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Overtraining syndrome
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==Differences from CFS== Overtraining syndrome includes a much narrower group of symptoms, can only be caused by repeatedly overexercising, and unlike CFS, is not either neurological in nature or a common cause of significant and long term disability affecting all aspects of life. ===ME/CFS symptoms not present in overtraining syndrome === * [[post-exertional malaise]], which is not limited to exercise, is the hallmark symptom of ME/CFS, and may be delayed by up to 3 days * [[chronic pain]], which is pain lasting for over six months, is common in ME/CFS, and may include [[joint pain]] or [[nerve pain]] rather than just [[muscle pain]] * the minimum level of impairment for diagnosis is typically only being able to function at 50% of their previous level in everyday day, although this depends on the diagnostic criteria used * some patients are housebound or bedbound, and the 25% of ME/CFS patients with [[severe and very severe ME]] are wheelchair users or bedbound * typically functioning is lower than that patients [[multiple sclerosis]] and class 3 heart failure * [[co-morbidities]] frequently occur, including [[Postural orthostatic tachycardia syndrome|POTS]], [[irritable bowel syndrome|IBS]], [[fibromyalgia]], [[Hashimoto's thyroiditis]], and [[migraine]]s * [[:Category:digestive_signs_and_symptoms|digestive symptoms]], which are persistent and may include [[nausea]] or vomiting, even at rest, new onset [[irritable bowel syndrome]] or [[gluten sensitivity]]; in particularly severe cases some patients require a feeding tube * endocrine symptoms may include [[thyroid]] problems, inability to regulate body temperature, and unexplained weight loss or gain * [[:Category:Sensitivity signs and symptoms|sensory overload]] symptoms, including [[photophobia]], [[hyperacusis]], touch sensitivity and even [[allodynia]] are fairly common in ME/CFS *[[exercise]] or over-exertion causes noticeable [[cognitive dysfunction]] *[[concentration]] is significantly impaired, and too much mental activity causes [[post-exertional malaise]] and an increase in symptoms such as pain, [[muscle weakness]], dizziness and gastrointestinal symptoms; some patients with [[ME/CFS]] are unable to watch TV due to severe cognitive dysfunction * [[Severe and very severe ME#verysevere|Very severe ME/CFS]] can be life-threatening and a number of people have died * Prognosis is very poor, most people do not fully recover from ME/CFS; in overtraining syndrome most recover within weeks or months<ref name="Derman2000" /> * ME/CFS can occur in sedentary people * ME/CFS is a [[Female predominant diseases|female predominant disease]] * [[ME/CFS]] is most commonly caused by a virus or bacterial disease, although severe injury and other events are also common * overtraining, inadequate food intake and poor [[nutrition]] are not among the many pre-onset [[:Category:Triggers and risk factors |triggers or risk factors]] commonly reported; nutritional deficiencies must be ruled out as a possible cause before diagnosis * significant brain and spinal cord changes have been found in patients with [[ME/CFS]], including in autopsies of patients who have died from the illness * [[paralysis]] is reported in some patients *symptoms may not be diagnosed unless present for at least 6 months, in the most commonly used diagnostic criteria<ref name="canadianconsensus">{{Citation | last1 = Carruthers | first1 = Bruce M. | authorlink1 = Bruce Carruthers | last2 = Jain | first2 = Anil Kumar | authorlink2 = Anil Kumar Jain | last3 = De Meirleir | first3 = Kenny L. | authorlink3 = Kenny De Meirleir | last4 = Peterson | first4 = Daniel L. | authorlink4 = Daniel Peterson | last5 = Klimas | first5 = Nancy G. | authorlink5 = Nancy Klimas | last6 = Lerner | first6 = A. Martin | authorlink6 = Martin Lerner | last7 = Bested | first7 = Alison C. | authorlink7 = Alison Bested | last8 = Flor-Henry | first8 = Pierre | authorlink8 = Pierre Flor-Henry | last9 = Joshi | first9 = Pradip | authorlink9 = Pradip Joshi | last10 = Powles | first10 = AC Peter | authorlink10 = A C Peter Powles | last11 = Sherkey | first11 = Jeffrey A. | authorlink11 = Jeffrey Sherkey | last12 = van de Sande | first12 = Marjorie I. | authorlink12 = Marjorie van de Sande | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols | journal = Journal of Chronic Fatigue Syndrome | volume = 11 | issue = 2 | pages = 7-115 | date = 2003 | pmid = | doi = 10.1300/J092v11n01_02 | url = http://www.investinme.org/Documents/PDFdocuments/CanadianDefinitionME-CFS.pdf }}</ref><ref name="ICP2011primer">{{citation | last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell | last7 = Staines | first7 = D | authorlink7 = Donald Staines | last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles | last9 = Speight | first9 = N | authorlink9 = Nigel Speight | last10 = Vallings | first10 = R | authorlink10 = Rosamund Vallings | last11 = Bateman | first11 = L | authorlink11 = Lucinda Bateman | last12 = Bell | first12 = DS | authorlink12 = David Bell | last13 = Carlo-Stella | first13 = N | authorlink13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | authorlink14 = John Chia | last15 = Darragh | first15 = A | authorlink15 = Austin Darragh | last16 = Gerken | first16 = A | authorlink16 = Anne Gerken | last17 = Jo | first17 = D | authorlink17 = Daehyun Jo | last18 = Lewis | first18 = DP | authorlink18 = Donald Lewis | last19 = Light | first19 = AR | authorlink19 = Alan Light | last20 = Light | first20 = KC | authorlink20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | authorlink21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | authorlink22 = John McLaren-Howard | last23 = Mena | first23 = I | authorlink23 = Ismael Mena | last24 = Miwa | first24 = K | authorlink24 = Kunihisa Miwa | last25 = Murovska | first25 = M | authorlink25= Modra Murovska | last26 = Stevens | first26 = SR | authorlink26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012 | isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf }}</ref><ref name="fukuda1994">{{Cite journal | last = Fukuda | first = K. | authorlink = Keiji Fukuda | last2 = Straus | first2 = S.E. | authorlink2 = Stephen Straus | last3 = Hickie | first3 = I. | authorlink3 = Ian Hickie | last4 = Sharpe | first4 = M.C. | authorlink4 = Michael Sharpe | last5 = Dobbins | first5 = J.G. | authorlink5 = James Dobbins | last6 = Komaroff | first6 = A. | authorlink6 = Anthony Komaroff | date = 1994-12-15| title = The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group | url =https://www.researchgate.net/profile/Michael_Sharpe2/publication/247808895_The_Chronic_Fatigue_Syndrome_A_Comprehensive_Approach_to_Its_Definition_and_Study/links/0c96053201643bfc4b000000/The-Chronic-Fatigue-Syndrome-A-Comprehensive-Approach-to-Its-Definition-and-Study.pdf|journal=Annals of Internal Medicine|volume=121|issue=12 | pages = 953β959|issn=0003-4819|pmid=7978722|via=|publisher=American College of Physicians}}</ref><ref name="who" /><ref name="Chu">{{Cite journal | last = Chu | first = Lily | authorlink = Lily Chu | last2 = Valencia | first2 = Ian J. | authorlink2 = Ian Valencia | last3 = Garvert | first3 = Donn W. | authorlink3 = | last4 = Montoya | first4 = Jose G. | authorlink4 = Jose Montoya | authorlink5 = | date = Jan 14, 2019| title = Onset patterns and course of myalgic encephalomyelitis/ chronic fatigue syndrome|url=https://www.frontiersin.org/articles/10.3389/fped.2019.00012/abstract|journal=Frontiers in Pediatrics|volume=|issue=|pages=|doi=10.3389/fped.2019.00012|quote=|via=}}</ref> [https://www.frontiersin.org/articles/10.3389/fped.2019.00012/abstract (Full text)] ===Overtraining signs symptoms not present in ME/CFS === * mood changes - these are not a diagnostic symptom of ME/CFS,<ref name="ICP2011primer" /> and not any more common than in ME/CFS compared to other chronic illnesses.{{citation needed | date = 2021}} In overtraining syndrome, mood changes are a key indicator.<ref name="jointstatement2012" /><ref name="Kreher2019" />
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