deWhat is Chronic Fatigue Syndrome (ME/CFS)?
When exhaustion persists
Myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS), has little in common with ordinary tiredness. The profound feeling of exhaustion persists even after sufficient sleep and rest.
Even minor physical or mental exertion can worsen symptoms so severely that everyday tasks may be almost impossible for several days. This exertion intolerance, characteristic of ME/CFS, is known as post-exertional malaise (PEM).
Many people affected have already undergone numerous examinations, medical appointments and treatments without experiencing sufficient improvement in their symptoms.
VitaSangius is a specialised centre for apheresis and extracorporeal blood purification procedures in Potsdam. A particular focus is physician-supervised apheresis for patients whose symptoms persist despite previous treatments.
Medical assessment and treatment are provided by independently practising partner physicians. They review your medical history and existing findings in detail. They then discuss with you which further examinations may be appropriate and whether any of the therapies offered at VitaSangius may be suitable for you.
What is Chronic Fatigue Syndrome (ME/CFS)?
ME/CFS is a chronic neurological multisystem disorder. Internationally, it is classified as a disease of the nervous system. However, the associated symptoms affect several areas of the body. The processes involved in its development have not yet been fully clarified.
The condition severely limits physical and cognitive capacity. Some people can still manage individual tasks, but only with major restrictions. In severe cases, it may become almost impossible to leave the house.
People with very severe illness may even be bedridden and depend on support with daily care.
In ME/CFS, fatigue refers to pathological exhaustion accompanied by a marked loss of previous capacity. It should not be confused with the normal tiredness healthy people experience after physical exertion or a long day. It is also important to note that the term fatigue syndrome is often used for persistent states of exhaustion, but does not automatically mean ME/CFS.
What do the abbreviations CFS, ME and ME/CFS mean?
CFS
is the abbreviation for Chronic Fatigue Syndrome. This term emphasizes persistent fatigue, but it only partially reflects the complex nature of the illness.
ME
stands for myalgic encephalomyelitis. The term is mainly used to emphasise that the condition cannot be reduced to fatigue alone.
ME/CFS
combines the two terms and has therefore become established for the condition as a whole. It makes clear that ME/CFS involves far more than an ordinary fatigue syndrome.
What distinguishes CFS from normal exhaustion?
Exhaustion is initially a normal reaction of the body: after physical exertion, insufficient sleep or a stressful period in life, performance temporarily declines. Rest and sleep normally allow the body to recover.
With CFS, this is not the case. Previous capacity remains significantly reduced over a prolonged period. Even sufficient sleep does not leave those affected feeling refreshed. Other symptoms may include difficulty concentrating, muscle and joint pain, or circulatory problems. The symptoms of chronic fatigue syndrome are therefore not limited to tiredness.
Effects of exertion often appear hours later
Post-exertional malaise (PEM) is characteristic of ME/CFS. It describes a worsening of the overall condition after physical or mental exertion. Emotional stress or intense sensory stimuli can also trigger such a reaction.
Symptoms usually do not occur during the activity itself. Some people can initially manage an appointment or an everyday task without difficulty. The effects only become noticeable the next day. Typically, the deterioration begins within 12 to 48 hours: exhaustion increases, thinking becomes more difficult, and existing pain or sleep problems worsen. This condition can last for days or even weeks.
This makes it difficult to realistically assess your own limits. What may still be possible on one day can lead to a prolonged setback afterwards. This delayed reaction is one of the key features that distinguishes ME/CFS from ordinary exhaustion.
