ME, or myalgic encephalomyelitis, is a serious, long-term chronic illness that impacts the sufferer, leaving them often suffering from extreme exhaustion. ME has for a long time been under-researched, but as awareness of the condition grows, more people are coming forward for help. As a grouping of symptoms, instead of a clearly identifiable illness, ME is very hard to diagnose and thus people can suffer for years before getting help for it. Symptoms can include exhaustion, digestive issues, muscle weakness, shortness of breath and irregular heart rate. But how do you know if you are suffering with ME, or are just really exhausted? Overlapping symptoms Covid has made ME more prevalent, but people still find it so difficult to know what may just be tiredness. “It is really difficult to tell the difference. ME and CFS (chronic fatigue syndrome) have a lot of overlap [with tiredness] and there have been a lot of issues with long covid with these long persisting post-viral malaise, where even if people sleep well, they may still feel exhausted,” says GP and men’s health specialist Dr Anand Patel. If you have had covid or another viral illness, this may increase the likelihood of having ME. Get checked out “If you have had persisting symptoms for more than a few weeks or they are really severe, speak to your GP,” says Patel. Particularly if “you are sleeping okay, your diet, caffeine and alcohol intake are okay, but your symptoms are persisting. They may check your thyroid and blood count”, he explains. “A quarter of our appointments these days are classed as ‘tired all the time’. It is very difficult to weed out what is what when ME and CFS are groups of symptoms that are bundled together. It is not necessarily something that will cause medical harm, but will cause really significant symptoms to sufferers,” says Patel. “With ME, you may be so tired you can barely stay awake in the day. We are still in the exploratory stage of what does cause it, but if you have had psychological trauma or illness it is more likely to be ME that has caused these prolonged symptoms. It can be hard to find things during tests and scans, but of course, there are conditions we don’t have tests for or are hard to identify,” he explains. Be clear of your symptoms “It is really difficult to diagnose something if you can’t find it, so a patient needs to explain symptoms and how they are feeling. Many people with it don’t feel seen, and a doctor may be struggling to find a specific answer,” Patel explains. Keeping a diary of symptoms may help to make it clear. Vitamin deficiencies Consider what the other causes may be. “Tiredness could be caused by blood count and anaemia, thyroid function and deficiencies, dietary changes and vitamin deficiencies,” says Patel. “If you have a varied diet, these are unlikely. B12 and folic acid deficiency are common, they make blood make new cells and are important in nerve function. Also, it could be vitamin D deficiency, a lot of people need to take a vitamin D tablet every day in the UK because we don’t get enough sun and slap on factor 50 as soon as it does come out,” Patel says. Read More Charity boss speaks out over ‘traumatic’ encounter with royal aide Ukraine war’s heaviest fight rages in east - follow live Dr Alex George: Five months of sobriety has made a ‘huge difference’ Everything you need to know about Sophie, the new Duchess of Edinburgh Beyonce kicks of Renaissance tour in string of glamorous outfits

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Britney Spears has reflected on the iconic double-denim outfit she wore alongside her then-boyfriend Justin Timberlake in 2001. Spears and Timberlake – who were dating at the time – attended the American Music Awards together and quickly made headlines with their showstopping outfits. The pair wore matching head-to-toe denim looks, including a blue denim cowboy hat on Timberlake. The instantly recognisable double-denim moment has gone down in sartorial history, with many people replicating the look for Halloween couple costumes. Reflecting on the starry fashion moment, Spears writes in her new memoir The Woman In Me that she initially suggested the idea to Timberlake and their stylist as a joke. “I still can’t believe that Justin was going to wear denim and I said, ‘We should match! Let’s do denim-on-denim!’’” she explained. “At first, honestly, I thought it was a joke. I didn’t think my stylist was actually going to do it, and I never thought Justin was going to do it with me. But they both went all in.” Spears continued: “The stylist brought Justin’s all-denim outfit, including a denim hat to match his denim jacket and denim pants. When he put it on, I thought, Whoa! I guess we’re really doing this!” At the time, the pop star was a newly famous pop sensation and Timberlake was an international heartthrob as the frontman of boy band NSYNC. Together, they would attend multiple red carpet events in the years they dated, from 1998 to 2002. “Justin and I were always going to events together,” Spears said. “We had so much fun doing the Teen Choice Awards, and we often color-coordinated our outfits. But with the matching denim, we blew it up.” Spears explained that the denim corset she wore to the event was so tight that she thought she might fall over on the red carpet. “I get that it was tacky, but it was also pretty great in its way, and I am always happy to see it parodied as a Halloween costume,” she said. Spears went on to address the criticism that Timberlake faced for wearing the matching outfit. “I’ve heard Justin get flak for the look. On one podcast where they were teasing him about it, he said, ‘You do a lot of things when you’re young and in love.’ And that’s exactly right. We were giddy, and those outfits reflected that,” Spears wrote. The pair began dating after meeting on the set of the All-New Mickey Mouse Club in 1992. Elsewhere in the memoir, Spears wrote about her decision to get an abortion after she became pregnant while dating Timberlake. “It was a surprise, but for me, it wasn’t a tragedy. I loved Justin so much. I always expected us to have a family together one day. This would just be much earlier than I’d anticipated” she said of the pregnancy. “But Justin definitely wasn’t happy about the pregnancy. He said we weren’t ready to have a baby in our lives, that we were way too young.” Spears appeared to imply that she decided to get an abortion because it was what Timberlake had wanted her to do. “I’m sure people will hate me for this, but I agreed not to have the baby. I don’t know if that was the right decision,” she wrote in the memoir. “If it had been left up to me alone, I never would have done it. And yet Justin was so sure that he didn’t want to be a father.” “To this day, it’s one of the most agonising things I have ever experienced in my life,” she said. The Independent has contacted representatives for Timberlake and Spears for comment. The Woman in Me is out now. You can read The Independent’s four-star review of the memoir here. Read More Britney Spears announces engagement to Sam Asghari Britney Spears’ fiance responds to fans calling for star to get prenup Britney Spears reassures fans after deactivating Instagram account Everything we know about Britney Spears and Sam Asghari divorce A timeline of Britney Spears and Sam Asghari’s relationship What is Sam Asghari’s net worth?

Max Verstappen finished fastest in practice in Qatar as he closes in on a hat-trick of world championships. The Dutchman needs to finish only sixth in Saturday’s sprint race to clinch the title and he made light work of Friday’s sole practice at the Lusail International Circuit. Verstappen finished three tenths clear of Ferrari’s Carlos Sainz, with Charles Leclerc third in the other scarlet car. Fernando Alonso took fourth spot for Aston Martin, one place ahead of Verstappen’s Red Bull team-mate Sergio Perez. George Russell and Lewis Hamilton finished only eighth and 13th for Mercedes. Verstappen has dominated this season – winning 13 of the 16 races staged – and he will claim his third straight title if he scores three points in the 19-lap sprint race. First, Verstappen must qualify for Sunday’s main event and, on the evidence of the early running, he appears favourite to take pole position. The Dutch driver soared to the top of the time sheets of the one-hour running in the final minutes with a healthy third-of-a-second advantage to the rest of the field. Russell was almost a second back in the lead Mercedes, with Hamilton 1.2 sec behind Verstappen. Qualifying takes place at 8pm local time (6pm BST). Read More Fernando Alonso lauds Max Verstappen as best F1 driver since Michael Schumacher Fernando Alonso lauds Max Verstappen as best F1 driver since Michael Schumacher Max Verstappen pips Oscar Piastri to pole after tense qualifying for Japanese GP

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