Rosenheimer Str. 6-8, 83043 Bad Aibling, Germany · info@clinicum-stgeorg.de
Treatment
CFS/ME is a complex, multi-system disease characterized by profound fatigue, post-exertional malaise, cognitive dysfunction, and immune impairment. It is not depression, deconditioning, or laziness. It is a biological illness with identifiable mechanisms.
You have stopped explaining it, because the explanation sounds like complaining. Your calendar is a list of things you cancelled. A friend says you look well, and from the outside you do. Inside, a shower is a decision that costs the afternoon.
This page sets out what ME/CFS is, biologically, and why it is neither depression nor deconditioning.
Everyone experiences fatigue. What distinguishes CFS/ME is the severity, persistence, and the presence of post-exertional malaise — a worsening of all symptoms following even minor physical or cognitive effort.
A person with CFS/ME who takes a short walk may be bedbound for the next three days. A student with CFS/ME who attends a one-hour class may be unable to read for a week afterward. This is not proportionate tiredness — it is a fundamental breakdown in the body’s energy production systems.
The World Health Organization classifies CFS/ME as a neurological disease (ICD-11 code 8E49). Research institutions worldwide have documented abnormalities in mitochondrial function, immune regulation, autonomic nervous system control, brain metabolism, and gut health in CFS patients.
CFS/ME does not have a single cause. It typically develops after a triggering event in a person with underlying biological vulnerabilities. Common triggers and contributing factors include:
Epstein-Barr virus (EBV), cytomegalovirus (CMV), enteroviruses, HHV-6, and SARS-CoV-2 are among the most common infectious triggers. CFS/ME has been documented after many different viral infections, and the post-COVID pandemic has dramatically increased CFS prevalence worldwide.
Lyme disease (Borrelia burgdorferi) and its co-infections are significant triggers for CFS. Many patients initially diagnosed with "post-treatment Lyme disease syndrome" meet full criteria for CFS/ME, suggesting shared underlying mechanisms.
Impaired natural killer cell function, shifted T-helper cell ratios, elevated pro-inflammatory cytokines, and mast cell activation are consistently found in CFS patients. The immune system appears stuck in a state of chronic, low-grade activation.
Reduced ATP production, increased oxidative stress, and impaired mitochondrial membrane potential are hallmarks of CFS. The cells literally cannot produce enough energy to meet the body's demands, explaining the characteristic fatigue and post-exertional malaise.
Dysfunction of the autonomic nervous system -- which controls heart rate, blood pressure, digestion, and temperature -- is present in most CFS patients. This explains the orthostatic intolerance, POTS, and exercise intolerance commonly reported.
Altered gut microbiome composition, increased intestinal permeability, and gut-brain axis disruption contribute to systemic inflammation, immune activation, and neurological symptoms. Gut health is increasingly recognized as central to CFS pathophysiology.
One of the most frustrating aspects of CFS/ME is that standard medical tests — complete blood count, basic metabolic panel, thyroid function, standard imaging — typically return normal results. This leads many physicians to conclude that nothing is wrong.
The problem is not that nothing is wrong. The problem is that the standard tests do not look in the right places. CFS/ME involves dysfunction at the cellular and immunological level that requires specialized testing to detect:
At St. George Hospital, our diagnostic protocol specifically targets these systems. We look for what standard medicine misses.
Understanding your condition is the first step. The next is finding a medical team that can investigate the root causes and provide targeted treatment.
Targets the mitochondrial dysfunction at the root of CFS by triggering new mitochondrial growth through controlled oxygen variation.
What IHHT training involves →Replenishes cellular energy currency depleted in chronic fatigue, supporting ATP production and neurological function.
What NAD+ infusion involves →Reduces neuroinflammation and improves tissue oxygenation, addressing two key mechanisms underlying CFS symptoms.
What a hyperbaric oxygen session involves →Enhances oxygen utilization at the cellular level and provides immune modulation for CFS-related immune dysfunction.
What ozone therapy involves →A video consultation in English before you travel. A physician reviews your findings first; we reply by email within one business day (Mon–Fri).
Mon–Thu 08:00–17:00, Fri 08:00–14:00 (CET/CEST)+49 8061 398-0info@clinicum-stgeorg.de
St. George Hospital is a specialist hospital, not an emergency department. In a medical emergency in Germany, dial 112.
