The Chronic Fatigue and Burnout Recovery Podcast

A recently published study investigating Hyperbaric Oxygen Therapy (HBOT) in people living with ME/CFS has generated considerable interest within the chronic illness community.

But what did the research actually find?

In this episode, Anna takes a balanced look at the study, exploring both the encouraging findings and the important limitations. Whilst the results suggest that HBOT may improve physical functioning, fatigue, pain and cognitive performance in a subset of people with ME/CFS, the study was observational and should be interpreted with appropriate caution.

Perhaps the most fascinating aspect of the research wasn't the treatment itself, but what it revealed about the brain.

Using MRI technology, researchers observed changes in communication involving the thalamus—a key brain region involved in filtering sensory information and coordinating communication between different brain networks. These findings add to a growing body of evidence suggesting that ME/CFS is associated with measurable physiological changes across multiple interconnected systems.

In this episode, Anna explores what these findings may mean, why they matter, and how they fit into the bigger picture of our evolving understanding of ME/CFS and Long COVID.

In this episode, we discuss:

What Hyperbaric Oxygen Therapy (HBOT) is and why researchers are interested in it

The design of the recent ME/CFS study and its key findings

Improvements observed in fatigue, pain, cognitive performance and physical function

Why the brain imaging findings were particularly interesting

Why this research does not prove that HBOT is an effective treatment for ME/CFS

Important study limitations and why they matter

My clinical perspective on who HBOT may (and may not) be appropriate for

Final Thoughts

As always, my goal isn't to chase headlines or promote individual interventions, but to help you better understand the emerging science behind ME/CFS and Long COVID.

Every well-conducted study adds another piece to the puzzle. Whilst we still have many unanswered questions, research like this continues to deepen our understanding of the complex interactions between the nervous system, immune system, energy metabolism and brain function.

If you found this episode helpful, I'd be so grateful if you could subscribe, leave a review, or share it with someone who may benefit from a more balanced interpretation of the latest research.

Useful Links

Research Article: https://pubmed.ncbi.nlm.nih.gov/42249466/

Take the Chronic Fatigue Quiz: https://app.annamarsh.co.uk/quiz-page

Instagram: https://www.instagram.com/anna__marsh_

Work with me: https://annamarsh.co.uk/work-together/

Website: https://annamarsh.co.uk/

In this episode, Anna shares the experience of completing her longest hike since chronic illness — a 21km hike lasting almost 6 hours — and reflects on what the following 72 hours revealed about recovery, capacity, and nervous system regulation.

This is not an episode about pushing harder.

It’s a conversation about what late-stage recovery often really involves:

understanding load distribution

preparing the body appropriately

supporting recovery intentionally

and learning how to take on bigger physical challenges without overwhelming the system.

Anna explores:

training and pacing considerations

planning around wider life stress and menstrual cycle timing

fuelling and post-exertion recovery

sleep and nervous system support

active recovery tools such as restorative movement, heat, cold and body work.

Blending personal reflection with clinical insight, this episode offers a realistic and grounded look at what rebuilding capacity can look like in the later stages of recovery.

Useful Links

Take the Chronic Fatigue Quiz: https://app.annamarsh.co.uk/quiz-page

Instagram: https://www.instagram.com/anna__marsh_

Work with me: https://annamarsh.co.uk/work-together/

Website: https://annamarsh.co.uk/

Creatine is often associated with the fitness industry and sports performance — but emerging research is now exploring whether it may have relevance far beyond the gym.

In this episode, Anna explores the current evidence surrounding creatine supplementation in Long Covid and fatigue-related conditions, including its potential role in energy metabolism, muscle function, cognitive symptoms, nervous system health, and recovery capacity.

This conversation also looks at:

Why creatine is being investigated in Long Covid

The link between ATP production and fatigue

Potential neuroprotective and antioxidant mechanisms

Brain fog and cognitive symptoms

Muscle weakness, PEM, and pacing considerations

Why individual responses to supplements can vary

Considerations around dosage, safety, and supplement sensitivity

Creatine and the menstrual cycle

Importantly, this episode takes a balanced and non-dogmatic approach. While early research is promising, creatine is not presented as a “magic bullet” or standalone solution for Long Covid.

As always, recovery is complex, individual, and multifactorial.

This episode is intended for educational purposes only and should not replace personalised medical advice.

Useful Links

Take the Chronic Fatigue Quiz: https://app.annamarsh.co.uk/quiz-page

Instagram: https://www.instagram.com/anna__marsh_

Work with me: https://annamarsh.co.uk/work-together/

Website: https://annamarsh.co.uk/

Referenced Articles

Effects of six-month creatine supplementation on patient- and clinician-reported outcomes, and tissue creatine levels in patients with post-COVID-19 fatigue syndrome

Reduced tissue creatine levels in patients with long COVID-19: A cross-sectional study

Creatine Supplementation in Women’s Health: A Lifespan Perspective

Creatine Supplementation and Brain Health

Diagnostic and Pharmacological Potency of Creatine in Post-Viral Fatigue Syndrome

Role of Creatine Supplementation in Conditions Involving Mitochondrial Dysfunction: A Narrative Review

In this episode, Anna explores a side of recovery that is rarely discussed:

What happens when the nervous system begins to reconnect with emotions, sensations, and internal experiences that were previously difficult to fully feel.

As the body becomes safer and more regulated, many people notice unexpected shifts:

emotions feeling stronger or more accessible

increased sensory awareness

old feelings resurfacing

a changing relationship with capacity, vulnerability, and self-protection.

Drawing from both personal experience and Somatic Experiencing concepts such as undercoupling and energy wells, Anna explores why these changes can emerge during recovery — and why they are often part of the nervous system recalibrating rather than “going backwards.”

This episode is a gentle conversation about the emotional and physiological complexity of healing, and the process of learning how to feel safely again.

Useful Links

Take the Chronic Fatigue Quiz: https://app.annamarsh.co.uk/quiz-page

Instagram: https://www.instagram.com/anna__marsh_

Work with me: https://annamarsh.co.uk/work-together/

Website: https://annamarsh.co.uk/

In this episode, Anna breaks down a recent study exploring brain neurochemicals in Long COVID and ME/CFS — with a particular focus on glutamate and its potential role in symptoms, particularly physical capacity. 

Rather than simply summarising the research, Anna walks you through what these findings may actually mean in practice. We’ll explore how glutamate fits into the wider picture of nervous system regulation, inflammation, and energy metabolism — and why these conditions can’t be understood through a single lens.

Anna talks about where targeted approaches like diet, supplements, or medication may have a role, and why addressing underlying drivers is often key to more meaningful, sustainable progress.

This episode is designed to help you make sense of the science — without oversimplifying it — and to offer a more integrated way of understanding your symptoms.

Useful Links

Take the Chronic Fatigue Quiz: https://app.annamarsh.co.uk/quiz-page

Instagram: https://www.instagram.com/anna__marsh_

Work with me: https://annamarsh.co.uk/work-together/

Website: https://annamarsh.co.uk/