Chronic Fatigue Syndrome

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

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 CFS.

Treatment Options

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 disease.

Drug Therapies

Over the Counter
Aspirin, acetaminophen, and ibuprofen—reduce pain; side effects may include nausea, vomiting, gastrointestinal bleeding, and kidney damage

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.


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 include:


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 changes.


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 system.


Therapeutic massage can reduce stress-related symptoms, improve circulation, and increase your overall sense of well-being.

Following Up

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.

Special Considerations

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.


Amitriptyline. NMIHI. Accessed at on October 21, 2018.

Bupropion. NMIHI. Accessed at on October 21, 2018.

Carr AC, Frei B. Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans. Am J Clin Nutr. 1999;69(6):1086-1107.

Castro M. The Complete Homeopathy Handbook. New York, NY: St Martin's Press; 1990.

Chronic Fatigue Syndrome. MedlinePlus. Accessed at on October 21, 2018.

Cummings S, Ullman D. Everybody's Guide to Homeopathic Medicines. 3rd ed. New York, NY: Penguin Putnam; 1997: 320, 327-328, 339-340, 345.

CFS. NMIHI. Accessed at on October 21, 2018.

Fukuda K, et al. The chronic fatigue syndrome: a comprehensive approach to its definition and study. Ann Intern Med. 1994;121:953-959.

JAMA Patient Page. How much vitamin C do you need? JAMA. 1999;281(15):1460.

How is chronic fatigue syndrome diagnosed? American Academy of Family Physicians Accessed at on October 21, 2018.

Johnston CS. Recommendations for vitamin C intake. JAMA. 1999;282(22):2118-2119.

Ibuprofen. NMIHI. Accessed at on October 21, 2018.

Levine M, Rumsey SC, Daruwala R, Park JB, Wang Y. Criteria and recommendations for vitamin C intake. JAMA. 1999;281(15):1415-1453.

Medications for Chronic Fatigue Syndrome Accessed at on October 21, 2018.

Management of CFS: Pharmacologic therapy and nonpharmacologic therapy. Centers for Disease Control and Prevention. Accessed at on January 4, 1999.

Noble J, ed. Textbook of Primary Care Medicine. 2nd ed. St Louis, Mo: Mosby-Year Book, Inc; 1996:918-922.

Paroxetine. NMIHI. Accessed at on October 21, 2018.

Sertraline. NMIHI. Accessed at on October 21, 2018.

Scalzo R. Naturopathic Handbook of Herbal Formulas. 2nd ed. Durango, Colo: Kivaki Press; 1994:S/A18-S/A19.

Ullman D. Homeopathic Medicine for Children and Infants. New York, NY: Penguin Putnam; 1992: 275.

Werbach M. Nutritional Influences on Illness. New Canaan, Conn: Keats Publishing; 1988:418-421.