Jodi just my opinion...pem from fibromyalgia can happen anywhere from immediately after movement as mine did but now since I have been working on my cns it now appears up to 2 days after activity. I have been told my baseline has adjusted but I still get it. Fibromyalgia always changes. I understand and have felt what you are feeling. It's difficult. I wish you well.🥰👍

I say rubbish, I saw 2 specialists within a week. 1 diagnosed me with fibro the other M.E I just walked away shaking my head. They don't know and when they don't know they put a name to it to relax the patient. All it does is relax them. They don't know everything about the body. Yet they think they are supposed too. The human body is the most complex thing. Can you find a thought if you cut up a brain? Yet people have roughly 6000 thoughts a day yet all they can find is brain patterns. They will never understand the human body 100%

I think I may have both. Will have to explore with my doctor. The only subtle difference is that my PEM does start right after activity and continues to worsen over 24-48 hour period of time before getting better.

Jodi,
You asked: "Do people with ME not use opioid pain meds, pregablin, anti depressants or medical marijuana? Still confused."
Good question and I personally do not know. There are off label medications prescribed for people with ME/CFS, but I think it's specific to the patient and what other medications they may be on, and so on. I don't believe opioids are commonly prescribed, though. One medication that is tried in some cases is LDN, low dose naltrexone, which helps some people.

I hope any of that is helpful. Any mistakes are my own as someone newly diagnosed with ME/CFS. :(

Jodi, fibromyalgia can be triggered by an infection, like a virus, too.

Fibromyalgia definitely involves not just widespread pain, but fatigue that is chronic. So, you can see there are some similarities between the two conditions.

However, there are significant differences.

ME/CFS has a unique feature that is called PEM, post exertion malaise. It usually follows 24-48 hours after any type of exertion even if the person feels it is in his or her energy envelope. What happens then is flu-like symptoms and worsening of existing symptoms.

ME/CFS has different severity levels.

*******

A diagnosis of ME/CFS requires the patient to have three core symptoms:
Impairment of normal function accompanied by fatigue >6 months
Post-exertional malaise (PEM)*
Unrefreshing sleep*
Plus at least one of the following manifestations:
Cognitive impairment*
Orthostatic intolerance (OI)
*Must be moderate-to-severe and present >50% of the time.

This is from the Bateman-Horne Center.