| Comparison | Normal Fatigue | ME/CFS |
|---|---|---|
| Recovery | Rest and sleep lead to a noticeable improvement. | Exhaustion persists despite adequate rest. After physical or mental exertion, symptoms become even worse. |
| Capacity for Exertion | Physical and mental performance is temporarily reduced but returns to normal after recovery. | Physical and cognitive capacity remains significantly below previous levels. Even minor exertion can trigger post-exertional malaise (PEM). |
| Daily Life | Usual daily activities become possible again after a period of rest. | Work, household tasks, personal care and social interactions remain significantly restricted. In severe cases, patients depend on assistance. |
| Sleep | Getting enough sleep usually provides a sense of recovery. | Sleep is not restorative. Patients wake up feeling exhausted even after sleeping through the night. |
| Duration | Symptoms subside once sleep deprivation or previous physical strain has been compensated for. | ME/CFS is a chronic condition. Symptoms may fluctuate but do not permanently disappear with rest. |
| Symptoms | The main symptoms are tiredness and a temporary reduction in physical or mental performance. | Typical ME/CFS symptoms include severe exhaustion, post-exertional malaise (PEM), brain fog, sleep disturbances, pain and orthostatic symptoms. |
Severe exhaustion alone is not sufficient for a diagnosis
Fatigue also occurs with other conditions, including cancer, multiple sclerosis and inflammatory rheumatic diseases. Anaemia, thyroid disorders, sleep disorders and mental health conditions can also be associated with persistent exhaustion.
Severe tiredness alone does not automatically mean that ME/CFS is present. Your complete symptom profile is crucial for an accurate medical assessment. The persistent loss of your previous capacity, unrefreshing sleep and post-exertional malaise (PEM) are particularly relevant. If your symptoms regularly worsen with a delay after minor exertion, this should always be taken into account during further diagnostic assessment.
Which CFS symptoms can occur?
ME/CFS causes physical, cognitive and neurological symptoms. The symptoms and their severity vary from person to person. The most characteristic features are a persistent reduction in capacity and deterioration after exertion.
Post-exertional malaise (PEM)
The central feature of ME/CFS is post-exertional malaise. Even minor physical, cognitive, emotional or sensory stress can cause a marked deterioration. The reaction often begins several hours later and may last for several days or longer.
Extreme exhaustion
Exhaustion in ME/CFS goes far beyond ordinary tiredness. Even everyday tasks such as showering, cooking or having a short conversation require a great deal of energy. Rest or sleep no longer provides the usual recovery.
Brain Fog
Brain fog describes the feeling of being mentally slowed down or dazed. People may have difficulty processing information, finding the right words or following a conversation. These symptoms often worsen with exertion.
Difficulty concentrating
Lesen, Bildschirmarbeit oder Aufgaben mit mehreren Arbeitsschritten können bei ME/CFS schnell überfordern. Manche Erkrankte verlieren immer wieder den Gedankengang, müssen Inhalte mehrfach lesen oder können ihre Aufmerksamkeit nur für kurze Zeit aufrechterhalten.
Sleep disorders
Many people with ME/CFS sleep for long periods but still feel exhausted the next morning. Other possible symptoms include difficulty falling or staying asleep, frequent awakenings, or a disrupted sleep-wake cycle.
Muscle and joint pain
Many people experience persistent muscle and joint pain or pain that varies in intensity. In some cases, the pain worsens after physical or mental exertion. Recurring headaches are also a possible symptom.
Circulatory problems
Prolonged sitting or standing can cause dizziness, a racing heart, weakness, nausea or difficulty concentrating. If symptoms improve when lying down, orthostatic intolerance may be present. One possible form is postural orthostatic tachycardia syndrome, or POTS.
Sensitivity to Stimuli
People with ME/CFS may perceive light, sounds, smells, or touch as unusually intense or even painful. In severe cases, even a normal everyday environment can lead to a significant worsening of symptoms.
Not all patients experience all of the ME/CFS symptoms mentioned. Therefore, the severity of symptoms, their progression over time, and their impact on daily life are always crucial for medical assessment.
Causes of ME/CFS
Current State of Scientific Research
The exact causes of ME/CFS are not yet fully understood. Current research suggests that several processes interact with one another. A distinction is made between potential triggers and the underlying mechanisms that subsequently sustain the illness.
Viral Infections
For many people, ME/CFS begins after an acute infection. Although the initial infection resolves, their previous level of physical and mental stamina does not return. Instead, symptoms such as fatigue, unrefreshing sleep, and post-exertional malaise persist.
A previous infection does not necessarily mean that the pathogen is still multiplying in the body. Researchers are investigating whether the infection may have triggered long-lasting dysregulation of various bodily systems. In other patients, however, ME/CFS develops gradually or without any clearly identifiable trigger.
