🕷️ Crawler Inspector

URL Lookup

Direct Parameter Lookup

Raw Queries and Responses

1. Shard Calculation

Query:

Response:

Calculated Shard: 75 (from laksa105)

2. Crawled Status Check

Query:

curl -X POST \
  'http://laksa075.int.ahrefs:8124/' \
  -H 'Content-Type: text/plain' \
  -H 'X-ClickHouse-Database: crawler3' \
  -H 'Authorization: Basic YXBpOg==' \
  -d 'SELECT getAhrefsURLFromUnparsed(src_unparsed) AS found_url, ifNull(toUnixTimestamp(download_stamp), 0) AS crawl_time, ifNull(toUnixTimestamp(props_url_first_seen), 0) AS first_indexed_time, download_http_code AS http_code, src_unparsed AS src_unparsed, src_root_hash AS src_root_hash, history_drop_reason AS history_drop_reason, meta_title AS meta_title, meta_descriptions AS meta_descriptions, attrs_boilerpipe_text AS attrs_boilerpipe_text, attrs_markdown AS attrs_markdown, attrs_readable_markdown AS attrs_readable_markdown, meta_canonical AS meta_canonical FROM crawler3.page_info_local FINAL PREWHERE (src_root_hash, src_unparsed) IN ((getAhrefsRootHashFromUnparsed(getAhrefsUnparsedNoserviceFromURL(\'https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/symptoms/\')), getAhrefsUnparsedNoserviceFromURL(\'https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/symptoms/\'))) FORMAT JSONEachRow'

Response:

