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The Allied Healthways website provides allied health professionals with guidance for a range of health conditions and concerns. The website now includes up to date information about ME/CFS. < Back New guidance for ME/CFS from CDHB for allied health professionals 22 Dec 2020 The Allied Healthways website provides allied health professionals with guidance for a range of health conditions and concerns. The website now includes up to date information about ME/CFS. We are grateful to the clinical editors from the Canterbury District Health Board who have worked with us recently to provide up-to-date guidance about ME/CFS for physiotherapists, occupational therapists, social workers, and other allied health professionals. This new guidance is available on the CDHB's Allied Healthways online platform, and will help health professionals to be aware of current understanding of this debilitating illness, and the need to move away from prior advice that is no longer recommended. Key points: Graded Exercise Therapy (GET) is not recommended for ME/CFS and may cause harm. Exercise can be used for physical maintenance (core strength, bone density and enjoyment) but needs to be at a level that avoids post-exertional malaise (PEM). Cognitive Behavioural Therapy (CBT) is no longer recommended as a treatment for ME/CFS as there is no evidence of specific benefit for ME/CFS. However, counselling may assist patients with adjustment to living with a debilitating chronic illness. Provide support for 'pacing' activities. The aim is to reduce physical and mental activity to a level that can be sustained without triggering post-exertional malaise (PEM). Make #movementforlife safe for #MyalgicEncephalomyelitis #ChronicFatigueSyndrome Previous Next

Loungewear and accessories for the ME/CFS community. Made to be lived in, rested in, and seen in. Wear a hoodie or tshirt to tell some of your story. Make a statement while supporting our charity. Crash Wear We're so excited to launch our official ME/CFS Canterbury merch range! Crash Wear is a collection designed with the ME/CFS community at heart - whether you live with it, care for someone who does, or advocate for awareness. From soft, sensory-friendly loungewear to bold minimalist accessories, every piece makes a quiet but powerful statement. Whether you're pacing in a hoodie, resting with a cup of tea, or advocating from bed with a statement pillowcase, each item helps support our local work for people with ME/CFS and Long Covid right here in Canterbury and the West Coast. We receive a small amount from every sale, and 100% of that goes directly to our advocacy, support, and awareness efforts. So, when you buy something, you're helping to make a real difference. Crash Wear Made to be lived in, rested in, and seen in. Wear your story. Support your community. Visit our Crash Wear Store

Dysautonomia often appears invisible, but it has a significant impact on daily life. < Back October is Dysautonomia Awareness Month 8 Oct 2025 Dysautonomia often appears invisible, but it has a significant impact on daily life. October is Dysautonomia Awareness Month. Many people with ME/CFS also live with Dysautonomia.  Dysautonomia is an umbrella term for a number of conditions that affect the autonomic nervous system (ANS). The ANS controls functions our bodies should regulate automatically, such as heart rate, blood pressure, and digestion. Some of the Dysautonomia conditions are: Orthostatic Intolerance (OI), Postural Orthostatic Tachycardia Syndrome (POTS), Inappropriate Sinus Tachycardia (IST), Neurocardiogenic Syncope (NCS) / Vasovagal Syncope, Orthostatic Hypotension, Multiple System Atrophy (MSA), Familial Dysautonomia and Pure Autonomic Failure (PAF). This can mean: Rapid heart rate when standing  Problems with temperature regulation Needing to sit or lie down to avoid fainting, headaches, nausea and other symptoms Feeling worse in the heat Needing to pace carefully to avoid crashes Dysautonomia often appears invisible, but it has a significant impact on daily life. Raising awareness is the first step to better recognition, care, and support. MANAGEMENT APPROACHES: OI symptoms are one of the most treatable symptoms associated with ME/CFS and it is usually possible to increase functional capacity through the following management approaches: Increase blood volume by drinking water and consuming more sodium (if safe for you to do so). Provide mechanical support by using compression garments and postural counter manoeuvres (movement that moves the blood up the legs to the heart). Make lifestyle adjustments such as avoiding overheating, alcohol, large meals. Introduce movement or gentle exercise done in a lying down or recumbent position first. #DysautonomiaAwareness #MECFS #InvisibleIllness #POTS ___________________________ FURTHER READING: To find out more, we recommend: https://www.dysautonomiainternational.org Recording of our OI Presentation https://youtu.be/HSj8zcK7XK0?si=dgvFt_RuzUHcYhRI https://www.cdc.gov/me-cfs/media/pdfs/2025/06/CDC-Dysauto-MECFS-Dec-4-2024-Alt-Text-Final.pdf https://healthify.nz/health-a-z/p/postural-orthostatic-tachycardia-syndrome-pots ME/CFS Canterbury West Coast Disclaimer Previous Next

