7 Key Insights: What Is Chronic Fatigue Syndrome & Why Post-COVID Fatigue Persists 

October 13, 2025

Our Approach: Listening First

At Hotze Health & Wellness Center, we specialize in uncovering root causes through integrative approaches, often serving as the last stop for guests (we call our patients guests) who have visited multiple doctors without answers. 

How are we different than most other medical providers? We listen. Our team takes the time to truly understand your story: your health goals, clinical symptoms, how you have been feeling, what you have tried, and what has worked or not worked. It can be discouraging to hear that “everything looks normal” when you feel anything but normal, and that’s where our approach begins.

What We’ve Learned About Fatigue

Here is what we have learned over the last 35 years of being leaders in alternative and integrative medicine: fatigue is never “just tiredness.” It is your body’s way of saying something deeper is out of tune, whether that is hormonal, metabolic, or immune-related. We look beyond surface-level labs to understand what your body is really telling us. 

Remember, your body is not lacking pharmaceutical drugs. Over time, your body can fall out of balance and begin producing fewer of the essential hormones that keep you energized and healthy. When that happens, replenishment is often what restores your vitality. 

Whole-Body Care for Lifelong Vitality

At Hotze Health & Wellness Center, we do not mask symptoms with pharmaceutical drugs, and we do not just treat individual symptoms.  Most often, it is not an individual symptom that is causing frustration for you to feel unwell or just not like yourself. We treat the whole body, uncovering what is behind your fatigue (or other symptoms) while helping you prevent future health struggles. We believe in working with our guests on longevity but importantly, healthspan.  Our population is living longer, and we believe that those extra years in life should also be your healthiest, most energetic ones, not ridden with illness and aches and pains. Aging is something we should look forward to, not dread. That starts with being a self-advocate and committing to your health. No one can do this except YOU! 

So, let’s talk about one of the most overlooked conditions we see, Chronic Fatigue Syndrome (CFS), and why post-COVID fatigue has made it harder than ever to feel like yourself again. 

1. What Is Chronic Fatigue Syndrome? 

If you have ever woken up exhausted even after eight hours of sleep or felt like you were “running on empty” no matter what you did, you have already felt a hint of what Chronic Fatigue Syndrome is like. 

Also known as myalgic encephalomyelitis (ME/CFS), this condition goes far beyond normal tiredness. It is a deep, unrelenting exhaustion that does not get better with rest and often gets worse after even small amounts of effort, whether that is grocery shopping, working a few hours, or simply thinking too hard.¹ ² 

Medical experts define ME/CFS as fatigue lasting six months or more, accompanied by unrefreshing sleep, brain fog, and sometimes dizziness when standing.³ While I understand these clinical words may assist, I also know they do not capture or even begin to replace the lived experience that far too many individuals are experiencing today, the frustration of feeling like your body has forgotten how to recharge. We see guests here at the Hotze Health & Wellness Center who are frustrated because no one can seem to get to the root cause for them and all they want is to feel rested and healthy again. 

2. Why Post-Viral Illness (Including COVID-19) Matters 

Many guests tell us their fatigue began after an illness, sometimes mild and sometimes severe, and never truly went away. Research now confirms that post-viral fatigue is one of the most common triggers for ME/CFS.⁴ 

COVID-19 magnified this connection. Studies show that 10–30% of those infected with SARS-CoV-2 experience lingering symptoms, including fatigue, brain fog, and poor concentration.⁵ In fact, new ME/CFS diagnoses have increased dramatically since 2020, suggesting that Long COVID may, in many cases, overlap with or evolve into ME/CFS.⁶ 

That is why understanding “chronic fatigue syndrome” is more relevant now than ever. The COVID years did not just change how we live; it changed how millions of people’s body’s function and this unfortunately is not for the better. 

3. Common Symptoms You Shouldn’t Ignore 

Chronic Fatigue Syndrome affects more than just your energy levels. It influences nearly every system in your body. Some days you may feel almost normal, and other days, even getting out of bed can feel impossible. 

