Question: I have a diagnosis of ME/CFS but a puzzling symptom that doesn't seem to fit. For many years, the more active I am, the more I suffer from muscle wasting in my lower legs. My calf muscles turn to flabby mush! This is accompanied by intense nerve pain (burning, tingling, shooting) for which I take Gabapentin -- and by debilitating fatigue and weakness. A period of rest allows my calf muscles to visibly rebuild, I feel stronger, the pain goes away. This cycle has been repeating for about 12 years and has completely changed my life. I'd love some suggestions! Thank you!

Dear Dr. Tayal,

Thank you for answering my query. Do I understand you correctly that my muscle wasting, weakness and pain might stem from my cardiac issues...?

I have had cardiac testing that showed slightly lower than normal output from my heart and slightly lower O2 levels in blood. Also, when I did a cardiac test on a stationary bike, my legs grew so weak that the test was halted.

So could cardiac problems lead to actual wasting of muscles? (This happens over a period of about 4 days when I am more active than normal.)

Is there anything else I could look into such as a metabolic problem (due to my thyroid goitre)...I have wondered if protein metabolism is part of the problem ---that my body 'eats' its own muscles. But perhaps this could happen also due to lower O2 and cardiac output?

Thank you for any further advice you could give me.