If you have ever felt so exhausted that a shower, a short walk, or answering emails wipes you out for days, you will know this is not ordinary tiredness. Chronic fatigue syndrome, also known as myalgic encephalomyelitis (ME/CFS), is a long-term condition where the body’s energy systems seem to misfire.
People often describe feeling as if their batteries never recharge, no matter how much they rest.
Despite this, chronic fatigue syndrome is still widely misunderstood. Many people wait years for a diagnosis, are told their symptoms are “just stress”, or feel they have to prove they are unwell. In this deep dive, we will look at what chronic fatigue syndrome is, how common it is, what might be happening in the body, and how people are managing symptoms in real life.
Table of contents
- Five key takeaways
- What is chronic fatigue syndrome?
- Post-exertional malaise
- How common is chronic fatigue syndrome?
- Main symptoms of chronic fatigue syndrome
- Why post-exertional malaise matters
- How is chronic fatigue syndrome diagnosed?
- What might cause chronic fatigue syndrome?
- What is happening in the body in CFS patients?
- Managing chronic fatigue syndrome
- Patient experiences and stigma
- Low-dose naltrexone (LDN) for ME/CFS
- Coenzyme Q10 and ME/CFS
- Melatonin buccal film for ME/CFS
- The 3R CFS treatment from Medical Mojo: Recover, Rest, Recharge
- Looking to the future for CFS
- New directions and personalised care
- Exciting developments at Medical Mojo for CFS treatment
- Who is this article for, and how can it help?
- Chronic fatigue syndrome FAQs
- References
Five key takeaways
- Chronic fatigue syndrome (ME/CFS) is a long-term illness that causes severe fatigue, brain fog, poor sleep, and a crash in symptoms after even small amounts of activity.
- Up until recently, there was no single test for chronic fatigue syndrome, so diagnosis was often delayed while other conditions were ruled out. However, researchers have now developed an objective method to diagnose CFS, which should hopefully lead to earlier diagnosis and treatment.
- ME/CFS affects hundreds of thousands of people in the UK and millions worldwide, yet it remains under-recognised and under-treated.
- Research suggests chronic fatigue syndrome involves immune changes, problems with energy production, gut imbalance, and possibly autoimmunity.
- New approaches, including low-dose naltrexone (LDN), CoQ10 and melatonin, are being explored alongside pacing, sleep support, and personalised nutrition. Medical Mojo offers the unique 3R CFS treatment, which combines LDN, CoQ10 and melatonin.
What is chronic fatigue syndrome?
Chronic fatigue syndrome (CFS), or myalgic encephalomyelitis (ME), is a complex, long-term illness that affects many body systems, including the immune, nervous, and energy-metabolic systems [1],[2], [3].
The hallmark symptom is profound fatigue that is not improved by rest and is often made worse by physical, mental, or emotional exertion [4].
Alongside fatigue, people with chronic fatigue syndrome may experience the following symptoms [3],[4] :
- unrefreshing sleep
- problems with memory, focus, and word-finding (often called brain fog)
- muscle and joint pain
- headaches and flu-like feelings
- dizziness or feeling faint when standing
- sensitivity to light, sound, or temperature
Post-exertional malaise
A key feature that distinguishes ME/CFS from simple tiredness is post-exertional malaise (PEM).
This is a delayed crash in symptoms after activity. Someone might manage a short trip to the shops or a phone call, feel okay at the time, and then find their symptoms worsen hours later and stay worse for days or even weeks [1], [4].
How common is chronic fatigue syndrome?
Chronic fatigue syndrome is more common than many people realise. Studies suggest that between 0.1% and 0.8% of the global population may be affected, which could mean 17 to 24 million people worldwide [1],[5], [6].
In the United States, estimates suggest up to 2.5 million people live with ME/CFS, and around a quarter of them are housebound or bedbound [6], [7], [8].
