Nutritional and herbal consideration in the management of chronic fatigue syndrome

Healthylife Pharmacy31 January 2023|4 min read

Chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME/CFS) and systemic exertional intolerance disease (SEID), is characterized by unexplained extreme fatigue which last more than 6 months. Both physical and mental exertion can exacerbate symptoms which are unresolved by rest. Along with the symptoms of physical and mental debility, work life, social life, and lifestyle may be impacted causing feelings of isolation and depression.

CFS is most commonly diagnosed in young to middle aged people, however people of any age can be affected. It is not connected to any particular medical condition which makes it hard to resolve [1]. A diagnosis of CFS is usually established after other possible health conditions have been ruled out.

Herbal and nutritional medicine aims to help with symptom management.

Characteristics and symptoms of CFS

  • Fatigue
  • Waking from sleep feeling unrefreshed
  • Poor concentration, focus and memory
  • Dizziness
  • Exhaustion after physical or mental exertion
  • Headaches, sore throat and enlarged lymph nodes in neck and armpit
  • Muscle and joint pain which cannot be explained

Symptoms of CFS have been found similar to those experience by sufferers of fibromyalgia – such as mental cloudiness, sleep disorders, pain, and fatigue felt after physical activity.  

What causes CFS?

Whist many suggestions have been put forth and explored as an explanation for the development of CFS, the exact cause has not been established and most experts suggest it is triggered from a combination of factors. These may include:

  • Viral infection
  • Toxins
  • Immune dysfunction
  • Hormonal imbalances
  • Physical or emotional trauma

There may be a predisposition to developing CFS and a genetic connection.

Debilitating fatigue

Whist fatigue is the most common concern for many illnesses, CFS fatigue is considered due to a combination of body dysfunctions and discord - metabolic dysfunction, mitochondrial dysfunction, impaired cell regeneration(biogenesis), and systemic inflammation.

The mitochondria are structures inside of cells which are primarily responsible for the production of energy. They are especially active in tissues of the body which are rich in oxygen and energy dependant – such as the brain. Cell death occurs when these structures are impaired. The cells may be programmed to die, die due to over excitability or from oxidative damage (caused by free radicals); or their DNA repair may be compromised. A chronic condition of mitochondrial damage and energy depletion is the result.

Nutritional and herbal considerations for symptom relief of CFS

Validation of disability is an important consideration for chronic fatigue sufferers. Nutritional and herbal medicine focus on supporting energy, sleep, and cognitive function; and the pain management of muscles and joints.

Nutrients to consider

Nutrient deficiency may be associated with the exacerbation and severity of symptoms. These include omega-3 fatty acids, vitamin B and C, magnesium, zinc and selenium.

Omega-3 fatty acids have been shown to be low in individuals with CFS and may be associated with inflammation, sleep problems, cardiovascular risk, major depression and other related health concerns. Increase omega-3 levels through supplements such as fish oil, krill oil and Schizochytrium algal oil may help reduce inflammation and many symptoms of CFS [3]. Dietary sources include fatty fish (salmon, herring and sardines); flaxseeds and chia seeds; walnuts; algae (seaweed, spirulina, chlorella).

Magnesium supplements can aid sleep by relaxing mind and body.

B12 (injections) and oral folic acid supplements have been shown to help for some CFS sufferers. Many of the vitamin B group are co factors for cell functions. Consider a B vitamin complex and sublingual vitamin B12 [4].

Selenium. Sub-optimal intake of selenium or reduced selenium status due to increased selenium toxic metal antagonist may lead to increased inflammation.

Damaged mitochondria

Damaged mitochondria components of cells, which occurs during chronic illness, can reduce the cell’s ability to produce molecules needed for energy. The following supplements enhance mitochondrial function [5].

  • N- acetylcysteine (NAC)
  • Nicotinamide adenine dinucleotide (NAD) + hydrogen (H)) (NADH)
  • Coenzyme Q10 (Co Q10)
  • Vitamins C and E

Neurotransmitters

Neurotransmitters can be out of balance with people suffering from chronic fatigue.

