CFS/ME involves a complex range of symptoms that includes fatigue, malaise, headaches, sleep disturbance, difficulties with concentration and muscle pain. The pattern and intensity of symptoms vary between people, and during the course of each person’s illness. People often have symptoms for many years before CFS/ME is diagnosed.
The causes and disease processes of CFS/ME are still not understood, and different combinations of approaches will be helpful for different people.
Dietary manipulation is one of the approaches for managing the symptoms:
Step 1: Diet analysis to assess nutritional content of the diet: vitamins, minerals, protein, calories etc. Correction of any nutritional deficiencies with appropriate dietary advice.
Step 2: Depending on presenting symptoms, look at possibility of food intolerances. For example, Coeliac Disease or non-coeliac gluten sensitivity (NCGS). The symptoms in NCGS may resemble those associated with Coeliac Disease but with a prevalence of additional symptoms, such as behavioral changes, bone or joint pain, muscle cramps, leg numbness, weight loss and chronic fatigue. Treatment of Coeliac Disease is elimination of gluten, while for NCGS gluten restriction/reduction can significantly improve symptoms.
Guidelines for the NHS (NICE, 2009): “Exclusion diets are not generally recommended for CFS, but many people find them helpful in managing symptoms, including bowel symptoms. If a person with CFS undertakes an exclusion diet or dietary manipulation, seek advice from a dietitian because of the risk of malnutrition.”