With chronic fatigue syndrome (CFS), you feel so worn out that you are unable
to do even half of your normal daily activities—and the
feeling doesn't go away. This syndrome affects twice as many women as men. It
may last a month, a couple of years, or many years.
Signs and Symptoms
Severe fatigue that comes on suddenly, especially after you've had
Low-grade fever (100.4oF) and chills
Sore throat and swollen glands
Muscle and joint aches
Feeling of being in a fog and unable to concentrate or
What Causes It?
No one knows what causes CFS, but a virus may be responsible. Risk factors
include extreme stress or anxiety, flu-like illness that doesn't completely go
away, and poor eating habits.
What to Expect at Your Provider's Office
Your health care provider will go over your symptoms, check your medical
history, and do a physical examination. He or she may use laboratory tests, such
as a blood or urine test, to rule out other problems. If you have CFS, your
health care provider will prescribe drugs to treat your symptoms, or will
suggest herbs, vitamins, or dietary changes to help you. Usually these
treatments and time will be enough to cure the problem.
If the usual treatments do not work, your doctor may check for other
conditions, such as a psychiatric illness, muscle disease, or exposure to a
toxic agent, that can cause symptoms similar to those of
Chronic fatigue syndrome is a stressful disease to have. It is important to
get emotional support as well as treatment for your symptoms. Treatment for
symptoms includes antidepressants and drugs to boost your immune system. Pain
relievers and anti-inflammatory drugs help relieve muscle and joint aches.
Support groups and stress-management techniques can help you to cope with the
Antidepressants—depending on type, in
addition to relieving depression, they can reduce fatigue, muscle tension, or
insomnia; various side effects
Benzodiazepines—help reduce anxiety; various
Histamine blockers—block production of
stomach acid, improving energy
Nonsedating antihistamines—relieve allergy
symptoms; side effects include drowsiness and headache
Immune system boosters—to activate or enhance
the immune system; some of these drugs are experimental
Over the Counter
Aspirin, acetaminophen, and ibuprofen—reduce pain;
side effects may include nausea, vomiting, gastrointestinal bleeding, and kidney
Complementary and Alternative Therapies
Following nutritional guidelines and using herbs and homeopathic remedies as
recommended may alleviate the debilitating symptoms of CFS and improve overall
vitality. Counseling, support groups, meditation, yoga, and progressive muscle
relaxation are stress-management techniques that may help as well.
Avoid refined foods, sugar, caffeine, alcohol, saturated fats, dairy
products, and gluten-containing grains. Eat more fresh vegetables, legumes,
whole grains (non-gluten), protein, and essential fatty acids (found in nuts,
seeds, and cold-water fish).
The following supplements may help reduce symptoms of CFS.
Beta-carotene (50,000 IU per day) to strengthen immune
Vitamin C (250 to 500 mg two times per day) to increase
B-complex (50 to 100 mg per day or 2 ml by injection one to two times
per week) with additional B6 (100 mg per day) and B5 (100 to 250 mg per day) to
reduce the effects of stress.
Pantothenic acid (4 to 7 mg per day).
Magnesium aspartate (400 to 1,000 mg per day) to support energy
L-carnitine (330 mg one to three times per day) to support energy
production in the cells.
Herbs may be used as dried extracts (capsules, powders, teas), glycerites
(glycerine extracts), or tinctures (alcohol extracts). Unless otherwise
indicated, teas should be made with 1 tsp. herb per cup of hot water. Steep
covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots.
Drink 2 to 4 cups per day. Tinctures may be used singly or in combination as
noted. As with any therapy, it is important to work with your provider on
getting your problem diagnosed before you start any treatment.
A tincture of Siberian ginseng (Eleutherococcus senticosus),
schizandra berry (Schizandra chinensis), ashwaganda root (Withania
somnifera), gotu kola (Centella asiatica), and astragalus root
(Astragalus membranaceus). Take 20 to 30 drops two to three times per
day. These are safe to take long-term and may need to be taken for four to six
months for maximum benefit.
