Chronic fatigue.
Find your pace.

Note the activity, when symptoms worsened, which symptoms changed, and how long recovery took. Include mental and social effort as well as physical tasks.

PEM often worsens 12–48 hours after activity, but timing varies. Look beyond the same day rather than requiring every episode to follow an exact timetable.

If it is manageable, use a simple daily rating alongside activity type, approximate duration, rest, and symptoms. A brief note is enough.

The aim is to recognize a tolerable pattern—not to find a fixed ceiling by pushing through. Limits may change from day to day. Stop or simplify tracking if it adds strain.

Record recurring differences alongside other changing conditions:

• Home, work, or time away.
• Specific rooms, odors, dampness, or known building problems.
• Sleep, activity, weather, and temperature.

Share a consistent pattern with your clinician and, where appropriate, a qualified environmental professional. A diary shows associations, not proof of cause.

Record whether sleep feels restorative, rather than logging hours alone. Note snoring, awakenings, and daytime sleepiness if present.

If standing or sitting upright causes dizziness, palpitations, or worsening symptoms, describe this to your clinician. Do not perform a prolonged standing challenge on your own to provoke symptoms.

Bring a concise history of symptoms, their duration, functional changes, medications, infections, and relevant exposure concerns. Ask which alternative or coexisting conditions need evaluation.

Testing should answer a specific clinical question. Neither routine normal bloodwork nor an environmental test alone confirms or excludes ME/CFS.