Overview 

Chronic fatigue syndrome (CFS) is a debilitating disorder of unknown origin that affects between one and four million Americans, more than ovarian cancer, multiple sclerosis or lupus. Of this number, nearly 20% are not aware that they have CFS and approximately 40% have a secondary condition of a medical or psychiatric nature, such as diabetes, depression, thyroid disease, etc. 

CFS is characterized by intense fatigue that is not resolved by additional sleep or rest. In addition, the patient generally functions at a lower activity level than previously experienced and may become overwhelmed by even moderate periods of physical or mental activity. Other symptoms commonly reported by CFS patients include muscle ache, joint pain, sore throat, swelling of the lymph nodes, headaches, loss of appetite, and poor memory and concentration. CFS has no distinct duration either; symptoms may continue for a month, a year, or several years. 

Risk Factors 

Currently, CFS has no known cause of specific origin. However, research has led many clinicians to suspect that CFS may have multiple underlying triggers that range from oxidative stress and low blood pressure to impaired immunity and even metal toxicity from dental fillings. There is also evidence that CFS may be launched after an infectious disease (such as flu), as well as being associated with endocrine disorders. 

There are also appears to be certain groups that may be at greater risk for developing CFS: 

Women are four times more likely to develop CFS than men. 

CFS can occur at any age, but most commonly affects adults between the ages of 40 and 60 years. In women, however, CFS tends to appear between 25 and 45 years of age. 

While further research is needed, there is evidence to suggest that people with nutritional deficiencies, hormonal imbalances, or those who endure chronic mental or physical stress may be at greater risk for CFS. 

While no specific genetic link has yet been found, CFS does appear to run in families. 

Additional factors common to CFS patients: 

Chronic stress or anxiety 

Nutritional deficiencies 

Lingering flu-like illness 

Symptoms and Diagnosis 

CFS is not easy to diagnose because its symptoms are common to many other conditions, including cancer, mononucleosis, depression, eating disorders, autoimmune diseases, hypothyroidism, fibromyalgia, multiple sclerosis, lupus, Lyme disease and still others.  Further, a diagnosis of CFS is contingent upon experiencing chronic fatigue of unexplained origin for a period of at least six months. In addition, at least four of the following symptoms must also be present: 

Sore throat 

Muscle pain 

Joint pain 

Tenderness of the lymph nodes 

Headaches (which may be of a different nature than previously experienced) 

Sleep disturbances (including feeling tired upon waking) 

Diminished cognitive functioning (difficulty concentrating, short-term memory loss, etc.) 

Feeling fatigue or general illness after exertion lasting 24 hours or more 

While the above criteria are used to help reach a diagnosis, CFS patients commonly experience additional symptoms, such as: 

Depression, anxiety, mood swings and/or panic attacks 

Night sweats 

Visual disturbances (i.e., sensitivity to light) 

Dizziness and/or difficulty maintaining balance 

The range and severity of symptoms will vary with each individual. In addition, CFS is not a progressive disease and usually improves with treatment, although it is a condition in which there are usually bouts of remission and relapse. For this reason, CFS patients should remain guarded about over exerting themselves mentally or physically during periods of remission to avoid triggering a reappearance of CFS symptoms.

Diagnosis 

Since CFS cannot be confirmed by any specific test, diagnosis is really a matter of symptom review, clinical observation and elimination of any other possible conditions. 

Treatment Options 

While there is no certain cure for CFS, there are a number of treatment options that may be explored, including the following conventional therapies: 

Antidepressant drugs to relieve feelings of depression as well as muscle aches and to improve sleep. 

Benzodiazepines to relieve anxiety and stress. 

Antihistamines to reduce allergy symptoms, if applicable. 

Nonsteroidal anti-inflammatory drugs to relieve pain. 