Common symptoms include: 

• Persistent, overwhelming fatigue not relieved by sleep or rest 
• Post-exertional malaise (PEM), feeling worse for days after minor activity 
• Brain fog, difficulty concentrating, remembering, or processing information 
• Unrefreshing sleep or trouble staying asleep 
• Pain, such as muscle aches, joint pain, or headaches 
• Dizziness or lightheadedness when standing 
• Temperature sensitivity or intolerance to stress 

When guests share that they feel exhausted even after resting, or that a short errand wipes them out for the day, we start looking beyond conventional explanations. 

This kind of fatigue is not laziness, depression, or weakness. It is the body’s signal that something deeper is off. 

4. What’s Happening Inside the Body 

Chronic Fatigue Syndrome is not “all in your head.” It is a whole-body imbalance that involves your immune, nervous, and metabolic systems working overtime and not in harmony.⁷ 

Immune System Overload 

After certain infections, the immune system does not fully return to balance. It stays on “high alert,” producing low-grade inflammation that affects energy, hormones, and even brain function.⁸ 

Mitochondrial Fatigue 

Your mitochondria, the tiny “batteries” (or “power plants” as I like to call them) in your cells, play a key role in energy production. In ME/CFS, they appear to function less efficiently, leaving you feeling drained even after minimal exertion.⁹ 

Brain and Nervous System Dysregulation 

Research suggests changes in blood flow and neurotransmitter function that affect memory, concentration, and mood.¹⁰ Some studies even show that brain scans of CFS patients look different, indicating an underlying neurological component. 

Gut Microbiome Imbalance 

Your gut communicates directly with your immune system and brain. When your gut bacteria are imbalanced, inflammation can spread and your energy plummets.¹¹ 

These combined factors create a perfect storm, one that makes your body feel stuck in a cycle of fatigue, stress, and depletion. 

5. How Post-COVID Fatigue Mirrors ME/CFS 

Many people recovering from COVID find themselves saying, “I just do not have my energy back.” They describe fatigue, brain fog, muscle weakness, and mood changes that sound remarkably similar to Chronic Fatigue Syndrome. 

That is because Long COVID and ME/CFS often overlap.⁶ Both involve immune dysregulation, mitochondrial dysfunction, and nervous system imbalance. The good news is that awareness is finally catching up. 

At Hotze Health & Wellness Center, we have seen more guests come in with post-viral fatigue than ever before. Their standard lab results often look “normal,” yet they feel far from it. That is why we go deeper, looking at thyroid function, hormone balance, nutrient levels, and inflammation markers to identify what others may have missed. 

6. Integrative Ways to Support Energy and Recovery 

While there is no single cure for ME/CFS, research and experience show that an integrative approach can help the body regain strength and stability over time. 

Support Mitochondrial Function 

Targeted nutrients such as CoQ10, B-vitamins, and magnesium support your body’s natural energy pathways.¹² 

Balance the Gut 

Restoring healthy gut bacteria with probiotics, clean nutrition, and yeast-free diets can help calm inflammation and improve nutrient absorption.¹³ 

To start supporting your gut at home, try our Healthy Probiotic Yogurt Recipe. It is rich in beneficial bacteria and a simple, delicious way to nurture your microbiome naturally. 

Gentle Pacing Instead of Pushing 

When your body is healing, “pushing through” can actually make symptoms worse. Learning to pace your activities helps preserve energy and prevent crashes.¹⁴ 

Optimize Hormone Balance 

Declining thyroid, adrenal, or sex hormones can amplify fatigue. Addressing these imbalances through bioidentical hormone replacement can help restore your body’s natural rhythm.¹⁵ 

Mind-Body and Nervous System Regulation 

Stress keeps your body in fight-or-flight mode, which burns through energy. Practices like prayer, breathwork, and vagal nerve stimulation (using the Truvaga device) can help reset your nervous system and promote calm, restorative balance. We have recently introduced the Truvaga device into the recommendations of our practice, not to promote the device but to promote symptom resolution (seeing some remarkable and very much immediate resolving migraine headaches, panic attacks, insomnia, gut issues, emotional imbalances, inflammation, stress and more in our current guests) and overall health. 

