Chronic fatigue syndrome (CFS) has received much attention in recent years, and it has long been a mysterious condition in which the underlying causes are poorly understood.

    It is not certain if CFS represents one disease process or a set of symptoms. Unfortunately, there is no known therapy available from modern medicine. The common symptoms of debilitating fatigue may represent an impairment of the production of mitochondrial adenosine triphosphate (ATP), the fundamental chemical energy source in the cell.  

    Only in the last twenty years has the Centers for Disease Control and Prevention acknowledged CFS as an “official disease.” More than 2 million Americans are affected by CFS, most often women. Frequently, a viral infection such as Epstein-Barr virus precedes the onset of CFS, but they are not the same thing. CFS is present when a person experiences persistent fatigue, as well as some of the following symptoms, for at least six months.


    Some of the most common symptoms associated with CFS include sore throat, headaches, swollen lymph nodes, muscle and joint pain, impaired short-term memory, depression, low blood pressure, low blood sugar, and post-exertion weariness lasting more than 24 hours.  The mental/emotional symptoms that include poor attention, depression, memory loss, and lack of concentration may be ATP, or impaired neurotransmitter production (akin to adrenal insufficiency).


    There are generally seven causes of fatigue:  

    1) NUTRITIONAL DEFICIENCIES play a large role in fatigue because ATP (the energy produced within the cell) depends on nutrients, especially magnesium, for its action. Some research indicates that 80 percent of the population is at risk for magnesium deficiency and therefore at risk for fatigue.  A quality multivitamin is necessary, along with iron (if anemic), vitamin B12, Coenzyme Q10, Acetyl-L-Carnitine, and D-ribose.

    2) EMOTIONAL STRESSORS AFFECTING THE ADRENAL AND THYROID GLANDS play a leading role in fatigue. In fact, depression is one of the major symptoms of fatigue. Suboptimal thyroid function is very common, and often thyroid-hormone replacement is necessary. However, in many cases the TSH test can be normal, indicating a “stressed” thyroid, not necessarily a malfunctioning thyroid gland.  The stress on the thyroid gland is mostly caused by adrenal insufficiency.  Symptoms of an under-active adrenal gland include hypoglycemia, irritability, fatigue, recurrent infections, and dry skin. Apathy, fear, grief, psychological or emotional stress, the flu or a cold, surgery and/or hospitalization, environmental toxins and insecticides, or even going through menopause are all stressors on the body and may lead to muscle weakness and chronic fatigue.  

    3) AN EXISTING DISEASE STATE, IMMUNE DYSFUNCTION OR INFECTION may fatigue the body. Immune dysfunction is part of the process for CFS/FMS patients. Opportunistic infections in CFS patients includes yeast/Candida, and urinary tract infections. Diseases like cancer, MS, Epstein-Barr, hypotension, obesity and hypothyroidism encourage fatigue, as do syndromes like fibromyalgia and PMS. Viral infections and post-viral fatigue syndrome is suspect. 

    4) TOO MUCH ACIDITY in the body and low alkaline reserves will zap your energy. People will have more energy if they stick to a largely raw foods diet of fresh, whole foods including whole grains, fish, legumes, vegetables, and more alkaline fruits like papaya and melons. Avoiding energy-zapping foods such as sugar, snack bars, caffeine, alcohol, fats, red meats, dairy foods and highly processed foods. 

    5) PHYSICAL OVERWORKING or over-exercising or a regular basis can cause fatigue. This type of fatigue may be the result of over-taxing your nutrient reserves. Electrolytes including potassium, magnesium, sodium, and phosphorus are lost in sweat during exercise.  

    6) INACTIVITY is another environmental trigger to fatigue. Our communication media is partially responsible for this, with many people becoming “couch potatoes” as they sit in front of the TV or computer screen for hours each day. This inactivity stresses our adrenal glands and causes unnecessary brain stimulation.

