Chronic Fatigue Syndrome (CFS)
Chronic fatigue syndrome is one of the most mysterious and controversial maladies of our time. Even now, more than ﬁfteen years after the disease was recognized and named, doctors argue about its origin or origins: Is it caused by a viral infection? Blood pressure abnormalities? Chronic infection? Food allergies? Chemical sensitivities? Some doctors wonder if the symptoms of CFS are indeed real.
Despite the doubts of a few doctors, chronic fatigue syndrome most deﬁnitely is real. And as its victims well know, it can also be horribly debilitating. Its predomi- nant symptom is persistent, overwhelming fatigue that dramatically reduces its sufferers’ ability to participate in the regular activities of life. Along with the fatigue are problems with memory and concentration. It is also usually accompanied by sev- eral out of a long list of symptoms, including but not limited to headaches, insom- nia, sore throat, and muscle and joint pain. These problems can come and go over a period of years. If you have deep fatigue for more than two weeks, or if for any rea- son you suspect that you have CFS, do not make a diagnosis on your own. See a doc- tor so that he or she can rule out other possible disorders. Once other disorders have been ruled out, your best chances of recovery are, in our opinion, from the use of nat- ural therapies.
CFS is probably caused by a combination of factors and often results in a depressed immune system. Of course, the key to treatment is to ﬁnd out and treat the reason(s) for the immune system imbalance, which can be related to many factors. For exam- ple, chronic infections are thought to play a role for some people, such as the viruses Epstein-Barr (EBV), cytomegalovirus (CMV), and human herpes virus (HHV-6).
Other infections, such as mycoplasma and chlamydia, are also suspect. The overgrowth of yeast (Candida albicans) seems to be a common problem for people with this condition, and health practitioners frequently ﬁnd parasite infection to be present.
One common ﬁnding in people with this condition is hormone imbalance. The most common one is adrenal gland insufﬁciency, also referred to as “adrenal burnout.” The adrenal glands, located on top of both kidneys, produce the stress hormones cortisol and DHEA. These hormones are commonly depleted in people with chronic fatigue, and we ﬁnd that restoring the levels to normal is generally quite helpful. The same can be said of many of the hormones in the body. Low thyroid function can be a core problem and will result in suboptimal energy production within the cells. In addition, deﬁciencies in testosterone or growth hormone and deﬁciencies or imbalances of estrogen and progesterone are common. Underlying much of the hormone imbalance can be hypothalamic dysfunction. This refers to an imbalance of the hormonal and the neural messages from the brain to the adrenal and the thyroid glands and other hormonal organs of the body.
Poor digestion and impaired detoxiﬁcation also need to be considered as root causes of chronic fatigue. Malabsorption of foods and nutrients contributes to nutritional deﬁ- ciencies. Environmental toxins, such as mercury and others, inhibit enzyme functions that are required for energy production.
An unhealthful diet can set the stage for chronic fatigue. A high amount of reﬁned carbohydrates contributes to blood sugar problems, yeast overgrowth, increased demand on the adrenal glands, and chronic inﬂammation, and immune suppression can set in. In addition, a diet of processed foods is deﬁcient of nutrients required for energy production and a healthy immune system.
Also of prime importance are the effects of chronic stress on the body. People who do not deal with mental, emotional, and spiritual stresses effectively are more likely to suffer fatigue. As well, unresolved problems with anxiety and depression contribute to fatigue.
Movement and exercise are fundamental keys to health. Too little exercise con- tributes to fatigue, while, at the opposite end of the spectrum, overtraining and overex- ertion lead to breakdown of the organs involved with energy production.
A ﬁnal area worth mentioning is sleep. This is your body’s way of recovering and regenerating. Adequate sleep is essential. If you suffer from a sleep problem, seek medical help and focus on natural ways to alleviate it. See the Insomnia section.
A good complementary care regimen will address the whole body—and therefore many of the possible causes. If you have CFS, it’s important to ﬁnd the treatments that give you the most relief; what works for one person might not be right for another.
