Is CFS Recovery a medical treatment?

No. CFS Recovery is a coaching-based recovery system built on neuroscience principles. We do not diagnose, prescribe, or provide medical treatment. Our recovery system is designed to complement clinical care, not replace it.

What training do your coaches have?

All Thriver Coaches have: (1) personally recovered from ME/CFS, Long COVID, fibromyalgia, or a related condition, (2) completed formal coaching methodology training, (3) been mentored under senior coaches, and (4) are under ongoing supervision. They are not licensed healthcare practitioners.

Can I see your outcome data methodology?

We use two instruments: the SF-36 Health Survey (scored with the standard RAND-36 algorithm) and our proprietary Nervous System Health Assessment (NSHA). The NSHA is repeated over time and compared within-person; the SF-36 is completed once at baseline and once at follow-up, with follow-ups grouped by client tenure. Our data represents aggregate real-world outcomes, not controlled trial results, and we are transparent about limitations including self-selection, no control group, and small subgroups.

Will my patient need to stop any medications or treatments?

No. We never advise patients to stop, start, or modify medications or medical treatments. Any changes to clinical care should be made in consultation with the prescribing physician. Our recovery system operates alongside medical management.

How do I know if my patient is a good fit?

Patients who benefit most from our recovery system have symptoms consistent with nervous system dysregulation: ME/CFS, Long COVID, fibromyalgia, POTS, chronic pain, or chemical sensitivity. They should be open to a coaching-based approach and able to engage in some level of daily practice (adapted to their capacity).

Can I receive updates on my patient's progress?

Yes, with the patient's written consent. We can provide SF-36 scores and general progress summaries to coordinating healthcare providers.

What about severely affected or bedbound patients?

Our recovery system is designed to be accessible at any severity level. For bedbound patients, coaches adapt the approach using short voice notes, text check-ins, and modified exercises. Some of our most meaningful recovery stories began from bedbound.

Our Outcomes, and the Honest Version of the Data

We measure client outcomes with two instruments: the SF-36 Health Survey, used in clinical research worldwide, and our own Nervous System Health Assessment. This page shows what that data says, how we collect it, and where it is thin. We report observed outcomes in a self-selected coaching population, not a controlled trial.

Data current as of April 2026. CFS Recovery is a coaching and educational organization, not a medical provider.

The Numbers at a Glance

Two complementary instruments, kept separate on purpose. The Nervous System Health Assessment (NSHA) gives us scale and repeated within-person tracking. The SF-36 gives us an external, internationally validated yardstick that we do not control.

5,313

NSHA assessments

2,418

Unique clients assessed

825

Tracked within-person (NSHA)

SF-36 clients with paired surveys

Who this data describes

Ages 9 to 86 (median 40). Illness duration from 1 month to 50 years (median 4 years). Conditions include CFS/ME, long COVID, post-viral fatigue, fibromyalgia, POTS, and dysautonomia.

Severity at intake

Share of assessments at each activity level (n=3,874 with activity data). 30.6% arrive housebound or worse.

Bedridden

6.3%

Mostly bedridden

10.9%

Housebound

13.4%

Can leave the house

25.1%

Semi-functional

39.8%

Mostly functional

4.6%

The most common symptoms at intake

Share of 5,313 assessments reporting each symptom. The average person reports 12.5 symptoms at once, from a list of 290 we track.

Fatigue

89.1%

Brain fog

70.4%

Anxiety

63.9%

Headaches

57.0%

Difficulty concentrating

49.8%

Muscle weakness or pain

46.3%

Sleep disturbances

45.3%

Heart palpitations

43.4%

Nervous System Health Assessment (NSHA): within-person change

Our proprietary assessment maps cognitive capabilities (7 sub-domains), physical capabilities (7 sub-domains), symptom load, and activity level on 0 to 5 and 1 to 7 scales. 825 clients completed two or more assessments, so we compare each client's first assessment to their most recent one, a median of 124 days apart. This is genuine before-and-after data in the same people.

64.1%

improved physical capability (avg +0.46 on a 0 to 5 scale)

58.5%

improved cognitive capability (avg +0.33 on a 0 to 5 scale)

47.5%

reduced their symptom count (avg -0.36 symptoms)

36.1%

improved activity level (of 438 with activity data)

"Improved" counts any measurable positive change from a client's first assessment to their most recent. We show the average magnitude alongside each rate so the numbers are not read as all-or-nothing.

