Consult a Specialist in
Complex Chronic Fatigue

Katie Brown, MD offers physician-to-physician consultations for patients with diagnosed or suspected Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS).

Primary care physicians are often left managing highly complex chronic fatigue cases with limited support. Dr. Brown partners with you to help care for medically complex patients, offering evidence-based guidance and clear, ongoing communication. Her consultation services are designed to support your clinical decision-making and reduce the burden of managing these challenging cases alone.

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Identifying Appropriate Referrals

Referral is appropriate when fatigue is severe and accompanied by post-exertional worsening of symptoms. Patients with ME/CFS typically also present with cognitive dysfunction (“brain fog”), orthostatic intolerance, disturbed sleep patterns, and reduced functional capacity.The most useful clinical clue pointing to ME/CFS is post-exertional malaise. This refers to a delayed worsening of symptoms after physical or cognitive exertion, lasting at least 24 hours. Patients often experience a push-crash pattern, where they fluctuate from days of being relatively functional to days of being highly symptomatic. Even relatively minor activity can trigger a flare, and many patients report feeling flu-like or markedly unwell during a "crash".About half of patients report a post-viral onset. Since the COVID-19 pandemic, ME/CFS has become more common, with approximately half of patients with Long COVID meeting diagnostic criteria.Patients frequently have overlapping conditions, including joint hypermobility, POTS, mast cell-related symptoms, fibromyalgia, migraines, and medication or food sensitivities.

Dr. Brown's Experience with ME/CFS

Dr. Brown developed ME/CFS in the fall of 2014 during her first semester at Indiana University School of Medicine. Her medical training was shaped by her personal experience with the condition, and she achieved remission during her final months of medical school.After completing Family Medicine residency in June 2023, Dr. Brown opened a micro-Direct Primary Care practice. In March 2024, she launched a specialty ME/CFS clinic, focusing on diagnosing and treating patients across the full spectrum of severity—from mild cases to very severe, bed-bound patients requiring feeding tubes and IV hydration.She has sought mentorship and advanced training to refine her approach, including participation in the Long COVID iECHO group, workshops with Dr. Raymond Perrin on lymphatic drainage massage, and regular consultation with Dr. Peter Rowe of Johns Hopkins and physical therapist Wendy Wagner. Dr. Brown has successfully supported disability cases, improved quality of life for patients, and helped a small number achieve remission.

What sorts of treatment recommendations does Dr. Brown provide?

ME/CFS is a complex, chronic condition without a universal cure. The goal of treatment is to improve quality of life while minimizing medical and financial harm. Dr. Brown prioritizes evidence-based treatments first, followed by safe, low-cost experimental options, and considers more expensive experimental therapies only when the potential benefits clearly outweigh the risks. She generally avoids high-risk interventions and costly functional medicine–style testing.Her approach draws on a wide range of strategies tailored to the individual patient, including prescription and over-the-counter medications, supplements and vitamins, manual therapies like lymphatic drainage massage, behavioral strategies such as pacing, mind-body techniques including stress reduction and meditation, procedures like stellate ganglion blocks, and surgeries such as cervical fusion. She can also support patients with long-term disability applications.Treating ME/CFS requires comfort with uncertainty. Strong evidence is limited for many interventions, but there are safe and experimental options at every level of severity. With the right approach, many patients can improve their quality of life.

More about peer-to-peer consultations

Peer-to-peer services do not establish a doctor-patient relationship between Dr. Brown and your patient so it may be used for patients located anywhere in the world. Using virtual or written communication, Dr. Brown will guide you through the diagnostic process and recommend evidence-based treatments for your patients with complex chronic fatigue.

This consultation is designed to provide you with a detailed 3-6 month treatment plan for your patient with diagnosed or suspected ME/CFS. Patient attendance at the virtual consultation is welcomed but is left to your discretion.Includes:

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