ME, or myalgic encephalomyelitis, is a serious, long-term chronic illness that impacts the sufferer, leaving them often suffering from extreme exhaustion. ME has for a long time been under-researched, but as awareness of the condition grows, more people are coming forward for help. As a grouping of symptoms, instead of a clearly identifiable illness, ME is very hard to diagnose and thus people can suffer for years before getting help for it. Symptoms can include exhaustion, digestive issues, muscle weakness, shortness of breath and irregular heart rate. But how do you know if you are suffering with ME, or are just really exhausted? Overlapping symptoms Covid has made ME more prevalent, but people still find it so difficult to know what may just be tiredness. “It is really difficult to tell the difference. ME and CFS (chronic fatigue syndrome) have a lot of overlap [with tiredness] and there have been a lot of issues with long covid with these long persisting post-viral malaise, where even if people sleep well, they may still feel exhausted,” says GP and men’s health specialist Dr Anand Patel. If you have had covid or another viral illness, this may increase the likelihood of having ME. Get checked out “If you have had persisting symptoms for more than a few weeks or they are really severe, speak to your GP,” says Patel. Particularly if “you are sleeping okay, your diet, caffeine and alcohol intake are okay, but your symptoms are persisting. They may check your thyroid and blood count”, he explains. “A quarter of our appointments these days are classed as ‘tired all the time’. It is very difficult to weed out what is what when ME and CFS are groups of symptoms that are bundled together. It is not necessarily something that will cause medical harm, but will cause really significant symptoms to sufferers,” says Patel. “With ME, you may be so tired you can barely stay awake in the day. We are still in the exploratory stage of what does cause it, but if you have had psychological trauma or illness it is more likely to be ME that has caused these prolonged symptoms. It can be hard to find things during tests and scans, but of course, there are conditions we don’t have tests for or are hard to identify,” he explains. Be clear of your symptoms “It is really difficult to diagnose something if you can’t find it, so a patient needs to explain symptoms and how they are feeling. Many people with it don’t feel seen, and a doctor may be struggling to find a specific answer,” Patel explains. Keeping a diary of symptoms may help to make it clear. Vitamin deficiencies Consider what the other causes may be. “Tiredness could be caused by blood count and anaemia, thyroid function and deficiencies, dietary changes and vitamin deficiencies,” says Patel. “If you have a varied diet, these are unlikely. B12 and folic acid deficiency are common, they make blood make new cells and are important in nerve function. Also, it could be vitamin D deficiency, a lot of people need to take a vitamin D tablet every day in the UK because we don’t get enough sun and slap on factor 50 as soon as it does come out,” Patel says. Read More Charity boss speaks out over ‘traumatic’ encounter with royal aide Ukraine war’s heaviest fight rages in east - follow live Dr Alex George: Five months of sobriety has made a ‘huge difference’ Everything you need to know about Sophie, the new Duchess of Edinburgh Beyonce kicks of Renaissance tour in string of glamorous outfits

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Feeling the urge to glug a glass of water shortly after you’ve munched a packet of crisps, bowl of popcorn or handful of peanuts, is a clear sign your snack was on salty side – and that’s not necessarily a bad thing. “Salt is a necessary requirement to eat – and not for flavour,” says Pippa Hill, nutritionist and founder of The Weight Loss Guru. Table salt, aka sodium chloride, contains around 40% sodium, an essential nutrient. “Eaten in a small quantity, sodium helps the conduction of nerve impulses, muscle contraction and relaxation, and helps maintain the balance of water and minerals,” she continues. “A lack of salt can lead to muscle cramps, nausea, fatigue and light-headedness.” However, consuming more than the 6g a day recommended by the NHS for adults – equating to around one teaspoon – can be detrimental for your health. “A high salt intake disrupts the natural sodium balance in the body,” says Olivia Burley, registered associate nutritionist who is currently working on the NHS Diabetes Prevention Programme. This can result in high blood pressure, she explains: “Hypertension is a condition where blood pressure remains elevated over time, which can increase the risk of heart and circulatory diseases.” Unless you keep a very close eye on food labels, it’s not always obvious how much salt you’re eating in a day. “Examples of foods high in salt can be canned fish or poultry, frozen foods such as breaded meats, salted nuts, canned beans, cured meats, soup and sandwiches,” says Hill. And just because you’ve drunk enough water to quench your thirst doesn’t mean you’re negating the effects of too much salt, which is why it’s important to be aware of other health indicators. “If you are experiencing any or all these symptoms, it is always best to seek medical advice,” Burley advises. 1. Headaches The dehydration caused by excess salt intake can lead to severe headaches. “These headaches tend to be more painful than a mild one, giving a throbbing sensation as the blood vessels are being expanded,” Hill says. “They tend to come on between an hour or two after you’ve eaten, as sodium levels rise through the body.” They may come on quicker if you have high blood pressure or suffer from chronic headaches in general, but can often be solved by rehydrating. “As your water levels are imbalanced, by drinking more water you’re able to minimise and get rid of the headache.” 2. Swollen feet and hands Also known as edema, swelling of the fingers, ankles or feet can be a delayed reaction to a spike of sodium. “When too much salt is consumed, the body retains the extra sodium and increases the fluid outside of the cells, Burley explains. “This causes the kidneys to have reduced function, remove less water and therefore increase blood pressure.” Swelling may occur more when sitting down for too long or on long journeys. “This isn’t an instant response after eating, but if in the next 24 hours of having eaten salty foods you notice swelling in these areas, it could be a link,” Hill says. “It’s best to seek medical advice if this is an ongoing occurrence, as it could be a sign of a more serious health concern.” 3. High blood pressure “Salt is the largest cause of high blood pressure,” Hill warns. “Within just 30 minutes, eating excess salt will have a bodily reaction to the blood vessels.” Also called hypertension, if left untreated it can increase your risk of serious problems such as heart attacks and strokes. Hills says: “If after eating a salty diet, your symptoms include blurred vision, chest pain such as a tight feeling, palpitations, shortness of breath or sudden nosebleeds, it could mean you have a raised blood pressure.” Burley adds: “Hypertension can often have no symptoms and the only way to know your blood pressure is to get it monitored using a machine.” 4. Frequent urination “Excessive thirst is a common response to eating salty foods and naturally leads to an increase in fluid consumption, causing excessive urination,” Burley says. By sending the signal that you need to guzzle lots of liquid, the body aims to remove the excess salt build-up. “Although drinking more fluids in response to an increase in salt is one of the main reasons for urine production, it could be a symptom of other conditions like polyuria, therefore medical checks are best.” Read More Charity boss speaks out over ‘traumatic’ encounter with royal aide Ukraine war’s heaviest fight rages in east - follow live Am I just tired or is it ME? Dr Alex George: Five months of sobriety has made a ‘huge difference’ Everything you need to know about Sophie, the new Duchess of Edinburgh