Epstein-Barr Virus
The Epstein-Barr virus is one of the most frequently studied potential triggers of ME/CFS. Some people develop persistent symptoms after infectious mononucleosis (glandular fever) and subsequently meet the diagnostic criteria for ME/CFS.
However, a positive EBV antibody test does not automatically confirm this connection. Since the virus is widespread, these antibodies can also be detected in many healthy individuals.
COVID-19 and Long COVID
Long COVID refers to a broad range of possible health consequences following a SARS-CoV-2 infection. However, only some people with Long COVID also meet the diagnostic criteria for ME/CFS.
Therefore, Long COVID does not necessarily involve the characteristic symptoms of ME/CFS, such as post-exertional malaise (PEM), unrefreshing sleep, and significantly reduced physical and mental stamina.
Investigated Disease Mechanisms
Current research is investigating the following processes, among others:
Immune Dysregulation
Studies have shown changes in various immune cells and immune signaling pathways. However, no definitive immune biomarker for diagnosis is currently available.
Autoimmune Processes
Abnormal autoantibodies have been detected in some patients. However, the findings to date are not yet sufficient to classify ME/CFS as an autoimmune disease in general.
Inflammatory Responses
Researchers are investigating altered inflammatory processes in the body and nervous system. Normal inflammatory marker levels do not rule out ME/CFS.
Microcirculatory Disorders
Changes in vascular regulation could impair blood supply to the muscles and brain during exertion. Whether these changes are a cause or a consequence of the disease remains unclear.
Current research therefore suggests that several mechanisms interact with one another. However, it is not yet possible to reliably determine which of these mechanisms are involved in an individual patient based on specific laboratory values alone.
How Is ME/CFS Diagnosed?
There is currently no single laboratory test or imaging finding that can definitively diagnose ME/CFS. The key factors are the course of the illness, the loss of previous physical and mental stamina, and the presence of post-exertional malaise (PEM).
Our collaborating physicians carefully assess whether other medical conditions might better explain your symptoms. However, ME/CFS is not simply a diagnosis of exclusion. Normal examination results and persistent fatigue alone are not sufficient for a diagnosis. The characteristic symptoms must be present in the required combination and severity.
Treatment Options for ME/CFS
There is currently no established treatment that addresses the underlying causes of ME/CFS. Treatment for chronic fatigue syndrome therefore focuses on relieving individual symptoms, managing treatable coexisting conditions, and preventing further episodes of symptom worsening caused by post-exertional malaise (PEM) whenever possible.
Depending on your symptoms, treatment may address sleep disturbances, pain, migraines, or circulatory problems. Any coexisting conditions, such as POTS, allergies, or confirmed nutrient deficiencies, are also taken into account when planning your treatment.
Symptom-Based Treatment
The symptoms that have the greatest impact on your daily life may change over the course of the illness. Our treating physicians therefore work with you to determine which specific treatment goal should take priority initially. Individual treatment measures are introduced gradually whenever possible and then evaluated for their effectiveness and tolerability. This allows physicians to assess over time how your symptoms respond to treatment and whether any adjustments are necessary.
Pacing
Pacing involves adapting physical, mental, and social activities to your available energy levels. Our collaborating physicians work with you to identify which activities trigger post-exertional malaise (PEM) and how to better balance tasks, rest periods, and sensory stimuli in the future. However, pacing does not mean continuously increasing your level of exertion.
Nutrition and Nutrient Intake
To date, no specific diet has been proven to cure ME/CFS. However, your energy, fluid, and nutrient intake is assessed to determine whether it is sufficient or whether any deficiencies need to be addressed through targeted supplementation. Food intolerances and digestive problems are also taken into account.
Medication-Based Treatment Options
Medications can help relieve individual symptoms such as pain, sleep disturbances, migraines, or circulatory problems. However, since some patients are particularly sensitive to certain medications, the choice of medication, dosage, and tolerability must be carefully evaluated. There is currently no approved medication that addresses the underlying cause of ME/CFS.