When considering what supplements and treatments might be beneficial, we can refer to expert ME/CFS clinicians around the world and anecdotal evidence from the ME/CFS community, along with what published research there is. But care must be taken to always consider the individual, the risk of harm, and to approach any new treatment safely. We offer some guidelines for this. Supplements and Treatments In a perfect world, it would be understood what each of our bodies need to enable improvement and recovery. In this future world, there will be duplicated, published peer-reviewed clinical trials to back up any treatment recommendations that might be made. There would also be medical professionals who are knowledgeable in assessing each person's health and who have the expertise to manage symptoms and monitor treatments. We certainly aren’t there yet. Right now, when considering what supplements and treatments might be beneficial, we can refer to expert ME/CFS clinicians around the world and anecdotal evidence from the ME/CFS community, along with what published research there is. But care must be taken to always consider the individual, the risk of harm, and to approach any new treatment safely. We offer some guidelines for this below. DISCLAIMER: MECFS Canterbury does not provide recommendations for any treatments for your particular situation on this website. Any advice, either explicit or implied, is not intended to replace the qualified medical advice that is necessary for each individual. Please discuss any lifestyle and treatment changes with your doctor first. MECFS Canterbury does not accept any responsibility for any treatment undertaken by readers of any content or for any error or omission in connection with an article or content published on this website. What Lived Experience Tells Us From decades of people with ME/CFS and their doctors sharing what may help, we can make these points: Pacing our activity and energy expenditure, and including rest periods in each day, seems to be the best treatment protocol to manage symptoms and improve quality of life. Managing stress and calming the parasympathetic system through relaxation therapies often helps. People often report a supplement may be helpful for a period of time, but then it loses its impact. That initial period of respite may still be of high value. Stopping and then starting again may restart effectiveness. Supplements and therapies can cost a lot – at a time when we are likely to have limited financial resources. Given many treatments do not have evidence to support their use, will not work for every individual, or not for long, it can be difficult justifying investing in them. Purchasing a mobility aid or hiring a cleaner to help pacing, may achieve more. It is likely that there are subtypes of ME/CFS, and these may require different treatment pathways. People are often diagnosed with ME/CFS when a differential diagnosis or comorbid condition should have been identified. e.g. EDS, MS. The Risk of Harm Some supplements, treatments and therapies can DO HARM: While “natural” medicines and conventional pharmaceuticals can be helpful, they can also be contraindicated or dangerous if you have other diagnoses or are on other medication. Examples: Did you know that anecdotally, even basic supplements like magnesium, vitamin D and C can have negative health effects? Did you know that an estimated 1 in 250 people in NZ are at risk of developing hereditary haemochromatosis (toxic iron overload) so should never take iron supplements? People with ME/CFS can be very sensitive to supplements and vitamins, so their response cannot be assumed or judged from the experience of others with ME/CFS, or the general public. Fillers in supplements (as an example, mag stearate) can affect people with ME/CFS badly. Stimulants may seem an intuitive choice, but they frequently backfire in ME/CFS, leading to a very brief boost followed by a crash. Some Neuro-linguistic programming (NLP) therapies encourage people to exceed their energy envelope and risk pushing people with ME/CFS into a more severe symptom level. Graded Exercise Therapy (GET) is contraindicated, and is harmful when exercise is increased and triggers PEM.. Guidelines for Introducing Something New We recommend that you consult with your GP before starting new treatments. Add only one supplement change at a time, so that it is easier to verify what is helping or not. Start supplements on extremely low doses, because many people with ME/CFS are hypersensitive. Stop