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Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME / CFS) Post Treatment Lyme Disease Syndrome (PTLDS), Fibromyalgia Leading Research. Delivering Hope.Open Medicine Foundation® Canada
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Diagnosis of ME/CFS

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is diagnosed after ruling out all other diseases that may explain the symptoms presented. The diagnosis relies upon a set of symptoms presented according to the type of criteria used. There are many different criteria and we have tried to simplify the most commonly used in Table 1. 

Table 1 Summary of the 5 major diagnostic criteria from 1988.

Chart with a summary of the 5 major diagnostic criteria from 1988.
Centers for Disease Control and Prevention (CDC)

Holmes 1988

This was the first definition put together by the CDC and the first to coin the term “chronic fatigue syndrome” (CFS). The definition required persistent fatigue along with 8 of 11 specific symptoms under the categories of short-term memory issues, pain, sleep disturbance, post-exertional malaise and flu-like symptoms. This diagnosis was very specific and hard to utilize in a clinical setting for diagnosis.
Holmes CDC 1988
Centers for Disease Control and Prevention (CDC)

Fukuda 1994

This definition is a revision of the Holmes definition except it requires half the number of symptoms to make a diagnosis. This diagnosis was much easier for clinicians and significantly increased the incidence of CFS numbers globally. It has been criticized for being too easy to misdiagnose.
Fukuda CDC 1994

Canadian Consensus Criteria (CCC) 2003

From a look at Table 1 you can see a significant change in the definitions from Holmes and Fukuda to the CCC 2003. This was the first definition to incorporate CFS with the Myalgic Encephalomyelitis (ME) definition by Dr Ramsay several decades earlier. This definition requires post-exertional malaise (PEM), fatigue, pain, sleep disturbance, a couple neurocognitive issues and symptoms from the immune, endocrine and autonomic systems. This diagnosis emphasized the multi-system component of the illness and attempted to homogenize the cohort diagnosed by requiring several specific symptoms. One of those specific symptoms, PEM, is clearly the most distinguishing feature of ME/CFS.
Canadian Consensus Criteria 2003

International Consensus Criteria (ICC) 2011

The CCC was further developed in 2011 to form the International Consensus Criteria (ICC). This was the first modern definition to not include fatigue as a required symptom and to not require 6 months of symptoms persisting to be diagnosed. PEM is the only required symptom. As compared to the CCC definition, the ICC definition puts a greater emphasis on the multi-system component of the illness, requiring more symptoms from the immune and endocrine systems. Removing fatigue as a necessary symptom and the minimum of 6 months for diagnosis enables the differentiation of ME from CFS for considerations in research and treatment.
International Consensus Criteria 2011

The improvement of research and SEID

The definition was further refined by the Institute of Medicine in 2015 to create a diagnosis that incorporated the most up-to-date research while providing a simple diagnosis in the clinical setting. The definition was a departure from all previous definitions and was therefore given a new name, Systemic Exertion Intolerance Disease (SEID). This definition is most similar to CCC in that it requires fatigue, PEM and sleep disturbance. Unlike CCC this definition only required cognitive problems or orthostatic intolerance, instead of having a broad range of symptoms to signify the multi-system component of the illness. Simplifying the diagnosis like this is beneficial to research for building cohorts around specific symptoms that are common throughout.
Institute of Medicine 2015
Button, symptoms of ME/CFS
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Disclaimer: This website is for informational purposes only. The information provided on this website is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

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Microvesicles and viral sequencing
Microvesicles are a type of extracellular vesicle that is released from the cell membrane. Vesicles are small, fluid-filled sacs or vacuoles within the body. Sequencing is a technique used to determine the exact sequence of bases (A, C, G, and T) in a DNA (or viral) molecule.
NMR Metabolomics
NMR (Nuclear Magnetic Resonance) is an instrument/tool used to perform metabolic studies, metabolic profiling, and metabolomics in biofluids and tissues for more than 40 years using magnetic fields. There is a very close connection between metabolic measurements and NMR. This connection has flourished because of NMR’s many unique strengths for characterizing complex mixtures’ chemical composition.
Proteomics
The large-scale study of proteins, which are large, complex molecules that are required for structure, function, and regulation of the human body's tissues and organs.
Autoantibodies
Antibodies that react with self-molecules and that occur in healthy individuals and are referred to as natural antibodies or autoantibodies.
Extracellular DNA for viral reactivation and Mitochondrial DNA
exDNA (extracellular DNA), exDNA is often secreted actively and is used to perform several tasks, thereby offering an attractive target or tool for biotechnological, medical, environmental, and general microbiological applications. Viruses are intracellular parasites that rely to a significant extent on the host cell for replication. Viral reactivation occurs when an active replication of the viral genome results in a lytic (degradation of the cell) infection characterized by the release of new progeny (descendant) virus particles.
Immune cell profiling
The immune system has many important regulatory roles in disease development and progression. Given the emergence of effective immune therapies, reliable predictors of response are needed. Immune cell profiling determines response by evaluating immune cell populations from treated and untreated samples. For our purposes, we will evaluate the white blood cell response to the viral infection using a process called “Cytof.”
Leukocyte Genomics
A leukocyte is a colorless cell circulating in the blood and body fluids and is involved in counteracting foreign substances and disease. A genome is all genetic material of an organism. Genomics is a biology field focusing on the structure, function, evolution, mapping, and editing of genomes. Therefore, leukocyte genomics is the study of all genetic material of leukocytes.
Metabolomics
Metabolomics is a way to study metabolism – that is, through measuring amounts of the metabolites (small molecules) produced by our bodies as we convert food into energy and other molecules that our cells need to survive. Metabolomics technology is ‘large-scale,’ meaning that several thousand metabolites can be measured from a single sample of e.g., blood or urine.
Micro RNA
Cells use Micro RNA to control whether a particular gene is making too much, too little or the normal amount of its protein at a particular time.