Source: Sussex & Kent ME/CFS Society
Date: July 25, 2025
URL:
https://measussex.org.uk
ME/CFS doctors comment on prognosis
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Dr Alan Stewart
Successful treatment depends upon a correct diagnosis and matching the treatment to suit the patient’s circumstances. This ideally addresses all of the predisposing, precipitating and in particular perpetuating factors in the patients CFS/ME. Accordingly the response rate and time frame are very variable.
That said, for some patients whose illness has followed an acute infection recovery may be relatively quick. Having an experienced and well-staffed team is essential.
Professor Anthony Komaroff (US)
People with ME/CFS usually experience their most severe symptoms in the first one to two years of illness. After that time, a small number of people recover totally, and others slowly improve their ability to function but do not recover fully. Unfortunately, a small number become totally incapacitated. For most people there is gradual improvement, although they usually cannot achieve the same activity level that they were capable of before becoming ill.
Professor Anthony J Pinching
Prognosis is variable and unpredictable. Quite a lot of people who become ill after infections can recover relatively soon (in a year or so), especially if diagnosed and managed early. But others may take longer to recover, either because their illness is more severe/prolonged, or because other factors interfere with the process of recovery and healing.
Although most people do gradually improve and adjust to the remaining restrictions, a significant minority remain severely affected for long periods.
Dr Vikki McKeever
The concept of recovery in ME/CFS is as complicated and heterogenous as the illness is ME/CFS is a condition currently defined and diagnosed based on the presence of specific symptoms which arise due to altered function in multiple dynamic physiological body systems. The reasons why these physiological systems become dysregulated varies and there are often multiple factors that have contributed. This means management of ME/CFS needs to be individualised and holistic and will need to address different issues for different people with the illness.
There are some people with ME/CFS who’s symptoms improve and some who recover back to a relatively normal level of function, including those who have been severely affected. However, the strategies that worked for one person may be ineffective for another and we do not yet have any way of predicting who will improve and why some people become more severely affected. It is a tricky balance to provide hope and optimism whilst also recognising the importance of being realistic and the need to continue management strategies in the long-term.
We must also acknowledge there are people with ME/CFS who remain severely affected for many years and that reflects our inadequate knowledge and treatment of this complex and life-changing illness.
Dr Alastair Miller – Consultant Physician Recovery from MECFS is extremely variable and will be affected by a number of factors. It is essential that those affected by MECFS are aware that full recovery is possible whatever the severity of the condition.
Dr Gabrielle Murphy – Consultant Physician Management approaches vary and should always be collaborative between health professional(s) of any discipline and the patient. Whether the illness is mild, moderate or severe, or vacillates between the different categories, most of those affected report that support from a specialist unit is always welcome.
Dr Sue Pemberton
Prognosis can be complex and means that it can vary widely across the same illness. Some people can find that with the right guidance they can stabilise their condition and that this may mean there is opportunity to make slow, careful changes in their daily activity, but this may not be back to the lifestyle they had before their illness.
Dr Jake Hollis
I am more optimistic than many about the possibility of recovery from ME/CFS. This is, no doubt, influenced by my own experience of having been housebound and barely able to sit up a few years ago, to now being fully recovered and able to work, travel and exercise. My optimism is also influenced by the recovery progress I see in many clients I work with, and the growing network of people I know who have recovered.
While this condition is undoubtedly complex and multifactorial, in my view it is best understood as a state of extreme dysregulation across multiple bodily systems. The upshot of this understanding is that it nudges us towards creating the conditions to support the body to shift away from dysregulation and towards greater regulation.