2026 Essentials in Family Medicine (ON-DEMAND)-Dr. Phillips Presentation Slides

Dr. Phillips Presentation Slides

Pdf Summary

The presentation reviews chronic fatigue syndrome/myalgic encephalomyelitis (ME/CFS), including cases associated with Long COVID. Diagnosis requires substantial impairment in work, education, social, or personal activities for at least six months, with symptoms occurring at least half the time. Core features are post-exertional malaise and unrefreshing sleep, plus cognitive impairment (“brain fog”) and/or orthostatic intolerance. Other causes of fatigue should be investigated before diagnosing ME/CFS.<br /><br />The recommended evaluation includes a careful symptom timeline, physical examination, and testing for possible causes such as sleep disorders, infection, anemia, thyroid or nutritional problems, heart or lung disease, medication effects, autoimmune illness, mood disorders, hormone changes, and neurological conditions. Suggested initial laboratory tests include blood counts, metabolic and thyroid tests, iron studies, inflammatory markers, selected infection tests, and vitamin levels.<br /><br />The talk describes possible contributors to Long COVID and ME/CFS, including immune-system disruption and altered hypothalamic-pituitary-adrenal (HPA) axis function, while emphasizing that mechanisms and individual responses vary. Management options discussed include pacing and energy management, sleep and stress support, probiotics, vagus nerve stimulation, and neuroplasticity-based “limbic retraining” programs. NAD, CoQ10, low-dose aripiprazole, and other interventions are also mentioned, but the presentation notes that evidence is limited for some approaches.<br /><br />The speaker stresses that treatments are not universally effective and that patients need individualized care. Direct primary care is presented as a way to provide more time for listening, evaluation, and patient validation. The materials also point to research and resources on pacing, sleep, nutrition, mental health, pain, gut health, and related conditions.

Keywords

chronic fatigue syndrome

myalgic encephalomyelitis

ME/CFS

Long COVID

post-exertional malaise

unrefreshing sleep

cognitive impairment

orthostatic intolerance

diagnosis evaluation

pacing management

brain fog

diagnosis

fatigue evaluation

pacing

individualized care