Constant, disabling fatigue is the primary symptom, but CFS usually incorporates sev- eral of the following:
• Low-grade fever
• Sleep disturbances
• Depression and anxiety
• Difﬁculty concentrating
• Temporary loss of memory
• Muscle and joint pain
• Exhaustion after even mild exercise
• Loss of appetite
• Upper respiratory tract infections
• Sore throat
• Intestinal problems
• Sore or swollen lymph nodes
In a randomized, double-blind study in the Journal of Chronic Fatigue,
• Chronic infection (often viral)
• Immune system damage
• Low blood pressure
• Nutritional deﬁciencies
• Intestinal permeability
• Impaired detoxiﬁcation
• Parasites and dysbiosis
• Food allergies
• Chemical sensitivities
• Neurological malfunction
• Chronic candidiasis
• Poor adrenal function
• Sleep disorders (such as apnea)
• Hormone deﬁciencies
• Environmental toxins (e.g., toxic
• Unresolved stress
• Side effects of pharmaceutical medications researchers found that people who received an integrated treatment approach, based on each indi- vidual’s symptoms and laboratory analy- sis, had signiﬁcantly greater beneﬁts than did people receiving a placebo. Long-term follow up found that the active group had increasing improvement.
Your diet should be dense with nutrients and strong in immune-building foods. Sea vegetables and whole grains are high in minerals that your body may lack; cultured foods with probiotics will ﬁght infection, especially candidiasis; cruciferous vegeta- bles are high in nutrients and ﬁber; and nuts, seeds, and cold-water ﬁsh contain lots of essential fatty acids, which support immune function.
Drink a glass of clean water every two waking hours to ﬂush out toxins and encour- age good general health.
Intestinal pain is an unpleasant symptom of CFS. Keep your digestive tract work- ing efﬁciently by eating foods that are high in ﬁber, especially cruciferous vegetables.
Food to Avoid
People with CFS usually have severely depleted immune systems. Keep as much stress off the body as possible by avoiding caffeine, alcohol, junk and processed food, and reﬁned sugars. In addition to taxing the immune system, some of these items aggra- vate conditions that may cause CFS. Caffeine depresses the adrenal glands, excess sugar consumption can lead to hypoglycemia, and junk and processed foods contain additives that stimulate chemical sensitivities.
CFS is often accompanied by food allergies; in fact, allergies may cause some cases of CFS. See the Food Allergies section and the accompanying elimination diet to help you determine which foods, if any, trigger an allergic response for you.
Be wary of wheat. Fatigue is a common symptom of wheat or gluten allergy or intolerance. Talk with your nutrition-oriented doctor about testing for a reaction to this food. Or, avoid gluten products for two to four weeks, and see if you notice an improvement.
When eliminating processed
foods, a good rule of thumb is to watch out for the “whites.” White ﬂour, white sugar, and salt are all hallmarks of artiﬁcial or junk food products.
Do a one– to three-day juice fast once a month to remove toxins. Green drinks are especially helpful; they speed the elimination of poisons, stimulate red blood cell production, and boost your energy.
The following tests help assess possible metabolic reasons for chronic fatigue syndrome:
Immune system imbalance or disease—blood
Low blood pressure
Hormone testing (thyroid, DHEA, cortisol, testosterone, IGF-1, estrogen, progesterone)—saliva, blood, or urine
Vitamin and mineral analysis (especially magnesium, B12, iron, and CoQ10) blood
Digestive function and microbe/parasite/candida testing—stool analysis
Anemia—blood test (CBC, iron, ferritin, % saturation)
Food and environmental allergies/sensitivities—blood, electrodermal
Blood sugar balance—blood Sleep disorder—sleep study Heart function—EKG
Toxic metals—urine or hair analysis
Super Seven Prescriptions—Chronic Fatigue
Super Prescription #1 B-complex
Take a 50 mg B-complex twice daily. B vitamins are involved with energy production.
Super Prescription #2 Magnesium
Take 250 mg two to three times daily. Magnesium is crucial for energy production within the cells. Reduce the dosage if diarrhea occurs.
Super Prescription #3 Vitamin B12
Take 200 to 400 mcg of the sublingual form daily or 1 cc (1,000 to 2,000 mcg) of the injectable form 1 to 2 times weekly from your doctor.
Super Prescription #4 Cordyceps sinensis
Take 800 mg twice daily of a standardized product. It supports adrenal gland
Super Prescription #5 DHEA
Take 5 to 25 mg daily under a doctor’s supervision if testing shows that your levels are low. This adrenal hormone helps with energy production and the effects of stress.
