The Institute of Integrative Medicine in Pretoria recommends a partnership between doctors and patients to tailor treatment plans for ME/CFS. Lisha Rajdhew offers these guidelines:

• LOW-GI DIET: Incorporate oats and wholegrains to ensure a steady supply of glucose. This supports sustained energy, aids in combating fatigue, and promotes gut health.

• INCREASE FLUID INTAKE:

More fluids are essential to prevent dehydration, which can worsen fatigue, muscle cramps, headaches and mood.

• OMEGA-3 AND -6: Supplementation is essential for immune system, brain function and mood regulation, and to support mitochondrial health, which is crucial for energy production.

• VITAMIN B12: Supplementation with vitamin B12 helps to improve energy, mood and cell function as well as sleep. ‘Studies indicate CFS patients have a higher prevalence of B12 deficiency, which can exacerbate fatigue and neurological symptoms’, Rajdhew says.

• NADH: This coenzyme is vital for mitochondrial energy production, helping to alleviate fatigue and support muscle, immune system and cognitive function, and mood.

• COENZYME Q10: It boosts cellular energy, improves oxygen utilisation, and supports mitochondrial, muscle, heart and brain function.

• L-CARNITINE: It facilitates the transport of long-chain fatty acids into the mitochondria, enhancing energy production and supporting exercise capacity and cognitive function.

• DEEP-BREATHING EXERCISES: These can help to reduce stress and anxiety, increase oxygen delivery and support cellular metabolism.

• MEDITATION: Useful for managing stress and anxiety, improving sleep quality, cognition and mood.