Healthily | 10/29/26
Chronic fatigue syndrome and ME have been with us for decades, but since COVID they've moved into the public conversation in a way they never have before. In this episode, I'm joined again by nutritional therapist Virginia Blake, who works with clients living with chronic fatigue and long COVID and teaches nutrition professionals in this area.
Virginia explains why chronic fatigue remains a diagnosis made by ruling other things out, and why the key symptoms (exhaustion, post-exertional malaise, disturbed sleep and pain) matter so much. We talk about the many possible triggers, from viral and bacterial infections to environmental toxins and hormonal change, and why Virginia is seeing more women in perimenopause developing chronic fatigue type symptoms, sometimes linked with late-diagnosed autism or ADHD and the exhausting work of masking.
We explore the mitochondrial cell danger response theory, the idea that the body can become stuck in "fight the infection" mode, and why the nervous system can stay switched on long after the original threat. Virginia shares the newer research on capillaries and energy production that helps explain why exercise can leave people feeling so much worse, and why she does not recommend graded exercise.
Then we get practical: protein at breakfast, protein powders (including vegan options), finding vegetables that don't cause bloating, supporting the gut rather than attacking it, reducing your environmental load, asking your GP for the right tests, and simple, free interventions such as morning daylight, watching the sunset, eating at regular times and lengthening your out-breath.
We finish with something I think matters enormously: compassion. Recovery from chronic fatigue doesn't come from pushing harder. It comes from working with your body, which is already working incredibly hard for you.
TAKEAWAYs
✔️ Chronic fatigue is real. There's no single diagnostic test, so it's identified by ruling out other causes and looking for core symptoms, particularly post-exertional malaise.
✔️ Viral infection is the most commonly cited trigger, but bacterial infections, environmental toxins, immune and hormonal factors can all play a part.
✔️ Perimenopause can be a tipping point, especially for women who have been masking undiagnosed autism or ADHD.
✔️ In the cell danger response theory, the mitochondria can become stuck in "fight mode", diverting energy to the immune system and away from the brain and daily life.
✔️ A nervous system stuck in fight or flight can leave people exhausted but wired, and can affect digestion and immunity.
✔️ Newer research on capillaries and energy production helps explain why exercise can make people with chronic fatigue feel worse. If a type of movement makes you feel bad, it isn't helping you.
✔️ A protein-rich breakfast helps stabilise blood sugar and sends the body a signal of safety. Protein powders can make this much easier.
✔️ If vegetables cause bloating, a low-fermentation approach offers more variety than strict low FODMAP. Restrictions should be short term.
✔️ Simple steps such as opening the windows, washing vegetables well and choosing quieter streets can reduce your environmental load.
✔️ Free interventions matter: morning daylight, watching the sunset, regular mealtimes and a longer out-breath all tell the body it is safe.
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