Herbs that support overall vitality and relieve exhaustion include licorice
root (Glycyrrhiza glabra), lomatium root (Lomatium dissectum),
skullcap (Scutellaria lateriflora), passionflower (Passiflora
incarnata), lavender (Lavandula angustifolia), and rosemary leaf
(Rosmarinus officinalis). Take 20 to 30 drops two to three times per day.
Do not take licorice if you have high blood pressure.
Essential oils of jasmine, peppermint, and rosemary are calming and
restorative and may be used in aromatherapy. Place several drops in a warm bath
or atomizer, or on a cotton ball.
The appropriate homeopathic treatment for CFS depends on the individual's
constitutional type. A constitutional type is defined as a person's physical,
emotional, and psychological makeup. An experienced homeopath assesses all of
these factors when determining the most appropriate remedy for each individual.
Some remedies commonly used by professional homeopaths to treat CFS
Arsenicum -- for restlessness and fatigue accompanied by chills
and burning pains that are worse at night
Gelsemium -- for mental exhaustion, including drowsiness and
indifference, and physical weakness, such as heaviness of the limbs and
Pulsatilla -- for people who are moody and emotional, although
usually with a calm and gentle disposition
Sulphur -- for people who feel fatigue and tend to be lazy and
unproductive; usually not as emotionally sensitive as those requiring
While no trials have specifically investigated the use of acupuncture in
treating CFS, a number of promising studies have found that acupuncture may be
helpful for conditions with similar symptoms such as fibromyalgia, depression,
headache, and irritable bowel syndrome. There is also some evidence that
acupuncture may help boost an individual's immune system.
Acupuncturists treat people with CFS based on an individualized assessment of
the excesses and deficiencies of qi located in various meridians. In the case of
CFS, a qi deficiency is usually detected in the spleen or kidney meridians, but
a deficiency may also be found in the lung or liver meridians. Acupuncturists
may use moxibustion (a technique in which the herb mugwort is burned over
specific acupuncture points) in addition to needling therapy, as it is thought
moxibustion helps to provide a deeper and stronger treatment. Practitioners with
herbal training may recommend specific herbal remedies as well as dietary
Although no well-designed trials have evaluated chiropractic treatment for
CFS, some chiropractors suggest that spinal manipulation may boost energy and
decrease pain in certain individuals with the condition. In these cases, it is
believed that spinal manipulation may have a stimulating effect on the nervous
Therapeutic massage can reduce stress-related symptoms, improve circulation,
and increase your overall sense of
Your health care provider will do routine checkups while you are taking the
drugs or following the treatments he or she has prescribed. Contact him or her
if new symptoms develop.
The effects of herbs in pregnancy have not been fully investigated and they
should be used only under the careful supervision of your health care provider.
Avoid high doses of vitamin C if you are pregnant.
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Review Date: August 1999
Reviewed By: Participants in the review process include: Gary Guebert, DC, DACBR,
(Chiropractic section October 2001) Login Chiropractic College, Maryland
Heights, MO; Richard A. Lippin, MD, President, The Lippin Group, Southampton,
PA; Joseph Trainor, DC, (Chiropractic section October 2001) Integrative
Therapeutics, Inc., Natick, MA; Marcellus Walker, MD, LAc, (Acupuncture section
October 2001) St. Vincent's Catholic Medical Center, New York, NY; Leonard
Wisneski, MD, FACP, George Washington University, Rockville, MD; Ira Zunin, MD,
MPH, MBA, (Acupuncture section October 2001) President and Chairman, Hawaii
State Consortium for Integrative Medicine, Honolulu,
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of any of the information contained herein, including any injury and/or damage
to any person or property as a matter of product liability, negligence, or
otherwise. No warranty, expressed or implied, is made in regard to the contents
of this material. No claims or endorsements are made for any drugs or compounds
currently marketed or in investigative use. This material is not intended as a
guide to self-medication. The reader is advised to discuss the information
provided here with a doctor, pharmacist, nurse, or other authorized healthcare
practitioner and to check product information (including package inserts)
regarding dosage, precautions, warnings, interactions, and contraindications
before administering any drug, herb, or supplement discussed