What to avoid

Treatments and programmes

CBT framed as a cure. Supportive counselling for coping with a serious illness can help. Programmes that claim ME/CFS is maintained by “unhelpful beliefs”, and that changing them will cure you, are not supported.
High-dose steroids. The PoCoVIT trial was stopped early after five serious blood clotting events, with no benefit.
Immunoadsorption outside a trial. It showed no benefit in unselected patients (Charité, 2026). It may help some people with specific autoantibodies, but only in a research setting for now.
Expensive “protocols” and clinics that promise recovery, especially with upfront packages.

VO₂ max or other maximal exercise testing is a known PEM trigger. The exception is a formal two-day CPET done specifically to document ME/CFS, and only if you decide the trade-off is worth it.
Private panels sold as an ME/CFS workup. They usually miss the tests that matter. See Tests.

Fitness-oriented coaching, e.g. “strain” scores, step goals, “you’re recovered, push harder”. See Wearables.

Stimulant-containing blends, such as flavoured “3-in-1” creatine with caffeine, or NMN blends with green-tea extract
Starting lots of things at once. You’ll never know what helped (or harmed).
Unverified internet cures. Check them against the evidence first.

Spending your good days. A good day is a sign pacing is working, not a sign you can do more. See Pacing.
Waiting until you’re bedbound to rest. Cut back early during a decline.
Visiting when unwell (for family and friends). New infections are the most common relapse trigger.

Ask these questions about any new treatment claim:

Was there a placebo group? In ME/CFS, 40% or more of people can feel better on a sugar pill. Without a placebo group, a high success rate can mean very little.
How many people? Results from 10 or 20 people often don’t hold up.
Was it in people, or in cells in a dish? Lab results are a starting point, not proof.
Was it ME/CFS, or a related condition? Long COVID and fibromyalgia results may not transfer.
Who’s selling it? Be wary when the person making the claim profits from the treatment.
Has anyone else replicated it?

Our evidence labels are designed to help with exactly this.