ME/CFS & Post-Exertional Illness

ME/CFS Treatment That Targets the Neurology Behind PEM

We measure and address the systems responsible for regulating blood flow to the brain — the variable most ME/CFS care never looks at.

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You're In The Right Place

Is this you?

If any of these sound familiar, you're in the right place.

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Keiser Clinic patient in waiting room recliner

Most ME/CFS workups end with "we can't find anything." Ours is built to find what they missed.

In study after study, ME/CFS patients show impaired cerebral blood flow when upright — neurovascular dysregulation that standard testing never measures and most clinicians never look for. That's where we start. Not as a theory, but as something we can measure on day one and build a treatment protocol around.

Data Callout
More than 9 in 10 people with ME/CFS have never been diagnosed. Why? Because most doctors were never given a useful framework to properly evaluate ME/CFS. The medical system is built to only rule out obvious disease — so patients with something as complex as ME/CFS are left with no real explanation.

It starts with a consultation.

Before booking your visit, schedule a free phone consultation with a Keiser Clinic physician. They'll listen to your story, answer your questions, and tell you plainly whether coming in makes sense for your situation.

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What to expect

  • —A physician listens to your full story
  • —No false hopes — if it's not a match, you'll know after this call
  • —Free — no cost to speak with a doctor
What You Can Expect From Diagnostic Testing With Us

A mechanism-focused evaluation that goes beyond observing fatigue.

Our diagnostic workup brings cutting-edge methods from leading neurovascular and autonomic research — including real-time cerebral blood flow measurement that most ME/CFS experts still don't have in routine practice. We do — and we use them with every patient. We also work with ME/CFS patients every day. Every test is paced and structured to stay within your metabolic window — so you leave with answers, not a crash.

Transcranial Doppler TCD

Transcranial Doppler (TCD)

The brain is the most oxygen-sensitive organ in the body — and in ME/CFS, it's often the one being starved. We measure blood flow to the brain in real time using transcranial Doppler ultrasound, giving us a live picture of whether your brain is getting what it needs to function — something no standard test ever looks at.

 Capnography EtCO2

Capnography (EtCO₂)

CO₂ is one of the brain's primary signals for controlling blood vessel dilation. When CO₂ levels drop — which research shows happens consistently in ME/CFS — blood vessels constrict at exactly the moment the brain needs more supply, not less. We measure this directly, because it's one of the most treatable variables in the picture.

 Cognitive Load Testing

Cognitive Load Testing

In ME/CFS, thinking feels like exertion — because for your brain, it is. We measure what happens to cerebral blood flow when we ask you to do cognitive work, because the crash that follows mental effort follows the same neurovascular logic as physical exertion. Understanding that distinction shapes how we approach your treatment.

 Visual and Oculomotor Assessment

Visual & Oculomotor Assessment

We assess the visual and vestibular systems using video-oculography (VOG) and pupil response testing. If these systems are misfiring, they can keep your autonomic nervous system stuck in overdrive.

 Autonomic Stress Testing

Autonomic Stress Testing

We use deep breathing, Valsalva, and postural stress to measure how your autonomic system responds and recovers under challenge. Then we layer in cognitive, cervical, and visual demands, because many patients only break down under combined load. What looks manageable at rest often becomes obvious when the system is pushed.

 Bedside Neurological Examination

Bedside Neurological Examination

Some of the most important findings still come from an experienced doctor examining you directly. We assess reflexes, eye tracking, cervical motion, and coordination to catch the neurological patterns that may not show up on a screen.

A Note From Our Team

We know what it feels like to be on the other side of this.

Several of our doctors have been patients or caregivers themselves. They know what it feels like to be dismissed and sent home with no answers. When you become a patient here, you have a care team of doctors who understand where you've been — and what it actually takes to get better.

Targeted Reflex Rehabilitation

Your treatment plan doesn't exist until your data does.