In the UK, research using primary care data suggests that at least 250,000 people may have chronic fatigue syndrome, with a prevalence of around 0.2% in some regions [9].
The real number may be higher, as many people remain undiagnosed or are given alternative labels such as anxiety, depression, or “burnout”.
Main symptoms of chronic fatigue syndrome
Guidance from the NHS and international experts highlights four core symptom areas for ME/CFS [3], [4]:
- Persistent, disabling fatigue that has lasted for at least three months and significantly reduces daily activities.
- Unrefreshing or disturbed sleep, including difficulty falling asleep, waking frequently, or waking feeling as if you have not slept at all.
- Cognitive difficulties, such as poor concentration, short-term memory problems, or feeling mentally “slowed”.
- Post-exertional malaise, where symptoms flare after physical, mental, or emotional effort.
Other common symptoms include [10]:
- widespread pain, muscle aches, or joint pain
- headaches or a feeling of pressure in the head
- sore throat or tender lymph nodes
- flu-like feelings without an obvious infection
- gut symptoms such as bloating, nausea, or irritable bowel syndrome
- palpitations, dizziness, or feeling worse when standing up (sometimes linked to orthostatic intolerance or POTS)
Because these symptoms overlap with many other conditions, careful assessment is essential.
Why post-exertional malaise matters
Post-exertional malaise is often described by patients as the “payback” after doing too much. Even small activities, such as a shower, a school run, or a short meeting, can trigger a flare of symptoms out of proportion to the effort involved [11].
PEM can affect both the body and the brain. People may feel as if their muscles are made of lead, their heart is racing, and their thoughts are wading through treacle. This delayed crash is one of the main reasons standard exercise programmes can backfire in chronic fatigue syndrome [12].
How is chronic fatigue syndrome diagnosed?
Up until recently, there was no single blood test or scan that could confirm chronic fatigue syndrome. Diagnosis was based on:
- a detailed history of symptoms and how long they have been present
- ruling out other causes of fatigue, such as anaemia, thyroid disease, uncontrolled diabetes, sleep apnoea, or major depression
- checking for the core features of ME/CFS, including post-exertional malaise, sleep disturbance, and cognitive problems [2], [3], [10], [13].
Different research groups and health systems use slightly different diagnostic criteria, which can further confuse matters [14].
New research is exploring metabolite patterns and immune markers that might one day become reliable tests [15].
A new blood-based test for chronic fatigue syndrome
The research for an objective test for CFS finally paid off. A new blood-based test for ME/CFS is starting to change the landscape. Using a technology called EpiSwitch® 3-dimensional genomic profiling, researchers have identified a pattern of immune-related gene regulation that appears to distinguish people with ME/CFS from healthy controls with high accuracy [16].
In simple terms, the test looks at how specific immune genes are switched on or off, rather than just measuring routine blood markers that often look “normal” in ME/CFS. It’s not yet in everyday clinical use, but it’s an important step towards an objective diagnostic tool – something patients and clinicians have been waiting on for decades.
What might cause chronic fatigue syndrome?
Most researchers now agree that a single factor does not cause chronic fatigue syndrome. Instead, it seems to arise when several vulnerabilities and triggers overlap [1], [17].
Possible contributors include:
- Genetic predisposition: ME/CFS appears to cluster in some families, suggesting inherited risk factors [18].
- Infections: Many people report that their illness began after a viral infection such as glandular fever, flu, or, more recently, COVID-19 [19], [20], [21].
- Immune dysregulation and inflammation: Studies show changes in immune signalling and evidence of chronic, low-grade inflammation in some patients [22].
- Gut dysbiosis: Differences in gut bacteria and a “leaky” gut barrier may feed ongoing inflammation [23], [24].
- Environmental exposures: In a minority of cases, toxins such as organophosphates or certain medicines may act as triggers [25], [26].
Importantly, not everyone with these risk factors will develop chronic fatigue syndrome. The illness seems to emerge when the body’s systems are pushed past a tipping point and struggle to return to normal [1],[17].