  • L-carnitine is a nutrient which help cells produce energy from fat and can help with the utilization of neurotransmitters – serotonin and glutamate. Helping with symptoms of fatigue, pain, and mental clarity.  
  • 5-HTP converts into serotonin and can enhance GABA (gamma-aminobutyric acid). Glutamate stimulating and GABA is calming.
  • Glutamine is converted into glutamate.
  • Theanine may boost GABA levels and lower glutamate activity.

Herbal medicine to consider

Herbal medicine can be used for specific symptoms such as sleep, energy and cognitive function. Adaptogens are herbs which bring balance - supporting the body to adapt to stress and general wellbeing, and help with symptoms of fatigue and anxiety [6,7]. Herbs to consider:

American ginseng (Panax quinquefolium) offers immune support; help with pain and inflammation; nervous system support - helping the stress response and may help with mood.

Asian ginseng (Panax ginseng) helps with mental and physical fatigue, improving energy and performance during stressful activities.

Siberian ginseng/Eleuthero (Eleutherococcus senticosus) is a gentle and supportive herb which helps relieve stress, fatigue, insomnia, inflammation, and immune function [8].

Ashwagandha (Withania somnifera) is a rejuvenating tonic for a debilitated body. It supports the stress response, is a nervine sedative, and has an antioxidant action - protecting cells from damage [9].

Rhodiola (Rhodiola rosea) can reduce symptoms of fatigue, anxiety and depression.

Diet and Lifestyle considerations

A diet of colourful fruit and vegetables full of antioxidant nutrients helps protect the body from free-radical damage and aids repair.

Remove non-nutritive foods - those found in processed foods, artificial colourings, preservatives and alcohol.

Follow good sleep hygiene practices. Go to bed and rise at the same time. Aim for 8 hours sleep. Support a healthy sleep with a warm bath or shower before bed, and reduce screen time (computers, phone, TV).

Herbal support can be provided with the following: 

  • Zizyphus/ jujube - relaxant, sedative and hypnotic actions.
  • Valerian—a mild relaxant for the muscles and the mind, valerian is traditionally used in instances of insomnia, anxiety and restlessness.
  • Sour cherry—a natural source of melatonin, sour cherry may improve sleep duration, efficiency and quality.
  • Kava kava—traditionally used as an herbal remedy to relieve stress, anxiety, depression and sleep disorders.

The information provided is not intended to be used for diagnosis or treatment. If you are experiencing any health concerns, please consult your doctor for advice.

References

https://www.msdmanuals.com/en-au/professional/special-subjects/chronic-fatigue-syndrome/chronic-fatigue-syndrome?query=myalgic%20encephalomyelitis

Mitochondrial modifying nutrients in treating chronic fatigue syndrome: A 16-week open-label pilot study https://www.sciencedirect.com/science/article/abs/pii/S2212958817300915

Low omega-3 index and polyunsaturated fatty acid status in patients with chronic fatigue syndrome/myalgic encephalomyelitis https://www.plefa.com/article/S0952-3278(18)30053-X/fulltext

Chronic fatigue syndrome (CFS): Suggestions for a nutritional treatment in the therapeutic approach https://www.sciencedirect.com/science/article/pii/S0753332218342987

Supplements for Chronic Fatigue Syndrome? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010273/

Traditional Chinese Medicine for Chronic Fatigue Syndrome https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2816380/

Ginseng for the Treatment of Chronic Fatigue Syndrome: A Systematic Review of Clinical Studies https://journals.sagepub.com/doi/full/10.1177/2164957X221079790#body-ref-bibr40-2164957X221079790

Fisher, Carole; 2009, MATERIA MEDICA OF WESTERN HERBS, Vitex Medica, New Zealand

Bone, Kerry; 1996, Clinical applications of Ayurvedic and Chinese Herbs - Monographs for the Western Herbal Practitioner; Phytotherapy Press QLD, Australia

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This article is for informational purposes only and does not provide medical advice, diagnosis, or treatment. Any information published on this website or by this brand is not intended as a substitute for medical advice. If you have any concerns or questions about your health you should consult with a health professional.