Your rehabilitation is not a program that existed before you walked in the door. Nothing is prescribed before we know exactly where the failure is and what's driving it. Instead of pacing & pain management being your only options, we prescribe an individualized neurological treatment — dose-specific to your needs, within your energy envelope.

We know ME/CFS is not one thing.

Whether your primary driver is autonomic dysregulation, neurovascular dysfunction, vestibular failure, or a combination — we strip away the labels and identify the mechanism that's failing in you specifically, so that we can treat the actual problem rather than the presentation of it.

Mitochondrial dysfunction is not the problem.

The mitochondria are the factory. But if blood flow to the brain is impaired, there's nothing to run through them — no oxygen, no glucose, no output. You can take every supplement on the market and it won't matter if the delivery system is broken. The mitochondria aren't failing because they're damaged. They're failing because they're not being fed. That's a cerebral perfusion problem, and that's where we start.

We focus on the brain before we ask the body to do anything.

Therapies begin by being applied to you — passive stimulation targeting the specific neurological systems that are failing — so your brain gains capacity before it's asked to perform. As those systems strengthen, therapies progress to active participation, then to independent function. That's how we expand your energy envelope without triggering harmful crashes. And throughout, we use capnography to monitor CO₂ in real time — giving us an objective early warning signal before your body crosses into PEM, so we can stop before the crash occurs, not after.

After you leave.

Virtual follow-up is included in your visit. Your protocols go home with you. We check in, answer questions, and make sure you stay consistent with what's working — until you no longer need us.

Most patients who come to us carry more than one of these diagnoses. These pages exist because that is often how people find us, not because we treat each diagnosis on a separate track. Our testing measures what your brain and nervous system are actually doing. The label you arrive with does not change that.

"Pacing as treatment has a ceiling. We work above it — in the brain."

Some of what you may be prescribed during your visit

Vestibular Rehabilitation

Vestibular Rehabilitation

Retrains the balance system when dizziness, motion sensitivity, visual instability, or autonomic symptoms are being worsened by vestibular dysfunction.
Visual-Spatial and Oculomotor Retraining

Visual-Spatial & Oculomotor Retraining

Targets the visual control systems that stabilize gaze and helps the brain build a more accurate map of the body in space. This can reduce neurostrain, disorientation, overload, and instability under cognitive and sensory load.

Peripheral Nerve Stimulation

Peripheral Nerve Stimulation

Uses targeted stimulation, including tools like the Neuro20 suit, to improve sensory input from the body and give the nervous system better information to regulate from.

 Cervical and Manual Therapy

Cervical & Manual Therapy

Addresses mechanical strain and poor sensory signaling coming from the neck and upper cervical region, where instability can interfere with brainstem function, and autonomic regulation.
Neuromuscular Retraining

Neuromuscular Retraining

Rebuilds cleaner movement patterns so activity becomes more tolerable and less likely to trigger compensation, overload, or crash responses.

Cognitive and Dual-Task Training

Cognitive & Dual-Task Training

Challenges the brain's ability to regulate under mental load, helping improve function when symptoms flare with thinking, multitasking, or divided attention.

Exercise Rehabilitation

Exercise Rehabilitation

Uses carefully dosed activity to improve tolerance and function without relying on generic exercise protocols like CHOP or GET that ignore cerebral blood flow, autonomic limitations, and issues related to fatigue.
Photobiomodulation

Photobiomodulation

Uses red light and laser therapy to support tissue recovery, reduce irritation, and complement neurological rehabilitation in areas that need targeted stimulation.

Magnetic Therapy

Magnetic Therapy

We use the non-invasive Magnetolith in patients with ligament laxity, including hEDS, to treat tendons and joints that may be contributing to instability in joints or the upper cervical spine.

