Natural Treatments for Chronic Fatigue Syndrome

Naturlig behandling av ME, kronisk utmattelse.

By Cathy Wong,

Updated: July 23, 2007 Health's Disease and Condition content is reviewed by our Medical Review Board

What is Chronic Fatigue Syndrome?

Related Terms: Chronic fatigue and immune dysfunction syndrome, CFIDS, CFS, Myalgic encephalomyelitis

Chronic fatigue syndrome is a complex illness affecting the brain and multiple body systems. It is defined by incapacitating fatigue that is not relieved by rest, and at least four of the following symptoms for at least six months:

· impaired short-term memory of concentration which significantly affects normal activities

· sore throat

· tender lymph nodes in the neck or underarms

· muscle pain

· pain in multiple joints with no joint swelling or redness

· headaches of a new type or severity

· unrefreshing sleep

· general malaise following physical exertion that lasts more than 24 hours

Other common symptoms include: bloating, nausea, diarrhea, night sweats or chills, brain fogginess, dizziness, shortness of breath, chronic cough, visual disturbances, allergies or sensitivities to foods, alcohol, chemicals, irregular heartbeat or palpitations, jaw pain, or eyes or mouth.

The Centers for Disease Control1 officially recognized this condition in 1988. Chronic fatigue syndrome is more common in women than men, and the majority of people affected are in their thirties.

What Causes Chronic Fatigue Syndrome?

The cause of chronic fatigue syndrome is unknown and there are no specific lab tests to diagnose this condition. Multiple triggers may be involved, such as viral infection, stress, nutrient deficiency, toxins, and hormone imbalances.

· Viral Infection. Chronic infection with viruses, such as Epstein-Barr virus, human herpes virus 6, and cytomegalovirus, may contribute to the development of chronic fatigue syndrome in some people.

· Immune Dysfunction. Another factor thought to be involved in chronic fatigue syndrome is immunologic dysfunction, such as the inappropriate production of inflammatory cytokines. This results in excessive amounts of nitric oxide and peroxynitrite and produces fatigue.

· Hormone imbalances. Some studies have found that people with chronic fatigue syndrome have lower levels of the hormone cortisol, which is secreted by the adrenal glands. Lowered level of cortisol may promote inflammation and activate immune cells. Thyroid disorders have also been implicated in chronic fatigue syndrome.

Alternative Treatments for Chronic Fatigue Syndrome

number of medications that are used to treat the various symptoms of Chronic Fatigue Syndrome Although medication may be prescribed to address the various symptoms of chronic fatigue syndrome, there is currently no known conventional treatment for chronic fatigue syndrome, which is why many people seek complementary and alternative treatments.

1) Ginseng

Ginseng is an herb that has been used in Asia for centuries to increase energy and combat fatigue. A survey of 155 people by researchers at the University of Iowa with persistent fatigue found that ginseng was considered one of the more helpful treatments, with 56% of people who used ginseng rating it as effective.

2) Nicotinamide Adenine Dinucleotide (NADH)

NADH is a naturally occurring molecule formed from vitamin B3 (niacin) that plays an essential role in cellular energy production.

A double-blind, placebo-controlled trial evaluated the effectiveness of NADH in 26 people diagnosed with chronic fatigue syndrome. Participants received either 1 mg of NADH or placebo for 4 weeks. At the end of the study, 8 out of 26 (31%) responded favorably to NADH in contrast to 2 out of 26 (8%) who responded to placebo. No severe adverse effects were reported. Although very promising, larger studies are needed to prove the effectiveness of this supplement.

3) L-Carnitine

Carnitine, found in nearly all body cells, is responsible for transporting long-chain fatty acids into mitochondria, the energy-producing centers of cells. It allows these fatty acids to be converted into energy.

Some studies have found that carnitine levels in the body are decreased in people with chronic fatigue syndrome and it has been linked with muscle fatigue and pain and impaired exercise tolerance. However, other studies haven't found an association between carnitine deficiency and symptoms of chronic fatigue syndrome.