SF-36 Health Survey: scores by tenure

The SF-36 is a clinician-recognized instrument used in thousands of published studies. We score it with the standard RAND-36 algorithm. Each client completes one baseline survey and one follow-up survey. We group those follow-ups by how long the client had been in the recovery system.

Where clients start: SF-36 baseline scores

Score out of 100 at intake, where higher is better (n=84). Role Limitation (Physical) at 6 of 100 means near-total inability to carry out normal daily roles.

Role Limitation (Physical)

Role Limitation (Emotional)

Energy / Fatigue

Social Functioning

General Health

Emotional Wellbeing

Physical Functioning

Pain

SF-36 Domain	Baseline	0-6 Month	6-12 Month	12+ Month
General Health	35%	+18%	+28%	+57%
Physical Functioning	48%	+16%	+28%	+34%
Role Limitation (Physical)	6%	+14%	+29%	+36%
Role Limitation (Emotional)	17%	+35%	+29%	+50%
Energy / Fatigue	25%	+18%	+24%	+17%
Emotional Wellbeing	47%	+16%	+20%	+12%
Social Functioning	34%	+26%	+37%	+55%
Pain	61%	+8%	+8%	+39%

SF-36 scores range from 0 to 100, where higher is better. Values are percentage-point gains from baseline. These bands are different clients at different tenures (n=84 baseline, n=92 at 0-6mo, n=61 at 6-12mo, n=14 at 12+mo), so they are cross-sectional snapshots, not a within-person trajectory over time. The 12+ month band is small (n=14). Clients whose scores stayed low may have left before reaching the longer bands.

The same table, visually: gains by tenure band

Percentage-point gain vs baseline (bar scale 0 to 60). Reminder: each band is a different set of clients, and the 12+ month band is 14 people.

General Health

+18

+28

+57

Social Functioning

+26

+37

+55

Role Limitation (Emotional)

+35

+29

+50

Pain

+39

Role Limitation (Physical)

+14

+29

+36

Physical Functioning

+16

+28

+34

Energy / Fatigue

+18

+24

+17

Emotional Wellbeing

+16

+20

+12

0-6 months (n=92) 6-12 months (n=61) 12+ months (n=14)

Most severe cases show the largest gains

Clients who entered at the lowest baseline scores averaged +41% improvement across all 8 SF-36 domains, versus +22% for the average client, with the largest gains in Pain (+60%), Social Functioning (+49%), and Emotional Wellbeing (+47%). Part of this gap reflects regression to the mean: clients selected at the floor tend to move upward on remeasurement regardless of intervention. We present it as an observed pattern worth studying, not as proof of effect.

Most severe cases vs the average client

Percentage-point gain vs baseline (bar scale 0 to 60). Part of this gap reflects regression to the mean, as noted above.

Pain

+60

+10

Social Functioning

+49

+32

Emotional Wellbeing

+47

+17

Role Limitation (Emotional)

+45

+36

General Health

+40

+24

Physical Functioning

+33

+21

Energy / Fatigue

+32

+20

Role Limitation (Physical)

+26

+21

Most severe at intake Average client

Cross-instrument check

52 clients completed both instruments. Of those 52, 47 improved on their overall SF-36 score, and 23 improved on both the SF-36 and the NSHA at the same time. Agreement between an independent, validated instrument and our own supports the reliability of the observed gains. It does not establish cause.

NSHA Sample

5,313 assessments, 2,418 unique clients, 825 tracked within-person (median 124 days)

SF-36 Sample

699 surveys from 90 unique clients (baseline plus a single follow-up, grouped into 0-6, 6-12, and 12+ month tenure bands)

Data Collection

SF-36 since December 2023, NSHA since April 2024, ongoing. Figures shown as of April 2026. Follow-up surveys are being collected for roughly 600 additional clients who have completed SF-36 baselines, so this dataset is set to grow several times over

What This Data Can and Cannot Say

These are aggregate, observed outcomes, not controlled trial results. There is no control group and no randomization.
The population is self-selected. Clients who complete a follow-up survey may differ from those who do not, which can bias results upward.
The SF-36 tenure bands are cross-sectional. Different clients sit in each band, so they cannot establish a within-person trajectory over time.
Some subgroups are small. The 12+ month SF-36 band is 14 people.
The most-severe subgroup analysis is affected by regression to the mean.
The SF-36 measures function and quality of life, not post-exertional malaise (the defining feature of ME/CFS). A normal-range score reflects normal-range functioning on this instrument, not a clinical determination of recovery.
We are transparent about all of this, and we will report the updated numbers as the larger cohort matures, whichever direction they move.