{"found_url":"https:\/\/www.nhs.uk\/conditions\/chronic-fatigue-syndrome-cfs\/symptoms\/","crawl_time":1776314763,"first_indexed_time":1510328405,"http_code":200,"src_unparsed":"uk,nhs,www!\/conditions\/chronic-fatigue-syndrome-cfs\/symptoms\/ s443","src_root_hash":"11359509702434384875","history_drop_reason":null,"meta_title":"Myalgic encephalomyelitis or chronic fatigue syndrome (ME\/CFS) - Symptoms - NHS","meta_descriptions":["Read about the symptoms of myalgic encephalomyelitis (chronic fatigue syndrome or ME\/CFS). The main symptom is extreme tiredness, which can severely affect your ability to carry out everyday activities."],"attrs_boilerpipe_text":"There are 4 main symptoms of myalgic encephalomyelitis or chronic fatigue syndrome (ME\/CFS).\nExtreme tiredness (fatigue)\nThe extreme tiredness (fatigue) associated with ME\/CFS does not go away with rest or sleep. This can make it difficult to carry out everyday tasks and activities.\nMost people with ME\/CFS describe their fatigue as overwhelming and a different type of tiredness from what they've experienced before.\nProblems sleeping\nMany people with ME\/CFS also have serious problems with their sleep that do not get better.\nYou may find that:\nyou do not feel refreshed after sleeping – like you have not had a proper good night's rest\nyou keep waking up during sleep\nyou feel stiff, tired or have flu-like symptoms when waking up\nyou feel very tired and sleepy during the day\nProblems with thinking, memory and concentration\nIf you have ME\/CFS, it's also common to:\nhave problems remembering certain words, names or numbers\nhave difficulty concentrating or difficulty focusing on more than one thing at a time\nhave problems remembering things that happened recently\nbe slow to speak or react to things\nThese problems are sometimes described \"brain fog\".\nPost-exertional malaise (PEM)\nSymptoms of ME\/CFS can get worse after activity (called post-exertional malaise, or PEM).\nPEM can be triggered by physical or mental activity, such as socialising or studying\nPEM can happen hours or days after the triggering activity, and it can take weeks to recover.\nOther symptoms\nOther symptoms of ME\/CFS can include:\nmuscle or joint pain\nheadaches\na\nsore throat\nor sore glands that are not swollen\nflu-like symptoms\nfeeling dizzy or sick\nfast or irregular heartbeats (\nheart palpitations\n)\nmuscle twitches or spasms\nintolerance to alcohol or certain foods or chemicals\nbeing very sensitive to light, sound, touch, taste and smell\nhaving hot flushes or cold chills if the temperature changes\nfeeling dizzy, sick or fainting when standing up from a sitting or lying position\nSeverity of symptoms\nMost cases of ME\/CFS are mild or moderate, but 1 in 4 people have severe symptoms.\nIf your symptoms are severe, a specialist should be involved in your treatment.\nME\/CFS symptoms can be considered:\nmild\n– you’re able to care for yourself but may have problems moving around; you may be able to go to work or school, but will not have energy to do much else\nmoderate\n– you may have difficulty moving around easily and problems carrying out daily activities; you may not be able to work or continue with your education and may need to rest often; you may also have problems sleeping at night\nsevere\n– you may not be able to do any activity, or only be able to do very basic daily tasks, such as brushing your teeth; you may be housebound or even bedbound and need a wheelchair to get around; you may also have difficulty concentrating, be sensitive to noise and light, and take a long time to recover after activities involving extra effort, such as leaving the house or talking for long periods\nvery severe\n– you may have to spend all your time in bed resting and be fully dependent on carers; you may need help eating, washing and going to the toilet; you may be extremely sensitive to light and noise; you may be unable to swallow and need to be fed using a tube\nThere may be times when your symptoms get worse. These periods are known as relapses.\nME\/CFS and work\nIf you have to take time off work, you may feel able to return to work in the future. But a sudden return to full time work may not be possible.