supplements/treatment if any negative reactions/symptoms are experienced (please check with your GP if this needs to be done gradually) Monitor the use of supplements extremely carefully. Keep a journal prior to starting – it is so easy to miss or over-inflate impacts. Trial for 2 – 3 months. If unsure whether it is helping, stop for a period (in a way that is safe to do) and monitor any changes. Start Low. Go Slow. Keep a record. Potential Supplements and Medications This is a list of potential supplements that some ME/CFS patients can tolerate and have sometimes found helpful. Unfortunately, this does not mean they will be good or helpful for you. PLEASE talk to your doctor and refer to the risks and approach guidelines above before trailing. Vitamin D - for those housebound and don’t get enough sun, preferably after a vitamin D test. Magnesium malate - in evening for insomnia, but some forms can disturb sleep and bowels. Lypospheric Vitamin C or the cheaper standard Vitamin C - for immune support. Vitamin B12 and B multi - for brain fog and fatigue (supplements are considered less effective than injections). Refer to our B12 information leaflet . Electrolytes – for those with Orthostatic Intolerance symptoms. Extra salt can be a good alternative, unless you have high blood pressure. Your GP can prescribe Electral. Gut health tonic - for digestive issues. Iron - only when deficiency has been confirmed by a blood test. Co-Q10 - some people have found this effective for mitochondrial support. NAC (N-acetylecysteine) – enhances mitochondrial support. Antihistamines – particularly if signs of MCAS, Mast Cell Activation Syndrome. Melatonin slow release – for sleep support. Horopito therapeutics - for systemic Candida. Low Dose Naltrexone (LDN) – evidence for pain support, emerging evidence for fatigue support. Used 'off-label' in New Zealand. Refer to our LDN leaflet . Evening primrose oil - may be helpful in relieving joint pain. Mestinon (pyridostigmine bromide) - emerging evidence for supporting aerobic capacity, fatigue, muscle strength and mental clarity. Used 'off-label' in New Zealand. Refer to our Mestinon leaflet . Refer to our further reading list for more information about these recommendations. Potential Therapies This is a list of potential therapies that some ME/CFS patients have found helpful. Unfortunately, this does not mean they will be good or helpful for you. PLEASE talk to your health team and refer to the risks and safe approaches suggested in our guidelines above before trailing. Vagus Nerve Stimulation (VNS ) - calming the Sympathetic Nervous System (SNS), the fight /flight response in the Autonomic Nervous System (ANS). Breathing Techniques such as 4-7-8 breath - for calming your ANS. Also see our Mental Wellbeing section for relaxation therapies. Further Reading Clinical Care Guide from Bateman Horne Centre, USA, a 98 page document published 2025. Clinical Primer from IACFSME (International [Clinician] Association for CFS/ME), 2014. Particularly Section 5 Management and Treatment. List (crowd-sourced) of supplements & considerations for pwME including what research exists https://me-pedia.org/wiki/MEpedia:Contents#Herbs.2C_supplements_and_nutraceuticals Statement from M.E. Awareness NZ on alternative medicine and therapy programmes https://m.e.awareness.nz/position-statements Advice from ME Association UK, who are strongly evidence-based. They provide general guidance and leaflets covering various supplements, therapies and medications https://meassociation.org.uk/free-literature-downloads/ There are supplement recommendations in Dr Sarah Myhill’s book about ME, “It’s Mitochondria not hypochondria” (we have a copy in our library). Again, no researched evidence on these, just anecdotal evidence. 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Join us as a member We invite you to join us as a member (it is free): To access our full range of services, To receive our news in your inbox, and to support our work. If you have any questions, please do ask. CONTACT US Please complete our membership form, either: Complete the membership form below, or Print PDF and post

Fundraise Do you have a birthday, anniversary, or other special occasion coming up? Or want to set yourself a physical challenge and participate in a running, cycling, swimming or triathlon event? Why not ask your whānau and networks to donate to MECFS Canterbury or sponsor your participation and raise some awareness at the same time? Want to host a fundraiser? Talk to us about setting up a fundraising page that links to MECFS Canterbury on sites such as Givealittle. First Name Last Name Email Message Thanks for your interest! Send Tshirts for fundraising events: If you are looking for tshirts that raise awareness of ME/CFS while you are doing your fundraising, we suggest you take a look at the range from M.E. Awareness NZ. SEE ALL M.E. AWARENESS NZ T SHIRTS