One study examined the use of L-carnitine in 30 people with chronic fatigue syndrome. After 8 weeks of treatment, there was statistically significant clinical improvement in 12 of the 18 parameters, with the greatest improvement occurring after 4 weeks of treatment. One person was unable to complete the 8 weeks of treatment due to diarrhea. There was no placebo group in this study and it wasn't blinded, so more clinical trials are needed.

Supplemental L-carnitine is generally well tolerated, however high doses of L-carnitine may cause digestive upset and diarrhea. Occasionally, increased appetite, body odor, and rash may occur.

A rare side effect that has been reported with L-carnitine use is seizures in people with or without pre-existing seizure disorders.

4) Coenzyme Q10

Coenzyme Q10 (Co Q10) is a compound found naturally in the mitochondria, the energy-producing center of our cells. Co Q10 is involved in the production of ATP, the main energy source of body cells. Co Q10 is also an antioxidant.

A survey of 155 people with persistent fatigue found that the percentage of users who found a treatment helpful was greatest for Co Q10 (69% of 13 people).

5) Dehydroepiandrosterone (DHEA) (Wild Yam)

DHEA is a hormone secreted by the adrenal glands and in smaller amounts by the ovaries and testes. DHEA can be converted in the body to other steroid hormones, such as estrogen and testosterone. It is also involved in memory, mood, and sleep. Levels of DHEA in the body peak when a person is in his or her mid-20's and then slowly decline with age.

Studies have shown that DHEA-s levels are abnormal in people with chronic fatigue syndrome.

DHEA is not recommended unless lab tests indicate there is a deficiency. Treatment should be closely supervised by a qualified health practitioner. Little is known about the long-term safety of DHEA.

Because DHEA is converted to estrogen and testosterone, people with estrogen- and testosterone-related conditions, such as breast, ovarian, prostate, and testicular cancer) should avoid DHEA.

Adverse effects of DHEA include high blood pressure, lowered HDL ("good") cholesterol, and liver toxicity. DHEA can increase testosterone in women and result in male pattern baldness, weight gain, acne, deepening of the voice, and other signs of masculinization.

DHEA can interact with certain medications. For example, it has been found to increase the effect of the HIV medication AZT (Zidovudine), barbituates, the cancer medication cisplatin, steroids, and estrogen replacement therapy.

6) Essential Fatty Acids (Omega)

Essential fatty acids have been used in the treatment of chronic fatigue syndrome. One theory about how they work is that viruses reduce the ability of cells to make 6-desaturated essential fatty acids and supplementing with essential fatty acids corrects this disorder.

In a double-blind, placebo-controlled study of 63 people, participants were given either a combination of essential fatty acids from evening primrose oil and fish oil (eight 500 mg capsules a day) or a placebo. After 1 and 3 months, people taking essential fatty acids had significant improvement in chronic fatigue syndrome symptoms compared to those taking the placebo pills.

More studies are needed, however, because a later 3 month study of 50 people with chronic fatigue syndrome found that a combination of evening primrose oil and fish oil did not result in a significant improvement in symptoms.

7) Traditional Chinese Medicine

Chronic fatigue syndrome may be related to the following syndromes in traditional Chinese medicine:

· spleen qi deficiency1

· kidney yin deficiency2

· essence deficiency

· kidney yang deficiency3

8) Ayurveda

A typical approach in ayurveda4, the traditional medicine of India, may be to improve digestion and eliminate toxins with a detox program. Ayurvedic herbs may also be used, such as ashwagandha, amla, bala, triphala, and lomatium, which are combined according to the patient's dosha, or constitutional type. The vata dosha is thought to be susceptible to chronic fatigue syndrome.