\nBy law, your employer must make reasonable adjustments to help you do your job.\nThe ME Association has A Guide to Employment Issues\nthat you may find useful.\nWhat else could it be?\nThe symptoms of ME\/CFS are similar to those of other conditions.\nIf you think you may have ME\/CFS it's important to see a GP to make sure you get a correct diagnosis. A GP should also be able to refer you to a ME\/CFS specialist if they think it would help you.\nPage last reviewed: 28 May 2024\nNext review due: 28 May 2027","attrs_markdown":"\n\n[Skip to main content](https:\/\/www.nhs.uk\/conditions\/chronic-fatigue-syndrome-cfs\/symptoms\/#maincontent)\n\n- [Health A to Z](https:\/\/www.nhs.uk\/health-a-to-z\/)\n- [NHS services](https:\/\/www.nhs.uk\/nhs-services\/)\n- [Healthy living](https:\/\/www.nhs.uk\/live-well\/)\n- [Mental health](https:\/\/www.nhs.uk\/mental-health\/)\n- [Care and support](https:\/\/www.nhs.uk\/social-care-and-support\/)\n- [Home](https:\/\/www.nhs.uk\/)\n- Browse More\n\n1. [Home](https:\/\/www.nhs.uk\/)\n2. [Health A to Z](https:\/\/www.nhs.uk\/health-a-to-z\/)\n3. [Conditions A to Z](https:\/\/www.nhs.uk\/conditions\/)\n4. [Myalgic encephalomyelitis or chronic fatigue syndrome (ME\/CFS)](https:\/\/www.nhs.uk\/conditions\/chronic-fatigue-syndrome-cfs\/)\n\n[Back to Myalgic encephalomyelitis or chronic fatigue syndrome (ME\/CFS)](https:\/\/www.nhs.uk\/conditions\/chronic-fatigue-syndrome-cfs\/)\n\n# Symptoms   -  Myalgic encephalomyelitis or chronic fatigue syndrome (ME\/CFS)\n## Contents\n1. [Overview](https:\/\/www.nhs.uk\/conditions\/chronic-fatigue-syndrome-cfs\/)\n2. Symptoms\n3. [Diagnosis](https:\/\/www.nhs.uk\/conditions\/chronic-fatigue-syndrome-cfs\/diagnosis\/)\n4. [Treatment](https:\/\/www.nhs.uk\/conditions\/chronic-fatigue-syndrome-cfs\/treatment\/)\n\n**There are 4 main symptoms of myalgic encephalomyelitis or chronic fatigue syndrome (ME\/CFS).**\n\n## Extreme tiredness (fatigue)\nThe extreme tiredness (fatigue) associated with ME\/CFS does not go away with rest or sleep. This can make it difficult to carry out everyday tasks and activities.\n\nMost people with ME\/CFS describe their fatigue as overwhelming and a different type of tiredness from what they've experienced before.\n\n## Problems sleeping\nMany people with ME\/CFS also have serious problems with their sleep that do not get better.\n\nYou may find that:\n\n- you do not feel refreshed after sleeping – like you have not had a proper good night's rest\n- you keep waking up during sleep\n- you feel stiff, tired or have flu-like symptoms when waking up\n- you feel very tired and sleepy during the day\n\n## Problems with thinking, memory and concentration\nIf you have ME\/CFS, it's also common to:\n\n- have problems remembering certain words, names or numbers\n- have difficulty concentrating or difficulty focusing on more than one thing at a time\n- have problems remembering things that happened recently\n- be slow to speak or react to things\n\nThese problems are sometimes described \"brain fog\".\n\n## Post-exertional malaise (PEM)\nSymptoms of ME\/CFS can get worse after activity (called post-exertional malaise, or PEM).\n\nPEM can be triggered by physical or mental activity, such as socialising or studying\n\nPEM can happen hours or days after the triggering activity, and it can take weeks to recover.\n\n## Other symptoms\nOther symptoms of ME\/CFS can include:\n\n- muscle or joint pain\n- [headaches](https:\/\/www.nhs.uk\/symptoms\/headaches\/)\n- a [sore throat](https:\/\/www.nhs.uk\/symptoms\/sore-throat\/) or sore glands that are not swollen\n- [flu-like symptoms](https:\/\/www.nhs.uk\/conditions\/flu\/)\n- feeling dizzy or sick\n- fast or irregular heartbeats ([heart palpitations](https:\/\/www.nhs.uk\/symptoms\/heart-palpitations\/))\n- muscle twitches or spasms\n- intolerance to alcohol or certain foods or chemicals\n- being very sensitive to light, sound, touch, taste and smell\n- having hot flushes or cold chills if the temperature changes\n- feeling dizzy, sick or fainting when standing up from a sitting or lying position\n\n## Severity of symptoms\nMost cases of ME\/CFS are mild or moderate, but 1 in 4 people have severe symptoms.