A Different Approach To ME/CFS Care

Category Conventional Care The Keiser Clinic
Framing ME/CFS is a syndrome — manage symptoms, pace carefully, stay within your energy envelope A measurable neurovascular mechanism underneath the symptoms — one we can test for and build treatment around.
The Crash Post-exertional malaise — avoid triggers, rest after exertion A measurable neurovascular event. We use real-time CO₂ monitoring to catch it before it happens — and dose activity to build capacity, not trigger collapse.
Testing Bloodwork and MRI return normal. No further workup ordered. Real-time cerebral blood flow, CO₂ reactivity, vestibular and autonomic reflex testing — measuring what actually fails.
Treatment CBT, graded exercise therapy, pacing advice, antidepressants Individualized neurological protocols built from your data — not a generic ME/CFS program.
Progress Patient self-report of energy and symptoms Objective retesting throughout your stay — if the data doesn't change, the protocol does.
Comorbidities POTS, MCAS, and small fiber neuropathy often missed or treated separately Screened for and treated as part of the same clinical picture — they frequently share the same underlying mechanism.
Doctor Access 15–45 minute visits spaced months apart Multiple hours a day with a full clinical team — with direct follow-up after you leave.
How It Works

Commit only to the first day. Stay as long as you need.

We intentionally see a small number of patients each week. When you're here, you have a full clinical team — not a rotating roster of one-off appointments. Our waiting area has movie theater reclining chairs to make your breaks comfortable.

Most patients stay two to three weeks. Some stay longer. But when you arrive, the only thing you commit to upfront is that first day of diagnostic testing. What comes after is your decision.

We don't run a copy-and-paste ME/CFS rehabilitation program. We become your care team and design a protocol specific to you.

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2,000+
patients helped on their recovery journey
4–6 wks
Typical time to be seen. Most autonomic centers have waitlists measured in years, not weeks.
No Supplements
We do not build your care around supplement protocols. By the time most patients reach us, they have already tried that.
The First Day
Your only commitment. You will leave with the most comprehensive neurovascular evaluation available for ME/CFS — regardless of what you decide next.
Common Questions

Before you reach out, you probably have questions.

Yes. It's 15 minutes with one of our physicians. No cost, no obligation. We use it to determine if our approach matches your situation.
Most ME/CFS care focuses on pacing, symptom management, and sometimes graded exercise — none of which addresses the underlying mechanism. Our evaluation looks at what's actually happening in the brain and nervous system: cerebral blood flow regulation, autonomic function under stress, vestibular processing, and neurological reflexes. If you've spent years managing symptoms without resolution, the missing piece may be in these systems.
Not at the beginning. The first phase of care has to happen in person, because we do not build treatment plans from symptoms, diagnostic labels, or guesswork. We need objective testing and in-person treatment to understand what is driving your symptoms and to see how your system responds in real time. Once that work is done, post-visit virtual follow-up is included in your care.
That is one of the most common concerns we hear, especially from patients who have been mostly housebound or bedridden. Many of our patients were convinced they were too unwell to make the trip — right up until they arrived. Our team can help you think through the logistics, timing, and lodging options that make the visit as manageable as possible.
We're out of network for most insurance. Many patients use HSA/FSA funds, and we provide superbills for potential reimbursement. We've chosen this model because we don't want your care limited by what insurance allows.
The total cost depends on how long you stay and what level of treatment makes sense once your findings are clear. That is exactly why we start with a free consultation. Once we understand your specific situation, we will give you a clear, straightforward breakdown of the costs before you commit to anything.
No. You can book directly.
We will be honest with you. By the time most people find us, they have already been through a lot — physically, emotionally, and financially. The last thing they need is another clinic giving them false hope. If we do not believe our approach is the right fit, we will tell you plainly.

Want to hear directly from patients who've been through this?

Read POTS & dysautonomia recovery stories →
Take the First Step

Start with a free consultation call.

A Keiser Clinic physician will listen to your story, answer your questions, and tell you plainly whether coming in makes sense for your situation. No pressure. No false hopes.

Schedule Your Free Call