What we know about chronic and post-COVID fatigue

Chronic fatigue has been around for a while, and there is renewed interest due to one of the main triggers being viral infection. It might be too soon to tell, but the recent outbreak of COVID-19 could be a trigger. Holistic nutritionist Laura Hett looks at what we know about chronic fatigue.
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If you have experienced the flu, a hangover, and jet lag, imagine combining all three at once. That’s what chronic fatigue has been described to feel like.   

Fatigue, that feeling of overwhelming exhaustion, can often be situational, meaning it’s related to something occurring in our life (think about a mother with a newborn, or a particularly stressful period at work). But sometimes it’s never-ending, all pervasive, and has no immediate explanation or treatment. People with this type of fatigue (along with other symptoms, most commonly brain fog) get (if they are lucky) diagnosed with Myalgic encephalomyelitis (ME) or chronic fatigue syndrome (CFS). 

Causes and what it looks like 

Traditionally, the belief has been that ME/CFS is a psychological disease (meaning doctors thought the patient was making it up) and fairly misunderstood by doctors and the general population alike. Some people didn’t even believe it was a thing. It’s been known that it usually develops after contracting a viral infection, but it’s generally been passed off that it’s ‘all in the patients head’. This misunderstanding likely came about due to the fact that regular blood testing and other medical tests don’t show anything amiss. Until Warren Tate’s research, there was no known biochemical or physiological basis for the illness.   

Warren Tate, a NZ-based scientist and researcher, has been looking into ME/CFS for 30 years which, though it isn’t technically the same thing as long COVID, Tate says they should be classified as the same illness.  

ME/CFS, aka chronic fatigue, seems to first have been described by a Babylonian philosopher – that’s how long it’s been around. Until COVID, there’s been a slow drip feed and accumulation of cases but that’s likely about to change. There’s been about 650 million people affected by COVID and approximately one in ten victims seem to be developing long COVID. That’s a potential 65 million people worldwide with long COVID! 

“It’s being brought to the surface. In front of the faces of GPs, nurses, and medical staff,” said Warren Tate. 

There’s not one single cause for CFS/ME but it seems that about 80% of cases are caused by a viral infection. Other causes include toxic agricultural chemicals (another reason to choose and campaign for organics!), major surgery, or childhood trauma.  In other words, a massive stressor on the immune system, nervous system, or body in some way. Sometimes it’s even a combination of multiple stressors. For example, one recovered ME/CFS sufferer I spoke to, believes that it’s a combination of viral (Epstein Barr virus), trauma, and nervous system dysregulation. 

Warren’s ground-breaking research showed the medical community that there’s a physiological and biochemical signature of the illness. In patients with ME/CFS there are clear changes in molecular signatures, immune cell proteins, and epigenetic code, with many of these changes being located in the mitochondria. If that’s all too much jargon, just rest assured that when we look deep at someone’s physiology and biochemistry (beyond what’s commonly tested for) we can see why this illness is life-changing – and not in a good way.  

There’s a total of 100 different symptoms that are considered part of ME/CFS with five core symptoms that most people experience. Many people can no longer work and can’t even get out of bed for that matter. Along with fatigue, brain fog seems to be a very common symptom. 

Core symptoms of chronic fatigue: 
  • Severe fatigue not relieved by rest 
  • Post-exertional malaise 
  • Unrefreshing sleep 
  • Problems with thinking and memory  
  • Orthostatic intolerance (lightheaded or dizzy when standing up) 


This is where it gets especially tricky (as if it wasn’t already!). The recovered person I spoke to is usual.  According to Tate, only 10 per cent who get this disease ever recover.   

Research and trials have been done to assess what medications or supplements could be effective, but nothing in particular is showing much promise. 

“Patients need to be addressed individually, as each individual’s [illness] manifests in subtlety different ways. That’s why it’s been hard to find medications or supplements to help,” said Tate. 

Take pregnancy for example. Tate’s daughter who suffers from ME/CFS felt a LOT better during pregnancy. But that’s not the case for everyone. When pregnant, about a third of people feel better, a third have no change, and a third feel worse! And that’s a good approximation for the results of many of the treatments that have been studied so far.  

Because there’s no one treatment, a good holistic practitioner (doctor, nutritionist, naturopath) can test to see what system in the body is causing the fatigue and symptomatology. There are a few body systems that might be culpable, and the possible treatments vary accordingly. 


  • Hydration: Drinking enough water and ensuring it’s good quality and getting into the right place with minerals (take a high-quality multi-vitamin). 
  • Mitochondria boosters: CoQ10, vitamin C, acetyl-L-carnitine, glutathione. 
  • B-vitamins: in their activated, methylated forms. 


  • Boosting and modulating the immune system with nutrients such as EPA/DHA, vitamin D, zinc, and selenium. 
  • Supporting the gut microbiome by eating fermented foods, using a high-quality probiotic and cutting down alcohol consumption. 


  • Regulate the nervous system with some very deliberate meditation, breathwork, or yin yoga. Relax the body at a subconscious level (this is harder than it sounds so use a practitioner or therapist). 
  • Process emotions and past trauma with the help of a qualified psychologist or therapist.  
  • The Lighting Process is something which helped some and has a good track record in supporting people with CFS/ME 

Laura Hett is a degree-qualified holistic nutritionist and yoga teacher. Since gaining her degree from the University of Otago, she’s spent eight years learning and developing her knowledge to help people find their own optimal health. Passionate about inspiring people to take control over their own health. Laura believes that food is medicine, and our body has the incredible ability to heal, we just need to feed it the right food, thoughts, and movement.  Alongside nutrition and health, Laura is also a big advocate for the environment and growing your own food. www.wildr.nz 

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