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The Diagnostic Protocol next provides a list of active disease processes that may explain most of the major illness symptoms. If one of these diseases is diagnosed it would likely exclude a diagnosis of CFS/CFIDS/ME. However, "If a confounding medical condition is under control, then the diagnosis of CFS/ME can be entertained if patients meet the criteria otherwise."
See the protocol list in the actual document for these exclusionary illnesses. They include diseases of various endocrine organs, cancers, blood diseases, deficiency diseases, known sleep disorders, and known immune, infectious, and neurological disorders.
The protocol then provides a list of co-morbid entities—that is, illnesses that may, and often do, accompany CFS/ME. Presence of these conditions does not exclude CFS/ME. Such illnesses include fibromyalgia (FM) (as a separate, coexisting condition); irritable bowel syndrome; depression; multiple chemical sensitivities, etc.