Chronic Fatigue Syndrome Treatments: What You Need to Know

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a debilitating and complex condition that affects approximately 0.9% of the global population. Despite its prevalence, many patients face skepticism from medical professionals and are often misdiagnosed or prescribed ineffective treatments like antidepressants. ME/CFS is not just "in your head"—it impacts multiple organ systems, including the brain, spinal cord, cardiovascular system, and immune system.

At Clarus Health, we focus on an integrative, patient-centered approach that includes treatments such as IV Ketamine infusions, Stellate Ganglion Block (SGB), and NAD+ therapy to address the underlying neurological, immune, and metabolic dysfunctions of ME/CFS.

What is ME/CFS?

ME/CFS is characterized by at least six months of moderate-to-severe symptoms affecting three core areas:

1. Impaired functioning in work, social, or personal activities, accompanied by persistent fatigue.
2. Post-exertional malaise (PEM), where symptoms worsen after physical or mental exertion.
3. Unrefreshing sleep.

Other common symptoms include:

• Cognitive impairment (“brain fog”)
• Autonomic dysregulation (e.g., dizziness when standing due to blood pressure instability)
• Small, soft lymph nodes in the neck, behind the ears, armpits, or groin

ME/CFS is not merely fatigue—it is a whole-body illness that impacts multiple organ systems, including:

• Nervous & Immune System Dysfunction: ME/CFS patients exhibit dysfunction in integrative brain regions and chronic immune activation.
• Endocrine System Imbalance: patients may have impaired hypothalamic-pituitary-adrenal (HPA) axis activation, which affects stress hormone regulation.
• Cardiovascular Dysfunction: Patients often experience poor exercise tolerance and orthostatic intolerance.
• Gut Dysbiosis: Changes in the gut microbiome and inflammation may contribute to symptoms.

ME/CFS is More Common Than We Thought

Contrary to past assumptions, ME/CFS is not a rare disease. Large-scale studies confirm its widespread prevalence:

• Women are affected nearly three times as often as men.
• It frequently coexists with conditions such as postural orthostatic tachycardia syndrome (POTS), fibromyalgia, Ehlers-Danlos syndrome, irritable bowel syndrome, and mast cell activation syndrome.

What Causes ME/CFS?

ME/CFS has multiple triggers, including:

• Infections: Viral and bacterial infections such as Epstein-Barr virus (EBV) and COVID-19.
• Physical & Psychological Stressors: Trauma, surgery, or PTSD.
• Environmental Toxins: Neuroimmune and oxidative stress interactions.
• Genetic Predisposition: Polymorphisms in HPA-axis genes may increase susceptibility.
• Mitochondrial Dysfunction: Impaired ATP production affects cellular energy metabolism.

Our Treatment Approach to ME/CFS

Since ME/CFS varies significantly among patients, we tailor treatment based on each individual's predominant symptoms and underlying dysfunctions.

1. Comprehensive Diagnostic Workup

We conduct a thorough evaluation, including blood tests for thyroid function, anemia, cortisol levels, and sleep studies. Identifying medication side effects is also critical.

2. Stellate Ganglion Block (SGB) for Nervous System Dysregulation

SGB is a specialized nerve block that modulates the autonomic nervous system. It has shown promise in treating:

• Long COVID-related ME/CFS
• PTSD-associated ME/CFS

You can learn more about the Stellate Ganglion Block for ME/CFS here.

3. IV Ketamine for Depression & Chronic Pain

Ketamine infusion therapy is a rapid-acting therapy for:

• Depression & Chronic Pain: Ketamine can significantly relieve symptoms in ME/CFS patients with coexisting depression.
• Post-Surgical Fatigue: IV ketamine has been shown to reduce postoperative fatigue syndrome.
• Direct Anti-Fatigue Effects: Independent of its antidepressant properties, ketamine may reduce fatigue in ME/CFS.

You can learn more about IV Ketamine for ME/CFS here.

4. NAD+ Therapy for Mitochondrial Support

For patients with severe energy depletion and exercise intolerance, we use:

• IV Nicotinamide Riboside (NR) to restore cellular metabolism and ATP production.
• NAD+ therapy, particularly in those with brain fog and cardiovascular dysfunction.

5. Genetic & Personalized Medicine Approaches

In patients with lifelong fatigue susceptibility, genomic testing helps identify:

• Mitochondrial health and energy metabolism genes, including B12 metabolism
• Inflammatory and oxidative stress pathways, especially those affecting circadian rhythim
• Thyroid and gut permeability markers

Take the Next Steps in Healing ME/CFS

ME/CFS is a complex, multifaceted condition that requires an individualized approach to treatment. At Clarus Health, we utilize cutting-edge therapies like IV ketamine, SGB, NAD+ and genetic testing to help patients restore their quality of life. Contact Clarus Health for an individualized approach to testosterone replacement therapy to optimize your mental health and wellbeing.