Super Prescription #6 CoQ10
Take 100 mg two to three times daily. It is utilized within cells to produce energy.
Super Prescription #7 NADH
Take 10 mg on an empty stomach each morning.
Tne double-blind study looked at the effect of using 10 mg of NADH or a placebo each day for four weeks on people with chronic fatigue syndrome. Thirty-one percent of those receiving NADH reported an improve- ment in fatigue, a decrease in other symptoms, and improved overall quality of life, in con- trast to 8 percent of those in the placebo group.
Vitamin C is used by the adrenal glands to manufacture stress hormones, and it also supports immune function.
A probiotic supplies the good bacteria needed for proper digestion, detoxiﬁcation, and immunity. Take a product that contains at least 4 billion organisms daily.
Essential fatty acids are important for healthy cell and brain function. Take 1 to 2 tablespoons of ﬂaxseed oil or 3 to 5 grams of ﬁsh oil daily.
L-carnitine is used by the cells for energy production. Take 500 mg three times daily. Panax ginseng is a strong adrenal gland tonic. Take 100 mg two to three times daily
of a product standardized to between 4 and 7 percent ginsenosides.
Eleutherococcus (Siberian) ginseng is good for energy production. Take 600 to 900 mg of a standardized product daily.
Reishi (Ganoderma lucidum) is an adaptogen that can help with energy and men- tal function. Take 800 mg of a standardized product twice daily.
Ginkgo biloba is a popular herb that improves circulation, which is good for peo- ple with low blood pressure, and improves memory. Take 60 to 120 mg twice daily of a standardized product containing 24 percent ﬂavone glycosides and 6 percent ter- pene lactones.
Saint-John’s-wort (Hypericum perforatum) can be helpful when depression accom- panies fatigue. Take 300 mg three times daily of a 0.3 percent hypericin extract. Do not combine with pharmaceutical antidepressants.
5-HTP is for insomnia and depression related to the fatigue. Take 100 mg two to three times daily. For insomnia, take 100 mg a half hour before bedtime on an empty stomach. Do not combine with pharmaceutical antidepressants.
Olive leaf (Olea europa) is for antiviral support. Take 500 mg three times daily. Phosphatidylserine is a naturally occurring phospholipid that improves memory and
increases cortisol levels. Take 300 mg daily.
Ashwagandha, known as “Indian Ginseng,” is a revered herb in Ayurvedic medi- cine and is used as a tonic for fatigue and anxiety. Take 1,000 to 3,000 mg daily.
Enzyme complex can be taken with meals to improve digestion and absorption. Oregano (Origanum vulgare) oil is for chronic infections. Take 500 mg of the cap-
sule form four times daily or as directed on the container.
Malic acid is used by cells for energy production. Take 500 mg two to three times daily.
Licorice (Glycyrrhiza glabra) works to increase the levels of cortisol in the body. Take 1,000 mg two to three times daily. Blood pressure should be monitored, because in some individuals it may elevate blood pressure.
Note: The use of low doses of cortisol can be effective for people with chronic fatigue syndrome and diagnosed cortisol deﬁciency. Consult with your local holistic doctor for its proper use.
Arsenicum Album is helpful for feelings of exhaustion, combined with anxiety and depression. The person is usually chilly, feels worse from cold food or cold environ- ments, and often has trouble sleeping between the hours of midnight and 2 A.M.
Calcarea Carbonica is for a person with fatigue and anxiety, who tends to take on too much. He or she also suffers from swollen glands, joint pain, headache, intestinal dis- tress, constipation, and food allergies. The person tends to be chilly, yet sweats easily.
Gelsemium (Gelsemium sempervirens) is for fatigue that includes drowsiness, weakness, and a bruising pain in the muscles.
Kali Phosphoricum is for a feeling of fatigue and mental weariness.
Phosphoric Acid is for extreme fatigue, where the person has an unusually strong craving for carbonated drinks. Fatigue may come on after episodes of emotional grief.
Silica (Silicea) is for bouts of fatigue and poor stamina. The person gets sick eas- ily and is usually thin and chilly. Constipation is often present.
• Stomach 36 is an important point for CFS, because it helps your digestive sys- tem absorb nutrients.
