Practical Guidance

Practical Guidance

If you have M.E., the following might help you practically:


If anyone can recommend good GPs in the Maidstone area for M.E. sufferers, please let us know.  Also if anyone can recommend good doctors anywhere in the UK for M.E. sufferers, e.g. consultants (NHS or private) please contact us.

Try to get a supportive G.P. They are the gateway to much needed benefits. If you can’t get a supportive G.P., empower yourself with knowledge about M.E. If you’re too ill to do this, encourage your carer to do this for you. Do be aware that in your search for knowledge, you may find lies written about M.E./CFS, especially of the psychological/psychiatric kind.

Canadian Guidelines

There are 25 case definitions of ME/CFS. (See page What is M.E.? The criteria preferred by sufferers seems to be the Canadian Guidelines, proper title, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Clinical Case Definition and Guidelines for Medical Practitioners (authors, Carruthers and van de Sande), published 2005. These, along with the International Consensus Criteria, are probably the best medical guidelines for both doctor and patient.  They can be downloaded from this website under ‘Links‘; alternatively, you can buy a hard copy for under £2 from Invest in M.E. at, or phone 02380 251719.

Why not give a copy of either the Canadian Guidelines or International Guidelines to your G.P?

The New International Consensus Criteria for M.E.

More recent (2011) than the Canadian Guidelines, the International Consensus Criteria (Adult & Paediatric) separates M.E. as a distinct entity from CFS. It can be obtained from us, The Grace Charity for M.E.  Alternatively, it can be viewed and downloaded at Invest in M.E.

The IOM Criteria (Institute of Medicine) 2015 influenced the NICE Guidelines in 2021. But some problems with the IOM are that they believe a 6 month delay should occur for a diagnosis; also that cognitive difficulties are not a compulsory feature.

Hospital Booklet.

You might find a hospital booklet helpful, for M.E. sufferers, which can be downloaded from this website under ‘Documents’, or contact us for a hard copy at This booklet mentions drug and chemical advice etc., should you need to go to hospital, even as a day patient.


There are some treatments, mainly supplements, which might be worth trying.

  1. VegEPA: this can help M.E. symptoms generally. Available from
  2. Co-Enzyme Q10: can help both muscular and cognitive problems.
  3. Acetyl L-Carnitine: can also help muscular and cognitive problems.
  4. Enada: mainly helps energy levels.
  5. Vitamin B injections: can help energy levels and help with sensory overload and cognitive problems.
  6. Magnesium injections: can help with muscle strength and energy (too much can give diarrhoea).

Some GPs give the above on the NHS but you’ll most likely have to pay for them privately. You can get some supplements from health food shops. The following might also sell the above supplements:

If you think you have true neurological M.E., then it’s best to avoid the popular therapy of Graded Exercise (GET) as it could ultimately make your illness worse. Also, beware of another popular therapy, CBT (Cognitive Behavioural Therapy) which often involves Graded Exercise. GET is no longer recommended in the NICE Guidelines 2021 and CBT is no longer to be offered as a cure. For further scientific findings and patient surveys on these therapies, please see our paper Saying No Can Be Positive, under ‘Documents‘.

Never push yourself to the point of exhaustion, physically or mentally. A general guide is to do less than you are able to do, so that your body won’t ‘crash’ (relapse).

Doctors who might be helpful…

You should be able to get medicine on the NHS to help with pain and sleep control. Regarding other treatments, e.g. supplements and drugs recommended for M.E. in the Canadian Guidelines, it really depends on your GP if they prescribe them on the NHS. Their hands, though, are greatly tied by the NICE guidelines (National Institute for Health and Clinical Excellence) which currently doesn’t favour treatments outside those previously listed. However, a GP can prescribe a drug outside the NICE guidelines for any patient on an individual basis, if he/she feels it would be appropriate. The GP would have to record why they have taken this action.


SARAH MYHILL (private treatment)

Although Dr. Myhill prefers to use the term CFS, she has helped patients of genuine neurological M.E. She used to offer a test called the Mitochondrial Function Profile test for M.E. sufferers but now suggests this is done through  the Academy of Nutritional Medicine (AONM) who offer several different types of mitochondria testing. (The mitochondria is the energy producing part of the muscle.) More about these tests can found at


Their prices may be found here:  Mitochondria Order Form 2023

Dr. Myhill often suggests treatment with certain supplements. The tests she offers can be seen at Category:Tests – DoctorMyhill ( Some M.E. sufferers have had an Adrenal Stress Profile Test through the post (cost £100 plus postage).