What is happening in the body in CFS patients?
Chronic fatigue syndrome is best thought of as a multi-system condition. Several overlapping processes may be involved.
Immune changes and inflammation
In many people, ME/CFS appears to follow an infection or severe stress. Instead of switching off once the threat has passed, parts of the immune system stay activated [1].
This can lead to ongoing inflammation, changes in cytokines (chemical messengers), and, in some cases, signs of autoimmunity, in which the immune system begins to react to the body’s own tissues [27].
Gut and microbiome
The gut is home to trillions of bacteria that help regulate immunity and metabolism. Studies have found differences in the gut microbiome of people with chronic fatigue syndrome, including fewer beneficial species and more pro-inflammatory bacteria [23], [24]. A leaky gut barrier may allow bacterial fragments into the bloodstream, further fuelling inflammation and symptoms such as bloating, pain, and brain fog [23], [24].
Energy production and mitochondria
Cells make energy in tiny structures called mitochondria. Several studies suggest that mitochondrial function may be impaired in ME/CFS, leading to reduced energy output and a tendency to switch to less efficient pathways under stress [28], [29]. This could help explain why even modest exertion can feel overwhelming and why recovery after activity is so slow.
Circulation and blood flow
Some research has found abnormalities in blood flow and small blood vessels in chronic fatigue syndrome, including evidence of micro clots and impaired oxygen delivery to tissues [29], [30]. Reduced blood flow to muscles and the brain may contribute to fatigue, pain, dizziness, and cognitive problems.
Brain and nervous system
Neuroimaging and spinal fluid studies suggest that some people with ME/CFS have signs of neuroinflammation and altered pain processing [31]. Changes in the autonomic nervous system, which controls heart rate and blood pressure, may also play a role, especially in those with orthostatic intolerance.
Hormones and stress systems
The stress response system, including the hypothalamic–pituitary–adrenal (HPA) axis, may be blunted or dysregulated in ME/CFS [32]. This can affect cortisol levels, sleep–wake rhythms, and the ability to cope with physical or emotional stress.
Managing chronic fatigue syndrome
There is currently no cure for chronic fatigue syndrome, but many people find that a combination of strategies helps them live better with the condition [3].
Pacing and energy management
Pacing is a core self-management tool. It involves:
- understanding your personal energy limits
- breaking tasks into smaller chunks
- building in regular rest before symptoms flare
- avoiding the boom and bust cycle of overdoing it on good days and crashing afterwards [10].
Some people find heart rate monitoring or activity diaries helpful for spotting patterns.
Sleep and routine
Sleep in ME/CFS is often unrefreshing, but improving sleep hygiene can still help. This might include a regular bedtime, a calming wind-down routine, limiting caffeine late in the day, and keeping screens out of the bedroom [3]. For some, targeted sleep medicines may be considered under medical supervision.
Managing ME/CFS: medicines and other approaches
Medicines used for CFS
There is no cure for ME/CFS yet, but some medicines can help ease specific symptoms. Treatment is usually tailored to the person, based on what is causing the most difficulty day to day.
Common options include the following [33]:
- Painkillers and anti-inflammatories (e.g. ibuprofen, naproxen)
These may help with headaches, muscle and joint pain, and general aches. They should be used at the lowest effective dose and for the shortest possible time. - Antidepressants
Certain antidepressants can help with pain, poor sleep, low mood, and anxiety. Tricyclics such as amitriptyline are often used at low doses for sleep and pain, but it can take a few weeks before any benefit is noticed. - Opioid based painkillers (e.g. tramadol, codeine)
These may be considered for short-term use in severe pain, but they carry risks of dependence, tolerance, and side effects such as constipation and drowsiness. Long-term use is generally avoided. - Antivirals and immune-modulating medicines
A small number of drugs, such as Ampligen, have shown promise in research settings, but they are not widely available and may have significant side effects. Other antivirals are sometimes tried on a case-by-case basis under specialist supervision.
