I've seen huge improvement on Mestinon. It is the only thing that has helped to improve my fatigue. I drink 2 Liquid IV packets in 3 + liters of water a day and take 2-4 Vitassium Salt Stick caps as well. I have also had good luck with a stationary recumbent bike. When I started, I could only go for 5 minutes. Now I do an hour or more a day. I've read of several people having luck with functional neurology as well. Best wishes!