We all feel tired, even exhausted, some of the time. But for some people, the exhaustion never lets up, and it comes along with physical discomfort, sleep issues, and trouble with memory and concentration. Anywhere from about 800,000 to 2.5 million Americans may have myalgic encephalomyelitis — more commonly called chronic fatigue syndrome (ME/CFS).
Medical experts once told people these symptoms were “all in their head" — but they have come to accept that the suffering is real.
As one patient put it, having ME/CFS feels “like permanently having the flu, a hangover, and jet lag while being continually electrocuted" — ME/CFS results in nerve pain as much as it does fatigue.
Though little understood and currently without a known cure, certain natural remedies may provide some relief from the discomfort and constant fatigue.
What Is Chronic Fatigue Syndrome?
Chronic fatigue syndrome, also called systemic exertion intolerance disease (SEID) as well as ME/CFS — is a serious, complex disorder of the central nervous system that affects the entire body. People with this illness feel constant, overwhelming tiredness along with other disabling symptoms that are not due to any other diagnosable medical condition.
Did you know that anywhere from 800,000 to 2.5 million Americans may have CFS?
Many people with chronic fatigue syndrome find it difficult to complete daily activities they once took for granted. It is chronic (which means long term), but symptoms may come and go and vary in severity.
People may even experience the symptoms but not realize they have chronic fatigue syndrome. According to experts, remission is possible, though it's unclear what will lead to that happy occurrence.
The symptoms of chronic fatigue syndrome vary from person to person and are not visible to others. The classic sign is extreme tiredness and lack of energy. Other common symptoms include:
- Sleep problems, trouble falling or staying asleep, vivid or upsetting dreams, and not feeling rested even when you get enough sleep.
- Brain fog, problems with concentration, thinking, and memory.
- Pain, especially in the joints (but without redness or swelling), and mild to severe headaches.
- Dizziness, particularly when you sit up or stand.
Some people develop sensitivities to light, sounds, foods, or chemicals. There may also be flu-like symptoms including tender lymph nodes, frequent sore throats, night sweats or cold chills, and intestinal problems, such as irritable bowel syndrome.
These symptoms usually get worse after some form of extra exertion.
Chronic Fatigue Syndrome Treatments
Medical scientists have not yet uncovered a clear cause of chronic fatigue syndrome — although a few theories exist. There is currently no known cure. Treatment focuses on controlling symptoms, often through lifestyle changes and complementary and alternative medicine techniques.
Since there isn't a cure for CFS, experts recommend finding symptoms that bother you and fixing those first.
Experts recommend you identify which symptoms bother you the most and find what helps you feel better. Try a combination of things; what helps one person may not help another. Also, what helps may vary day to day, so try different approaches at different times.
Make sure your professional team has experience working with people who have chronic fatigue syndrome. Below, I list some of the top suggestions that may help deal with day-to-day symptoms.
Even a little exertion, such as cooking a meal or working an hour at the computer, can result in a bout of extreme fatigue. Identify your limits — and stop before that point. That way, you can plan for what you truly need and want to do, and not spend all your energy on unnecessary tasks.
Daily reminder: Know your limits — physically, emotionally, and mentally — and be sure to stop before that point.
Some people find it helpful to break tasks into several smaller ones and rest in between. For example, if you are folding laundry, you may first remove the clothes from the dryer, then rest, then fold two items, then rest again, and repeat until done.
Form Healthy Sleeping Habits
Good sleep habits are especially important for people with chronic fatigue syndrome. Go to bed at the same time each night and get up at the same time in the morning. Create a quiet, dark, comfortable haven in your bedroom that you use only for sleep; do not use phones or computers or watch TV in this space. Also, avoid using electronics close to bedtime.
Pro tip: Create your own comfortable haven in your bedroom by reducing electronics and noise while also keeping your room dark and cool.
Eat your last meal several hours ahead of when you turn in for the night. Avoid caffeine and alcohol in the evening. If you can tolerate exercise, do it in the early part of the day to help you drift off faster at night. Together, these ideas will improve your ability to fall — and stay — asleep. For more ideas, check out our Can't Sleep? Causes and Natural Solution article.
Try Graded Exercise Therapy
Those with chronic fatigue syndrome may find that vigorous exercise makes their symptoms flare. You may experience "push-and-crash" cycles, in which you push yourself to do more on days when you feel better but soon find yourself incapacitated for a longer time. Graded exercise therapy attempts to break this cycle.
This therapy incorporates gentle stretches and exercises for just a few minutes a day!
This therapy includes a structured program of gentle moves, starting with a few minutes a day. Working with a physical therapist, you'll practice stretching or other low-impact exercises, such as tai chi or swimming, that you can handle. Then, you'll gradually increase how long you do them.