At Hotze Health & Wellness Center, we take the entire body into account, evaluating not just lab values but also lifestyle, nutrition, and emotional health. We create individualized treatment plans that align with your unique needs. 

7. When to Seek Help 

If you have been tired for months or years and your doctors keep telling you that your tests are “normal,” do not give up. Fatigue always has a cause, even if it has not been uncovered yet. 

It is time to dig deeper if: 

• You feel exhausted after simple daily tasks. 
• You experience brain fog, dizziness, or unrefreshing sleep. 
• You notice sensitivity to stress or temperature. 
• You have been told your thyroid labs are “normal,” yet you still feel fatigued and off balance. 

This is where an alternative and integrative approach can make all the difference. By viewing your body as a connected system, not a collection of symptoms, we can help identify the real source of imbalance. 

8. Taking the Next Step Toward Renewed Energy 

Fatigue is not a personality flaw. It is a message from your body asking for attention. If you have been living with unexplained exhaustion or post-viral fatigue, it is time to get to the root cause. 

At Hotze Health & Wellness Center, we have spent 35 years helping our guests uncover what is draining their energy and depleting their immune systems.  We have unique expertise in designing personalized plans to restore it. How are we different than other providers?  We listen. We go beyond routine testing. And we partner with you on your health journey as you regain your energy, vitality, and enthusiasm for life. 

If you are ready to stop feeling exhausted and start feeling like yourself again, call 281-698-8698 or schedule your complimentary wellness consultation today by clicking HERE.

It is time to get to the root cause and get your life back. 

References 

¹ Hwang, J. H. et al. “Evaluation of Viral Infection as an Etiology of ME/CFS.” Translational Medicine, 2023. 
² “Chronic Fatigue Syndrome: Diagnosis, Treatment, and Related Conditions.” PMC, 2024. 
³ CDC. “Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).” Centers for Disease Control and Prevention, 2023. 
⁴ Graves, B. S. et al. “Post-Infectious Fatigue and ME/CFS Links.” Journal of Translational Medicine, 2024. 
⁵ RECOVER Initiative. “Long COVID and ME/CFS Overlap Findings.” NIH, 2024. 
⁶ Harvard Health. “Chronic Fatigue Syndrome After COVID-19.” 2024. 
⁷ NIH. “Insights into the Mechanisms of ME/CFS.” 2024. 
⁸ Tang, R. et al. “Immune Dysfunction in Chronic Fatigue Syndrome.” Nature Medicine, 2024. 
⁹ Unravelling Shared Mechanisms: ME/CFS Research Update. ScienceDirect, 2024. 
¹⁰ Harvard Medical School. “Brain Imaging Reveals Differences in ME/CFS.” 2023. 
¹¹ Xiong, R. et al. “Gut Microbiota in Chronic Fatigue Syndrome.” Frontiers in Immunology, 2025. 
¹² Judy, W. “Coenzyme Q10 and Energy Production in CFS.” Clinical Nutrition Insights, 2023. 
¹³ Tang, Y. et al. “Gut Health and ME/CFS: A Therapeutic Perspective.” Translational Medicine, 2025. 
¹⁴ PACE Trial Re-Evaluated. BMJ Review, 2024. 
¹⁵ Hotze, S. F. Hormones, Health, and Happiness. 2007. 

Categories: Fatigue, Long COVID

Tags: adrenal fatigue, chronic fatigue syndrome, gut health, hormone imbalance, immune support, integrative medicine, long covid fatigue, mitochondrial health, post-pandemic fatigue, root cause medicine, truvaga, vagus nerve stimulation

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