\n\nIf your symptoms are severe, a specialist should be involved in your treatment.\n\nME\/CFS symptoms can be considered:\n\n- **mild** – you’re able to care for yourself but may have problems moving around; you may be able to go to work or school, but will not have energy to do much else\n- **moderate** – you may have difficulty moving around easily and problems carrying out daily activities; you may not be able to work or continue with your education and may need to rest often; you may also have problems sleeping at night\n- **severe** – you may not be able to do any activity, or only be able to do very basic daily tasks, such as brushing your teeth; you may be housebound or even bedbound and need a wheelchair to get around; you may also have difficulty concentrating, be sensitive to noise and light, and take a long time to recover after activities involving extra effort, such as leaving the house or talking for long periods\n- **very severe** – you may have to spend all your time in bed resting and be fully dependent on carers; you may need help eating, washing and going to the toilet; you may be extremely sensitive to light and noise; you may be unable to swallow and need to be fed using a tube\n\nThere may be times when your symptoms get worse. These periods are known as relapses.\n\n### ME\/CFS and work\nIf you have to take time off work, you may feel able to return to work in the future. But a sudden return to full time work may not be possible.\n\nBy law, your employer must make reasonable adjustments to help you do your job.\n\n[The ME Association has A Guide to Employment Issues](https:\/\/meassociation.org.uk\/2022\/10\/comprehensive-guide-on-employment-issues-and-me-cfs\/) that you may find useful.\n\n## What else could it be?\nThe symptoms of ME\/CFS are similar to those of other conditions.\n\nIf you think you may have ME\/CFS it's important to see a GP to make sure you get a correct diagnosis. A GP should also be able to refer you to a ME\/CFS specialist if they think it would help you.\n\nPage last reviewed: 28 May 2024  \n Next review due: 28 May 2027\n\n- [Previous : Myalgic encephalomyelitis or chronic fatigue syndrome (ME\/CFS)](https:\/\/www.nhs.uk\/conditions\/chronic-fatigue-syndrome-cfs\/)\n- [Next : Diagnosis](https:\/\/www.nhs.uk\/conditions\/chronic-fatigue-syndrome-cfs\/diagnosis\/)\n\n## Support links\n- [Home](https:\/\/www.nhs.uk\/)\n- [Health A to Z](https:\/\/www.nhs.uk\/health-a-to-z\/)\n- [NHS services](https:\/\/www.nhs.uk\/nhs-services\/)\n- [Healthy living](https:\/\/www.nhs.uk\/live-well\/)\n- [Mental health](https:\/\/www.nhs.uk\/mental-health\/)\n- [Care and support](https:\/\/www.nhs.uk\/social-care-and-support\/)\n- [COVID-19](https:\/\/www.nhs.uk\/conditions\/covid-19\/)\n\n- [NHS App](https:\/\/www.nhs.uk\/nhs-app\/)\n- [Find my NHS number](https:\/\/www.nhs.uk\/nhs-services\/online-services\/find-nhs-number\/)\n- [View your GP health record](https:\/\/www.nhs.uk\/nhs-services\/gps\/view-your-gp-health-record\/)\n- [View your test results](https:\/\/www.nhs.uk\/nhs-services\/online-services\/view-your-test-results\/)\n- [About the NHS](https:\/\/www.nhs.uk\/using-the-nhs\/about-the-nhs\/)\n- [Healthcare abroad](https:\/\/www.nhs.uk\/using-the-nhs\/healthcare-abroad\/)\n\n- [Other NHS websites](https:\/\/www.nhs.uk\/nhs-sites\/)\n- [Profile editor login](https:\/\/www.nhs.uk\/our-policies\/profile-editor-login\/)\n\n- [About us](https:\/\/www.nhs.uk\/about-us\/)\n- [Report an issue with the NHS website](https:\/\/www.nhs.uk\/report-an-issue-with-the-nhs-website)\n- [Accessibility statement](https:\/\/www.nhs.uk\/accessibility-statement\/)\n- [Our policies](https:\/\/www.nhs.uk\/our-policies\/)\n- [Cookies](https:\/\/www.nhs.uk\/our-policies\/choose-your-cookie-settings\/)\n\n© Crown copyright","attrs_readable_markdown":"**There are 4 main symptoms of myalgic encephalomyelitis or chronic fatigue syndrome (ME\/CFS).**\n\n## Extreme tiredness (fatigue)\nThe extreme tiredness (fatigue) associated with ME\/CFS does not go away with rest or sleep. This can make it difficult to carry out everyday tasks and activities.