The most broadly accepted management strategy for ME/CFS. Staying within your energy envelope prevents post-exertional malaise crashes and gradually expands functional capacity.

Vitamin D deficiency is common and undertreated in fatigue conditions. Correcting deficiency consistently improves fatigue, mood, and immune function.

Vitamin B12 deficiency is a correctable cause of fatigue. Methylcobalamin is the active form and may be better absorbed in some individuals.

Iron deficiency without anaemia is a common and frequently missed cause of fatigue. Correcting iron stores (ferritin) improves energy even without full anaemia.

Coenzyme Q10 and NADH are key components of the mitochondrial electron transport chain. Used together, they may address the mitochondrial dysfunction suspected in ME/CFS.

A five-carbon sugar that is a structural component of ATP. May support cellular energy production in individuals with impaired mitochondrial function.

At doses of 1.5–4.5mg (far below the addiction treatment dose), naltrexone modulates the immune system and may reduce the neuroinflammation driving ME/CFS symptoms.

Maintaining a consistent sleep schedule with the same wake time every day helps stabilise circadian rhythm, which is often severely disrupted in chronic fatigue.

A diet rich in omega-3s, polyphenols, and low in processed foods and sugar that reduces systemic inflammation — a key driver of fatigue in ME/CFS and related conditions.