Some notes on the case study coauthored by Jennifer McIntosh:
Chronic fatigue syndrome/myalgic encephalopathy
https://onlinelibrary.wiley.com/doi/abs/10.1002/9781119163411.ch20
The case study is coauthored with Caroline Foster. An answers chapter (16) is based on an earlier chapter presenting a case study, 'Melissa', who has CFS, nausea with weight loss, and inadequate energy intake due to gluten and lactose elimination. She is considering seeing a homeopath and takes 10mg Amitriptyline.
The chapter discussing the case study recommends the Eatwell plate, eating little and often, choosing low GI foods, and avoiding energy drinks and caffeine due to energy and GI implications. It states that a number of diets such as the anti-candida diet are promoted for CFS/ME but are based on unreliable evidence.
It briefly explains coeliac testing. It states there is no evidence there is greater incidence of IgE mediated allergy in CFS/ME than in the general population and exclusion diets are generally not recommended but can be helpful w/ symptom management and IBS, and that patients should receive dietician input when excluding to ensure a balanced diet.
Nausea management advice is to avoid drinking w/ meals, eat little and often, avoid fatty or antagonising foods and GP may prescribe antiemetic if severe.
The chapter has the following on lactose intolerance:
Regarding the reported lactose intolerance, this often occurs in association with the gluten intolerance as the gut inflammation can cause a deficiency in lactase. This associated lactose intolerance usually resolves as the gut heals over a period of time.
The chapter states there is no conclusive evidence to support supplementation for CFS/ME management but multivit and EFA may be appropriate and vit D for housebound.
The case study subject is on 10mg amitriptyline. The mention of this for sleep and muscle pain is uncritical and does not mention side effects. The chapter takes a critical stance on CAM, explicitly stating there is insufficient evidence for homeopathy but sensitivity to patient beliefs is required.
There is no mention of CBT, GET, pacing, activity management, etc in the chapter.