\n\nMost people with ME\/CFS describe their fatigue as overwhelming and a different type of tiredness from what they've experienced before.\n\n## Problems sleeping\nMany people with ME\/CFS also have serious problems with their sleep that do not get better.\n\nYou may find that:\n\n- you do not feel refreshed after sleeping – like you have not had a proper good night's rest\n- you keep waking up during sleep\n- you feel stiff, tired or have flu-like symptoms when waking up\n- you feel very tired and sleepy during the day\n\n## Problems with thinking, memory and concentration\nIf you have ME\/CFS, it's also common to:\n\n- have problems remembering certain words, names or numbers\n- have difficulty concentrating or difficulty focusing on more than one thing at a time\n- have problems remembering things that happened recently\n- be slow to speak or react to things\n\nThese problems are sometimes described \"brain fog\".\n\n## Post-exertional malaise (PEM)\nSymptoms of ME\/CFS can get worse after activity (called post-exertional malaise, or PEM).\n\nPEM can be triggered by physical or mental activity, such as socialising or studying\n\nPEM can happen hours or days after the triggering activity, and it can take weeks to recover.\n\n## Other symptoms\nOther symptoms of ME\/CFS can include:\n\n- muscle or joint pain\n- [headaches](https:\/\/www.nhs.uk\/symptoms\/headaches\/)\n- a [sore throat](https:\/\/www.nhs.uk\/symptoms\/sore-throat\/) or sore glands that are not swollen\n- [flu-like symptoms](https:\/\/www.nhs.uk\/conditions\/flu\/)\n- feeling dizzy or sick\n- fast or irregular heartbeats ([heart palpitations](https:\/\/www.nhs.uk\/symptoms\/heart-palpitations\/))\n- muscle twitches or spasms\n- intolerance to alcohol or certain foods or chemicals\n- being very sensitive to light, sound, touch, taste and smell\n- having hot flushes or cold chills if the temperature changes\n- feeling dizzy, sick or fainting when standing up from a sitting or lying position\n\n## Severity of symptoms\nMost cases of ME\/CFS are mild or moderate, but 1 in 4 people have severe symptoms.\n\nIf your symptoms are severe, a specialist should be involved in your treatment.\n\nME\/CFS symptoms can be considered:\n\n- **mild** – you’re able to care for yourself but may have problems moving around; you may be able to go to work or school, but will not have energy to do much else\n- **moderate** – you may have difficulty moving around easily and problems carrying out daily activities; you may not be able to work or continue with your education and may need to rest often; you may also have problems sleeping at night\n- **severe** – you may not be able to do any activity, or only be able to do very basic daily tasks, such as brushing your teeth; you may be housebound or even bedbound and need a wheelchair to get around; you may also have difficulty concentrating, be sensitive to noise and light, and take a long time to recover after activities involving extra effort, such as leaving the house or talking for long periods\n- **very severe** – you may have to spend all your time in bed resting and be fully dependent on carers; you may need help eating, washing and going to the toilet; you may be extremely sensitive to light and noise; you may be unable to swallow and need to be fed using a tube\n\nThere may be times when your symptoms get worse. These periods are known as relapses.\n\n### ME\/CFS and work\nIf you have to take time off work, you may feel able to return to work in the future. But a sudden return to full time work may not be possible.\n\nBy law, your employer must make reasonable adjustments to help you do your job.\n\n[The ME Association has A Guide to Employment Issues](https:\/\/meassociation.org.uk\/2022\/10\/comprehensive-guide-on-employment-issues-and-me-cfs\/) that you may find useful.\n\n## What else could it be?\nThe symptoms of ME\/CFS are similar to those of other conditions.\n\nIf you think you may have ME\/CFS it's important to see a GP to make sure you get a correct diagnosis. A GP should also be able to refer you to a ME\/CFS specialist if they think it would help you.\n\nPage last reviewed: 28 May 2024  \n Next review due: 28 May 2027","meta_canonical":null}

