Four types of Fatigue May 12th CFS/ME Awareness The Flare

The Flare

The Flare is a word borrowed from MS symptomology and really hasn’t been used by ME/CFS doctors so much as GP’s who are confused about an illness that looks so much like MS but isn’t MS. A flare is usually defined

as a returning set of symptoms that crops up periodically and chronically through out the course of the patients lifetime.

A flare is sometimes called a relapse by ME patients. This is when the original viral trigger seems to get set off again. For many patients who had a “mono” trigger it’s like getting Mono all over again. These chronic reactivations of antibodies to the original virus can happen for no apparent reason.

Who gets it:
Most ME patients will deal with a flare at some point. Some patients experience ongoing flares that crop up two to three times a year. Others may have one or two in the beginning of the illness and then not experience a flare for years if ever.

Speculation on what set’s off a flare runs from simple reactivation due to stressors, both physical and mental, including heat or cold or traumatic events, to an autoimmune response where the body over activates the immune response and attacks itself.

What you can tell your doctor:
A flare is unique in that there is a resurgence of the original viral trigger. Unlike PEM which is a lack of energy that ebbs and flows with daily activity or the more intense PENE which includes some immune as well neurological but is over in 24 to 48 hours; the Flare is primarily immune symptoms and can last from a week to a month. What your doctor looks for;

  • Swelling of lymph nodes in neck, chest and under arms as well as spleen. (The spleen is good way to tell when you are having a viral flare or relapse. Unlike PENE there is usually no swelling at the back of the neck.)

  • Sore throat

  • Headache and body ache

  • Chills (without fever in a reactivation)

  • Sores in the mouth or chin area and sometimes in the nasal area.

In addition there are noticeable problems with thinking and moving such as muscle weakness.

The best way to confirm a flare is to have your doctor test you for antibodies to your original virus trigger. If this comes back negative then have your doctor test you for other possible virus antibodies as this means that your body is triggering to a variety of viri rather than just the original virus.

What can be done about it:
Most General practitioners will not offer antiviral medication in regular cases as the general wisdom is that virus will run its course. In chronic cases GP will sometimes refer the patient to a virologist who might be more inclined to offer antiviral medications. Some patients who take this solution have complete or very good recoveries. Most however, see mild improvement until the next flare.


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