Diagnosis and Treatment of Chronic Fatigue Syndrome, Myalgic Encephalitis and Long-Covid (3rd Edition)

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"Diagnosis and Treatment of CFS, ME & LC- it's mitochondria, not hypochondria!" book cover

Introduction - The "Need To Know" basis

The 3rd edition of this book is now available to buy. The 1st edition of this book was awarded a Highly Commended Certificate at the British Medical Association Book Awards in 2015 - please see British Medical Association Book Awards 2015

I have fully updated and revised this book for this NEW edition.

The KEY CHANGE is that this edition is written on a need to know basis - I have cut to the chase and concentrated on what CFS/ME/LC sufferers need to know and, more importantly, what they need to do in order to recover. Advice is easy to find and follow and is expressed in an easy-to-follow and succint way.

You can read the first chapter for free here

Book2Look Diagnosis and Treatment of Chronic Fatigue Syndrome, Myalgic Encephalitis and Long-Covid (3rd Edition)


The following abbreviations are used in this book:

  • CFS – chronic fatigue syndrome
  • ME – myalgic encepahalitis
  • LC – long Covid

What these terms actually mean is detailed in Chapters 2 and 10, but in brief:

  • Chronic fatigue syndrome (CFS) is characterised by poor energy delivery mechanisms.
  • Myalgic encephalitis (ME) is characterised by poor energy delivery mechanisms and inflammation.
  • Long Covid is ME which follows acute Covid infection and/or Covid-19 mRNA gene therapy ‘vaccines’.

And note that:

  • Poor energy delivery is caused by poor diet and gut function, poor breathing, poor sleep, mitochondrial failure and poor adrenal and thyroid function.
  • Inflammation occurs when the immune system is activated. The immune system is activated in allergy, chronic infection and autoimmunity.

Notice further that:

  • These 3 terms are NOT diagnoses, but rather clinical pictures, that have some causation in common, but also arise from many different causal factors.

Book Publisher's Description of what this book is about

Since the publication of its first edition in April 2014, Dr Myhill’s guide to understanding and overcoming CFS/ME has become a must-read for sufferers from this poorly understood condition. As one example of the nearly 300 5-star reviewers on Amazon says: ‘Extremely useful, well written, concepts well explained, absolutely great investment of money and time in reading it.’ In the seven years since the second edition was published (January 2017) both new research and new clinical findings have thrown further light onto a condition that for sufferers is life-stopping but for many doctors is ‘all in the mind’. Most recently, the UK’s NICE guidelines have been updated and Long Covid has changed mainstream perceptions of post-viral fatigue, while Dr Myhill has looked further beyond mainstream medicine into often-ignored more traditional treatments including methylene blue and DMSO. Dr Myhill, supported by expert patient Craig Robinson, has fully rewritten and updated her book to include new insights throughout and new chapters on the PK diet, photodynamic therapy, micro-immunotherapy, ME and Long Covid, and the politics of CFS and ME.

Chapter List

Each chapter has a chapter summary. This is useful for those who are severely fatigued and maybe have difficulty concentrating or, for those who suffer with brain fog. The chapter summary pulls out the key points for you to keep in mind.

Here is the chapter list:

  • Introduction This book is written on the need-to-know principle*
  • Chapter 1 The road map for recovery
  • Chapter 2 Chronic fatigue syndrome - the symptoms of poor energy delivery
  • Chapter 3 Overview of the mechanisms of poor energy delivery and how to fix them
  • Chapter 4 First do the PK diet, then sort the upper fermenting gut then take the basic package of supplements
  • Chapter 5 The mitochondrial engines
  • Chapter 6 Oxygen
  • Chapter 7 The thyroid accelerator pedal and the adrenal gearbox
  • Chapter 8 Sleep – when healing and repair take place
  • Chapter 9 Pacing and the right sort of exercise
  • Chapter 10 Myalgic-encephalitis and Long Covid – the symptoms of inflammation
  • Chapter 11 Overview of the mechanisms of inflammation and how to fix them
  • Chapter 12 Allergy and auto-immunity
  • Chapter 13 The general approach to reducing inflammation
  • Chapter 14 Detoxing to reduce the toxic load of metals, pesticides, volatile organic compounds, prescription drugs, mycotoxins and more
  • Chapter 15 The general approach to treating chronic infection – reduce the infectious load
  • Chapter 16 DMSO (Dimethylsulphoxide )
  • Chapter 17 Methylene blue for many chronic infections
  • Chapter 18 Photodynamic therapy – using light to kill infections
  • Chapter 19 Reprogramming the immune system with micro-immunotherapy
  • Chapter 20 Reducing the infectious load with specific anti-microbials
  • Chapter 21 Plugging the emotional holes in the energy bucket
  • Chapter 22 The pattern of recovery
  • Chapter 23 The politics of CFS and ME – the name the shame and the blame