All medicines for ME/CFS should be started cautiously and reviewed regularly, as many people are sensitive to side effects. Any changes to treatment should be discussed with a doctor or specialist pharmacist.
Non medicine approaches
Medicines are only one part of managing ME/CFS. Many people find that lifestyle strategies and supportive therapies make just as much difference – sometimes more.
Key approaches include:
- Adaptive pacing therapy (APT)
Pacing is about balancing activity and rest so you stay within your “energy envelope”. Rather than pushing through symptoms, you plan your day around realistic limits, build in rest before you crash, and adjust goals over time. For many people, APT is safer and more sustainable than trying to increase activity in a fixed way[10]. - Cognitive behavioural therapy (CBT)
CBT is a talking therapy that can help people cope with the emotional impact of long-term illness, manage stress, and develop practical coping strategies. It does not cure ME/CFS, but some people find it helpful for dealing with anxiety, low mood, or the losses that come with chronic illness [33]. - Graded exercise therapy (GET)
GET involves steadily increasing exercise according to a set plan [34]. Many people with ME/CFS report that this approach worsened their symptoms, especially post-exertional malaise (PEM). Re-analysis of key trials suggests that GET offers little, if any, benefit and may be harmful for some patients [35]. Because of this, fixed?increase exercise programmes are no longer recommended for most people with ME/CFS [35].
Ongoing debates
There is still an active debate about the best way to manage chronic fatigue syndrome. Some older models framed it mainly as a psychological condition. Newer research points towards complex changes in the immune system, gut microbiota, circulation and blood flow, energy metabolism, nervous system, hormone disruptions and response to infection [1], [23], [24], [27], [29], [30], [31], [32].
The previously endorsed combination of CBT and GET has been heavily criticised. Evidence now suggests that these approaches provide minimal benefit and, in the case of GET, may cause more harm than good for many patients [34], [35],[36].
Updated guidance has shifted towards pacing, symptom-led activity, and personalised care.
More high-quality research is needed to understand the underlying biology of ME/CFS and to develop safe, effective treatments.
The latest breakthrough with the discovery of an objective test for CFS will hopefully lead to more targeted therapies [16].
Patient experiences and stigma
Living with chronic fatigue syndrome or ME/CFS is not just about symptoms. Many people struggle to get a diagnosis, feel dismissed, or are told their illness is “just stress” or “all in the mind”. Because there is no single diagnostic test and symptoms overlap with other conditions, some healthcare professionals still underestimate how disabling ME/CFS can be.
This can lead to:
- long delays in diagnosis
- difficulty accessing benefits or workplace support
- strained relationships and social isolation
- a sense of not being believed or taken seriously
The history does not help. The World Health Organisation classified ME/CFS as a neurological disease in 1969. Yet in 1970, two psychiatrists suggested that some outbreaks were “mass hysteria” [37]. Their work was later criticised for poor methods, and their conclusions were challenged [38], but the stigma they helped create still affects patients today.
Improving education for healthcare professionals and challenging outdated beliefs are key steps in reducing harm and improving care.
![Steampunk-style infographic from https://medicalmojo.co.uk showing Dr. Rosalind Jex standing in her Etherwell laboratory, arms folded and looking determined, surrounded by thought bubbles that highlight the stigma people with chronic fatigue syndrome (ME/CFS) face. The bubbles read: “Told it’s ‘just stress’ or ‘all in the mind’”, “Years of waiting for diagnosis”, “Struggling to get benefits or workplace support”, “Friends and family don’t always understand”, and “History of ‘mass hysteria’ still casting a shadow [37],[38]”. A brass banner at the bottom states that stigma can hurt just as much as symptoms and that patients deserve to be believed, reinforcing the ME/CFS blog content on https://medicalmojo.co.uk.](https://i0.wp.com/medicalmojo.co.uk/wp-content/uploads/2025/11/Patient-exeperience-and-stigam-with-ME-CFS-medicalmojo.co_.uk_.jpg?resize=895%2C1229&ssl=1 "Patient experiences and stigma in chronic fatigue syndrome (ME/CFS) – Dr Rosalind Jex stands up for patients | https://medicalmojo.co.uk")
Low-dose naltrexone (LDN) for ME/CFS
Low-dose naltrexone (LDN) is attracting interest as a potential treatment for ME/CFS and related conditions such as fibromyalgia [39], [40], [41]. At low doses, naltrexone appears to modulate immune activity and glial cells in the nervous system, which may help reduce pain and fatigue [39], [40], [41].
