Do Not Do Recommendation

Do Not Do Recommendation Details

Recommendation:

Tests for vitamin B12 deficiency should not be carried out unless a full blood count and mean cell volume show a macrocytosis.

Interventions:

vitamin B12 deficiency test

Source guidance details

Guidance:

Chronic fatigue syndrome/Myalgic encephalomyelitis (CG53)

Published date:

August 2007

Paragraph number:

1.2.2.5

Page number:

16

View all NICE do not do from this Guidance

• Tests for serum ferritin in adults should not be carried out unless a full blood count and other haematological indices suggest iron deficiency
• Tests for folate levels should not be carried out unless a full blood count and mean cell volume show a macrocytosis.
• The the head-up tilt test should not be done routinely to aid diagnosis.
• Auditory brainstem responses should not be done routinely to aid diagnosis.
• Electrodermal conductivity should not be done routinely to aid diagnosis.
• Serological testing should not be carried out unless the history is indicative of an infection.
• Monoamine oxidase inhibitors should not be used for the treatment of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME).
• Glucocorticoids (such as hydrocortisone) should not be used for the treatment of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME).
• Mineralocorticoids (such as fludrocortisone) should not be used for the treatment of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME).
• Dexamphetamine should not be used for the treatment of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME).
• Methylphenidate should not be used for the treatment of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME).
• Thyroxine should not be used for the treatment of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME).
• Antiviral agents should not be used for the treatment of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME).
• Advice to undertake unsupervised, or unstructured, vigorous exercise (such as simply go to the gym or exercise more) should not be offered to people with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) because this may worsen symptoms.
• Specialist management programmes delivered by practitioners with no experience in the condition should not be offered to people with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME).
• Strategies for managing chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) should not include prolonged or complete rest or extended periods of daytime rest in response to a slight increase in symptoms.
• Strategies for managing chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) should not include an imposed rigid schedule of activity and rest.
• There is insufficient evidence for the use of supplements such as vitamin B12, vitamin C, co enzyme Q10, magnesium, NADH (nicotinamide adenine dinucleotide) or multivitamins and minerals for people with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), and therefore they should not be prescribed for treating the symptoms of the condition. However, some people with CFS/ME have reported finding these helpful as a part of a self-management strategy for their symptoms.
• There is insufficient evidence that complementary therapies are effective treatments for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and therefore their use is not recommended. However, some people with CFS/ME choose to use some of these therapies for symptom control, and find them helpful.