What diagnostic tests and treatments?

We start by collecting data. The questionnaires provide information to understand which complaints and symptoms of ME/CFS or Long COVID exist. We have agreements in Europe regarding laboratory tests. This is intended to prevent people coming to us who could be better helped elsewhere. Therefore, we see it as assistance for the general practitioner. The laboratory tests are not intended for diagnosis.

First video session
Then, there follows a first video session in which we discuss your medical history, sleep, activities, and illness.

Second video session
After the questionnaires and the first conversation, questions always remain. These are addressed in the second video session. We then also have time to talk about the symptoms and complaints, we discuss the outcomes of the laboratory tests, and you get a lot of information.

Third video session
You have received a package at home with a blood pressure monitor, a hand dynamometer, and sheets for the Stroop color-word test. With these, we measure the reaction of the blood circulation to the transition from lying to standing with the NASA 10-minute lean test, the test that we, as ME/CFS experts, have agreed upon to establish orthostatic intolerance. With the hand dynamometer, we measure energy production. This test, too, is an international agreement and has replaced the test or tests on the bicycle ergometer. The most important cognitive limitation is the reduction of speed. We measure this with the Stroop test. All tests are done at home and adapted to your capabilities.

Fourth video session
Then, we make a report to establish the diagnosis, the severity of the symptoms, and the physical and cognitive limitations. You receive the draft report by email, and the next day, there is a fourth video session in which we discuss the report and the treatments. After that, a final report is made that is also sent to your general practitioner.

NEW:
Expansion of the tests
New is that we supplement the measurement with the hand dynamometer with more tests if the values are abnormal. In the last three years, we have tried various substances, and we can now objectively measure whether the energy production has improved after an hour. You can find examples of this on the site.

We send you a hand dynamometer again, with several substances that can improve energy production. We use pyruvate, beta-hydroxybutyrate, alpha-ketoglutaric acid, oxaloacetate, creatinine, and more in weekly repeated video sessions with handgrip tests. This way, you know in an hour whether a substance will help.

Hand dynamometer tests of energy production with substances from metabolism can be done if the first measurement shows a reason. Other medications, such as Low-Dose Naltrexone (LDN), Mestinon, and L-carnitine, require more time.

What treatments are done?
We already know many processes that have changed in ME/CFS and Long COVID. Therefore, we can reduce complaints and symptoms with substances that adjust these processes. We do this systematically and cautiously. Many systems are less stable in these syndromes, and low dosing is wise. As European experts, we have compiled a list of substances that can be given alone or in combination. New substances are added regularly. We aim for a safe, logical combination that can be used for a long time. We advise against expensive treatments with a temporary effect because it must be for a long time, safe, and affordable. We can now choose from thirty-two medicines and supplements.

What guidance is provided?
We consult with you at least every three weeks, usually alternating once to adjust the used substances and one or two times to provide guidance. Tests are repeated if necessary. We are available 24/7 for consultation and questions.

Multidisciplinary treatment
We have the option for a multidisciplinary consultation via video with you and your healthcare providers, such as a general practitioner, physiotherapist, occupational therapist, psychologist, and other involved parties. In our opinion, this form offers the best multidisciplinary treatment without traveling to Amsterdam.

The costs for the consults and six months of treatment amount to €950.