ME/CFS or Long Covid can affect people in different ways. Symptoms, severity and day-to-day functioning can fluctuate over time, and no two experiences are exactly the same.
Keeping track of symptoms and activity levels can help you better understand your condition and identify patterns that may affect your wellbeing.
Four Key Symptoms
According to the NICE guideline for ME/CFS, four core symptoms are central to the condition:
- Post-Exertional Malaise (PEM) – a worsening of symptoms following physical, mental, emotional or social activity.
- Debilitating fatigue – fatigue that is worsened by activity and is not significantly relieved by rest.
- Sleep disturbance – unrefreshing sleep, broken sleep, altered sleep patterns or excessive sleeping.
- Cognitive difficulties (“brain fog”) – problems with concentration, memory, finding words, processing information or multitasking.
Other Common Symptoms
People may also experience:
Pain
- Muscle aches
- Joint pain
- Headaches or migraines
- Nerve pain or pins and needles
- Abdominal pain
- Chest or back pain
Dizziness and Sensitivity
- Dizziness when standing or sitting upright
- Poor temperature regulation
- Balance problems
- Increased sensitivity to light, noise, smells, foods or medications
Digestive Symptoms
- Nausea
- Loss of appetite
- Bloating
- Indigestion
- Diarrhoea or constipation
- Irritable Bowel Syndrome (IBS)
General Symptoms
- Flu-like feelings
- Sore throats
- Swollen glands
- Feeling generally unwell
Symptoms Can Fluctuate
Many people experience periods when symptoms improve and others when they worsen. Relapses or setbacks are common and can sometimes occur after exceeding energy limits.
Understanding your symptoms and learning effective self-management strategies can help reduce the impact of flare-ups and support day-to-day wellbeing.
Key Message
ME/CFS and Long Covid are much more than feeling tired. Symptoms can affect multiple body systems and have a significant impact on daily life. Recognising your personal symptom pattern is an important step towards managing your health and accessing appropriate support.
Find out more about the symptoms of ME/CFS:
Action for ME – Symptoms and Diagnosis Resources
Source: Information adapted from Action for ME symptom guidance and the NICE Guideline for ME/CFS (2021).