A retrospective study of 218 people with ME/CFS found that around 70% reported improvements in fatigue, pain, and cognitive function after starting LDN. Many also reported better sleep and overall quality of life, and the medicine was generally well tolerated [42]. However, this type of study looks back at existing records rather than testing treatment in a controlled trial, so the results are less definitive than those from randomised studies.
At present, LDN is used off-label and is not part of standard NHS treatment pathways. It may be considered on an individual basis after discussion with a knowledgeable clinician.
If you would like to explore whether LDN might be suitable for you, you can contact Courier Pharmacy or complete the online chronic fatigue syndrome consultation form for more information.
Coenzyme Q10 and ME/CFS
Coenzyme Q10 (CoQ10) is a key part of mitochondrial energy production and also acts as an antioxidant [43], [44], [45]. Several small trials suggest that CoQ10 may help some people with ME/CFS:
- In one study, a combination of CoQ10 and NADH improved fatigue, sleep, quality of life, and exercise tolerance [46].
- Another trial found that CoQ10 plus selenium reduced tiredness, improved quality of life, and lowered markers of oxidative stress and inflammation [47].
One major challenge is absorption. CoQ10 is fat-soluble and poorly water-soluble, so many standard capsules and tablets are poorly absorbed. Even some “advanced” formulations do not significantly increase blood levels [48].
CoQ10 buccal film from Medical Mojo
To address this, Medical Mojo has worked with APC Labs to develop a CoQ10 50 mg buccal film. This is placed inside the cheek, where it dissolves and is absorbed directly through the lining of the mouth. This route bypasses much of the digestive system and may increase the amount of CoQ10 that reaches the bloodstream.
Better absorption could mean more reliable support for:
- cellular energy production
- antioxidant protection
- recovery after exertion
To access the CoQ10 buccal film, patients are asked to complete the ME/CFS consultation form to ensure treatment is used safely and appropriately.
Melatonin buccal film for ME/CFS
Melatonin is a hormone that helps regulate the sleep–wake cycle [49]. It also has antioxidant and anti-inflammatory effects, which may be relevant in ME/CFS [50].
A 16-week randomised, placebo-controlled trial of melatonin (1 mg) plus zinc (10 mg) in 50 people with ME/CFS found:
- reduced physical fatigue
- improved physical quality of life
- good overall tolerability [50].
Building on this, Medical Mojo and APC Labs have developed a melatonin buccal film designed to improve absorption through the mouth’s lining. This allows melatonin to enter the bloodstream more directly than standard tablets.
The melatonin buccal film is available via the ME/CFS questionnaire pathway, allowing dosing and safety to be reviewed by a pharmacist and prescriber.
The 3R CFS treatment from Medical Mojo: Recover, Rest, Recharge
Medical Mojo’s 3R CFS treatment programme brings together three compounded treatments designed to support people living with ME/CFS:
- Recover – Low-dose naltrexone (LDN)
Aims to modulate immune activity and reduce neuro?inflammation and pain. - Rest – Melatonin buccal film
Supports sleep quality and may help with physical fatigue and recovery. - Recharge – CoQ10 50 mg buccal film
Targets mitochondrial energy production and antioxidant support.