Complimentary Therapies 

The following therapies help some people to better cope with CFS: 

Yoga

Acupuncture

Guided Meditation

Support Groups 

Recommended Supplements in the Treatment of CFS 

Essential Fatty Acids 

The essential fatty acids (EFAs) found in fish oil (linolenic, gamma-linolenic, eicosapentaenoic, and docosahexaenoic acids) are involved in maintaining brain functioning and in generating new cell growth. Studies have shown that supplementation with EFAs may be of benefit to CFS patients. In a series of case studies, researchers observed a 90% improvement in 75% of the treatment group within three months. 

Coenzyme Q10 (CoQ10) 

CoQ10 is needed by cells in order to produce sufficient energy. One study involving 20 female CFS subjects who were deficient in CoQ10 experienced marked improvement after three months of supplementation. In fact, the ability to tolerate exercise without subsequently requiring bed rest increased two-fold. 

NADH 

NADH (reduced B-nicotanamide dinucleotide) is also involved in cellular energy production since it helps to make ATP, the primary fuel of the body. It seems to work most efficiently when partnered with CoQ10. 

Magnesium 

Magnesium is reserved in the bones and tissue to help regulate more than 300 enzymatic processes. However, many CFS patients are found to have low levels of this nutrient. Supplementation with magnesium sulfate has effected change in CFS symptoms in studies, but with mixed results. In one randomized, double-blind, placebo-controlled study, CFS patients treated with magnesium reported reduce pain and greater energy levels after six weeks. However, another study resulted in an increase in symptoms in subjects receiving magnesium between six and 24 months. The reason for this discrepancy is unknown. However, researchers suspect that this therapy may only be that beneficial to patients deficient in magnesium. Therefore, magnesium supplementation may be helpful for some CFS patients in the short-term, but should be discontinued if negative results occur. 

L-carnitine 

L-carnitine also supports energy production, yet adequate levels are often found lacking in CFS patients. A few early studies have shown that L-carnitine supplementation improves symptoms of CFS. More recent studies on various forms of carnitine, namely acetyl-L-carnitine and propionyl-L-carnitine, reduced mental and physical fatigue. 

Glutathione 

Glutathione may play a key role in CFS. The antioxidant and immune-boosting properties of glutathione are well known. However, cellular levels of this nutrient diminish with age. In addition, many CFS patients are deficient in glutathione and some researchers believe that this is the cause of muscle fatigue associated with CFS. Clinicians refer to this deficiency as ‘low CG syndrome,’ which also includes low levels of cysteine, a precursor to glutathione. This syndrome has not only been linked to CFS, but also certain cancers, Crohn’s disease and HIV infection. 

Herbs Used in the Treatment of Chronic Fatigue Syndrome 

The following herbs have a long history of use in boosting the immune system, the efficacy of which being supported by current research. 

Astragalus 

Astragalus promotes increased production of white blood cells to combat inflammation and infection. 

Echinacea 

The extract of this botanical protects cellular membranes from being penetrated by invading pathogens. It may be alternated with astragalus. 

Siberian Ginseng 

Also known as eleuthero, this botanical offers antioxidant properties and helps to improve the body’s resistance to infection and fatigue. In fact, Siberian ginseng is referred to as one of the adaptogen herbs since it is believed to help the body adapt to stress by stimulating adrenal function. It also improves oxygen utilization by muscles during physical activity. 

Licorice Root 

Many researchers believe that CFS may be triggered by low adrenal function, either as the result of chronic stress or viral infection. Like Siberian ginseng, licorice root improves adrenal function by stimulating the adrenal glands and inhibiting the breakdown of cortisol in the body. 

Safety Precautions 

Coenzyme Q10 

Statin drugs decrease CoQ10 levels. 

Use with supervision if you have diabetes. 

Magnesium

Do not take if you have myasthenia gravis or kidney disease. 

Glutathione 

Use with supervision if you have a history of liver or kidney disorders. 

Echinacea 

Allergic responses are rare but can occur if you are allergic to flowers in the daisy family. 

Siberian Ginseng 

Should be avoided if you have high blood pressure. 

Licorice Root 

Avoid if you have a history of liver or kidney disorders. 

References

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