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Conventional Once the possibility of other illness is ruled out, the patient must be informed of the syndrome, its prognosis, and its potential impact on the patient's life. Patients are often relieved when their complaints are taken seriously. Many symptoms of chronic fatigue syndrome may respond to treatment. Nonsteroidal anti-inflammatory medications relieve headache, diffuse pain, and relieve feverishness. Antihistamines and decongestants are helpful for allergic rhinitis and sinusitis.
Although many patients are averse to psychiatric diagnoses, depression is a prominent symptom that may be alleviated with nonsedating antidepressants. Frequently, they not only improve mood, they also help with sleep disturbances, thereby relieving the fatigue somewhat. Many times, even modest improvement can make a vast difference in a patient's degree of self-sufficiency and ability to enjoy life.
Consumption of heavy meals, caffeine, and alcohol in the evening can make it harder to sleep, compounding fatigue. Also, total rest is not good as it leads to further de-conditioning and contributes to the feeling of being an invalid. Strenuous exercise only leads to greater fatigue, so a well-planned, moderate exercise regimen should be a part of the treatment plan.
Nutritional Supplementation Additional information (Precautions) is available by clicking on the underlined supplement. Nicotinamide Adenine Dinucleotide (NADH)
NADH was studied in a randomized, double-blind, placebo-controlled crossover study in patients with chronic fatigue syndrome. 26 subjects were randomly assigned to receive either 10 mg of NADH or placebo for a 4-week period. After a 4-week washout period, subjects were crossed to the alternate regimen for a final 4-week period. In this study, 8 of 26 patients (31%) responded favorably to NADH while only 2 of 26 (8%) subjects taking the placebo improved. Although longer term follow-up studies are needed, the favorable results in this preliminary study indicate that NADH may be a valuable therapy in the management of the chronic fatigue syndrome.(1) Coenzyme Q10 (CO-Q10)
Chronic fatigue syndrome has been identified as a symptom or condition that frequently precedes by years the development of congestive heart failure. In one study, administration of coenzyme Q10 resulted in improvement of cardiovascular function and fatigue.(2) Magnesium
One group of researchers reported that individuals with chronic fatigue syndrome were found to have lower red cell magnesium concentrations compared to matched controls. In a double-blind study, 32 patients with chronic fatigue syndrome were either given 50% magnesium sulfate in a 1 gm/2 ml I.M. weekly injections or a placebo of 2 ml of injectable water. Patients treated with magnesium claimed to have improved energy levels, better emotional states, and less pain. Twelve of 15 patients reported benefiting from the therapy and 7 patients reported significant energy improvement. In the placebo group only 3 of 17 patients said they felt better and one patient had improvement energy. Red cell magnesium normalized in all patients receiving the injection, but only 1 patient returned to normal in the placebo group. The authors conclude that chronic fatigue syndrome patients have slightly lower magnesium levels than healthy controls and that magnesium therapy appeared to be of benefit. They cautioned that their trial was small and only had a follow-up of 6 weeks.(3) L-Carnitine
Investigation of 35 patients with chronic fatigue syndrome (27 females and 8 males) revealed that CFS patients have statistically significantly lower serum total carnitine, free carnitine, and acylcarnitine levels.(4) Omega-3 Fatty Acids and Omega-6 Fatty Acids
Sixty-three adults with postviral chronic fatigue syndrome were studied in a double-blind, placebo-controlled study of essential fatty acid therapy. The patients had been ill for from one to three years, suffering from severe fatigue, myalgia, and a variety of psychiatric symptoms. Patients were given capsules containing linoleic, gamma-linolenic, eicosapentaenoic, and docosahexaenoic acids (8 x 500 mg capsules per day over a 3-month period) or a placebo. After 3 months, 85% of patients on active treatment assessed themselves as improved over the baseline compared to 17% of placebo patients reporting improvement. The essential fatty acid levels were abnormal at the baseline and corrected by active treatment. These results suggest that essential fatty acids may provide a rational, safe, and effective treatment for patients with post-viral chronic fatigue syndrome.(5) Folic Acid
Researchers assayed the serum folic acid levels of 60 patients with chronic fatigue syndrome (CFS) and found that 50% had values below 3.0 micrograms/l. The results of this study indicate that a substantial percentage of patients with chronic fatigue syndrome may be deficient in folic acid.(6)
Herbal Supplementation Additional information (Precautions) is available by clicking on the underlined supplement. Ashwagandha
Ashwagandha root, also known as winter cherry or Indian ginseng, is an important herb from the Ayurvedic or Indian system of medicine. Ashwagandha has been traditionally used for the treatment of debility, emaciation, impotence, and premature aging.(7) This dietary supplement is used to enhance mental and physical performance, improve learning ability, and decrease stress and fatigue. Ashwagandha is a general tonic to be used in stressful situations, especially insomnia, overwork, nervousness, restlessness, and chronic fatigue syndrome.(8) Rhodiola
Rhodiola has long been used in traditional folk medicine in China, Serbia, and the Carpathian Mountains of the Ukraine. In the former Soviet Union, it has long been used as an adaptogen, decreasing fatigue and increasing the body's natural resistance to various stresses. In Siberia it is said that "those who drink rhodiola tea regularly will live more than 100 years."