3. Robots.txt Check

Query:

Response:

4. Spam/Ban Check

Query:

Response:

5. Seen Status Check

ℹ️ Skipped - page is already crawled

📄

INDEXABLE

✅

CRAWLED

4 days ago

🤖

ROBOTS ALLOWED

Page Info Filters

Filter	Status	Condition	Details
HTTP status	PASS	`download_http_code = 200`	HTTP 200
Age cutoff	PASS	`download_stamp > now() - 6 MONTH`	0.1 months ago
History drop	PASS	`isNull(history_drop_reason)`	No drop reason
Spam/ban	PASS	`fh_dont_index != 1 AND ml_spam_score = 0`	ml_spam_score=0
Canonical	PASS	`meta_canonical IS NULL OR = '' OR = src_unparsed`	Not set

Page Details

Property	Value
URL	https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/symptoms/
Last Crawled	2026-04-16 04:46:03 (4 days ago)
First Indexed	2017-11-10 15:40:05 (8 years ago)
HTTP Status Code	200
Meta Title	Myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS) - Symptoms - NHS
Meta Description	Read about the symptoms of myalgic encephalomyelitis (chronic fatigue syndrome or ME/CFS). The main symptom is extreme tiredness, which can severely affect your ability to carry out everyday activities.
Meta Canonical	null
Boilerpipe Text	There are 4 main symptoms of myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS). Extreme tiredness (fatigue) The extreme tiredness (fatigue) associated with ME/CFS does not go away with rest or sleep. This can make it difficult to carry out everyday tasks and activities. Most people with ME/CFS describe their fatigue as overwhelming and a different type of tiredness from what they've experienced before. Problems sleeping Many people with ME/CFS also have serious problems with their sleep that do not get better. You may find that: you do not feel refreshed after sleeping – like you have not had a proper good night's rest you keep waking up during sleep you feel stiff, tired or have flu-like symptoms when waking up you feel very tired and sleepy during the day Problems with thinking, memory and concentration If you have ME/CFS, it's also common to: have problems remembering certain words, names or numbers have difficulty concentrating or difficulty focusing on more than one thing at a time have problems remembering things that happened recently be slow to speak or react to things These problems are sometimes described "brain fog". Post-exertional malaise (PEM) Symptoms of ME/CFS can get worse after activity (called post-exertional malaise, or PEM). PEM can be triggered by physical or mental activity, such as socialising or studying PEM can happen hours or days after the triggering activity, and it can take weeks to recover. Other symptoms Other symptoms of ME/CFS can include: muscle or joint pain headaches a sore throat or sore glands that are not swollen flu-like symptoms feeling dizzy or sick fast or irregular heartbeats ( heart palpitations ) muscle twitches or spasms intolerance to alcohol or certain foods or chemicals being very sensitive to light, sound, touch, taste and smell having hot flushes or cold chills if the temperature changes feeling dizzy, sick or fainting when standing up from a sitting or lying position Severity of symptoms Most cases of ME/CFS are mild or moderate, but 1 in 4 people have severe symptoms. If your symptoms are severe, a specialist should be involved in your treatment. ME/CFS symptoms can be considered: mild – you’re able to care for yourself but may have problems moving around; you may be able to go to work or school, but will not have energy to do much else moderate – you may have difficulty moving around easily and problems carrying out daily activities; you may not be able to work or continue with your education and may need to rest often; you may also have problems sleeping at night severe – you may not be able to do any activity, or only be able to do very basic daily tasks, such as brushing your teeth; you may be housebound or even bedbound and need a wheelchair to get around; you may also have difficulty concentrating, be sensitive to noise and light, and take a long time to recover after activities involving extra effort, such as leaving the house or talking for long periods very severe – you may have to spend all your time in bed resting and be fully dependent on carers; you may need help eating, washing and going to the toilet; you may be extremely sensitive to light and noise; you may be unable to swallow and need to be fed using a tube There may be times when your symptoms get worse. These periods are known as relapses. ME/CFS and work If you have to take time off work, you may feel able to return to work in the future. But a sudden return to full time work may not be possible. By law, your employer must make reasonable adjustments to help you do your job. The ME Association has A Guide to Employment Issues that you may find useful. What else could it be? The symptoms of ME/CFS are similar to those of other conditions. If you think you may have ME/CFS it's important to see a GP to make sure you get a correct diagnosis. A GP should also be able to refer you to a ME/CFS specialist if they think it would help you. Page last reviewed: 28 May 2024 Next review due: 28 May 2027
