Diagnosis and Treatment of Chronic Fatigue Syndrome, Myalgic Encephalitis and Long Covid

This is the third edition of this seminal book on chronic fatigue, to which Long Covid has now been added. It is strongly endorsed by many medical practitioners who share the view expressed in the subtitle – it's mitochondria, not hypochondria (there is a chapter on the politics). I have reviewed a number of books by the authors in these pages, all of which are underpinned by a paleo-ketogenic understanding and corresponding dietary recommendations. The hypothesis is that mitochondrial dysfunction leads to poor energy delivery and that a clinical picture is a collection of symptoms pointing to an underlying pathology that has to be addressed systemically by changes in diet and lifestyle. The book presents a comprehensive roadmap to recovery with a clear explanation of basic mitochondrial mechanisms – and simple summaries at the end of each chapter as well as helpful charts in the text.

The text is also useful for those without such symptoms in providing basic health advice explaining why the PK diet is non-negotiable, excluding as it does dairy, grains, sugar and starchy carbohydrates, feeding the body instead with fat and fibre. A particular issue is the upper fermenting gut, which is one of the first symptoms to address, and here large doses of Vitamin C can play an important role along with what the authors call the basic package of supplements. Further chapters are devoted to breathing, sleep, pacing of exercise regimes, the mechanisms of inflammation, allergy and autoimmunity, detoxing, chronic infection and reducing infectious load on the way to recovery. All these themes are also addressed in the authors' Magnum Opus Ecological Medicine, and there are more than 500 pages available on the website above.