Here is the appendix list:

  • Appendix 1A Groundhog Basic
  • Appendix 1B Groundhog Acute
  • Appendix 1C Groundhog Chronic
  • Appendix 2 DDD. Diet, detox and die off reactions.
  • Appendix 3 Commonly used tests and how to interpret them
  • Appendix 4 How to access benefits.
  • Appendix 5 The Bell CFS ability scale

The Cover Blurb

Cfs3e cover blurb.png

What has changed since the 2nd edition was published

  • The 2nd addition was printed 7 years ago in 2017. It is 436 pages long. The 3rd edition is 326 pages long. My ideas have been refined, and have also been added to, a lot over the last 7 years. This new edition puts all those refinements and additions in one place in an easy-to-access format.
  • There are some things that are 100% new - namely
    • Chapter 6 Oxygen
    • Chapter 16 DMSO
    • Chapter 17 Methylene Blue
    • Chapter 18 Photodynamic Therapy
    • Chapter 22 Pattern of Recovery.
    • Groundhog regimes are included in the Appendices - these did not exist 7 years ago
    • Diet Detox and Die off reactions are included in the Appendices - this did not exist 7 years ago
    • There is a new section on Useful Resources including supplements' links, testing labs, links to transdermals, herbals' websites, glandulars' links, keto testing, vitamin c strips, FIR products, food suppliers, and so on.
    • In the 2nd edition, I talked about the use of prescription drugs for the treatment of underactive thyroid. That has been replaced with glandulars and herbals and also the same for adrenals.
  • All the other chapters have been re-written, and for example:
    • Chapter 2 defines CFS clearly
    • Chapter 10 defines ME and LC clearly
    • To treat CFS you follow the advice in Chapters 3 --> 9.
    • To treat ME and LC you follow the advice in Chapters 3-->9 and then add in advice in chapters 11 --> 20 that is relevant to your case [eg chronic infections, allergy, autoimmunity]
    • The Basic and Mitochondrial Packages are clearly laid out.
  • Craig has laid out his personal journey in more detail. There are 6 Personal Notes from Craig comments in the Introduction, Chapter 2, Chapter 9, Chapter 12 and Chapter 21 [2 Personal Notes in this chapter]. Some of these Notes are quite detailed.
  • The Appendix on State Welfare Benefits has been updated for new rules and rates of benefits etc
  • Appendices overall have been reduced from 11 to 5
  • Some chapters have been removed
    • Catastrophe Theory has been removed, and this has been removed from the website too. The model in the new Chapter 22 Patterns of Recovery is different.
    • Reprogramming the brain has been removed also.

Buy "Diagnosis and Treatment of CFS/ME & LC"

  • Please see here for UK delivery

"Diagnosis and Treatment of CFS/ME & LC" - UK delivery

  • Please see here for delivery to USA

This will not be available until August 2024 - Chelsea Green hold the right of the 2nd Edition until then

  • Please see here for delivery to Europe

"Diagnosis and Treatment of CFS/ME & LC" - delivery to Europe

  • Please see here for delivery to the Rest of the World

"Diagnosis and Treatment of CFS/ME & LC" - delivery to the Rest of the World

Hammersmith page "Diagnosis & Treatment of CFS/ME & LC"

Diagnosis and treatment of Chronic Fatigue Syndrome, Myalgic Encephalitis and Long Covid THIRD EDITION

Amazon link for "Diagnosis & Treatment of CFS/ME & LC"

Stylistic note

Use of the first person singular in this book refers to me, Dr Sarah Myhill. One can assume that the medicine, biochemistry and opinions are mine, as edited by Craig Robinson, and that the classical and mathematical references are Craig’s.

Book Reviews

Dr. Myhill has written an extraordinary book. She is the no 1 authority on CFS in the UK. Whereas many doctors dismiss the condition, she explains what it is, what has gone wrong in the body, using appropriate tests that are not done by mainstream medicine, and tells people what they can do about it. Whereas mainstream medicine only uses drugs to deal with a particular symptom, Dr. Myhill explains the reasons 'Why'. In my opinion, you will never cure anything unless you understand and deal with the why.

Dr. P J Kingsley MB.BS.,MRCS,LRCP.,FAAEM., DA.,DObst.RCOG.

This book is logical and evidence-based but is still an easy read. Dr Myhill has made the mitochondrial story clear for the non-expert. It makes essential reading for family members or friends of CFS sufferers. This book will help these patients to obtain understanding and effective management from their physicians.

Dr Sybil Birtwistle, MB ChB, DObstRCOG, DCH, Post Graduate Tutor, British Society for Environmental Medicine.