Dr. Sarah Myhill
Upper Weston



Telephone: 01547 550331


PROF. BASANT PURI (private treatment)

N.B. As from Summer 2020 Prof. Puri is fully booked and not taking on more patients.

Prof. Puri sees M.E. patients privately. He can be contacted through Breakspear Medical. In the past, his treatment has involved Essential Fatty Acids for sufferers.  He has also conducted SPECT scans but is now cautious about them due to radiation.

Prof. Basant Puri
c/o Breakspear Medical
Hertfordshire House
Wood Lane
Hemel Hempstead
Hertfordshire, HP2 4FD

Telephone: +44 (0) 1442 261333


WILLIAM WEIR (private treatment)

Dr. Weir treats M.E. from a biomedical perspective.  His basic consultation is £250 which includes a letter type summary of his findings.  More extensive reports would be around £500.  Further tests can be arranged, should he feel they are necessary, either on the NHS or privately.

Dr. William Weir
10 Harley Street
W1G  9PF

Telephone:  020 7467 8478


 RAYMOND PERRIN (private treatment)

Dr. Perrin has developed a technique for M.E. sufferers call The Perrin Technique.  It is an osteopathic approach, which may include some massage, to help drain toxins from the body.  N.B.: Not all M.E. sufferers can tolerate massage.  Whilst it can alleviate pain in some sufferers, we’ve also had reports of massage worsening pain. A sufferer has reported that the technique can make a patient worse to begin with, before improvement.

Dr. Raymond Perrin
The Perrin Clinic
83 Whittaker Lane
M25 1ET

Telephone:  0161  773 0123

There are practices outside Manchester.  Currently, Dr. Perrin charges £200 for one and a half hour consultation in Manchester.  He sometimes comes to Hertfordshire, where he charges £250 for a one and a half hour consultation.  There is weekly treatment following the consultation, at approximately £40 per treatment.


 BYRON HYDE (private) Update 2023: Dr. Hyde is temporarily not working at the moment, but intends to restart in the near future. The website linked to his work has excellent information with some free downloads.


The telephone number of Dr. Hyde’s clinic is: 001 613 7298995
(Remember that Canada is several hours behind, if you phone from the UK.)

Dr. Byron Hyde
Nightingale Research Foundation
121 Iona Street
K1Y 3M1


N.B. (update as from 2014):  In the past, we have advertised Dr. Andrew Wright’s private clinic in Bolton, England.  Currently, Dr. Wright is no longer practising as an M.E. specialist due to legislation by the GMC (General Medical Council).  This is a tragedy, as Dr. Wright has helped many M.E. sufferers over the years, especially by using antibiotics for an infectious cause to their illness.  Some patients say he was the only doctor who helped them with M.E. and Lyme, improving their health.  The GMC charge against him appears to be trivial.  Dr. Wright is now practising as an NHS GP in the Bolton area.

Although the Grace Charity for M.E. intends to help sufferers, we can’t take responsibility for any ill-effects caused by the above list of practitioners, should you try them.  However, we do want to hear of both positive and negative experiences of the above and other practitioners.

Biomedical Research

Biomedical research is currently being done by the following organisations:

ME Research UK
The Gateway
North Methven Street

Telephone: 01738 451234

also, by the Nightingale Foundation in Canada (see above details).

Children and M.E.

Children with M.E. might find support from the Tymes Trust. This charity has been set up by former Head Teacher Jane Colby.

The Young ME Sufferers Trust
PO Box 4347

Telephone: 0845 003 9002

Severe M.E. sufferers

There is an excellent support group for severe M.E. sufferers from the 25% M.E. Group in Scotland (although members can be from all over the world).

Telephone: 01292 318611

Please see also Useful Links (under Useful Documents page) for other contacts.


Get people to pray for you and your carer. Peace of mind and hope are essential for you both as you battle your way through this illness together.



Currently, there is no specific test to diagnose M.E. but there are many tests which can contribute to making a positive M.E. diagnosis. Tragically, the latter are not generally available on the British NHS. In fact, the opinion from the NICE Guidelines is that M.E. is a diagnosis only after excluding other possible illnesses.

Most CFS/ME ‘clinics’ on the NHS will probably want the following tests done before attending their ‘clinics’:

Urinalysis for protein blood and glucose; full blood count; urea and electrolytes; liver function; erythrocyte sedimentation rate or plasma viscosity; C-reactive protein; random blood glucose; screening tests for gluten sensitivity; creatinine kinase; thyroid function; serum calcium; serum creatinine.