Use These Stress-Relievers
Stress-relieving techniques may help soothe your discomfort and improve your mood. Consider joining a chronic fatigue syndrome support group and also try the following:
You can engage in deep breathing exercises at any time of day, in any place, whether standing, sitting, or lying down.
Inhale slowly through your nose, making sure you breathe in from your diaphragm (belly). Hold for 16 seconds, then exhale through your mouth for about eight seconds. Repeat nine times.
Deep breathing not only helps with relaxation, but also pain and fatigue because it brings more oxygen into your lungs, brain, and muscles.
The ancient practice of meditation may ease chronic fatigue syndrome symptoms, relieve stress, and improve focus. Scientists have shown that meditation slows down your nervous system's fight-or-flight response. A relaxed state is essential for repairing the body, activating the immune system, and improving digestion.
Pro tip: Start by meditating for 5-minutes per day, then slowly increase the time each week!
One of the easiest techniques to learn is mindfulness meditation: Focus on becoming aware of your breathing and thoughts, progressively relaxing all areas of your body. You can learn how to meditate through helpful online videos or this meditation guide.
Cognitive Behavioral Therapy
Psychological counseling helps many people with chronic fatigue syndrome work through their frustration and find ways to cope with the challenges they face.
Research shows that cognitive behavioral therapy, in which a therapist helps you identify and replace negative thoughts with constructive and positive ones, can ease the depression and anxiety that co-occur with the condition.
Use Pain-Relieving Techniques
When it comes to relieving the constant discomfort of chronic fatigue syndrome, I recommend trying complementary therapies that focus on treating the whole person, rather than a specific symptom. Below are a few recommendations.
Acupuncture is an ancient Chinese medicine technique designed to balance the "life force" (called qi or chi) in all your body systems. A trained professional inserts slim, short needles into specific "acupoints" on your skin. Despite the needles, the technique is painless.
The length of each session and how many you'll need to feel better depends on your condition. Some people have achieved significant symptom relief with a chronic fatigue syndrome treatment plan centered on acupuncture.
The health benefits of massage go beyond relieving tension and muscle aches. It stimulates blood flow and helps eliminate toxins from your body. Massage helps to reduce pain, depression, and anxiety in all people, but particularly those with chronic fatigue syndrome.
However, some people with the condition are unable to tolerate deep-tissue and other heavy-pressure massage techniques, so opt for Swedish or other gentle forms that focus on the top layers of skin.
Nutritional Remedies for ME/CFS
Maintaining proper nutrition is as important for people with chronic fatigue syndrome as it is for everyone else, and is one of the simplest ways to help manage the condition.
Eating a well-balanced, whole-foods diet — preferably plant-based — will keep your energy up and ensure your system has optimal nourishment. Make sure to include essential fatty acids in your diet, especially omega-3, which may help reduce fatigue. These fats are found in nuts, flaxseed oil, olives, olive oil, and algae oil.
Also, avoid inflammatory foods such as sugar, simple carbohydrates, processed foods, and fried foods. Some people with chronic fatigue syndrome notice certain foods trigger symptoms, so pay attention to what you've eaten if you get a flare-up. For more ideas, check out these stress-relieving foods.
Vitamins & Supplements
There are no long-term studies that show vitamins or supplements improve chronic fatigue syndrome symptoms. But some people with the ailment have deficiencies in certain micronutrients; if you do, supplements may be able to provide what you're lacking.
Did you know that many people with CFS have low levels of CoQ10?
You can find coenzyme Q10, or CoQ10, naturally in many foods. Your body produces it, though it declines with age. CoQ10 plays an important role in regulating your metabolism. Further, it is an antioxidant that protects cells from damage. Research has found that people with ME/CFS tend to have lower levels of CoQ10 than healthy people.
While no one knows why people with ME/CFS have low CoQ10 levels, experts have not only suggested that a deficiency in CoQ10 is directly involved in the development of chronic fatigue syndrome symptoms but also that supplementation may help.
Some research shows magnesium improves mood and promotes normal energy and body comfort levels in people with chronic fatigue syndrome. You can take it as a supplement or eat foods rich in it, such as leafy greens, avocados, beans, bananas — even dark chocolate.
What Causes Chronic Fatigue Syndrome?
So far, experts have not identified a cause of chronic fatigue syndrome — or how to prevent it. Scientists think the condition might be the combined result of more than one illness, or that if it is a single disease, two or more factors may trigger it.
Risk factors include:
- Age: Chronic fatigue syndrome tends to affect people in their 40s and 50s (though anyone can get it).
- Gender: Women are four times more likely to get chronic fatigue syndrome than men.
- Race: White (Caucasian) people tend to get it more than people of other races.