Markdown	[Skip to main content](https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/symptoms/#maincontent) - [Health A to Z](https://www.nhs.uk/health-a-to-z/) - [NHS services](https://www.nhs.uk/nhs-services/) - [Healthy living](https://www.nhs.uk/live-well/) - [Mental health](https://www.nhs.uk/mental-health/) - [Care and support](https://www.nhs.uk/social-care-and-support/) - [Home](https://www.nhs.uk/) - Browse More 1. [Home](https://www.nhs.uk/) 2. [Health A to Z](https://www.nhs.uk/health-a-to-z/) 3. [Conditions A to Z](https://www.nhs.uk/conditions/) 4. [Myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS)](https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/) [Back to Myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS)](https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/) # Symptoms - Myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS) ## Contents 1. [Overview](https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/) 2. Symptoms 3. [Diagnosis](https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/diagnosis/) 4. [Treatment](https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/treatment/) There are 4 main symptoms of myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS). ## Extreme tiredness (fatigue) The extreme tiredness (fatigue) associated with ME/CFS does not go away with rest or sleep. This can make it difficult to carry out everyday tasks and activities. Most people with ME/CFS describe their fatigue as overwhelming and a different type of tiredness from what they've experienced before. ## Problems sleeping Many people with ME/CFS also have serious problems with their sleep that do not get better. You may find that: - you do not feel refreshed after sleeping – like you have not had a proper good night's rest - you keep waking up during sleep - you feel stiff, tired or have flu-like symptoms when waking up - you feel very tired and sleepy during the day ## Problems with thinking, memory and concentration If you have ME/CFS, it's also common to: - have problems remembering certain words, names or numbers - have difficulty concentrating or difficulty focusing on more than one thing at a time - have problems remembering things that happened recently - be slow to speak or react to things These problems are sometimes described "brain fog". ## Post-exertional malaise (PEM) Symptoms of ME/CFS can get worse after activity (called post-exertional malaise, or PEM). PEM can be triggered by physical or mental activity, such as socialising or studying PEM can happen hours or days after the triggering activity, and it can take weeks to recover. ## Other symptoms Other symptoms of ME/CFS can include: - muscle or joint pain - [headaches](https://www.nhs.uk/symptoms/headaches/) - a [sore throat](https://www.nhs.uk/symptoms/sore-throat/) or sore glands that are not swollen - [flu-like symptoms](https://www.nhs.uk/conditions/flu/) - feeling dizzy or sick - fast or irregular heartbeats ([heart palpitations](https://www.nhs.uk/symptoms/heart-palpitations/)) - muscle twitches or spasms - intolerance to alcohol or certain foods or chemicals - being very sensitive to light, sound, touch, taste and smell - having hot flushes or cold chills if the temperature changes - feeling dizzy, sick or fainting when standing up from a sitting or lying position ## Severity of symptoms Most cases of ME/CFS are mild or moderate, but 1 in 4 people have severe symptoms. If your symptoms are severe, a specialist should be involved in your treatment. ME/CFS symptoms can be considered: - mild – you’re able to care for yourself but may have problems moving around; you may be able to go to work or school, but will not have energy to do much else - moderate – you may have difficulty moving around easily and problems carrying out daily activities; you may not be able to work or continue with your education and may need to rest often; you may also have problems sleeping at night - severe – you may not be able to do any activity, or only be able to do very basic daily tasks, such as brushing your teeth; you may be housebound or even bedbound and need a wheelchair to get around; you may also have difficulty concentrating, be sensitive to noise and light, and take a long time to recover after activities involving extra effort, such as leaving the house or talking for long periods - very severe – you may have to spend all your time in bed resting and be fully dependent on carers; you may need help eating, washing and going to the toilet; you may be extremely sensitive to light and noise; you may be unable to swallow and need to be fed using a tube There may be times when your symptoms get worse. These periods are known as relapses. ### ME/CFS and work If you have to take time off work, you may feel able to return to work in the future. But a sudden return to full time work may not be possible. By law, your employer must make reasonable adjustments to help you do your job. [The ME Association has A Guide to Employment Issues](https://meassociation.org.uk/2022/10/comprehensive-guide-on-employment-issues-and-me-cfs/) that you may find useful. ## What else could it be? The symptoms of ME/CFS are similar to those of other conditions. If you think you may have ME/CFS it's important to see a GP to make sure you get a correct diagnosis. A GP should also be able to refer you to a ME/CFS specialist if they think it would help you. Page last reviewed: 28 May 2024 Next review due: 28 May 2027 - [Previous : Myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS)](https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/) - [Next : Diagnosis](https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/diagnosis/) ## Support links - [Home](https://www.nhs.uk/) - [Health A to Z](https://www.nhs.uk/health-a-to-z/) - [NHS services](https://www.nhs.uk/nhs-services/) - [Healthy living](https://www.nhs.uk/live-well/) - [Mental