• Gallbladder 21 stimulates circulation. It also alleviates anxiety, irritability, and headaches.
• Pericardium 6 is good for indigestion, sleeplessness, and nervous tension.
• Bladder 23 and 47 support the nervous system and are especially good for
fatigue, weakness, and confusion. Do not press on these points if you have
severe back pain.
• Lung 3 helps tiredness, head pain, confusion, and lightheadedness.
• Triple Warmer 5 soothes joint pain.
Bodywork is a good way to address the many causes and symptoms of CFS. Include at least one bodywork strategy in your treatment program.
In general, massage improves the systems weakened by CFS: immune, muscular, cir- culatory, digestive, and limbic. Almost any kind of massage will make you feel bet- ter, but if you’re seeing a professional, you may want to ask for a lymphatic drainage massage to stimulate your immune response. Any of the essential oils listed in this section under Aromatherapy will compound the beneﬁcial effects of massage.
You can practice gentle self-massage of your gums, tongue, and lower abdomen to strengthen your digestive system.
Chiropractic and osteopathic treatments are also helpful for proper nerve and energy ﬂow.
Acupuncture can be very effective for fatigue. Consult with a qualiﬁed practitioner.
Since CFS is a systemic disorder, it’s best to massage the entire foot. If you want to focus on speciﬁc symptoms, here are some suggestions.
For fatigue, work the adrenals, the diaphragm, the spine, and all the glands.
Work the endocrine glands, the solar plexus, the pancreas, and the head in case of depression.
If your doctor suspects that hypoglycemia is a cause of your CFS, massaging the pancreas area can help (although it’s not a substitute for other treatment).
The liver, the gallbladder, and the stomach will ease indigestion.
Constitutional hydrotherapy renews the nervous system. See pages 676–677 for more information.
Many oils may reduce your levels of tension and depression. Several suggestions are listed here, but you may want to refer to page 658 and try others that seem best suited to your particular needs. All of the oils mentioned here can be used as inhalants (with steam or without), in baths or diffusers, or as part of a massage.
To stimulate your muscular and nervous systems, use lavender, peppermint, or rosemary.
Geranium, bergamot, and neroli combat fatigue related to depression.
Tea tree oil ﬁghts bacteria, viruses, and fungi. Because it strengthens the immune system, it’s an especially good complement to a lymphatic massage.
For general relaxation and calming beneﬁts, try rose, jasmine, lavender, or ber– gamot in any preparation you like. If you need all-day stress relief, consider using a diffuser that allows the scent to ﬁll your home or ofﬁce.
CFS sufferers can grow weary of well-meaning friends and family members who sug- gest that their problem is “all in your head.” But don’t let exasperation regarding this popular misconception prevent you from seeking relief from depression, tension, and anxiety—all of which are linked in some way to CFS, as either a cause or a symp- tom. Experiment with several stress-reduction techniques, and practice them daily.
General Stress-Reduction Therapies
If you’re ready for a gentle workout, take a yoga class. Yoga relieves joint and mus- cle pain, and several of the poses help strengthen the digestive muscles.
If you suffer from anxiety, consider EEG biofeedback to teach you to control your brainwaves.
Bach Flower Remedies
Consult the chart on pages 648–650 to ﬁnd the appropriate ﬂower remedy for your particular condition. Once you’ve select the right remedy, place 10 drops of the liq- uid under your tongue. Hold the drops in place for thirty seconds and swallow. Use as often as needed.
If you are burned out and exhausted at the thought of any activity, whether men- tal or physical, take Hornbeam.
Olive is the remedy for people who have little interest in anything or anyone. Mustard is for sadness and depression without an obvious cause.
If you despair of ever feeling better again, try Gorse.
• Take a walk every day in the early morning sunlight. You’ll stimulate your immune system, get vitamin D, and ward off the depression and the anxiety that often attend CFS.
• Don’t try to do too much. Listen to your body; when it tells you to get rest, do so.
• Don’t smoke or expose yourself to secondhand smoke. You’ll wreak havoc on your immune system.
• Breathe slowly and deeply to encourage relaxation and to diminish stress.
• Try to keep an optimistic outlook, and focus on a positive outcome.
• Go to bed by 9 P.M. and take a thirty-minute nap after lunch each day.