I have a post-viral syndrome case of chronic fatigue. I've not been diagnosed with CFS formally, but I match many of the symptoms required, including orthostati

I have a post-viral syndrome case of chronic fatigue. I've not been diagnosed with CFS formally, but I match many of the symptoms required, including orthostatic intolerance. It is an extremely complicated condition. I personally have had a pet theory that disturbed barrier function is involved somehow, and seeing this article is extremely confirming for me, since it mentions that as a potential factor. In fact, one study on just the metabolites of people with CFS vs healthy people found that a Vitamin E derivative -- one often a part of healthy cell barrier function -- was significantly lacking in CFS people compared to the normal population, and was a strong marker. However, this seems to have been largely brushed over in later literature, with more popular things like fatty acid processing and such being mentioned. What has worked for me: -- Ketogenic diet (avoiding lactic acid production) -- greatly dampened PEMS. -- Blood glutamate scavengers + Niacinamide + Ribose (1g): Provides NAD + a cofactor needed to transform glutamate in the blood into something else. For some reason, this really seems to help with CFS patients. Helps with resting fatigue. The cheap and accessible BGS I use are NAC, pyruvate, and (sometimes) malic/citric acid. Malic is better as it is right before oxaloacetate, a BGS, in the Krebs cycle, and it turns into Citrate. Citrate IIRC raises the levels of one of the enzymes that eliminates lactic acid. Your blood cells can only use glycogen, so there will always be some level of lactic acid production to be suppressed. -- Reduced glutamate + free glutamate intake: Lower-glutamate proteins (tuna, etc), no hydrolyzed soy protein, yeast extract, etc. -- Gotu Kola (biases the glutamate<->GABA conversion towards glutmate->GABA as I understand, a double-bonus), various anti-inflammatories (Quercetin+non-citrus C, liposomal Turmeric+curcuminoids (!! Important, piperine inhibits both Pgp and glucoronidation, which increases absolutely everything in absorption. Liposomal is better), and boswellia for LOX-5 inhibition. Looking to move to a stronger Boswellia extract (5-Loxin) as it's lighter weight. These changes, while I still have energy issues, have made it safe enough for me to be able to backpack outdoors for extended periods of time. My longest so far has been a 2 month trip (with 1-2 nights indoors). Hope this helps anyone who struggles with this and is looking to experiment. I wish I was back to 100%, but being able to be out in nature after being mostly bedbound is...well, my heart is much more full when I am. <3 :')