Functional Medicine
Chronic Fatigue Syndrome (CFS/ME)
Functional Medicine
Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) is a complex biological condition that can have a profound impact on your daily function and quality of life.
Rather than relying on generic protocols or broad advice, we focus on understanding your individual symptom profile and medical history, identifying clinically relevant contributing factors and how best to address them.
Our goal is to help you better understand your condition, what may have led to its development and what may be continuing to drive it, so that treatment can be more targeted, informed, and effective.
Our approach differs from other clinics in that we focus on:
Many people with CFS/ME feel
overlooked or dismissed
overlooked or dismissed
We listen carefully and focus on identifying possible causes and what is driving your symptoms.
Dr Harpal Bains
MBBS, DFSRH, PGCAestMed (Dist)
Many individuals come to us without a formal diagnosis of CFS/ME.
Our functional medicine-trained doctors specialise in recognising patterns consistent with CFS/ME, understanding underlying factors, and what may be continuing to drive your symptoms.
Underlying causes of CFS/ME can include:
Together, these may lead to longer-term changes in the immune system, nervous system, hormone balance, and how the body produces energy, contributing to ongoing symptoms.
Whilst some patients present with a clear post-viral onset, others may have a more gradual development with multiple contributing factors. Recognising these different patterns is key to selecting the most appropriate testing and treatment plan.
Functional medicine is a well established medical approach centred on identifying and addressing the underlying biological mechanisms contributing to a chronic illness, diagnosis or symptoms.
A detailed medical history is taken and used to map the sequence of events leading to illness, including potential triggers, predisposing factors, and ongoing drivers.
Testing is sometimes advised, and the results are interpreted in the context of you and your health rather than in isolation.
The functional medicine framework is particularly relevant and useful for CFS/ME. This condition is rarely explained by a single cause and more often reflects a combination of factors, such as post-viral changes, immune dysregulation, altered stress response, and impaired mitochondrial function. These processes can interact to produce the characteristic symptoms of fatigue, Post-Exertional Malaise (PEM), cognitive dysfunction, and reduced physiological resilience. A functional medicine approach allows these factors to be assessed systematically and addressed in a structured way so the treatment can be more targeted and effective.
We are mindful of post-exertional malaise, where even small amounts of physical or cognitive activity can worsen symptoms. Treatment plans are designed to work within your current capacity, rather than pushing beyond it.
Our two main consultations are Focussed & Comprehensive.
Both options follow the same structure and clinical process. The price difference reflects the amount of clinical and consultation time allocated to you.
Both include:
Consultations can be online, via phone, or in-clinic. Blood testing can take place at our London-based clinic or in your local area via one of our providers (Superdrug or Goodbody).
A specialist approach to CFS/ME involves careful analysis of symptoms, medical history, and, where appropriate, targeted laboratory testing. Consultation fees reflect the level of clinical time required for assessment, clinical reasoning, and development of a structured treatment plan. Treatment plans for either option may include prescriptions, hormones, supplements, nutritional changes or lifestyle recommendations.
A focussed option to access specific treatments (such as LDN or bioidentical hormones), in combination with an analysis of selected blood markers (e.g., hormones, blood sugar, or other specific markers) where clinically appropriate.
Laboratory testing is not included in the consultation fee.
A detailed, whole-system evaluation of your CFS/ME and overall health. This allows for broader and more in-depth testing across multiple systems, helping to identify overlapping or contributing factors that may not be captured through more limited assessment.
People completing this pathway are able to complete more comprehensive testing which covers multiple areas of your health. For example, you may wish to look at gut testing, targeted immune testing (e.g., EBV, Lyme, Long COVID, or mycotoxins) or mitochondrial testing.
Laboratory testing is not included in the consultation fee.
If you choose to complete testing at our clinic location phlebotomy is included. We can accept external test results if they include the markers our doctor requires and were taken within the last 3 months. All patients begin with an initial consultation, where the doctor reviews any existing results and advises on any further testing if needed.
We also have an LDN membership for those specifically looking for LDN and who do not wish to take a deeper dive with testing at this time.
Before we can prescribe LDN, a one-off, standalone 30-minute medical consultation is required. This allows our doctor to assess your full medical history, discuss your symptoms and goals, and determine if LDN is an appropriate and safe option for you.
This includes:
Please note: This non-refundable fee covers your doctor’s time, expertise and guidance. It applies whether or not you proceed with our LDN monthly membership.
If you’re a good candidate for treatment, we will invite you to join our monthly LDN membership programme.
This includes:
Testing is recommended selectively, based on your clinical history, symptom pattern, potential triggers, and what may still be driving your condition. We avoid unnecessary or excessive testing, only recommending investigations that are clinically justified and likely to influence management.
Your doctor will also take your personal circumstances and budget into account when suggesting investigations and treatment. We recognise that many people with CFS/ME may have had to reduce their working hours or stop working altogether, and that symptoms can significantly impact the ability to manage everyday activities.
LDN: If you are specifically looking for LDN, this can be provided without the need to complete any testing. Our GMC-registered doctors can also prescribe LDN without the need for an NHS diagnosis of CFS/ME.
Testing may range from comprehensive blood work through to more specialised investigations, depending on your clinical presentation.
