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Myalgic Encephalomyelitis / Chronic Fatigue Syndrome
ME/CFS is a serious multi-system illness defined by post-exertional malaise. We pace carefully, lower total burden, and support immune, autonomic, and mitochondrial systems in sequence.
What you may be noticing
After a short walk, a phone call, or a busy morning, you crash, often a day later, and the crash lasts days. Sleep is unrefreshing. Brain fog, sore throat, tender lymph nodes, dizziness on standing, and sensitivity to light and sound are common. Your world has narrowed, and others may not understand that this is not ordinary tiredness.
Why it is rarely one thing
ME/CFS is a recognized, serious illness, not deconditioning and not depression. Its hallmark is post-exertional malaise: a worsening of symptoms after physical, cognitive, or emotional effort that exceeds your current energy envelope.
Many cases begin after an infection. Research points to immune dysregulation, impaired energy metabolism, autonomic dysfunction, and neuroinflammation, though the full mechanism is still being defined.
One principle guides everything: graded exercise that pushes through symptoms can cause harm in ME/CFS. Pacing, staying inside your energy envelope, is the foundation on which every other step rests.
In my clinical model, persistent fatigue often reflects an overloaded toxic burden bucket: mold, dormant viruses such as Epstein-Barr, gut imbalance, heavy metals, and chemical exposures layered together until the system can no longer keep up. This is a working hypothesis, and it is never a reason to push. ME/CFS also overlaps with long COVID, POTS, fibromyalgia, and mast cell activation. The aim is to reduce what is draining the body and support the systems that produce and regulate energy, so the envelope can widen on its own terms.
Patterns we look for
- Post-exertional malaise and your current energy envelope.
- Autonomic dysfunction, including orthostatic intolerance and POTS.
- Mitochondrial function and cellular energy production.
- Immune activation and viral reactivation, including Epstein-Barr virus and other herpesviruses.
- Neuroinflammation and microglial priming.
- Mast cell activation.
- HPA axis output, a flattened cortisol rhythm, and thyroid conversion.
- Gut microbiome disruption.
- Toxic burden, including mold, which can mimic or worsen ME/CFS.
- Sleep architecture and sleep apnea.
How I evaluate it
Evaluation itself is paced. A comprehensive functional neurological exam is adapted to your energy, with autonomic measurements from lying to standing, eye movements, and balance, avoiding anything that would trigger a crash.
Functional labs may include a complete blood count, ferritin, inflammatory markers, viral panels, a full thyroid panel, cortisol rhythm, vitamin D, B12, fasting insulin, mast cell markers, organic acids for mitochondrial pathways, and mycotoxin testing when exposure is possible.
How we address it
- Pace within your energy envelope, using heart rate and symptom tracking to avoid crashes.
- Build stability before intensity: sleep, circadian light, steady blood sugar, minerals, and orthostatic support with hydration, electrolytes, and compression.
- Open drainage pathways gently before any detox or clearing work, so the body is never asked to mobilize more than it can release.
- Remove additional load, such as mold, infections, and inflammatory foods, one change at a time.
- Support mitochondrial function and calm immune and mast cell activation.
- Restore sleep and hormonal rhythm.
- Rebuild gently with very low-intensity neurological rehabilitation, short and below your symptom threshold, expanding only as the envelope grows.
Your energy envelope can widen. Slowly, steadily, and with care, capacity can return.
Book your Comprehensive Functional Medicine Eval/Neurological Exam today to discover what the contributing root causes are that are underlying your health concerns.