Gramont, B, Goutte, J, Féasson, L et al. · La Revue de medecine interne · 2023 · DOI
When people feel tired all the time, doctors need to figure out why. This article explains how doctors should approach chronic fatigue: by asking careful questions, doing a physical exam, and using only necessary blood tests. It emphasizes that chronic fatigue often has multiple causes—physical, emotional, and life circumstances—working together, and that exercise testing and personalized activity programs are the most helpful treatments.
This editorial provides a framework for clinicians evaluating ME/CFS patients, emphasizing that fatigue is multifactorial and requires systematic but judicious investigation. For patients, it highlights that current medical understanding does not support a single biomarker-based diagnosis, and supports exercise-based rehabilitation as evidence-based management.
This editorial does not present new research data or clinical trial results, so it cannot prove efficacy of specific treatments. It does not establish whether exercise testing or APA are superior to other approaches through experimental comparison, and its statements about the lack of CFS biomarkers reflect the state of knowledge at publication but do not prove biomarkers cannot exist.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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