Long COVID & Chronic Fatigue Syndrome (ME/CFS) Doctor

Understanding Long COVID and ME/CFS

Long COVID describes symptoms that persist or appear after a COVID-19 infection. ME/CFS is a long-term illness marked by profound fatigue, post-exertional malaise and unrefreshing sleep, which can follow COVID-19 or other infections. Both are real, physiological illnesses, and both are often dismissed when standard tests come back normal.

Factors that can add to the burden

Ongoing environmental exposures such as mold
Mast cell activation
Reactivated infections such as Epstein–Barr virus
Gut and microbiome disruption
Hormone and thyroid changes
Poor sleep and a stressed nervous system

How Dr. Madeira approaches care

Pacing first. Learn your energy limits to reduce crashes.
Look for contributors with a careful history and targeted testing.
Gentle, personalized support: nutritional and botanical medicine, sleep and nervous system support, and mindfulness practices, introduced at a pace you tolerate.
Coordinate with your other doctors when specialist care or medications are needed.

From The Dr. Madeira Show

Listen and learn more

Episode 18 · 61 min
Stealth infections: EBV, Lyme and mold
with Dr. Kasey Holland, ND
Listen to episode 18 →
Episode 55 · 65 min
Mold illness and brain health
with Dr. Lauren Tessier
Listen to episode 55 →
Episode 34 · 111 min
Sleep science and hormone health
with Dr. Kirk Parsley, MD
Listen to episode 34 →
Episode 48 · 109 min
Creating inner safety with mind-body practices
with Dr. Brad Lichtenstein, ND
Listen to episode 48 →

Frequently asked questions

What is the difference between Long COVID and ME/CFS?

Long COVID refers to symptoms that continue or develop after COVID-19 infection. Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a long-term illness defined by profound fatigue, post-exertional malaise and unrefreshing sleep, and it can follow different infections. Many people with Long COVID meet criteria for ME/CFS.

What is post-exertional malaise?

Post-exertional malaise (PEM) is a worsening of symptoms after physical, mental or emotional effort, often delayed by a day or more. Recognizing it matters because pushing through can make symptoms worse, so pacing is a core part of care.

Is there a treatment for Long COVID or ME/CFS?

There is no single cure. Care focuses on pacing, sleep, symptom relief and identifying factors that may be adding to the burden, such as environmental exposures, mast cell activation, gut problems or reactivated infections.

Can you see me by telemedicine if I’m too tired to travel?

Yes. Telemedicine is often easier for people with ME/CFS or Long COVID. Dr. Madeira sees adults by secure video who are located in Arizona, Montana or Washington.

This page is general education, not medical advice, and does not create a doctor–patient relationship.

Free discovery call

Ready for care that works at your pace?

Book a free 30-minute discovery call with Dr. Madeira. We’ll talk about your goals, your situation and whether working together is the right fit.

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Telemedicine for adults in Arizona, Montana & Washington.

Long COVID & chronic fatigue syndrome (ME/CFS)