9 Strategies against ME/CFS and fatigue


Dr. Martina Melzer, published: 18.06.2022


Deutsche Version


Under the menu item "Strategies" you will find nine overview texts on points that, from my point of view, play an important role in chronic fatigue and ME/CFS. On the one hand they contribute to the exhaustion and the many other symptoms, on the other hand they can be the way out.

They are the factors that I have come across again and again during my three years of research and that have been central to so many people who have recovered. I've also noticed these points in other illnesses associated with chronic fatigue, and I've learned that the disease-causing mechanisms sometimes overlap greatly. But, of course, each fatigue disorder has its "idiosyncrasies" that differ from others.


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1. Autonomic Nervous System: from everything I've learned, the autonomic nervous system (ANS) is THE BIG PLAYER in our bodies. If it is malfunctioning, I believe this (along with other factors) can lead to many chronic diseases - not only ME/CFS, but other syndromes, autoimmune diseases, depression, anxiety disorders, etc. The autonomic nervous system consists of the sympathetic nervous system, the activating part, and the parasympathetic nervous system, also called the vagus nerve. This is the calming part. Both control numerous vital functions in the body. Therefore, if the ANS is out of balance, it affects numerous body systems and can also cause numerous symptoms. The main causes of an out-of-balance ANS are chronic stress and trauma - both can be physical or psychological, usually a combination of several stressors makes you sick. There are many ways to rebalance the autonomic nervous system. They are all basically based on neuroplasticity - the ability of our brain to unlearn the old and learn the new. You can find more about the autonomic nervous system under the strategy "Nervous system".

2. Psyche: For many people with ME/CFS, the topic of psyche is a red rag. It was for me, too. But in the meantime I am convinced that mind, brain and body are an inseparable unit. Just like the psyche, nervous system, immune system and hormone system. One influences the other. Any physical illness also affects the mind, and any mental illness also affects the body. A focus on healing is extremely important if you want to heal. Also, beliefs like "I'm not good enough" and behaviors like perfectionism and helper syndrome can get in the way when it comes to recovery. Repressed emotions play a role in more illnesses than I thought possible. Psyche is also about retraining the brain to let go of the old and embrace the new. More about this under the strategy "Mindset".

3. Immune system: There is no doubt that an out-of-balance immune system plays an important role in ME/CFS, but also in fatigue due to other causes. Whether it's Long Covid, an autoimmune disease like MS, cancer, or even depression. Chronic inflammation is the driver here. They deplete, make our brains foggy and make us feel sick. There is no magic formula here. But I think it makes sense to find out the causes of a weakened or overactive immune system, to fight chronic infections and to bring the immune system back into balance through a holistic approach. More information under the strategy "Immune system".

4. Gut health: In my opinion, the influence of the intestine on our health is still underestimated. It contains 70 to 80 percent of our immune cells, has its own nervous system and is in communication with the brain via the vagus nerve. I mean: If the gut doesn't run smoothly, nothing runs smoothly at all. That's why it's always worth taking care of your intestinal health - regardless of the disease. If the gut is inflamed or its nervous system is out of balance, this can lead not only to chronic fatigue, but to many other complaints. Read more about this in the "Gut health" strategy.

5. Nutrition: many people eat an unhealthy diet and can make a big difference by changing their diet. When it comes to fatigue and ME/CFS, it makes sense from my perspective to find a balanced diet that stabilizes your blood sugar and is good for you. I have tried numerous diets and heard or read from other people what has helped them. Bottom line: what helps me or another person doesn't have to help you! Nutrition is something very individual, which is why you have to find your personal nutrition form! Find out what is good for you and what is not, eat as much unprocessed food as possible and not too many carbohydrates (although here too: as it is good for you!). More about this under the strategy "Diet".

6. Sleep: without sleep, no rest, no regeneration, no energy. Although people with chronic fatigue often really sleep a lot, they never feel recovered. Sleep is disturbed. Unfortunately, again, there is no magic formula for what will improve your sleep. Your best bet is to find your personal disruptors and eliminate them as best you can. Make sure you get some sunlight in the morning and during the day, don't eat too late at night, and shut down mentally, physically, and nervously one to two hours before bedtime. More info under the "Sleep" strategy.

7. Pacing: Those who have ME/CFS are usually well acquainted with pacing. However, pacing has now entered the wider community and is recommended not only for ME/CFS, but also for Long Covid, Multiple Sclerosis, and other fatigue disorders. Pacing is incredibly important for you if you suffer from chronic fatigue! For tips on how to do this, check out the „Pacing“ strategy.

8. Movement: Tricky topic in ME/CFS - but still very important from my point of view. Very individually adapted forms of movement are also important for people with ME/CFS to stimulate blood circulation, lymph flow, metabolism, muscles. What kind of movement is suitable for you is of course very specific. Important: do something, and if it's some stretching in bed every day - that's an important start. Adapted movement is actually always recommended for other fatigue disorders. More on this topic under the strategy "Movement".

9. Hormones: If you have ME/CFS, Long Covid or another fatigue disorder, your hormones may also be out of balance. For example, thyroid hormones, adrenal hormones, and sex hormones, as well as insulin, which is important for blood sugar. Therefore, have your hormone status determined, preferably by an endocrinologist. You will have to discuss with your doctor whether special medication is recommended. From my point of view, this is central to rebalancing the hormonal axis between the brain and the periphery: Stress management, sleep-wake rhythm and balancing the nervous system. More information under the strategy "Hormones".

Which factors play the biggest role for you and with which measures and tools you bring them back into balance is of course something very individual. And of course, in your case other points can play a role, which I have not listed here!