Long COVID / ME/CFS Mechanism Questionnaire
This tool estimates likely dominant drivers and contributors using symptom domains, triggers, timing, positional clues, and relief patterns.
How this works
Please answer based only on the last 30 days. Choose the symptom domains that apply, select only the specific symptoms that were current or recurring during the last 30 days, then answer the core pattern questions based on your usual pattern during the last 30 days.
These percentages are pattern-based estimates from symptoms, triggers, timing, positional clues, and relief patterns. They are not a diagnosis and do not replace medical evaluation.
Step 1: Select symptom domains
Choose the main symptom areas that apply to you during the last 30 days.
Step 3: Core pattern questions
Answer based on your usual trigger, timing, positional, relief, and symptom pattern during the last 30 days. Focus on your current or clearly recurring pattern, not isolated events from the more distant past.
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Does physical activity tend to worsen your main symptoms?
Does mental activity or concentration tend to worsen your main symptoms?
Does emotional stress tend to worsen your main symptoms?
Are your symptoms worse when standing still?
Are your symptoms worse after being upright for a while, even if you are not doing much?
Are your symptoms worse when sitting upright for a long time?
Do heat or hot showers worsen your symptoms?
Does cold exposure worsen your symptoms?
Do meals tend to worsen your symptoms?
Do carbohydrates or sugary foods tend to worsen your symptoms?
Do fiber-rich or fermentable foods tend to worsen your symptoms?
Does poor sleep clearly worsen your symptoms the next day?
Do your symptoms worsen around hormone shifts such as ovulation, premenstrual days, or other cycle changes?
Do your symptoms improve once you start walking?
Do your symptoms improve when you sit down?
Do your symptoms improve when you lie flat on your back?
Do your symptoms improve when you elevate your legs?
Do salt or fluids improve your symptoms?
Do compression garments improve your symptoms?
Do antihistamines improve your symptoms?
When symptoms flare, is rest the main thing that helps?
If you have tried a beta blocker or ivabradine, does lowering your heart rate improve lightheadedness, palpitations, head pressure, or upright symptoms?
If you have tried a beta blocker or ivabradine, did lowering your heart rate make lightheadedness, weakness, head pressure, or upright symptoms worse?
If you have tried pyridostigmine (Mestinon), does it improve lightheadedness, upright tolerance, brain pressure, or post-meal worsening?
When you measure your resting heart rate first thing in the morning after lying quietly for 5 to 10 minutes, before caffeine, before activity, and ideally before taking rate-affecting medication, is it often clearly elevated for you?
If you track HRV, is your RMSSD trend often clearly lower than your usual baseline over several days?
When a trigger makes you worse, do symptoms usually worsen during the trigger or within minutes?
When a trigger makes you worse, do symptoms often worsen later the same day rather than immediately?
Do you often feel clearly worse the next morning after physical, mental, or emotional exertion?
If activity makes you worse, does the worsening often happen 12 to 48 hours later?
Once symptoms flare, do you often need more than 24 hours to recover?
Are symptoms often worse in the morning before you get moving?
Do symptoms often become worse in the evening or at night?
If meals make you worse, do symptoms usually begin during the meal or within 30 to 60 minutes after?
If hormone changes affect you, do symptoms predictably worsen around ovulation, premenstrual days, or similar cycle phases?
Can mental effort make you feel somewhat okay at first, but noticeably worse hours later or the next day?
Can emotional stress trigger a delayed worsening later that day or the next day rather than only an immediate reaction?
Do you often feel wired but tired, overstimulated, or unable to calm down when symptoms flare?
Do your symptoms often come with palpitations, lightheadedness, or head pressure?