Apheresis as a Key Treatment Focus at VitaSangius
At VitaSangius, apheresis is primarily considered for patients who continue to experience significant symptoms despite previous medical treatments. Our collaborating physicians assess whether the procedure is medically appropriate and justifiable in each individual case, taking into account existing medical findings, the course of the illness, and the patient’s current physical and mental stamina.
Based on our experience to date, approximately 9 out of 10 patients who have undergone treatment report a significant to very significant improvement in their well-being. Many notice the first changes after their initial apheresis session. Individual treatment results may vary, and no specific treatment outcome can be guaranteed.
For patients with more severe symptoms, the treating physicians often recommend two treatment sessions within 48 hours, following an individual medical assessment. An apheresis session typically lasts approximately 3.5 to a maximum of 5 hours.
In certain cases, hemoperfusion may also be appropriate following an individual medical assessment. The choice of blood purification procedure depends on the patient’s symptoms, medical findings, and clinical indication.
Why Choose VitaSangius for ME/CFS?
ME/CFS affects everyone differently. Therefore, the focus is never solely on the diagnosis, but also on your individual symptoms, existing medical findings, coexisting conditions, and current physical and mental stamina. At VitaSangius, we offer specialized blood purification procedures. Medical examinations, assessment of treatment indications, performance of procedures, and patient monitoring are carried out by independent physicians who work closely with VitaSangius.
Specialization
We focus on complex chronic and post-infectious conditions such as ME/CFS and Long COVID. Our primary focus is on reduced physical and mental stamina and the risk of post-exertional malaise (PEM).
Apheresis as the Main Focus
Apheresis is a central focus of treatment at VitaSangius. In medically justified cases, additional extracorporeal procedures such as hemoperfusion may also be considered.
Individualized Care
We do not follow a fixed, standardized treatment program. Instead, our recommendations are tailored to your individual symptoms, the course of your illness, and your medical examination results.
Comprehensive diagnostics
Our collaborating physicians review your existing medical findings and work with you to determine which additional examinations may be appropriate. These may include specialized laboratory tests as well as cardiovascular and vascular examinations.
Interdisciplinary Collaboration
When necessary, we coordinate with independent medical specialists, specialized laboratories, and external partner practices. This allows us to address different medical concerns in a targeted manner.
Persönliche Begleitung
We explain each step of the process clearly, answer any questions you may have, and continue to provide personalized support after your treatment. Together with you, we monitor any changes in your condition and potential adverse reactions.
Patient Experiences with Apheresis
On the Path to Improved Well-Being
Who Should Consider a Consultation at VitaSangius?
A consultation at VitaSangius may be suitable for patients who have already been diagnosed with ME/CFS or Long COVID. You can also contact us if you have been experiencing severe fatigue, reduced physical and mental stamina, or worsening symptoms after physical or mental exertion for an extended period of time.
If ME/CFS is suspected, we assess your symptoms, the course of your illness, and any existing medical findings. Together, we determine which additional examinations may be appropriate for you and whether you meet the characteristic diagnostic criteria.
A further medical assessment may also be helpful if previous treatments have not provided sufficient improvement. We review which treatment approaches have already been tried and explore additional options, taking into account your current physical and mental stamina.
ME/CFS Diagnosis and Treatment Process at VitaSangius
Since the treatment of chronic fatigue syndrome involves several aspects, diagnosis, treatment planning, and follow-up monitoring at VitaSangius are carried out in a gradual, integrated process.
Schedule Your Appointment for an Early ME/CFS Assessment
Myalgic encephalomyelitis, also known as chronic fatigue syndrome, is a serious medical condition. Early diagnosis is important to identify characteristic CFS symptoms such as post-exertional malaise (PEM), investigate other possible causes, and prevent further episodes of symptom worsening whenever possible.
There is currently no established treatment that addresses the underlying cause of ME/CFS. However, individually tailored treatment approaches can help manage specific symptoms. At VitaSangius, patients have access to modern diagnostic procedures and personalized treatment plans. Our collaborating physicians assess your medical findings to determine which treatments may be appropriate and whether additional procedures such as apheresis or hemoperfusion should be considered as part of your ME/CFS treatment. VitaSangius provides the specialized infrastructure and personal support throughout the process.