This can include detailed blood testing assessing multiple systems, such as nutritional status, hormonal balance, metabolic function, and markers of inflammation.
In some cases, more in-depth functional testing may be used to assess areas such as:
CFS/ME is a complex, chronic condition characterised by persistent fatigue, post-exertional malaise (PEM), cognitive dysfunction, and other multisystem symptoms. Diagnosis is clinical, based on symptoms and exclusion of other causes. There is currently no single definitive test for CFA/ME.
CFS/ME can affect multiple systems in the body, with symptoms varying between individuals. The most widely-associated symptom is post-exertional malaise (PEM), where even small amounts of physical or mental activity can lead to a significant worsening of symptoms.
Common symptoms include:
Symptoms often fluctuate over time and can vary in severity from day to day.
Fluctuation is a hallmark of CFS/ME and can reflect an underlying instability in energy production, nervous system regulation, and immune function. This is why personalised pacing and a structured treatment approach are important.
CFS/ME is generally considered a complex, multifactorial condition, meaning it is often influenced by a combination of factors rather than a single cause.
In many cases, symptoms begin following a triggering event, most commonly a viral infection. Other potential triggers can include periods of significant stress, physical or emotional trauma, hormonal changes, and certain medications.
Following this initial trigger, a range of biological systems may become dysregulated, including:
These changes can contribute to the persistence of symptoms over time.
Not all patients have the same underlying drivers, which is why a more individualised approach to assessment and management is often needed.
This is known as post-exertional malaise (PEM), where the body is unable to recover normally after physical or cognitive effort. It is a key feature of CFS/ME and is always taken into account when designing treatment plans.
There is no single cure. However, we find that CFS/ME can be greatly improved using a functional medicine approach to management. This whole-body approach helps us to identify and address all contributing factors. This can help improve symptoms, function, and quality of life in many individuals.
No. Many patients we see present with symptoms consistent with CFS/ME without a formal diagnosis. They feel like they have reached an end of what their GP and the NHS can offer them. Some have even been told their symptoms are ‘all in their head’. Our medical experience with CFS/ME allows us to make an assessment and treatment plan based on your symptoms and clinical history.
Unlike traditional treatment for CFS/ME, we focus on understanding what is causing your symptoms and addressing those underlying biological factors, rather than giving general advice or only treating symptoms.
Underlying biological factors can include:
Yes. CFS/ME is a biological, multisystem condition. While psychological stress can play a role in some individuals, it is not considered a primary cause, and symptoms are not “in your head.”
This varies between individuals. Some patients experience significant improvements in energy, cognition, and symptom stability, while others may see more gradual or partial changes.
We are mindful of post-exertional malaise, where activity can worsen symptoms. Treatment plans are designed to work within your current capacity, with changes introduced gradually and monitored closely.
Yes. LDN can be prescribed where appropriate following a medical consultation. We also offer a dedicated LDN pathway (LDN membership programme) for patients seeking this treatment specifically.
No. We do not recommend graded exercise therapy. Any activity recommendations are tailored carefully to your current tolerance and designed to avoid worsening your symptoms.
Some of our CFS patients choose to start supporting their health with us by first correcting a known deficiency in vitamin D through our IV nutrient team. Vitamin D deficiency is often identified in individuals with CFS/ME, and something we frequently see in clinical practice, although it is not considered a primary cause of the condition.
There is currently no single definitive test for CFS/ME. Diagnosis is clinical, based on symptoms and exclusion of other causes.
Testing may range from comprehensive blood work through to more specialised investigations, depending on your clinical presentation.
This can include detailed blood testing assessing multiple systems, such as nutritional status, hormonal balance, metabolic function, and markers of inflammation.
Where clinically indicated, more targeted testing may be recommended. This can include an advanced immune or viral assessment (for example EBV, Lyme, or post-viral patterns such as Long COVID), gut health testing, and mitochondrial or metabolic analysis.
In some cases, in-depth functional testing may be used to assess areas such as environmental chemicals, mycotoxins, or biochemical pathways involved in energy production, helping to identify potential nutrient insufficiencies or inefficiencies at different stages of cellular energy metabolism.
All testing is selected carefully, based on clinical relevance, and only where results are likely to inform treatment decisions.
Yes, if they include the required markers. To obtain some prescriptive items (e.g., hormones) the test results will need to be from the last 3 months to make an accurate assessment.
No. Testing is optional and recommended only where it is clinically justified and going to influence your treatment plan. We aim to keep investigations focused and proportionate, and your doctor will always take your budget into account.
If you are primarily looking for LDN, there is no required testing to obtain this prescription.
Yes. Consultations can be conducted online, by phone, or in-clinic.
Testing can be arranged at our London clinic or through partner providers that are closer to your home address. We can send a test kit to your home address for you to arrange a phlebotomy appointment local to you.
You are welcome to have a family member or friend attend your consultation for support, and they may speak on your behalf where helpful. However, you must be present, able to engage in the consultation, and confirm that you understand and agree with what is being discussed.
Patients need to be able to communicate directly with the doctor at some points of the consultation, including understanding the consultation and the medical information discussed. If this is not possible, we may unfortunately be unable to proceed with the appointment.