(Please note that the above NHS tests do not give a positive M.E. diagnosis but are used to exclude other illnesses. Although M.E. sufferers often have problems with blood sugar, thyroid etc., the above tests may not be of the correct type to perform for M.E. thyroid, blood sugar problems etc. ‘Standard tests’ are often returned with a ‘normal’ result for M.E., so keep this in mind if you feel discouraged. It may still be useful to have some of the above tests done though, if offered on the NHS.)

Although the above tests are often requested by a local CFS/ME ‘clinic’ to be done before attending there, please note that our charity does not generally recommend the current NHS ‘clinics’ for CFS/ME as they still tend to promote exercise and Cognitive Behavioural Therapy [which is often linked with increased exercise]. This approach usually worsens the symptoms of sufferers of true neurological M.E.


What tests can you try and get on the NHS?

  1. Virus test.
    As most (perhaps all) M.E. cases seem to be triggered by a virus, a viral test would be helpful to substantiate the onset of your illness. Again, this will depend on how willing your GP is. The main types of viruses which cause M.E. are enteroviruses (e.g. ECHO, Coxsackie). There is also an opinion that Herpesviruses  such as HHV6 (Human Herpes Virus 6) and other viruses can trigger M.E. as well.[1]Viruses can be difficult to show up in tests; for me personally, I had to have 8 months of regular blood tests on the NHS before an ECHO 2 virus was discovered. (I had a persistent GP, thankfully.)If a virus is not found, this doesn’t necessarily imply that the M.E. was not triggered by a virus. Did you have tender neck glands, sore throat etc. at the start of your illness? These could be symptoms of a virus.
  2. Blood test for Natural Killer Cells.
    M.E. sufferers tend to have a low number of natural killer cells. This blood test needs to be tested per cell for low NK cell cytotoxicity. [2]
  3. High Sensitivity CRP test.
    This is a blood test which can show up inflammation and infection. It’s recommended to have for M.E. patients by Professor Malcolm Hooper.
  4. IAG test.
    This is a urine test which determines a leaky gut.


Clinical signs to help diagnose M.E. on the NHS

  1. The Romberg Test:
    This tests for brain stem function.
  2. Tilt Table Test:
    This tests for circulating blood volume; it must be done professionally as a patient’s heart can stop. There is an alternative test called ‘a poor man’s tilt table test’ using blood pressure and pulse readings.

N.B.  Any test for an M.E. patient may cause a deterioration of their health, so must be done cautiously and professionally.


For more information on tests and clinical signs to help make a diagnosis of M.E., go to Jodi Bassett’s site at A Hummingbird’s Guide to M.E. Go to the home page and click on M.E. tests. Jodi describes both scientific tests and physical signs on examination to help make a diagnosis of M.E. Again, sadly, the majority of the scientific tests may have to be done privately and not on the NHS.


Private tests

Unfortunately, more M.E. sufferers are feeling that they have to go privately for tests to help confirm their diagnosis of M.E. This is unfair for sufferers, as many tests could be done on the NHS but sadly the trend is for this not to happen.

Please see our page ‘Practical Guidance’ for more information of private tests from doctors such as Dr. Sarah Myhill (U.K.) who offers the Mitochondrial Function Profile Test; also Dr. Byron Hyde (Canada) who offers brain scans.

There is a private clinic in Kent known as The Celestine Clinic which some M.E. sufferers have found helpful. It uses a method called B.E.S.T. testing. (Bio Energetic Stress Test) which is an electrical testing method; this can show up weaknesses in the body, apparently. (Before considering this test, ask yourself if you have an electrical sensitivity as the test may exacerbate your sensitivity.)

Although some sufferers have benefitted from the endocrinological (hormonal) advice given by this clinic, it is rather unsettling from an M.E. sufferer’s point of view that a large hypnotherapy sign greets all patients at the entrance!