Are you experiencing persistent fatigue, post-exertional malaise, or symptoms following Long COVID? Schedule an appointment at VitaSangius and let our physicians advise you on which diagnostic and treatment options may be appropriate for your individual situation.
Apheresis at VitaSangius in Potsdam
Apheresis is a central focus of treatment at VitaSangius in Potsdam. It is primarily considered for patients who continue to experience significant symptoms despite previous medical treatments. Our collaborating physicians determine whether the procedure is appropriate for you based on an individual assessment of your medical findings and current physical and mental stamina.
A treatment session typically lasts approximately 3.5 to a maximum of 5 hours. For patients with more severe symptoms, physicians may recommend two apheresis sessions within 48 hours following an individual medical assessment. In certain cases, hemoperfusion may also be considered.
Information About Costs: Treatment is generally self-funded. In individual cases, health insurance providers may cover part or even all of the costs following a prior assessment.
FAQ: Frequently Asked Questions About ME/CFS
What Is Chronic Fatigue Syndrome?
ME/CFS is a complex chronic illness that affects multiple body systems. It can significantly limit physical and mental stamina. Its most characteristic feature is post-exertional malaise (PEM): even minor exertion can cause a significant and prolonged worsening of symptoms.
Is ME/CFS Curable?
There is currently no treatment proven to cure the underlying cause of ME/CFS. The course of the illness varies from person to person. However, targeted symptom-based treatment can help relieve symptoms, manage coexisting conditions, and prevent further episodes of symptom worsening.
What Are the Typical Symptoms of Chronic Fatigue Syndrome?
Common ME/CFS symptoms include severe fatigue, post-exertional malaise (PEM), unrefreshing sleep, brain fog, difficulty concentrating, muscle and joint pain, and circulatory problems. However, the type and severity of symptoms vary from person to person.
How Is ME/CFS Diagnosed?
ME/CFS is diagnosed based on a detailed medical history, the presence of post-exertional malaise (PEM), and internationally recognized diagnostic criteria. Other possible causes of your symptoms must also be investigated. At VitaSangius, we review your existing medical findings and determine which additional diagnostic steps may be necessary in your individual case.
What Is Post-Exertional Malaise (PEM)?
PEM refers to a significant worsening of symptoms following physical, mental, emotional, or sensory exertion. It may occur after a delay and can last for several days or longer. Even activities that were previously manageable without difficulty can trigger this reaction.
What Is the Difference Between Long COVID and ME/CFS?
Long COVID includes a wide range of symptoms that persist or develop after a SARS-CoV-2 infection. Some patients develop a condition that meets the diagnostic criteria for ME/CFS. However, ME/CFS can also develop following other infections or without a clearly identifiable trigger.
What Treatment Options Are Available for ME/CFS?
Our treatment approach for CFS is always tailored to your specific chronic fatigue syndrome symptoms and any coexisting conditions. Possible components include pacing, treatment of sleep disturbances, pain or circulatory problems, adequate nutrient intake, and medication-based therapies. At VitaSangius, we also assess whether additional procedures such as hemoperfusion may be medically appropriate for you.
Can Hemoperfusion Be Used to Treat ME/CFS?
At VitaSangius, we consider hemoperfusion as a complementary component of ME/CFS treatment following a medical assessment. During this procedure, blood is passed through an adsorber outside the body. Hemoperfusion is not currently an established standard treatment for ME/CFS. Scientific evidence remains limited, and successful treatment outcomes cannot be guaranteed.
How Long Does an Apheresis Session Take?
An apheresis session typically lasts approximately 3.5 to a maximum of 5 hours. The exact duration may vary depending on the individual course of treatment. For patients with more severe symptoms, the treating physicians often recommend two treatment sessions within 48 hours following an individual medical assessment.
Does Health Insurance Cover the Costs?
Treatment is generally self-funded. In individual cases, health insurance providers may cover part or even all of the costs following a prior assessment. However, reimbursement cannot be guaranteed and should be clarified individually with your health insurance provider before starting treatment.
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