How to Best Recover From a Crash: the ME/CFS Community Reports


The push/crash part of chronic fatigue syndrome is well-known to people with ME/CFS.  Exert yourself too hard physically and/or mentally and you ‘crash’ – your normal symptoms flare up, sometimes new and exciting ones show up and you’re hurting.  In scientific terms a crash is called post-exertional malaise (PEM) and unless you’re managing your chronic fatigue syndrome really well you’re going to have to deal with it…. sometimes frequently.

What do you do to recover from a crash?

What do you do to recover from a crash?

So what to do about these crashes? Are there any magic cures out there? In this, the first Community Report  we aimed to find out. We asked a tough question: “once you’re in a crash what can you do to get out of one?”  We didn’t expect easy answers and we didn’t get any but we did get some intriguing possibilities.

For myself, I got a couple of clues; my symptoms (burning muscles) suggest lactic acid accumulation is a possibility and doing gentle stretching exercises did, surprisingly enough, help a bit.  Salt loading did as well and I’m interested in trying NAC, glutathione and other antioxidants and nortriptyline.

If you’d like to tell us how you get out of a crash simply let us know in the comment section of this page and we’ll incorporate it into the report.

Community Report

Resting and Mind/Body Practices

Resting, simply resting was easily the most commonly reported ‘fix’ for a crash. Sleeping was next and then reducing stimuli but these answers really all went together; i.e. reducing stimuli is part of the package when you get away and simply rest and/or sleep. Some people found doing breathing meditations and mindfulness exercises to relax and reduce the whir of thoughts helpful.

Resting, Sleep,  Stress Reduction, Distraction                                                                                   # of People Reporting
Resting 22
Sleep 10
Reduce stimuli 7
Mindfulness activities to reduce stress 3
Doing breathing meditations 3
Stop thinking (stop rush of thoughts) 2
Distraction 1
Practice good sleep hygiene 1

Drugs and Similar Treatments

Oxygen (hyperbaric or otherwise) popped up as the first choice among drugs with saline, surprisingly, not mentioned much – which probably indicates that the word needs to get more about saline. Nortrityline was very effective for one person. The at least partial success oxygen provided is in line with Dr. DeMeirleirs theory that tissue oxygen depletion plays a major role in ME/CFS.

Drugs                                                                                                                                                   # of People Reporting
Oxygen (including hyperbaric oxygen) 5
IV saline 1
Nortryptilene (25 mg – 40 mg pm) 1


Supplements were not mentioned often but when they were they tended to be detox and/or energy enhancing supplements. People interested in this approach might want to check out Rich Van Konynenburg’s Methylation protocol. 

Supplements # of People Reporting
Modified Myer’s cocktail with glutathione push 1
Mitochondrial enhancers (AMP, NADH, B Complex, Glutathione, Creatine, D-Ribose, acetyl-l-carnitine, COQ10, 1
Megavitamin/superfoods 1
N-acetylcysteine (NAC) (pre-dose to avoid crash) 1

Diet and Liquids

Keeping the blood volume up (being well hydrated, salt loading, electrolyte drinks) was mentioned enough that every one with ME/CFS might want to give this a shot. Check out more on saline IV’s here. 

Diet and Liquids                                                                                                                                     # of People Reporting
Eating smaller, very nutritional, meals 2
Eating more protein/ less carbs and sugar 1
Drinking lots of water/electrolyte drinks and hydrating fluids 5
Keeping well hydrated with salt 5
Eating olive oil rich foods 1
Low glycemic diet 1

Physical Therapy / Movement

Physical  Therapy / Movement                                                                                                              # of People Reporting
Massage 1
Yoga to reduce lactic acid 1
When coming out of a crash do small amounts of exercise to get better sleep 1


Others                                                                                                                                                     # of People Reporting
Heating pad  1
Watching TV  1
Communicating with friend  1
Baths with Epsom Salts  1
Music, Books on Tape  1
Use heart rate monitor religiously  1
Monitor activities on spreadsheet  1

Have your own suggestions to add? Simply put them in the comment box below.

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