The Celestine Clinic
ME20 6JA



Telephone: 01634 247500


There is also a private test via post, based in Belgium, the Th1/Th2 balance test (UBT), which is different to H2S urine test below. It detects cytokines linked with the immune system. It is available from Protea biopharma in Belgium. The following is an extract from their website:

‘The Urine Balance Test aims at detecting alterations of the Th1/Th2 balance. Modulation of the Th1/Th2 balance may affect the susceptibility to, or the outcome of infections, allergic diseases, auto-immunity, cancer and other deleterious conditions. The UBT test may detect disturbances of this delicate equilibrium in time in order to restore balance whenever required and before irreversible conditions are developing. The test allows patients to follow-up on Th1/Th2 balance during therapy and to evaluate whether the treatment he or she is undergoing is really effective. In addition the test also provides a tool to check the effectiveness of over the counter sold products claiming to balance Th1/Th2 status such as: anti-oxidants, probiotics and other. Thus far Th1/Th2 profiles can only be determined in specialized laboratories. ‘

The test can be performed at home with a kit priced at around 75 Euros.
To obtain the above home kit, order from Protea Biopharma


Diagnostic Tests

Diagnostic tests (proving that someone has an illness) for M.E. do not exist on the NHS. There are several potential diagnostic tests, world-wide, which have been funded privately.


1)    The ATP Profile test

This used to be offered by Dr. Sarah Myhill but can now be performed at the Academy of Nutritional Medicine

Mitochondria Order Form 2023  See form for the price list.

The ATP Profile test was published in a peer reviewed medical magazine, The International Journal of Clinical and Experimental Medicine (2009) 2, 1-16.

2)    The M.E./CFS H2S Urine Test

This has been worked on by Prof. Kenny De Meirleir’s from Brussels, Belgium. It detects amounts of hydrogen sulphide (H2S); an excessive amount may indicate a gut dysbiosis (i.e. wrong bugs in the gut). It appears that M.E./CFS sufferers tend to have a gut dysbiosis. It appears to be difficult to get this test nowadays, so if anyone knows, then please tell us.

Dr. Myhill’s office don’t offer the H2S  test routinely, but say that if someone was interested then they would look into it for them. Contact email:

This test may be preferable for an M.E. sufferer rather than a ‘breath test’ which can also be performed (sometimes on the NHS) to diagnose an overgrowth of bacteria in the small intestine. NHS breath tests for Small Intestine Bowel Overgrowth, can be quite demanding to endure.

My personal opinion (and that of others) is that although this might be a useful piece of information for a sufferer, I don’t believe it is a diagnostic test as such because M.E. is a complex illness. Also, the test may indicate another bowel problem which is present other than in M.E.


4)    Kerr’s work with gene expression

Dr. Jonathan Kerr, working from St. George’s University Hospital, London, discovered since 2005 that CFS patients have different gene expression patterns compared to other illnesses and controls. This important work was funded by the CFS Research Foundation, UK and Invest in M.E. There was promise that this work could be a diagnostic test for CFS. (Please note that this particular research was referred to only as CFS, rather than M.E. It is still important research, though. Sadly, Dr. Kerr passed away in 2023. Gene research into ME/CFS is still continuing via Home page – DecodeME )

5)    SPECT scans (Single Photon Emission Computed Tomography)

The abnormality of SPECT scans for an M.E. sufferer appears to be one of the most hopeful as a diagnostic test. Indeed, some doctors are confident enough that this is already the case and has been for a long time.

SPECT scans have been shown to demonstrate low blood flow to the brain in areas unique to M.E. (distinguishing M.E. from depression).

Dr. Byron Hyde from Canada is a keen user of SPECT scans to help diagnose patients with M.E.

The same results with SPECT scans in M.E. patients has been found by both De Costa (1995) and Schwartz (1994).

Studies have shown that 80% of M.E. patients have abnormal SPECT scans. (See book Care for Someone with Severe Myalgic Encephalomyelitis, page 136,by Greg Crowhurst ISBN 978-1-4710-9889-5 available from Lulu publishers.)

It is extremely unusual to get a SPECT scan for M.E. on the NHS, although not impossible. Please also remember that the person interpreting the scan may or may not be trained to interpret it for M.E.


Please let us know if you do get any of the above tests on the NHS or if you manage to get other tests done, and if they have or have not been helpful. Thank you.



Compiled by Catherine Ashenfelter

[1] A new and simple definition of Myalgic Encephalomyelitis and a new simple definition of Chronic Fatigue Syndrome 2006, by Dr. Byron Hyde pp.9,18. Dr. Hyde believes that M.E. is almost always caused by enteroviruses, whereas other doctors widen the cause to other viruses.

[2] Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Clinical Case Definition and Guidelines for Medical Practitioners (popularly known as the Canadian Guidelines), Bruce Carruthers and Marjorie van de Sande, Haworth Medical Press 2005, page 18

Disclaimer: Although our intentions are to help M.E. sufferers, the Grace Charity does not accept responsibility for any treatments, therapies, programmes, or practitioners that may appear on this website.