· What is Your Ayurvedic Type?5

· Foods to Eat for Your Ayurvedic Type6

Other Natural Treatments

· Digestive enzymes (Papaya kosttillskudd er laget av fordøyelsesenzymer)

· Probiotics7

· Vitamin C

· Magnesium

· Beta-carotene

· Licorice

· Melatonin

· Glutamine

· Whey Protein

· Folic Acid

· Tyrosine


Cleare AJ, O'Keane V, Miell JP. Levels of DHEA and DHEAS and responses to CRH stimulation and hydrocortisone treatment in chronic fatigue syndrome. Psychoneuroendocrinology. 29.6 (2004): 724-732.

Forsyth LM, Preuss HG, MacDowell AL, Chiazze L Jr, Birkmayer GD, Bellanti JA. Therapeutic effects of oral NADH on the symptoms of patients with chronic fatigue syndrome. Ann Allergy Asthma Immunol. 82.2 (1999): 185-191.

Hartz AJ, Bentler S, Noyes R, Hoehns J, Logemann C, Sinift S, Butani Y, Wang W, Brake K, Ernst M, Kautzman H. Randomized controlled trial of Siberian ginseng for chronic fatigue. Psychol Med. 34.1 (2004): 51-61.

Jones MG, Goodwin CS, Amjad S, Chalmers RA. Plasma and urinary carnitine and acylcarnitines in chronic fatigue syndrome. Clin Chim Acta. 36.1-2 (2005): 173-177.

Kuratsune H, Yamaguti K, Lindh G, Evengard B, Takahashi M, Machii T, Matsumura K, Takaishi J, Kawata S, Langstrom B, Kanakura Y, Kitani T, Watanabe Y. Low levels of serum acylcarnitine in chronic fatigue syndrome and chronic hepatitis type C, but not seen in other diseases. Int J Mol Med. 2.1 (1998): 51-56.

Kuratsune H, Yamaguti K, Sawada M, Kodate S, Machii T, Kanakura Y, Kitani T. Dehydroepiandrosterone sulfate deficiency in chronic fatigue syndrome. Int J Mol Med. 1.1 (1998): 143-146.

Laviano A, Meguid MM, Guijarro A, Muscaritoli M, Cascino A, Preziosa I, Molfino A, Fanelli FR. Antimyopathic effects of carnitine and nicotine. Curr Opin Clin Nutr Metab Care. 9.4 (2006): 442-448.

Maes M, Mihaylova I, De Ruyter M. Decreased dehydroepiandrosterone sulfate but normal insulin-like growth factor in chronic fatigue syndrome (CFS): relevance for the inflammatory response in CFS. Neuro Endocrinol Lett. 26.5 (2005): 487-492.

Plioplys AV, Plioplys S. Amantadine and L-carnitine treatment of Chronic Fatigue Syndrome. Neuropsychobiology. 35.1 (1997): 16-23.

Puri BK. Long-chain polyunsaturated fatty acids and the pathophysiology of myalgic encephalomyelitis (chronic fatigue syndrome). J Clin Pathol. 2006 Aug 25

Puri BK, Holmes J, Hamilton G. Eicosapentaenoic acid-rich essential fatty acid supplementation in chronic fatigue syndrome associated with symptom remission and structural brain changes. Int J Clin Pract. 58.3 (2004): 297-299.

See DM, Broumand N, Sahl L, Tilles JG. In vitro effects of echinacea and ginseng on natural killer and antibody-dependent cell cytotoxicity in healthy subjects and chronic fatigue syndrome or acquired immunodeficiency syndrome patients. Immunopharmacology. 35.3 (1997): 229-235.

Soetekouw PM, Wevers RA, Vreken P, Elving LD, Janssen AJ, van der Veen Y, Bleijenberg G, van der Meer JW. Normal carnitine levels in patients with chronic fatigue syndrome. Neth J Med. 57.1 (2000): 20-24.

Warren G, McKendrick M, Peet M. The role of essential fatty acids in chronic fatigue syndrome. A case-controlled study of red-cell membrane essential fatty acids (EFA) and a placebo-controlled treatment study with high dose of EFA. Acta Neurol Scand. 99.2 (1999): 112-116.

Links in this article: