a variety of reasons. In some countries there isn't a single doctor specializing in CFS/ME.

Another problem is that "if you have a hammer, everything looks like a nail". It is often difficult to pinpoint the origin of CFS/ME symptoms and doctors tend to see them from the perspective of their specialty. An endocrinologist might think the fatigue stems from adrenal insufficiency, a a sleep specialist would blame sleep apnea and an immunologist might tell you it's all caused by your immune dysfunction. The reality could be a combination of all of these factors and more.

Neurologist

Since CFS/ME is a neurological illness, a neurologist is a logical choice of a doctor to see. Unfortunately most doctors know very little about CFS/ME and are often keen to blame peculiar symptoms, even those of clearly neurological origin, to psychiatric or psychosomatic causes.

Cardiologist

CFS/ME often causes cardiac symptoms and has even been suspected to be a herpesviral infection of the heart. Sadly very few cardiologists are aware of this and the true extent of cardiac problems in CFS/ME may not be revealed without very specialized testing.

Endocrinologist

Endocrinologists treat illnesses related to the secretion of hormones, such as diabetes and thyroid problems. They tend to be fairly well-versed in CFS/ME and even those who aren't can often spot endocrinological problems like hypothyroidism that other doctors have missed.

Rheumatologist

Rheumatologists mainly treat autoimmune diseases and different forms of arthritis. CFS/ME is not considered to fall under a rheumatologist's specialty, but especially if you also have fibromyalgia, a rheumatologist could be useful.

Immunologist/Infection Doctor

In some countries infection specialists are the doctors who primarily treat CFS/ME. Their tests can be very useful when immune deficiencies are suspected, but peculiarly, even they often don't know how to diagnose and treat chronic infections. Often they also neglect the neurological and endocrinological sides of the illness.

Almost all medications can be prescribed by any kind of a physician, but e.g. some immunomodulators can only be prescribed by an immunologist.

Physiatrist

Not to be confused with psychiatrist or physiotherapists, physiatrists can be helpful for those with chronic pain caused by CFS/ME (or fibromyalgia or myofascial trigger points).

Pain Specialist

Pain specialists come from several different specialties of medicine. A pain doctor is definitely recommended for those with severe chronic pain, preferably one with a background in neurology.

Sleep Specialist

A sleep specialist is usually a neurologist or a pulmonologist who has specialized in sleep disorders. They tend to understand CFS/ME fairly well and often treat it proactively, but may overestimate the impact of dysfunctional sleep.

Psychiatrist

CFS/ME is not a psychiatric illness and many psychiatrists have trouble understanding this, but a good psychiatrist who realizes the distinction can be very helpful for those suffering from depression and/or anxiety.

Naturopath

Naturopaths tend to have a good understanding of complex illnesses like CFS/ME and know how to treat them with e.g. nutritional approaches. Many of them are more open-minded than other physicians to non-mainstream pharmaceutical treatments like low dose naltrexone, but some are very averse to medication.

Other Practitioners

Depending on your symptoms you may also need an allergologist, gynecologist or a gastroenterologist.

The Bottom Line

Any kind of a doctor can diagnose and treat CFS/ME. More important than their field of study, or even how much they know about CFS/ME, is whether they are open-minded and willing to learn. A general practitioner or a family doctor who is willing to try new treatments is much more useful than a specialist who doesn't want to try to help the patient.

The copyright of the article What Kind of a Specialist to See For CFS/ME? in General Medicine is owned by Maija Haavisto. Permission to republish What Kind of a Specialist to See For CFS/ME? in print or online must be granted by the author in writing.