health](https://www.nhs.uk/mental-health/) - [Care and support](https://www.nhs.uk/social-care-and-support/) - [COVID-19](https://www.nhs.uk/conditions/covid-19/) - [NHS App](https://www.nhs.uk/nhs-app/) - [Find my NHS number](https://www.nhs.uk/nhs-services/online-services/find-nhs-number/) - [View your GP health record](https://www.nhs.uk/nhs-services/gps/view-your-gp-health-record/) - [View your test results](https://www.nhs.uk/nhs-services/online-services/view-your-test-results/) - [About the NHS](https://www.nhs.uk/using-the-nhs/about-the-nhs/) - [Healthcare abroad](https://www.nhs.uk/using-the-nhs/healthcare-abroad/) - [Other NHS websites](https://www.nhs.uk/nhs-sites/) - [Profile editor login](https://www.nhs.uk/our-policies/profile-editor-login/) - [About us](https://www.nhs.uk/about-us/) - [Report an issue with the NHS website](https://www.nhs.uk/report-an-issue-with-the-nhs-website) - [Accessibility statement](https://www.nhs.uk/accessibility-statement/) - [Our policies](https://www.nhs.uk/our-policies/) - [Cookies](https://www.nhs.uk/our-policies/choose-your-cookie-settings/) © Crown copyright
Readable Markdown	There are 4 main symptoms of myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS). ## Extreme tiredness (fatigue) The extreme tiredness (fatigue) associated with ME/CFS does not go away with rest or sleep. This can make it difficult to carry out everyday tasks and activities. Most people with ME/CFS describe their fatigue as overwhelming and a different type of tiredness from what they've experienced before. ## Problems sleeping Many people with ME/CFS also have serious problems with their sleep that do not get better. You may find that: - you do not feel refreshed after sleeping – like you have not had a proper good night's rest - you keep waking up during sleep - you feel stiff, tired or have flu-like symptoms when waking up - you feel very tired and sleepy during the day ## Problems with thinking, memory and concentration If you have ME/CFS, it's also common to: - have problems remembering certain words, names or numbers - have difficulty concentrating or difficulty focusing on more than one thing at a time - have problems remembering things that happened recently - be slow to speak or react to things These problems are sometimes described "brain fog". ## Post-exertional malaise (PEM) Symptoms of ME/CFS can get worse after activity (called post-exertional malaise, or PEM). PEM can be triggered by physical or mental activity, such as socialising or studying PEM can happen hours or days after the triggering activity, and it can take weeks to recover. ## Other symptoms Other symptoms of ME/CFS can include: - muscle or joint pain - [headaches](https://www.nhs.uk/symptoms/headaches/) - a [sore throat](https://www.nhs.uk/symptoms/sore-throat/) or sore glands that are not swollen - [flu-like symptoms](https://www.nhs.uk/conditions/flu/) - feeling dizzy or sick - fast or irregular heartbeats ([heart palpitations](https://www.nhs.uk/symptoms/heart-palpitations/)) - muscle twitches or spasms - intolerance to alcohol or certain foods or chemicals - being very sensitive to light, sound, touch, taste and smell - having hot flushes or cold chills if the temperature changes - feeling dizzy, sick or fainting when standing up from a sitting or lying position ## Severity of symptoms Most cases of ME/CFS are mild or moderate, but 1 in 4 people have severe symptoms. If your symptoms are severe, a specialist should be involved in your treatment. ME/CFS symptoms can be considered: - mild – you’re able to care for yourself but may have problems moving around; you may be able to go to work or school, but will not have energy to do much else - moderate – you may have difficulty moving around easily and problems carrying out daily activities; you may not be able to work or continue with your education and may need to rest often; you may also have problems sleeping at night - severe – you may not be able to do any activity, or only be able to do very basic daily tasks, such as brushing your teeth; you may be housebound or even bedbound and need a wheelchair to get around; you may also have difficulty concentrating, be sensitive to noise and light, and take a long time to recover after activities involving extra effort, such as leaving the house or talking for long periods - very severe – you may have to spend all your time in bed resting and be fully dependent on carers; you may need help eating, washing and going to the toilet; you may be extremely sensitive to light and noise; you may be unable to swallow and need to be fed using a tube There may be times when your symptoms get worse. These periods are known as relapses. ### ME/CFS and work If you have to take time off work, you may feel able to return to work in the future. But a sudden return to full time work may not be possible. By law, your employer must make reasonable adjustments to help you do your job. [The ME Association has A Guide to Employment Issues](https://meassociation.org.uk/2022/10/comprehensive-guide-on-employment-issues-and-me-cfs/) that you may find useful. ## What else could it be? The symptoms of ME/CFS are similar to those of other conditions. If you think you may have ME/CFS it's important to see a GP to make sure you get a correct diagnosis. A GP should also be able to refer you to a ME/CFS specialist if they think it would help you. Page last reviewed: 28 May 2024 Next review due: 28 May 2027
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