Each of these treatments has some evidence of benefit when used alone [42], [46], [47], [50].
The 3R CFS treatment programme combines them in a structured way, with dosing overseen by Courier Pharmacy in partnership with APC Labs.
The goal is not a quick fix, but a realistic, science-informed approach that aims to:
- support energy production
- improve sleep and recovery
- calm overactive or dysregulated immune responses
If you are interested in the 3R CFS treatment programme, you can contact Medical Mojo or complete the ME/CFS consultation form to see whether it may be appropriate for you.
Looking to the future for CFS
Chronic fatigue syndrome remains a challenging condition, but research is moving quickly. Scientists are studying:
- detailed immune and microbiome profiles
- mitochondrial function and redox balance
- blood-based biomarkers and genomic signatures
- links with long COVID and other post-viral syndromes
For now, management focuses on symptom control, pacing, and personalised support. Working with clinicians who understand ME/CFS, listening to your body, and making gradual, sustainable changes can make a real difference over time.
New directions and personalised care
Research into chronic fatigue syndrome has accelerated in recent years, helped in part by interest in long COVID, which shares many features with ME/CFS. Scientists are exploring:
- biomarkers in blood, urine, and spinal fluid
- detailed immune and microbiome profiles
- mitochondrial function and redox balance
- blood-based biomarkers and genomic signatures
- links with long COVID and other post-viral syndromes
- detailed immune and microbiome profiles
- wearable technology to track activity and heart rate
- personalised approaches that combine pacing, nutrition, targeted medicines, and psychological support.
Exciting developments at Medical Mojo for CFS treatment
At Medical Mojo, we’re moving beyond one?size?fits?all advice and building a genuinely personalised approach to long?term health.
Genetic testing for optimal nutrition
Our next phase focuses on Nutrigen genetic testing, using SNP analysis to understand how your genes affect nutrient needs, detox pathways, and energy production, so we can fine?tune your nutrition rather than guessing.
SIBO breath testing and microbiome analysis
Alongside this, we’re introducing SUBO breath testing to assess gut fermentation and carbohydrate tolerance, gut microbiome analysis to map the balance of your gut bacteria, and targeted blood testing to track inflammation, nutrient status, and metabolic health.
An integrated algorithm to pull all the data streams together
Behind the scenes, we’re developing an integrated algorithm that pulls all these data streams together – genetics, breath tests, microbiome, and blood markers – to generate clear, personalised recommendations.
Bespoke compounded solutions
The final step is where it gets really exciting: using these insights to design bespoke medicines and tailored supplements that match your unique biology. Instead of generic protocols, you’ll receive carefully compounded formulations and nutrition plans built around your own data, to move you towards optimal health, not just “within range” on a lab report.
Who is this article for, and how can it help?
This guide is for anyone who has wondered “What is chronic fatigue syndrome?”—whether you are living with long-term fatigue yourself, supporting a loved one, or trying to understand a patient’s experience. Our aim is to:
- explain the condition in clear, accessible language
- bring together current scientific understanding with real-world experience
- outline practical steps you can discuss with your healthcare team
If chronic fatigue syndrome is affecting your life, you are not alone, and it is not your fault. With the correct information, pacing strategies, and support, many people find ways to stabilise their symptoms and improve their quality of life over time.
Chronic fatigue syndrome FAQs
1. What exactly is chronic fatigue syndrome (ME/CFS)?
Chronic fatigue syndrome, also called myalgic encephalomyelitis (ME/CFS), is a long?term illness that affects many body systems at once – including the immune system, nervous system, hormones, circulation, and how your cells make energy.
The hallmark symptom is profound fatigue that doesn’t improve with rest and often gets worse after even small amounts of physical, mental, or emotional effort.
2. How is ME/CFS different from “normal” tiredness or burnout?
Normal tiredness usually improves with a good night’s sleep or a few days’ rest.