The Questions a Careful Reviewer Should Ask

These are the toughest fair questions about our data, asked the way a skeptical clinician or researcher would ask them, with our honest answers. We'd rather raise them ourselves than have you wonder if we've thought about them.

Your SF-36 sample is only 90 people. Isn't that small?

▼

Yes, and we keep it clearly separate from the larger numbers. The 5,313 assessments and 2,418 clients are from our own NSHA. The SF-36, the validated instrument, covers 90 clients with paired surveys as of April 2026. It's also growing quickly: roughly 600 more clients have completed baselines and their follow-up surveys are being collected now, under a documented protocol. We committed before that data is in to publish the results whichever way they move.

Do the SF-36 tenure bands show the same people improving over time?

▼

No, and we label them accordingly. Each client completes one baseline and one follow-up, grouped by tenure. The 0-6, 6-12, and 12+ month bands contain different clients, so they are cross-sectional snapshots. Where we do claim within-person change, it comes from the NSHA, which is genuinely repeated on the same person (first vs latest assessment, a median of 124 days apart, n=825).

Isn't the "most severe cases improve most" result just regression to the mean?

▼

Partly, yes. When you select the clients who scored at the very floor, some measured gain is regression to the mean regardless of any intervention, and we can't cleanly separate the real effect from that artifact in observational data. What we still find notable is the direction and consistency, which run against the common assumption that severe means hopeless. We present it as a pattern worth studying, and we say so wherever the number appears.

Without a control group, how do you know the recovery system caused any of this?

▼

We don't claim it did. This is observational, uncontrolled, before-and-after data, and we describe it as observed outcomes, never as proof of cause. The context we offer is the natural course of the illness: the most cited prognosis review found roughly 5% full recovery in untreated chronic fatigue syndrome. Our observed within-person improvement rates sit well above that baseline. In our view that justifies a proper controlled study, and we'd welcome one.

The NSHA is a questionnaire you designed yourselves. Why should anyone trust it?

▼

On its own, it would be weaker evidence, and that's exactly why we also run the SF-36, which we didn't design and can't tune. Among the 52 clients who completed both instruments, 47 improved on their overall SF-36 score and 23 improved on both at the same time. Agreement between our own tool and an independent validated one is what gives the NSHA numbers their credibility.

"64% improved" by how much? Does any tiny change count?

▼

Any measurable positive change counts toward that figure, so yes, small changes are included. That's why we always publish the average magnitude next to the rate: +0.46 points physical and +0.33 cognitive on a 0 to 5 scale. Those are modest, real average gains, and we'd rather show the honest average than the percentage alone.

What about the people who didn't improve and stopped filling in surveys?

▼

Attrition is a real limitation and it's in our stated list. Clients who feel better may be likelier to complete a follow-up survey, which can bias results upward, and we can't rule that out in observational data. We also apply a one-month-minimum inclusion rule even though it may modestly lower our average improvement, because it's the more honest figure.

Explore the Data Yourself: The Live Outcomes Dashboard

The numbers on this page are a snapshot. The full dataset lives in an interactive dashboard that reads our SF-36 responses directly, scores them with the standard RAND-36 method, and shows the before-and-after change across all eight domains with filters, effect sizes, and confidence intervals. It refreshes nightly, so as the roughly 600 pending follow-up surveys come in, the dashboard updates with them.

All charts run on de-identified data. Access is code-gated, and we share it with verified healthcare professionals.

Request dashboard access

We verify each request and reply with your access code and our practitioner packet: the outcomes one-pager, the methodology and limitations write-up, and our referral guide. Prefer email? Write to miguel@cfsrecovery.co or message us on LinkedIn.

Already have a code? Open the dashboard.

Want the Full Picture?

We keep a detailed outcomes whitepaper with the complete methodology, scoring approach, sample sizes, and every limitation. If you are a clinician evaluating our work, or a person deciding whether this is worth your time, we would rather you scrutinize it than take our word for it.

For Practitioners: request the whitepaper

You can also watch real recovery stories on our recovery stories page, or take the free Nervous System Health Assessment to see where you stand.