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Former English Football League defender Tommy Spurr continues to live with worry even though his son has recently overcome cancer. The ex-Sheffield Wednesday and Blackburn full-back has had to endure every parent’s worst nightmare as his four-year-old boy Rio was diagnosed with Wilms Tumour – a form of kidney cancer – last April. The disease spread to his lungs and contained anaplastic features which made it harder to cure and more likely to return. But after nine months of a punishing chemotherapy treatment and 10 days of radiotherapy Rio got the great news last month that there was no longer any evidence of the cancer. However, because of the anaplasia, doctors have said the cancer has a 50 per cent chance of returning and if it does not only does the survival rate plummet to just 10 per cent, there are no further treatment options on the NHS. Alongside Rio’s treatment, the Spurr family have been fundraising, with the former player quitting his job as a teacher, in case the worst does happen. But although they are able to enjoy seeing their little boy start to live a normal life again, the worry of what might be to come has been hard for Spurr and his wife Chloe to deal with. “The first meeting when you hear them say what it was was just horrific,” Spurr, who retired four years ago aged just 31, told the PA news agency. “It turned our world upside down and I don’t think it’s something that will ever leave me or my wife. “We were petrified because we knew he was up against it and the thought of losing our little boy was horrendous. “But fast forward to a couple of weeks ago to be told there was nothing there was a massive relief. “You want to get on with your life and forget about it but you know the risk of it coming back is still there. “My wife and I are still struggling to deal with that and live normally, it is hard to put that out of your mind, knowing he is going to get scanned again and praying and hoping they come back with nothing on. “It has been really hard. I am lucky that I have got my wife. Mentally it has been really hard, the fundraising has been keeping us going because it feels like we are trying to do something positive for Rio but even now I don’t want to sound negative but it is difficult not knowing where we are going to be in a year’s time.” If that news ever does come, Spurr wants to be in the best position possible as their only likely option is going to be treatment in America and that will not come cheaply. “This is the difficulty at the moment. We would more than likely have to access a clinical trial or something that is not available in this country,” he added. “What that is yet we don’t know because we are hoping we don’t get to that point. We were petrified because we knew he was up against it and the thought of losing our little boy was horrendous. Tommy Spurr “We know another family whose child had an identical diagnosis to Rio had treatment in America and their hospital bill for that trip was £650,000 so it is what it is. We will be as prepared as we can be but every day we are praying we are not going to be in that position.” The next step of the fundraising sees Spurr staging a charity match this Sunday, where former Sheffield Wednesday and Sheffield United players will go head-to-head in a Steel City Derby at the Olympic Legacy Park. Ron Atkinson and Neil Warnock will be in the dugouts, with a number of high-profile ex-players giving their time. Spurr said: “The lads are giving up their time to come and play, it’s been amazing that people want to be involved. “The number of people that have bought tickets and wanting to help has been overwhelming. Me and my wife are so thankful. “I think I’ll be playing the whole thing but I might have to give Big Ron a sign if I am struggling. Some of the lads I used to play with I have not seen for 10 years, it will be nice to catch up.” Read More Charity boss speaks out over ‘traumatic’ encounter with royal aide Ukraine war’s heaviest fight rages in east - follow live Football rumours: Tottenham ready for fight to keep hold of Harry Kane 5 contenders as Justin Thomas sets out to defend US PGA Championship crown Jordan Spieth suffers injury in bid for grand slam as US PGA returns to Oak Hill

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