Meet our Team Governance Board Rose Camp Chairperson Rose joined the MECFS Canterbury committee in 2019, with a focus on improving how people with ME/CFS are treated by the health system. Both Rose and a family member have ME/CFS, and she is currently unable to work consistent regular hours because of it. Rose has a background in software development (as a tester), and in charity administration. With Nicola Stokes, our Manager, Rose forms a part time Leadership Team to manage our organisation and services. Nicola McDowell Secretary We have had the privilege of having Nicola on our committee since November 2021. Nicola brings the lived experience to our discussions and written material, as she has had ME/CFS and Fibromyalgia since 2003. Her health has significantly interrupted her professional career as a biologist, teacher, and librarian, but she has enjoyed volunteering and contributing to a variety or community organisations over the years. Siju Thomas Treasurer Siju kindly joined our committee in February 2024, to help us monitor our cashflow and grants pipeline, and to participate in governance discussions. Siju brings experience in financial management overseas and is a semi-qualified Chartered Accountant. Karen Lawton Karen joined the MECFS Canterbury committee in February 2022, as a consequence of having a family member who lives with ME/CFS and its impacts. Karen has experience in writing applications for government funding for companies, in sponsorship and funding for various regional and national photographic events, and as registrar for the NZ Acupuncture Standards Authority. Her main focus for our organisation is to ensure that the organisation attracts funding to sustain and grow the support that is available to our local ME/CFS community. Tom Harris Tom joined MECFS Canterbury and the Committee in April 2022. He has had CFS on and off for about 8 years. Tom trained as a psychology researcher, is an avid follower of new ME/CFS research (which he blogs about) and contributes to the quality of our written material and awareness raising activities. Ruth Keating Ruth joined our Board in January 2025, and brings experience as a lawyer working in NZ, London and Melbourne in both large firms and most recently in house as a General Manager. Ruth has a rare auto immune condition and has lived experience with Chronic Fatigue, and has had to stop working. Since 2022 she has been solely focusing on furthering her Governance career in Not for Profit entities. She is a Chartered Member of the NZ Institute of Directors. Greta Bond Greta joined our Board in September 2025, and brings experience as CEO of Aged Concern Canterbury and a previous project specialist role with the Canterbury District Health Board. Advisors Jan Barber, Board Advisor Jan is a Clinical Pharmacist by training but since 1997 worked in various roles in the New Zealand health system, including the Health Funding Authority, General Practice Organisations and Regional District Health Board organisations. From 2011 until May 2017, she was employed by the five South Island DHBs as the General Manager of the South Island Alliance Programme Office (SIAPO). Jan also has a history of governance experience for netball charities. Jan joined our committee in Feb 2021 and made significant contributions around strategy, governance processes and recruitment. In January 2025 she resigned from our Board, but continues to provide valuable support. Angus Mackay, Science Advisor Dr Angus Mackay joined us as Science Advisor in April 2024. The role is designed t o support our staff and our services by providing evidence-based scientific information on ME/CFS. This advisory role is non-clinical. Angus brings both the ability to carry out in-depth reading of published research, and also, a personal understanding of ME/CFS having developed the illness in 1995 after contracting glandular fever. Angus graduated with a PhD from the University of Otago in April 2023 after publishing several papers on his literature /theory-based neuroinflammatory hypothesis for ME/CFS that is also applicable to Long-COVID related post-viral fatigue syndrome (same model, different trigger). Operations Staff Rose Acting Manager Rose has stepped in as Acting Manager until we have worked through our recruitment process for a new part time Manager. Rose has responsibility for developing appropriate services, building our team of employees and volunteers, and networking with other service providers. Amanda Registered Nurse Amanda joined our team in January 2023 in a part-time role. She brings experience in community nursing, where she supported people with palliative care, wound care, and chronic health conditions. Wendy Registered Nurse Wendy joined our team in March 2024 in a part-time role. She has a community nursing background and spent most of her working life in South