Chronic fatigue, fibromyalgia, long COVID—these conditions converge on one disruptive commonality: an energy crisis. Beyond fleeting tiredness, this crisis often leaves sufferers enveloped in relentless fatigue, pain, brain fog, and disrupted sleep.

Dr. Jacob Teitelbaum, an internal medicine physician with decades of experience treating CFS/FMS (Chronic Fatigue Syndrome and Fibromyalgia), developed the S.H.I.N.E.® Protocol as a holistic, disease-modifying approach to restoring vitality by addressing five core systems. (The Educated Patient)

What Does “S.H.I.N.E.” Stand For?

• S—Sleep

• H—Hormones

• I—Immunity / Infections

• N—Nutrition

• E—Exercise (as able) (vitality101.com)

Some variations replace Exercise with Emotions (especially in contexts emphasizing stress management or mental health) (drhui.com).

Why S.H.I.N.E. Matters

1. Sleep

Sleep isn’t just rest—it’s restoration. According to Dr. Teitelbaum, people with CFS/FMS often don’t achieve true, deep sleep because of hypothalamic dysfunction, leading to pain and fatigue that don’t resolve with conventional sleep durations. Cultivating 8–9 hours of quality, restorative sleep (possibly supported with melatonin, sleep hygiene, or gentle prescription aids) is foundational. (vitality101.com)

2. Hormones

Hormonal imbalances are frequently overlooked. Even “normal” lab results may mask functional deficiencies in:

• Thyroid (affecting energy metabolism)

• Adrenal function (stress response & blood pressure regulation)

• Sex hormones (menopause, low testosterone, etc.)
  Dr. T encourages corrective support—with thyroid, bioidentical hormones, or adrenal-boosting strategies where appropriate. (Renewed Vitality)

3. Immunity / Infections

Hidden infections—from chronic viruses to yeast overgrowth or gut imbalance—frequently perpetuate fatigue and inflammation. Identifying and supporting resolution of these is central. (Renewed Vitality)

4. Nutrition

Optimal nutrient balance fuels energy production and cellular repair. Frequent key deficits include:

• B12

• Magnesium

• Acetyl-L-carnitine

• Glutathione
  Plus vitamins A, C, D (and others). A nutrient-rich diet, along with supplement support, is tailored based on individual needs. (vitality101.com)

5. Exercise (as able)

Movement is medicine—but pacing is key. After building balance via the first four pillars, a gradual, controlled increase in gentle exercise supports conditioning and well-being, without triggering post-exertional malaise. (vitality101.com)

What the Research Says

• In one of Dr. Teitelbaum’s studies, over 90% of patients with CFS/FMS improved using the full S.H.I.N.E. protocol, with ~75% improvement in quality of life within 3 months—and around 90% by 2 years. (vitality101.com)

• Long-term follow-up showed many could gradually wean off treatments, once underlying disruptions resolved. (vitality101.com)

• More recently, the protocol has been applied to long COVID, under the view that post-viral fatigue mirrors chronic fatigue and fibromyalgia. The same five domains are targeted to restore energy and resilience. (The Educated Patient)

Empowerment Through Integration: Why S.H.I.N.E. Works

1. Holistic targeting: Chronic conditions rarely stem from a single cause. S.H.I.N.E. addresses multiple, interacting systems.

2. Personalized approach: Lab tests guide interventions—but functional symptoms and response patterns also direct adjustments.

3. Gradual progression: The protocol emphasizes building balance before pushing forward with intensity.

4. Supportive tools: The Energy Analysis Program, a free questionnaire, helps identify which areas need focus. (vitality101.com)

5. Self-advocacy: Patients are encouraged to take an active role, find practitioners who understand these conditions, and push for comprehensive care. (The Educated Patient)

Cautions and Considerations

• Not a quick fix: S.H.I.N.E. is a long-term recovery framework—not a one-and-done remedy.

• Individual variability: While many benefit significantly, some may need additional therapies or encounter persistent challenges.

• Medical supervision required: Especially regarding hormone replacement, infection treatment, and supplement dosing.

• Research limitations: While clinical experience is compelling, more large-scale, controlled studies would strengthen evidence.

Final Thoughts

The S.H.I.N.E.® Protocol offers an integrative roadmap to regain energy, reduce pain, and rebuild life for those living with chronic fatigue, fibromyalgia, or long COVID. By focusing, one by one, on the pillars of sleep, hormones, immunity, nutrition, and gentle movement, it inspires hope—and often, tangible results.

Bibliography

1. Teitelbaum, J. (2001). From Fatigued to Fantastic! 3rd ed. Avery Publishing Group.

2. Teitelbaum, J. (2012). The Fatigue and Fibromyalgia Solution: The Essential Guide to Overcoming Chronic Fatigue and Fibromyalgia. Avery Publishing Group.

3. Teitelbaum, J., Bird, B., Greenfield, R., Weiss, A., Muenz, L., & Gould, L. (2001). Effective treatment of chronic fatigue syndrome and fibromyalgia—a randomized, double-blind, placebo-controlled, intent-to-treat study. Journal of Chronic Fatigue Syndrome, 8(2), 3–28. doi:10.1300/J092v08n02_02

4. Teitelbaum, J., Johnson, C., St. Cyr, J. (2006). The use of D-ribose in chronic fatigue syndrome and fibromyalgia: A pilot study. Journal of Alternative and Complementary Medicine, 12(9), 857–862. doi:10.1089/acm.2006.12.857

5. Vitality101. (n.d.). The S.H.I.N.E.® Protocol. Retrieved September 2025 from https://vitality101.com/shine

6. The Educated Patient. (2024). Jacob Teitelbaum, M.D. on diagnosing and treating fibromyalgia. Retrieved September 2025 from https://www.theeducatedpatient.com/view/jacob-teitelbaum-m-d-on-diagnosing-and-treating-fibromyalgia

7. Renewed Vitality. (n.d.). SHINE Protocol for CFS and Fibromyalgia. Retrieved September 2025 from https://www.renewedvitalitymd.com/shine-protocol

8. Hui, J. (2022). The S.H.I.N.E.® Approach to Fatigue. Retrieved September 2025 from https://drhui.com/s-h-i-n-e-approach-to-fatigue