Understanding CFS
What chronic fatigue syndrome really is, how it differs from ordinary tiredness, and why it remains misunderstood.
Understanding ME/CFS →
Chronic Fatigue Syndrome
Restoring Energy at the Cellular Level
Chronic Fatigue Syndrome is not psychological. It is a biological disease involving mitochondrial dysfunction, immune dysregulation, and nervous system impairment. We investigate the root causes and treat them directly.
- Mitochondrial Testing
- NAD+ & IHHT Protocols
- Root-Cause Diagnostics
- Dr. Julian Douwes, CMO
Understanding CFS/ME
A Disease That Deserves Better Medicine
Chronic Fatigue Syndrome (CFS), also known as Myalgic Encephalomyelitis (ME), affects an estimated 17-24 million people worldwide. Despite this, the average patient sees multiple doctors over several years before receiving a diagnosis — and many are told their symptoms are psychological.
At St. George Hospital, we take CFS/ME seriously as a biological disease. Research has identified clear abnormalities in mitochondrial energy production, immune function, autonomic regulation, and brain inflammation in CFS patients. Our diagnostic approach investigates these systems in depth, and our treatment program targets the specific dysfunctions identified in each patient.
Our experience treating Lyme disease and Post-COVID has given us deep expertise in the overlapping mechanisms of chronic fatigue, immune dysfunction, and post-infectious illness. Treatment protocols at St. George Hospital are developed by Dr. Julian Douwes, our Chief Medical Officer, with protocols supervised by Dr. Martin Rößner, drawing on decades of combined clinical experience in functional and integrative medicine.
CFS programme
Explore the programme
Our Diagnostic Approach
Advanced testing for mitochondrial function, immune status, infections, hormone levels, and autonomic health.
How we diagnose chronic fatigue →Treatment Program
Our multi-modal treatment protocol targeting mitochondrial repair, immune modulation, and nervous system restoration.
How we treat chronic fatigue →Mitochondrial Dysfunction
The central role of cellular energy failure in CFS and how targeted mitochondrial therapy can restore function.
Mitochondrial dysfunction in CFS →Core Symptoms
Hallmarks of CFS/ME
Post-Exertional Malaise
The defining symptom: disproportionate worsening of all symptoms after physical or cognitive exertion, often delayed by 24-72 hours and lasting days or weeks.
Unrefreshing Sleep
Despite sleeping adequate hours, patients wake feeling unrestored. Sleep architecture is disrupted, and deep restorative sleep phases are often reduced or absent.
Cognitive Impairment
Difficulty concentrating, word-finding problems, impaired short-term memory, and slowed processing speed -- often described as "brain fog."
Orthostatic Intolerance
Dizziness, lightheadedness, or worsening symptoms when standing. Many CFS patients meet criteria for POTS or neurally mediated hypotension.
Immune Dysfunction
Recurring sore throats, swollen lymph nodes, new sensitivities, and susceptibility to infections. Laboratory testing often reveals impaired natural killer cell function.
Pain
Widespread muscle and joint pain, headaches, and sensitivity to touch, light, sound, and temperature. Pain often fluctuates without clear mechanical cause.
17M+People Affected Worldwide
5+Years Average Time to Diagnosis
75%Unable to Work Full-Time
25%Housebound or Bedbound
RELATED THERAPIES
Treatments Used in This Program
IHHT Oxygen Therapy
Intermittent hypoxia-hyperoxia training stimulates mitochondrial regeneration, a core target in chronic fatigue recovery.
What IHHT training involves →NAD+ IV Therapy
Intravenous NAD+ restores cellular energy metabolism and supports mitochondrial repair in CFS patients.
What NAD+ infusion involves →Hyperbaric Oxygen (HBOT)
Pressurized oxygen therapy reduces neuroinflammation and improves oxygen delivery to fatigued tissues.
What a hyperbaric oxygen session involves →H.E.L.P. Apheresis
Blood filtration therapy removes inflammatory proteins and microclots that contribute to chronic fatigue symptoms.
What H.E.L.P. apheresis involves →Immune Therapy
Targeted immune modulation addresses the immune dysfunction frequently identified in CFS/ME patients.
What immune therapy involves →FREQUENTLY ASKED QUESTIONS
Common Questions About CFS Treatment
How do you diagnose CFS differently?
Unlike conventional approaches that diagnose CFS primarily by ruling out other conditions, we perform comprehensive testing including mitochondrial function assessment, detailed immune panels, hormone evaluation, autonomic nervous system testing, and screening for underlying infections. This allows us to identify the specific biological dysfunctions driving your fatigue and design targeted treatment.
What treatments do you use for chronic fatigue?
Our CFS treatment program includes IHHT (Intermittent Hypoxia-Hyperoxia Training) for mitochondrial regeneration, NAD+ IV therapy for cellular energy restoration, hyperbaric oxygen therapy (HBOT), immune modulation, hormone optimization, and targeted detoxification. The specific combination is individualized based on your diagnostic findings.
How long until I see improvement?
Some patients notice changes in energy levels and cognitive function within the first weeks of treatment. However, full recovery from CFS is typically a gradual process that unfolds over 3-6 months as mitochondrial function improves, the immune system rebalances, and the nervous system stabilizes. We provide remote follow-up to support your continued recovery.
Is CFS the same as burnout?
No. While burnout and CFS can share symptoms like fatigue and cognitive difficulty, CFS involves measurable immune dysfunction, mitochondrial impairment, and neurological abnormalities that are not present in burnout. CFS patients experience post-exertional malaise — a defining feature where symptoms worsen significantly after minimal physical or cognitive effort — which distinguishes it from other fatigue-related conditions.
Do you treat ME/CFS specifically?
Yes. Our protocols specifically address the pathophysiology of ME/CFS, including mitochondrial dysfunction, immune dysregulation, neuroinflammation, and autonomic impairment. We recognize ME/CFS as a serious biological disease and our treatment approach reflects the latest clinical understanding of its underlying mechanisms.
What does the programme cost?
There is no fixed price. After our physicians have reviewed your findings, you receive an individual estimate that lists the daily inpatient rate, diagnostics and therapy blocks. Treatment is self-pay; the itemised invoice can be submitted to a US insurer for out-of-network review. We cannot promise reimbursement.
Request a consultation
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.