    7) HEAVY METAL TOXICITY and CHEMICAL TOXICITY can be a suspected factor in promoting chronic fatigue syndrome. Toxins such as arsenic, lead, cadmium, aluminum and antimony, along with high levels of copper and manganese, can be suspect.

    8) HORMONAL IMBALANCE including low estrogen and testosterone.  The symptoms of estrogen deficiency include poor sleep, low libido, brain fog, and worsening CFS/FMS. In 70% of men and women with CFS they have low “free” testosterone levels.  Testosterone supplementation can elevate thyroid hormone levels in men taking thyroid drugs. Many CFS/FMS patients also have suboptimal DHEA, and supplementation often has dramatic results.


    Avoid caffeine, alcohol, junk food, soft drinks and refined carbohydrates. Drink more water and eat high-water foods like vegetables and fruit. Desensitize environmental allergies, food allergies, and possible food sensitivities. Eat a higher quality protein (whey or soy protein), low-fat, high-complex carbohydrate diet. Extra garlic may add antiviral, antibiotic and antibacterial effects as well.

    Specific foods that may increase dopamine include almonds, EFA, organic eggs, free-range chicken, soybeans, wheat germ, flax and walnut oils, and protein. (A lack of dopamine lowers energy and increases cravings for sweets and carbohydrates.) 

    Eat lots of green foods. These are especially beneficial for post and pre menopausal women suffering from fatigue and depression. Green foods provide more energy, possibly because of their huge potassium content, and can improve mood at the same time. Super green foods contain chlorella, blue-green algae, barley green, spirulina, kale, spinach, and many more nutrient-packed sources of minerals and vitamins. 

    fish and greens for dinner


    CFS is associated with Epstein-Barr virus but is often not correctly diagnosed. Other conditions that can mimic CFS are fibromyalgia, depression, hypothyroidism, and immune and adrenal insufficiency. Heavy metal poisoning can be a factor in CFS. A hair or urine analysis can be done to determine if lead or other heavy metals are causing fatigue. Other factors leading to a misdiagnosis of CFS include lack of exercise, low blood pressure, low iron, low potassium, stress, an unbalanced diet, and a poor life style. Exercise regularly! 


    Perhaps the best way to reverse chronic fatigue includes obtaining an assessment of your health, improving your diet, detoxifying your bowel, liver and lymph, getting active and starting to exercise, and finally, taking supplements.  