With ME/CFS, people often feel as if their “battery” never recharges. Simple tasks – a shower, a short walk, a school run, or answering emails – can lead to a delayed crash in symptoms that lasts days or even weeks.
This delayed worsening after activity is called post?exertional malaise (PEM) and is one of the key features that separates ME/CFS from everyday fatigue, stress, or burnout.
3. What are the main symptoms of chronic fatigue syndrome?
Guidance from the NHS and international experts highlights four core symptom areas:
- Persistent, disabling fatigue for at least three months
- Unrefreshing or disturbed sleep
- Cognitive problems (“brain fog”) – poor focus, memory issues, word?finding difficulty
- Post?exertional malaise – symptoms flaring after physical, mental, or emotional effort
Many people also experience pain, headaches, flu?like feelings, gut issues (such as bloating, nausea or IBS), dizziness, palpitations, and feeling worse when standing up.
4. What is post?exertional malaise (PEM) and why is it so important?
Post?exertional malaise is the “payback” after doing more than your body can handle.
You might feel okay during an activity, but hours later – or the next day – your symptoms suddenly worsen. Fatigue, pain, brain fog, dizziness and flu?like feelings can all spike and stay worse for days or longer.
PEM is crucial because it means standard “push through it” exercise programmes can backfire in ME/CFS, making people significantly worse instead of better.
5. How common is chronic fatigue syndrome?
ME/CFS is more common than many people realise:
- Globally, around 0.1–0.8% of the population may be affected – an estimated 17–24 million people
- In the United States, up to 2.5 million people may live with ME/CFS, with about a quarter housebound or bedbound
- In the UK, at least 250,000 people are thought to have ME/CFS, with prevalence around 0.2% in some regions
The real numbers are likely higher, because many people remain undiagnosed or are given alternative labels such as anxiety, depression, or “burnout”.
6. How is ME/CFS diagnosed if there isn’t a simple blood test?
Until very recently, there was no single test for ME/CFS. Diagnosis relied on:
- A detailed history of symptoms and how long they’ve been present
- Ruling out other causes of fatigue (such as anaemia, thyroid problems, uncontrolled diabetes, sleep apnoea, or major depression)
- Checking for the core features of ME/CFS – especially post?exertional malaise, unrefreshing sleep, and cognitive problems
New research has now identified a blood?based test using EpiSwitch® 3D genomic profiling that can distinguish people with ME/CFS from healthy controls. It’s not yet routine in everyday clinics, but it’s a big step towards an objective diagnostic tool.
7. What might be causing chronic fatigue syndrome?
There doesn’t seem to be a single cause. Instead, ME/CFS appears when several vulnerabilities and triggers overlap. Research points to:
- Genetic predisposition (it can run in families)
- Infections (e.g. glandular fever, flu, COVID?19 and other viral illnesses)
- Immune dysregulation and chronic, low?grade inflammation
- Gut dysbiosis and a “leaky” gut barrier
- Problems with mitochondrial energy production
- Changes in blood flow and oxygen delivery
- Neuroinflammation and altered pain processing
- Hormone and stress?response imbalances
Not everyone with these risk factors develops ME/CFS, but when the body is pushed past a tipping point, it may struggle to reset.
8. Is there a cure for ME/CFS – and what treatments are available?
There is currently no cure, but many people find that symptoms can be managed and quality of life improved with a combination of:
- Pacing and energy management (staying within your “energy envelope”)
- Sleep support and good sleep hygiene
- Pain relief and symptom?targeted medicines
- Supportive therapies such as CBT for coping with long?term illness
- Careful, symptom?led activity rather than fixed graded exercise programmes
Newer approaches under investigation include low?dose naltrexone (LDN), CoQ10, melatonin, and other immune?modulating or metabolic treatments.