Rhodiola seems to enhance the body's physical and mental work capacity and productivity, working to strengthen the nervous system, fight depression, enhance immunity, elevate the capacity for exercise, enhance memorization, improve energy levels, and possibly prolong the life span.(9) In Siberia it was taken regularly especially during the cold and wet winters to prevent sickness. In Mongolia it was used for the treatment of tuberculosis and cancer. Eleuthero, Siberian Ginseng
Eleuthero is a different genus than other popular ginsengs such as the American and Panax or Asian varieties. The use of eleuthero root dates back 2,000 years in the records of Chinese medicine. It was used for respiratory tract infections, as well as colds and influenza.(10) The Chinese also believed that eleuthero provided energy and vitality. In Russia, it was originally used by the Siberian people to increase physical performance and to increase the quality of life and decrease infections. Eleuthero has been studied extensively since the 1940's. The root has been found to have many adaptogenic benefits.(11, 12) Eleuthero has been reported to increase stamina and endurance and protect the body systems against stress-induced illness.(13, 14) It is rumored that Soviet Olympic athletes have used eleuthero successfully to enhance sports performance and concentration. Astragalus
Astragalus has been valued by the Chinese for centuries for its immune-enhancing and adaptogenic properties. As an adaptogen, it may modify and improve the body's response to stress through action on the adrenal cortex.(15, 16) Cordyceps
Cordyceps is a unique black mushroom that extracts nutrients from and grows only on a caterpillar found in the high altitudes of Tibet and China. Cordyceps is one of the most valued medicinal agents in the Chinese Materia Medica. Cordyceps has been used in traditional Chinese medicine as the herb of choice in lung and kidney problems, and as a general tonic for promoting longevity, vitality, and endurance.(17) Cordyceps is beneficial in helping individuals with decreased energy restore their capacity to function at a greater level of activity. Cordyceps has traditionally been used for its improvement in respiration and in individuals with decreased lung function, such as asthma and bronchitis, by increasing oxygenation (improving VO2 max by 9-15%).(18) Reishi Mushroom
Reishi mushroom is called the “mushroom of immortality” in China and has been used as a tonic and strengthening medicine for thousands of years. Uses in traditional healing include increasing intellectual capacity and memory, promoting agility, and lengthening the life span.(19) Reishi is reported to have some of the most active polysaccharides in the plant kingdom. Polysaccharides are claimed to have immunomodulating activity. Reishi is also reported beneficial as an antioxidant, antihypertensive, hypoglycemic, antiviral, and hepatoprotective agent. Schisandra
Schisandra has been used in Chinese medicine for centuries as a kidney tonifying agent and sedative. It has historically been used to treat cough and wheezing, spontaneous sweating, chronic diarrhea, insomnia, and forgetfulness.(20) In Russia, schisandra has been used as an adaptogen, increasing the body's natural ability to fight off disease and stresses from chemical, physical, mental, and environmental sources.(21) Schisandra has been reported to increase human endurance and mental and physical performance.(22)
Homeopathy Arsenicum album
Typical Dosage: 6X or 6C, 30X or 30C
Weak;
Pale;
Sensitive to cold;
Burning sensations;
Restless, worse at night between 1:00-3:00AM;
Better from heat Gelsemium sempervirens
Typical Dosage: 6X or 6C, 30X or 30C
General weakness;
Lethargy;
Sleepiness;
Stiffness in body;
Limbs feel heavy Phosphoricum acidum
Typical Dosage: 6X or 6C, 30X or 30C
Prostration and severe fatigue;
Nervous exhaustion;
Better from heat and rest;
Worse from any physical or mental effort
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