Auckland. She has personal experience of ME/CFS having a close family member who lives with it. Beth Intern Psychologist Beth is a registered Intern Health Psychologist working with us for 2025. She is an experienced mental health and trauma therapist and has a strong foundational knowledge of ME/CFS and Long Covid. Health Psychologists seek to help people cope with the emotional and psychological impacts of adjusting to living with chronic physical health problems, and to foster hope for the future. Rose-elle Work and Income Advocate Rose-elle is a social work student and joined our volunteer Outreach team in 2022. She moved into a part time Work and Income Advocacy role for us in 2023. Vacant Volunteer Coordinator We are currently recruiting for a Coordinator for our Volunteer Outreach Service. This is an important role and involves onboarding volunteers and matching these to clients who need practical or friendly support. Mell Office Administrator Mell joined us as volunteer Office Administrator in April 2025 to support our team. Mell became a part-time employee in October 2025. She responds to email and phone queries, looks after our library, helps prepare documentation, plus a wide range of other tasks. Hannah Accounts Administrator Hannah joined us in May 2021 to be our part time volunteer Office Administrator, later moving to an employed capacity. In January 2023, she changed focus to the Accounts Administrator role and now looks after our day-to-day financial accounts. She manages these tasks while living with ME/CFS and POTS. Tamara Social Media Coordinator Tamara joined us in this volunteer role in December 2024. Tamara posts content on our social media channels to raise awareness of ME/CFS, our services and guidance for living with ME/CFS and related conditions. Desiree North Canterbury Support Desiree has been a volunteer with us since March 2024 in a Client Outreach and Support role. She helps connect people in our ME/CFS community with others and the wider community. She also provides assistance for working through a next step, developing a special interest, or just catching up with a friendly call. Desiree also helps facilitate our group meetings in Rangiora.. Jordan Christchurch Support Jordan began volunteering with us in the Client Outreach and Supports role for Christchurch in July 2025. She has a BSci in Genetics and is currenlty doing a Masters in Nursing. Jordan is available to provide assistance for working through a next step, developing a special interest, or just catching up with a friendly call or visit. Rissa South Canterbury Support Rissa has provided advice around Work and Income benefits and allowances on a volunteer part time basis for us since February 2022. In the end of 2023, she moved to Waimate and is providing local support and facilitating gatherings in Timaru for people with ME/CFS. Vacant Mid Canterbury Support We are looking for a volunteer to be our Client Outreach and Support in Mid Canterbury. This position helps connect people in our ME/CFS community with others and the wider community. The volunteer also provides assistance for working through a next step, developing a special interest, or just catching up with a friendly call or visit. They may also help facilitate our group meetings in the area e.g. in Ashburton. Vacant West Coast Support We are looking for volunteers to be our Client Outreach and Supports on the West Coast. This position helps connect people in our ME/CFS community with others and the wider community. The volunteer also provides assistance for working through a next step, developing a special interest, or just catching up with a friendly call or visit. They may also help facilitate our group meetings in the area. e.g. Westport, Greymouth, Hokitika, Reefton. Andy Video Editor Andy joined us in November 2024 as a volunteer. He edits the recordings from our educational sessions so that we can share these on our YouTube channel. Stéphanie Seller of Donated Goods Stéphanie joined us in December 2022 as a volunteer to sell items that are donated to us on Trade Me. She manages the listings and sales interactions, and helps us increase our income. Jill Afternoon Tea Host Jill joined us in April 2022 as a volunteer. She home bakes delicious gluten free and dairy free treats for our afternoon teas at our group meetings. Volunteers We have a remarkable team of volunteers who contribute to our organisation or support people one-on-one. Some help with one-off projects and others help on a regular basis. Their support makes a real difference to the lives of the people in our ME/CFS community. FIND OUT MORE ABOUT VOLUNTEERING