- Health history: About 10 percent of people exposed to certain infections sometimes later develop chronic fatigue syndrome symptoms. These include the Epstein-Barr, herpes 6, and Ross River viruses and a bacterial infection known as Q fever. Others develop symptoms after a bout of flu or following a stressful event, such as surgery.
Some experts think an immune system malfunction, where the body attacks its own tissues, may cause chronic fatigue syndrome. Others believe a possible cause is an abnormal number of disease-fighting proteins or cells. Alternatively, hormonal changes — an imbalance of stress hormones in the brain and body — could be the culprit. Genetics plays a role, so it can run in families.
How Is Chronic Fatigue Syndrome Diagnosed?
Currently, there is no test to specifically diagnose chronic fatigue syndrome. Before your healthcare professional can diagnose you, they will rule out other treatable disorders that cause similar symptoms, such as mononucleosis or other viral infection, a sleep disorder, a thyroid disorder, mental health issues, or another serious illness.
Did you know that there are no tests that can specifically diagnose CFS?
This process of elimination may require you to answer detailed questions about your symptoms and health history, as well as undergo a physical exam, blood tests, imaging tests, and other types of screening.
If your healthcare provider can find no other explanation and you have the following symptoms, they may diagnose you with chronic fatigue syndrome.
- Ongoing tiredness: This type of fatigue is more severe than you had experienced before feeling ill and it prevents you from doing ordinary things, most of the time, for at least six months. The tiredness is not due to over-exertion — although over-exertion can make it worse.
- Post-exertional malaise: Your symptoms flare 12 to 48 hours after you make some type of physical, mental, or emotional effort, such as a big project or holiday shopping — but it can happen from an activity that doesn't require much effort, such as folding laundry.
- Non-refreshing sleep: You feel no more rested after sleeping than you did before going to bed.
- At least one of the following: Trouble with concentration, thinking, or memory, and feeling dizzy when you sit up or stand.
Points to Remember
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a serious, chronic disorder of the central nervous system that affects your entire body.
The main symptoms of chronic fatigue syndrome are extreme tiredness and lack of energy to the point that daily activities become challenging. Others include sleep difficulties, worsening of symptoms after physical or mental effort, cognitive problems, and dizziness when sitting or standing. Healthcare providers use these symptoms to diagnose chronic fatigue syndrome but must rule out other conditions first.
Chronic fatigue syndrome has no known cure, so treatment focuses on symptom control. Lifestyle changes may help. These include pacing yourself, forming healthy sleeping habits, and using "graded exercise therapy." Techniques such as deep breathing, meditation, and cognitive-behavioral psychotherapy can help ease stress and pain, as can acupuncture and gentle forms of massage. A diet rich in essential fatty acids and certain micronutrients can support your overall health.
No one is sure what causes chronic fatigue syndrome. Possibilities include an infection, immune system malfunction, hormonal changes, problems with energy in cells, and genetics.
- Institute of Medicine. 2015. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness. Washington, DC:The National Academies Press. Accessed 21 Nov 2018.
- Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Report Guide for Clinicians. Institute of Medicine of the National Academies. 2015. Accessed 21 Nov 2018.
- Boccia M, et al. The meditative mind: a comprehensive meta-analysis of MRI studies. BioMed Res Int. 2015;2015:419808.
- McGreevey, S. Eight weeks to a better brain: Meditation study shows changes associated with awareness, stress. The Harvard Gazette. 21 Jan. 2011. Accessed 26 Nov 2018.
- Malouff JM, et al. Efficacy of cognitive behavioral therapy for chronic fatigue syndrome: A meta-analysis. Clin Psychol Rev. 2008 Jun;28(5):736–745.
- Son C-G. A case of chronic fatigue syndrome improved by traditional Korean medicine. Integr Med Res. 2013 Mar;2(1):32–35.
- Field TM, et al. Massage therapy effects on depression and somatic symptoms in chronic fatigue syndrome. J Chronic Fatigue Syndr. 1998;3(3):43–51.
- Werbach MR. Nutritional strategies for treating chronic fatigue syndrome. Altern Med Rev. 2000;5(2):93–108.
- Maes M, et al. Coenzyme Q10 deficiency in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is related to fatigue, autonomic and neurocognitive symptoms and is another risk factor explaining the early mortality in ME/CFS due to cardiovascular disorder. Neuroendocrinol Lett. 2009 Jan 1;30(4):470-476.
- Guerrera MP, et al. Therapeutic uses of magnesium. Am Fam Physician. 2009;80(2):157–162.
- American Nutrition Association. Magnesium and Chronic Fatigue Syndrome. Nutrition Digest website. 2018;38(2). Accessed 26 Nov 2018.
†Results may vary. Information and statements made are for education purposes and are not intended to replace the advice of your doctor. If you have a severe medical condition or health concern, see your physician.