Recognition by our national health service (NHS) that ME (“myalgic encephalomyelitis” (May 16) and fibromyalgia are real and not imaginary diseases would be a very positive first step towards helping these sufferers.

The American medical scene uses the name “chronic fatigue syndrome” (CFS), rather than ME, because the term encephalomyelitis indicates inflammation of the brain and spinal cord, which most claim has never been convincingly demonstrated.

Some support groups waste a lot of energy arguing about semantics. What is important is for the NHS to recognise that ME/CFS and fibromyalgia are very disabling medical problems which require attention and are not feigned maladies of work-shy or mentally-disturbed individuals.

Besides unending disagreements within the medical profession about whether or not these are real pathologies and not psycho-social problems, medical insurance companies have also had a vested interest in classifying them as psycho-social problems.

What the NHS could do is organise a small support team of sympathetic doctors to look after these sufferers. The fact alone that a service is available for these patients would lift their morale – doctors and nurses with the right attitude to the suffering of others can have significant beneficial effects even on very sick patients.

ME and fibromyalgia are poorly understood and their exact cause remains unclear. ME resembles a neuro-autoimmune disease while fibromyalgia seems to revolve around a deranged pain perception abnormality. Recent claims that ME was caused by a specific viral infection have proved unfounded, but there is at present a lot of controversial interest in whether or not ME and fibromyalgia are undiagnosed chronic Lyme disease. Chronic Lyme disease does in fact mimic ME and fibromyalgia very closely. Early experience with laboratory testing suggests that many, but not all, cases of ME and fibromyalgia appear to be chronic Lyme disease.

This area of medicine is still controversial, not least because the accuracy of laboratory testing for chronic Lyme disease continues to be debated. The treatment of chronic Lyme disease is also not clearly established and right now consists of antibiotics, with or without a specific plant-derived product, combined with nutritional supplement support.

A small Maltese NHS team could do much useful work investigating these patients to exclude other established abnormalities – infective, autoimmune, anaemia, poor nutrition, etc. A nutritional therapist needs to be part of the team. They usually suffer from poor sleep which may be helped by some nutritional supplements and hormones (melatonin). The possibility that some of them might be suffering from chronic Lyme disease would need to be investigated.

There is a lot that could be done to help this group of disabled individuals, some very severely so. Many of them are obviously depressed by their condition, but the last thing they need is pharmaceutical anti-depression drugs. Nor is there good evidence that they are improved by cognitive behavioural therapy and graded exercise.