This book is an invaluable tool to recover from fatigue-related disorders for patients and practitioners alike! It is based on years of clinical experience, backed by research; written in a clear, concise way with lots of practical instructions - and from what I can say using these methods in my practice: it works!

Dr Franziska Meuschel MD, PhD, ND, LFhom

This book is both a superb self-help guide for any person with CFS/ME and a concise manual for the liberated clinician. In her unerringly defiant style, Sarah shares her vast specialist expertise, in a lighthearted and upbeat fashion, using analogies that make complex scientific concepts sound simple. The practical tips make it a unique, up to date, resource book, a "must read" for all those in the health professions who sympathise with the quest of thousands of debilitated people for answers and better care.

Dr Apelles Econs, MRCS, LRCP. Allergist

Drawing on decades of clinical experience, and unparalleled success in restoring health, hope and energy to thousands of CFS patients, Dr Myhill brings solid scientific evidence together with biological common sense to explain how to recover from this ghastly and increasingly common illness.

She describes the underlying cellular mechanisms in a way that everyone can understand, demonstrating simply the physiological basis of low energy production in CFS. This is an aspect that is largely ignored by most current approaches to CFS, but Dr Myhill shows clearly that CFS is in your mitochondria, not in your mind!

This book is an invaluable step-by-step guide to recovery, for patient and physician alike. I would not be without a copy in my clinic!

Dr Jenny Goodman MA MBChB

Over the years, working as a General Practitioner, I have recommended Dr Myhill's work to hundreds of patients. Her approach combines an in-depth understanding of human physiology, with years of practical experience and the use of cutting edge laboratory testing, to diagnose and treat the root causes of complex chronic diseases. Writing with humour and compassion, Dr Myhill has put together a simple step-by-step guide for patients, to take back control of their own health and start their journey to recovery. I am delighted that I can now recommend this book to every patient.

Dr. Jens Rohrbeck M.D (Dr. med.) M.Phil. GP and Functional Medicine Physician

Brilliant! This book offers the most complete, logical, practical and optimistic guide for people trying to recover from CFS that I am aware of. If every doctor could also take its contents on board, the management of CFS would be revolutionised.

Dr Charles Forsyth MBBS FFHom

The brilliant work of John McLaren-Howard, Sarah Myhill and Norman Booth has revealed that the illness is due to mitochondrial dysfunction. This discovery revolutionizes the world’s understanding of this condition - common in women who have used contraceptive or menopausal hormones and have toxic DNA adducts.

Dr Ellen Grant MB ChB, D ObstRCOG

Dr Myhill breaks new ground in her approach to Chronic Fatigue Syndrome and demonstrates clearly, with compelling scientific evidence, that this condition is not psychological but has treatable physical causes. She gives detailed guidance on practical ecological measures that need to be followed to effect recovery. A book which should cause many doctors and health professionals to radically revise their understanding of CFS and gives sufferers real encouragement and hope for their future health.

Dr John Meldrum MBChB, MRCGP, DA, DCH, DObst RCOG, HTD

What really struck me about this book is the degree of empowerment it gives to CFS sufferers in managing their own recovery, and the confidence it provides, through the authority of the author, in knowing what to ask for from health professionals. It explains with real clarity the complex biochemical processes underlying chronic disease and CFS, and the link with allergies, microorganisms and aspects of the Western lifestyle. There is a detailed and clear discussion of the tests available, how to interpret them, and what to do to get better. All this without ignoring the importance of introducing regular routines into your life, developing good organisational skills and ditching any perfectionist streak! A fantastic book for all health professionals too.

Dr Dee Marshall MBBS MFHom AllergyMedicalUK

Dr Myhill's wonderful book presents the clearest and most helpful information I have ever read on what Chronic Fatigue Syndrome actually is and what the many possible causes of it are. It is also extremely easy to read, even for someone without medical training. This is the only book that I've found that presents a comprehensive approach for assessing the underlying causes of CFS and treating them that may be tailored for the individual patient.

Understanding how mitochondrial failure can arise, why mitochondrial function problems are often a major factor in CFS and the approaches for restoring good mitochondrial function should form part of all medical training. Dr Myhill's book should be a standard text in all medical schools as well as being essential reading for all CFS patients and their doctors.

Dr Myhill's wonderful book is 'the bomb' for sufferers of Chronic Fatigue Syndrome and for doctors treating CFS or ME patients.

This book is easy to read, laden with information and shows practical ways of actually assessing and treating CFS. Loved it!!

This book explains clearly how mitochondrial failure is at the heart of conditions like CFS and ME. It is underpinned with solid science and presents a solid and practical approach for genuine and long-term recovery that can be understood by patients and their doctors.

Paul Robinson BSc Hons author of “Recovering with T3” and “The CT3M Handbook”

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