Reduced ATP Production
Mitochondrial testing frequently shows impaired ATP synthesis, blocked electron transport chain complexes, and elevated markers of oxidative damage. This directly explains the energy deficit that defines CFS.
Diagnosis
Diagnosing Chronic Fatigue Syndrome
Standard blood tests rarely reveal the biological dysfunctions underlying CFS/ME. Our comprehensive diagnostic protocol examines mitochondrial function, immune status, chronic infections, hormonal balance, and autonomic regulation to identify treatable causes.
Is this you?
Every test comes back normal, and you feel worse than the paper says.
You have had the blood count, the thyroid panel, maybe a sleep study. Each is “within range,” and each appointment ends the same way: a shrug, advice to exercise more, a referral months out. You do not want a label. You want someone to measure what is actually broken.
This page explains which tests we run for ME/CFS, what they look for, and why they differ from the ones you have had.
How we think about it
Finding What Others Miss
The diagnosis of CFS/ME is typically made by exclusion — ruling out other conditions and then concluding that fatigue of unknown cause persists. This approach tells the patient what they do not have, but never explains what they do have or why.
At St. George Hospital, we go beyond exclusion. Our diagnostic approach actively seeks the biological dysfunctions driving each patient’s symptoms. We test mitochondrial energy production, map immune dysregulation, screen for chronic and reactivated infections, evaluate hormonal pathways, and assess autonomic nervous system function.
The result is not merely a label, but a mechanistic understanding of why you are sick — which directly informs a targeted treatment plan.
What we test
Step-by-Step Assessment
1
Comprehensive Medical History
A detailed review of your symptom timeline, onset triggers, prior diagnoses, treatments tried, functional capacity, and quality-of-life impact. We use validated CFS/ME assessment tools to quantify symptom severity.
2
Mitochondrial Function Testing
ATP profile testing, organic acid analysis, and oxidative stress markers reveal the efficiency of cellular energy production. These tests identify specific metabolic blocks that can be targeted with therapy.
3
Immune System Assessment
Extended immune panel including natural killer cell activity, lymphocyte subsets (CD4/CD8 ratio, T-regulatory cells), cytokine profiling, and immunoglobulin levels. We also screen for autoantibodies that may indicate immune dysregulation.
4
Chronic Infection Screening
Comprehensive testing for Epstein-Barr virus reactivation, CMV, HHV-6, Borrelia (Lyme), co-infections (Bartonella, Babesia, Chlamydia pneumoniae, Mycoplasma), and viral persistence markers.
5
Hormonal & Metabolic Panel
Full thyroid panel (including rT3), adrenal function (cortisol rhythm), sex hormones, vitamin D, B12, folate, iron studies, and metabolic markers to identify correctable imbalances.
6
Autonomic & Neurological Assessment
Heart rate variability analysis, orthostatic testing, and clinical neurological evaluation to assess autonomic function and identify dysautonomia.
7
Gut Health Analysis
Comprehensive stool analysis, intestinal permeability testing, and microbiome profiling to evaluate gut-brain axis function and identify gut-mediated inflammation.
Key Diagnostic Findings
Common Abnormalities We Identify
Low NK Cell Activity
Natural killer cell cytotoxicity is consistently reduced in CFS patients, indicating impaired immune surveillance. This may explain susceptibility to viral reactivation and persistent infections.
Viral Reactivation
Elevated antibody titers to EBV (especially early antigen), CMV, or HHV-6 suggest ongoing viral activity that may be driving chronic immune activation and inflammation.
Hormonal Imbalance
Subclinical hypothyroidism, adrenal insufficiency, low sex hormones, and vitamin D deficiency are frequently found and contribute to fatigue, cognitive dysfunction, and immune impairment.
Gut Permeability
Increased intestinal permeability ("leaky gut") allows bacterial endotoxins to enter the bloodstream, triggering systemic inflammation and contributing to both fatigue and neurological symptoms.
Autonomic Imbalance
Heart rate variability testing often reveals sympathetic dominance and reduced parasympathetic tone, indicating a nervous system stuck in a stress response pattern.
After Diagnosis
From Diagnosis to Treatment
Once we have identified the specific biological dysfunctions driving your CFS, we design a targeted treatment plan that addresses each finding. No two treatment plans are identical because no two patients have exactly the same pattern of dysfunction.
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+ supports cellular energy metabolism and mitochondrial repair identified as impaired in diagnostic testing.
What NAD+ infusion involves →Ozone Therapy
Medical ozone improves oxygen utilization and modulates immune function, targeting findings from CFS diagnostic panels.
What ozone therapy involves →Hormone Therapy
Addresses hormonal imbalances -- thyroid, adrenal, and sex hormones -- frequently uncovered during CFS diagnostic workup.
What hormone therapy involves →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.