Registered Nurse Service Our Registered Nurses provide a range of clinical supports for our members and their whanau. A Nurse can also talk to your health team, education provider and workplace, to improve understanding and to discuss care and accommodations. The Registered Nurse Service is free and is delivered through home visits, zoom consultations, and other interactions to people of all ages. An initial assessment involves discussing your previous medical history, your current situation and what ongoing supports you may need. Areas of support may include: Clinical support for symptom management and obtaining a diagnosis. Short term loan of a wearable activity tracker, to help monitor the impact of your activity on your symptoms, and to assist you to pace within your energy envelope. Advocacy with GP’s, Physicians, allied health, employers, education providers, whānau and others. Management plans for students attending the Southern Regional Health School. (SRHS is a state school for children in Years 1 to 13 who are unwell.) Referrals to allied health and other external supportive services (including CDHB Occupational Therapy, CDHB LTS-CHC (Long Term Support – Chronic Health Conditions), Pegasus Health PCW (Partnership Community Workers), Comcare – Peer Support, Total Mobility Card) Applications for the Hāpai Access Card which give people with disabilities better access and support from retailers and public areas. Due to funding constraints, our Registered Nurse Service is only available to people who have or suspect they have ME/CFS or Long Covid in the Canterbury and West Coast regions. The exception to this is for young people from throughout the South Island who attend the Southern Regional Health School. Please note that there is currently a waiting list for our Registered Nurse Service and you may need to wait for several months before receiving first contact from a nurse. We apologise for this and assure you that we are working hard to increase the funding for our services. To access this service: To refer yourself to the Registered Nurse Service, sign up as a member and note on the form what help would be beneficial, and one of our team will be in touch. Existing members can email us to request a referral to the Registered Nurse Service. FILL OUT OUR MEMBERSHIP FORM OR ASK YOUR GP TO FILL OUT THE REFERRAL FORM Our Registered Nurse team is also available to provide general information about ME/CFS to medical professionals and community-based service providers.

Ways to Help The generosity of the wider community enables MECFS Canterbury to provide our services. We welcome all sorts of contributions whether it be specific expertise, practical help, or donations of money and goods. We currently do not receive any income from government health funds. We are grateful for your interest in our organisation and assure you that any contribution makes an important impact. Help a friend with ME/CFS READ MORE Volunteer READ MORE Donate READ MORE Fundraise READ MORE Buy from us READ MORE Support businesses in our community READ MORE Bequest READ MORE Sponsorship READ MORE

Health NZ has acknowledged that ME/CFS is a debilitating, long-term illness in the new Health Conditions section on their website. < Back New Health Information page for ME/CFS from Health NZ 22 Sept 2025 Health NZ has acknowledged that ME/CFS is a debilitating, long-term illness in the new Health Conditions section on their website. The Health Conditions pages are intended for the public to provide introductory information about health conditions and their causes, symptoms, diagnosis, and treatments. For Chronic Fatigue Syndrome, Health NZ highlights the key symptoms, the diagnostic criteria in use in New Health NZ has acknowledged that ME/CFS is a debilitating, long-term illness in the new Health Conditions section on their website. For Chronic Fatigue Syndrome, Health NZ highlights the key symptoms, the diagnostic criteria in use in New Zealand, the need to pace your activity to avoid triggering Post Exertional Malaise, and more. You can read the information and share it with whānau from here: https://info.health.nz/conditions-treatments/brain-and-nerves/chronic-fatigue-syndrome It’s worth mentioning that GPs have access to more extensive clinical guidance for ME/CFS on Health NZ’s Health Pathways website for doctors. The Health Pathways for ME/CFS was updated and extended in February 2025, so do ask your GP if they have read the guidance for ME/CFS on Health Pathways recently. Previous Next