    Supplement Protocol

      A multi-vitamin/mineral formula is an essential supplement to maintain a nutritional level to support energy for the body.  All Americans adults should at least be taking a multi-vitamin each day. Extra antioxidants (i.e. vitamins C,E, selenium, beta-carotene and green tea) are essential to decrease free-radical (toxic overload) destruction to our cells and immune system. A deficiency of Vitamin C may cause fatigue and depression.  Dosage: As directed on package.
      Magnesium activates most of the key enzymes that allow the Krebs cycle (energy production in the body) that turns sugar (carbohydrates) and fat into energy. Magnesium is involved in protein synthesis needed for calcium metabolism, helps to maintain proper balance of potassium and sodium, and is critical for nerve and muscle activity levels. Dosage: 200mg (men), 400-800 mg (women) daily. Sources: almonds, spinach, greens.
    3. B-COMPLEX
      Extra potent B-complex can rejuvenate energy cells and decrease stress. Extra VITAMIN B-12 (1,000-3,000mcg IV every few days as directed by a physician), FOLIC ACID (up to 5,000 mcg daily), and VITAMIN B6 (50-100 mg daily) should be included for extra energy. Dosage: 50-200 mg daily.
      Panax Ginseng improves athletic performance, increases endurance, and fights fatigue. Do not use for extended periods of time. Dosage of dried root: 1-2 g daily.  Eleuthero ginseng is an adaptogenic herb from Asia that helps the body adapt to stressful situations. It is well known to enhance energy and stamina, and is effectively utilized as an adrenal enhancer. Dosage: 30-100 mg a day.
      Omega 3, 6 fatty acids may provide a rational, safe, and effective treatment for patients with post-viral chronic fatigue syndrome. Essential fatty acids (EFAs) decrease inflammation, increase stamina, and assist in generate cellular energy (from the mitachondria). Dosage: 1,000-5,000mg a day.
      Protein supplementation enhances the body’s production of GLUTATHIONE, one of the body’s powerful natural antioxidants. Soy protein may be counterproductive for male athletes, but can help women experience less menopausal symptoms and increased bone density. Dosage: 1-2 scoops daily as described on the container.
    7. COENZYME Q10
      Another energy-oriented nutrient that is present in every cell in the body, CoQ10 works with enzymes to break down food and convert it into energy. Supplementation at doses of 60-100 mg per day improves exercise tolerance and alleviates fatigue. Dosage: 30-200mg a day, or as directed by a qualified health care practitioner.
    8. NADH
      NADH is a reduced form of coenzyme-1 which is a critical substance in catalyzing and stimulating the production of cellular energy. NADH increases energy fuel and stimulates the body to naturally manufacture the key brain chemistry responsible for energy production and muscle coordination. It may be a valuable adjunct in the management of CFS. Dosage: 5-10mg a day.
    9. D-RIBOSE
      Ribose is a needed carbohydrate (sugar) that helps the body quickly replace depleted energy levels. D-Ribose is a compound used by the body to rebuild energy levels during and following stressors in the body (on both the adrenal glands and the thyroid gland). Clinical studies have shown benefits in the treatment of heart disease, congestive heart failure, and fibromyalgia, as well as rapid athletic recovery, dramatic increases in muscle growth, and increased energy levels and anaerobic thresholds. Dosage: As directed on package.
    10. NONI JUICE
      This Polynesian fruit has antioxidant properties that can help with energy and a stronger sense of well being. Dosage: 1-4 tablespoonfuls daily. Dosage: 1-2 ounces daily.
    11. CREATINE
      Made from a combination of arginine, glycine and methionine (three amino acids), creatine is an amino acid type of compound made in the body to help produce the energy that the heart, brain, and skeletal muscle use to function. All animals depend on creatine to help produce the energy for the heart to contract and the brain to function. Creatine can increase the volume of muscle cells, serve as an energy reservoir, and enhance protein synthesis. Dosage: Do not exceed recommended dosage on package.
      This adaptogen herb will increase physical work capacity and dramatically shorten the recovery time between bouts of high-intensity exercise. It can act as a stimulant for the nervous system to decrease fatigue, increase attention span, ease depression and improve memory and work productivity. As an adaptagen it helps the body deal with multiple stressors. Dosage: Take as directed on package or see a qualified practitioner.
      Acetyl L-Carnitine is an important amino acid that fuels cells and aids in energy production by shuttling fatty acids into mitochondria [define mitochondria]. Higher serum levels of free and serum L-caritine may correlate with better cardiac function and may decrease mitochondrial (the energy-producing part of the cell) dysfunction, which may cause the fatigue in CFS. L-carnitine was also found useful in improving energy and sleep quality in patients with cancer-associated fatigue. Dosage: 1-3 gm daily for 1-2 months.
