How Medical Guidelines Become Suffering



By Melanie Schickedanz in


At the end of January, DEGAM (German Society for General Medicine and Family Medicine ) published the newly revised guideline “Tiredness” , although it is still “in progress” on the homepage of the AWMF (as of 15.02.2018). DEGAM is a German non-profit professional association that represents the professional and scientific interests of general medicine in Germany.

The disease ME (Myalgic Encephalomyelitis), also known as CFS (Chronic Fatigue Syndrome), does not have its own medical guideline, but is only discussed in the guideline “Fatigue” in a separate section. This is where the mistake starts. The disease has been classified by the World Health Organization in the ICD since 1969 as a central nervous system disorder and has nothing to do with fatigue. The organism is no longer able to produce physical energy. A metabolic disorder affecting mitochondrial metabolism, immune function, gastrointestinal function, microbiome, autonomic nervous system, neuroendocrine and other brain functions has been demonstrated.


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