The main management approach for ME/CFS is reducing your activity to a level that can be sustained and that avoids triggering Post-Exertional Malaise (PEM). We provide some guidance on activity management and pacing here. Activity Management The main management approach for ME/CFS is reducing your activity to a level that can be sustained and that avoids triggering Post-Exertional Malaise (PEM). Post-exertional Malaise (PEM) is a core symptom of ME/CFS and it is an abnormal response to normal activity. It is a disproportionate and prolonged increase in symptoms. PEM makes us sicker and makes it harder to function and participate in our daily life. PEM can be triggered by various kinds of activity - physical, mental, emotional, orthostatic (moving to an upright position), sensory overload, multi-tasking, and physiological processes (temperature regulation, digestion). PEM often occurs hours or days after the triggering activity. Activity management is key to minimising PEM and to stabilising symptom severity. Adopt the ‘Stop, Rest, Pace.’ approach and practice pacing as your commitments allow. We provide more detailed information below. Pacing Pacing helps us avoid triggering PEM. Pacing means adjusting your life to stay within your 'Energy Envelope' as much as possible. Pacing involves: Prioritising what to spend energy on - and choosing which activities to reduce or drop altogether (this may include making life-changing decisions such as reducing employment, retiring, or dropping out of education). Changing the way chosen activities are done so they require less energy (this may include use of mobility aids). Breaking activities down into short bursts. Interspersing activity with rest (physical, cognitive & sensory rest - including rest from screens). Aiming for a balance of necessary activities and pleasurable activities. Creating (usually) safe and energy-efficient routines for regular necessary tasks (this helps reduce cognitive load). Stopping before symptoms increase and taking pre-emptive rest (some patients experience subtle cues when getting close to exceeding their Energy Envelope but many don't so they need to be proactive). Pacing sounds simple but it is not easy to put into practice, and it is individual to you. Be kind to yourself as you cope with daily demands and as you learn about your energy envelope. When exploring what you can manage, it can be useful to keep an 'activity and symptom diary' for a few weeks to see if you can identify any patterns, early warning signs and triggers which could help to reduce PEM episodes. You might find our diary template useful to do this. Wearable Biometric Devices: Some people find using a wearable activity tracker helpful for completing their activity diary, and for keeping steps or heart rate under a certain level. Although a tracker does not measure cognitive or emotional activity, it can help you recognise activities and tasks where your heart is elevated (meaning you are using more energy or under more stress). A good basic activity tracker is the Xiaomi Smart Band and we have some of these available for loan. The Polar H10 HR strap is recommended if you wish to monitor Heart Rate Variability. Further reading: To find out more about pacing, we recommend these resources from Emerge Australia : Introduction to the 'Stop.Rest.Pace ' approach. Two-page Pacing handout which provides a 4-step approach. Five-page handout on Pacing with a Heart Rate Monitor to help determine your anaerobic threshold and energy envelope. ME Support - NZ also has an eight-page Basics of Pacing handout in their Long Covid Support Tool . We also recommend these resources from M.E. Awareness NZ: An Explanation of PEM for people with ME article The Art and Science of Pacing for ME article Articles about Heart Rate Variability: One-page HRV handout from Bateman Horne Centre What is Heart Rate Variability? , Elite HRV Lifehacks for ME/CFS Visit our Lifehacks section for some tips and tricks for managing your daily activities. Practical Supports Visit our Practical Supports section for some other ideas for finding easier ways to do things, so that you can more often live within your energy envelope. Suggestions include using mobility aids and energy saving approaches. Safely exploring exercise When you live with a broken energy system, you need to a pproach exercise as ‘movement’ for your health and wellbeing, rather than ‘exercise’ to improve fitness. We have a few presentations on this topic that you may wish to watch: Safely exploring 'exercise' or movement when you have ME/CFS Rachel Sullivan, Clinical Exercise Physiologist, covers the dangers and recommendations. Analeptic restorative activity in ME/CFS Catherine George, Physiotherapist, explains how to improve functional strength and flexibility. The following organisations provide guidance for safe exercise: Physios for ME (UK-based) Workwell Foundation ( USA)

Sponsorship If your business or organisation is interested in supporting people living with ME/CFS, we would love to hear from you. There are opportunities to make a difference by sponsoring an event, service area, operational costs, funding key positions, and more. First Name Last Name Email Message Thanks for submitting! Send What to know more about us, our community, and our work? Review our introduction documents: Statistics Snapshot . Introduction to our Services and Community Needs . Testimonies and Service Statistics . Watch our 3-minute introductory video for potential funders...