      Tyrosine is an amino acid that revs up the metabolism, boosts your stamina, and renews enthusiasm for life. Tyrosine is contains in fish, soybeans and poultry. Dosage: 500 mg 1-3 times a day. L-Carnitine prevents toxic accumulations of fatty acids in cells while providing acetylCoA for mitochondrial energy production. Dosage: 1 gram 3-4 times a day. Administration of a free-form amino acid mixture may decrease the relapse of debilitating symptoms often accompanied by CFS patients. The two most common deficient amino acids seen in CFS subjects are phenyl-alanine and tryptophan.  Dosage: As directed on package.
    15. IRON and ZINC
      Anemia is always a possible reason for chronic fatigue. If blood tests prove low, supplement with ferrous sulfate, gluconate, or fumarate. Taking VITAMIN C with iron enhances its absorption. Zinc improves muscle strength and endurance, enhances immune function, and is part of many enzymes involve din metabolism and digestion. Dosage of iron: one tablet 1-3 times daily. Caution with constipation. Dosage of zinc: 15-50 mg daily.
    16. IODINE
      Since your thyroid is the master gland that controls our body’s energy level, iodine supplementation may help make thyroid hormone and balance thyroid production. The best sources of iodine are kelp, garlic, bladderwrack and certain shellfish. Dosage: 150-5,000 mcg of iodine daily. See a qualified practitioner before taking higher doses.
    17. INOSITOL
      Inositol may be a key vitamin required by chronic fatigue and fibromyalgia patients. Many times inositol is combined with niacin. Dosage: As directed on label.
    18. DHEA
      The most abundant steroid hormone produced by the adrenal glands, DHEA is effective in reducing stress and possibly increasing energy. It is also an anti-aging supplement. Dosage: 5-50 mg daily.
      Glandular extracts refer to supplements derived from animal-gland tissues or organs and are thought to supply biologically active hormones needed to enhance the function of the adrenal and thyroid glands. Dosage: See a qualified health practitioner.
      A traditional Chinese herb used to strengthen the immune system, astragalus has antiviral- and immunity-enhancing properties as well as many of the same benefits as ginseng. Dosage: As directed on  package, or see a qualified health practitioner.
      An herb commonly used in Indian Ayurvedic medicine. This very useful herb has antioxidant, anti-stress and anti-tumor properties. Is useful in stress-induced nervous exhaustion (adrenal exhaustion), and overall health and longevity. Dosage: 25-200 mg daily. Ashwaganda may be used effectively in combination with ginseng.
    22. PYRUVATE
      A naturally occurring compound found in the body, pyruvate metabolizes sugars and starches and assists in transporting glucose into the muscles, thus naturally burning body fat and increasing endurance, stamina, and exercise performance. Dosage: 1-6 grams daily will increase vigor.
      Two amino acids that may help the body produce human growth hormone, a natural substance that increases energy levels and muscle growth. This hormone, made by the pituitary gland, has been shown to have anti-aging effects. Dosage: As directed.
    24. DMAE
      DMAE is a naturally occurring nutrient found in sardines and anchovies that is thought to enhance mental function. Dosage: As directed on package.
      Cordyceps is a Tibetan mushroom that increases stamina and aerobic capacity. Dosage: 500-2,000 mg daily. Other medical mushrooms as MAITAKE and REISHI may speed recovery.
    26. ST. JOHN’S WORT
      This herb will help to reduce fatigue, improve sleep, and minimize depressed feelings. Therapy should last for at least 4-6 weeks. Dosage: 300 mg 2-3 times a day.
      An herb that increases blood flow, Ginkgo biloba is considered a benefit to those with chronic fatigue syndrome. Dosage: 40-180 mg a day.
    28. BEE POLLEN
      Collected from the stamens of flowers, bee pollen it is thought to counter weakness and fatigue and to boost energy. Dosage: As directed on package.
    29. SAM-E
      SAM-e may help with fatigue, stiffness and pain. It is widely utilized in treating depression, arthritis and inflammation, and liver disease. Dosage: 200-600 mg daily.
    30. MACA ROOT
      Also known as Peruvian ginseng, Maca root enhances vitality and energy and maintains hormonal and glucose balance. Dosage: Take as directed on package.
    31. SUMA
      Suma is also known as Brazilian ginseng and has many of the same effects as Siberian or panax ginseng. Dosage: As directed on package.

    Other Energy Medicine Therapies

    Energy medicine works on the principle that all living things have an energy field that can be tapped into and stimulated. Since CFS patients may have a low life-force for various reasons, the following alternative treatments may be effective in warding off chronic fatigue: 

    Acupuncture, Biofeedback, Reflexology, Magnetic Therapy, Meditation and yoga, Homeopathy, and Reiki.

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