9. What is the Medical Mojo 3R CFS treatment?
Medical Mojo’s 3R CFS treatment is a personalised programme that combines three compounded medicines:
- Recover – Low?dose naltrexone (LDN): aims to modulate immune activity and reduce neuroinflammation and pain
- Rest – Melatonin buccal film: supports sleep quality and may help with physical fatigue and recovery
- Recharge – CoQ10 50 mg buccal film: targets mitochondrial energy production and antioxidant support
Each component has some evidence of benefit on its own. The 3R programme brings them together in a structured way, with dosing overseen by Courier Pharmacy and APC Labs. It’s not a quick fix, but a science?informed attempt to support energy, sleep, and immune balance.
10. What can I do if I think I might have chronic fatigue syndrome?
If you recognise yourself in these symptoms:
- Speak to your GP or contact us– explain how long symptoms have been present, how they affect daily life, and whether you experience post?exertional malaise.
- Rule out other causes – ask about blood tests and checks for common medical conditions that can mimic ME/CFS.
- Start gentle pacing – keep an activity and symptom diary, and experiment with staying within your energy limits.
- Look for informed support – clinicians, pharmacists, and services that understand ME/CFS can help you explore options such as LDN, CoQ10, melatonin and personalised nutrition.
Most importantly, remember that ME/CFS is a real, biological illness. It is not your fault, and you don’t have to “prove” you are unwell. With the right information, pacing strategies, and tailored treatment, many people find ways to stabilise their symptoms and gradually improve their quality of life.
Disclaimer: This article is for informational purposes only and does not replace professional medical advice.
References
What is chronic fatigue syndrome?
[3] NHS. Chronic fatigue syndrome (CFS/ME). NHS website. Available at: https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/
How common is chronic fatigue syndrome?
[6] American ME and CFS Society. How many people have ME/CFS? U.S. 2019. https://ammes.org/how-many-people-have-mecfs/. Accessed 31 Jan 2019.
Main symptoms of chronic fatigue syndrome
Why post-exertional malaise matters
How is chronic fatigue syndrome diagnosed?
A new blood-based test for chronic fatigue syndrome
What might cause chronic fatigue syndrome?
What is happening in the body in CFS patients?
Energy production and mitochondria
Circulation and blood flow
Brain and nervous system
Hormones and stress systems
Medicines used for CFS
Non?medicine approaches
Ongoing debates
Patient experiences and stigma
Low-dose naltrexone (LDN) for ME/CFS
[39] Medical Mojo. (no date) Low dose naltrexone (LDN): could it help with chronic illness? Available at: https://medicalmojo.co.uk/low-dose-naltrexone/ (Accessed 18 November 2025).
[40] Medical Mojo. (no date) Fibromyalgia and low-dose naltrexone (LDN): can it help manage pain and fatigue? Available at: https://medicalmojo.co.uk/fibromyalgia-and-ldn/ (Accessed 18 November 2025).
[41] Medical Mojo. (no date) Long COVID and low-dose naltrexone (LDN): could it help recovery? Available at: https://medicalmojo.co.uk/long-covid-and-ldn/ (Accessed 18 November 2025).
Coenzyme Q10 and ME/CFS
[43] Medical Mojo. (no date) What’s the role of CoQ10 in fertility? Available at: https://medicalmojo.co.uk/whats-the-role-of-coq10-in-fertility/ (Accessed 18 November 2025).
[44] Medical Mojo. (no date) CoQ10 and fertility: Can coenzyme Q10 improve egg and sperm quality? Available at: https://medicalmojo.co.uk/coq10-and-fertility/ (Accessed 18 November 2025).
[45] Medical Mojo. (no date) Coenzyme Q10 and long COVID: Can CoQ10 support recovery and energy? Available at: https://medicalmojo.co.uk/coenzyme-q10-and-long-covid/ (Accessed 18 November 2025).
Melatonin buccal film for ME/CFS
[49] Medical Mojo. (no date) What is melatonin? Available at: https://medicalmojo.co.uk/what-is-melatonin/ (Accessed 18 November 2025).
