Chronic fatigue syndrome (CFS) is an extremely debilitating disease that can cause persistent fatigue leading to declining productive activity of the sufferer along with a loss of quality of life and mental peace.  It can also pose a serious threat to health.  Fatigue, even persistent fatigue, can be a common symptom of various medical conditions, but CFS is exceptionally different from those conditions in many aspects.  The most important being the severity of persistent fatigue, a sudden onset, made worse with physical or mental activity but not relieved by rest and the absence of any other fatigue producing medical condition.

Despite a shared diagnosis, the functional ability of persons with CFS varies. Some individuals suffering from CFS lead relatively healthy lives while others are completely bedridden and incapable of caring for themselves.  

What Causes Chronic Fatigue?

Unfortunately a specific cause for CFS has not been identified but it is suspected that it may be a combination of factors that leads to the development of this disease.   There are many theories on this subject, some believe a viral infection may be involved while others believe that psychological stress plays a key role.  Since there is also no specific test that can diagnose CFS it is important to rule out all other conditions that may cause similar symptoms.

Signs and Symptoms

The signs and symptoms of chronic fatigue syndrome includes of malaise, widespread muscle and joint pain, sore throat, dizziness, numbness and tingling sensation of the extremities, chronic headache, insomnia, mood swing, difficulty in breathing, tender lymph node (axillary and cervical), difficulty to maintain upright posture, reduction in activity levels, visual disturbance, periodic fever and chills.


The impact of CFS

The majority of cases of CFS are mild or moderate; these are illustrated as follows:

Mild – you're able to care for yourself, but may need days off work to rest

Moderate– you may have diminished mobility, and your symptoms can vary; you may also have disturbed sleep patterns and want to nap in the afternoon

Severe– you can carry out trivial daily tasks, such as combing your hair but have significantly diminished mobility, and may also have difficulty concentrating


Treatment options

To date there is no cure for CFS so treatments involve managing and reducing symptoms allowing sufferers to cope better with day to day activities.


Cognitive Behavioural Therapy (CBT)

CBT cannot eliminate your predicaments, but it can help you deal with them in a more definitive form.  It is based on the theory that your feelings, thoughts, actions and physical sensations are interconnected and that negative views and feelings can trap you in a vicious circle.  CBT aims to assist you to break this circle by breaking down devastating problems into smaller parts and revealing how you can change these negative patterns to enhance the way you feel.  CBT deals with your present challenges, rather than focusing on subjects from your past.


Graded Exercise Therapy (GET)

Although high-intensity exercises are great for healthy individuals, that would not be wise for those with CFS.  Gentle walking, progressively building up to 1 to 2 hours a day could have profoundly beneficial results.  Graded exercise therapy is an organized program that aims to gradually extend how long you can carry out a physical activity.  These involve exercise that increases your heart rate, such as swimming or walking.  You'll have your training program adapted to your physical capabilities.  As part of your training program, you and your therapist will set goals for you to achieve goals, but it is important not to exceed the exercise duration and intensity set for you.  



While everyone is different, there are some basic foods that can be help in managing symptoms of CFS.  Starchy foods, particularly slow releasing types with a low GI (glycemic index), are recommended as they help to keep energy levels more stable. These comprise porridge, whole grain bread, brown rice and whole grain pasta.  A proper diet includes lots of fresh vegetables and fruits, dairy products such as cheese and yogurt, as well as eggs, meat, fish, nuts, and legumes.  Restrictive diets are not encouraged unless there is evidence of a particular food hypersensitivity and then it should be under the observation of a dietician.  Many people with CFS also experience irritable bowel syndrome symptoms, and can see an improvement with removal of problem foods. One method to identify problem foods is by following an exclusion diet under the regulation of a healthcare provider.


Nutritional Supplements

Nutritional supplements are a vital component of any Chronic Fatigue Syndrome treatment protocol.   Research has shown that people with CFS are routinely deficient in several essential nutrients.  These deficiencies can reduce the degree to which the body can absorb and make use of other nutrients.

  • Acetyl-L-Carnitine (a more bioavailable form of Carnitine).  CFS clients have a deficiency in intracellular levels of acylcarnitine. Carnitine is crucial for the transport of long-chain fatty acids into the mitochondria of cells, providing energy to the heart muscles and skeleton.  Lack of Carnitine produces fatigue, muscle weakness, malaise, heartbeat abnormalities, exercise intolerance and tissue acidosis.
  • Antioxidants:  Vitamin E, Alpha Lipoic Acid, Vitamin C, etc.  Antioxidants are a group of minerals, enzymes, and vitamins that help protect cells from free radical damage.  Because there is ample evidence that CFS produces oxidative stress, many patients are advised to take antioxidants.  Antioxidants not only reduce oxidative stress, but they also improve mitochondrial function.
  • CoQ10 / Ubiquinol: CoQ10 (ubiquinone) is one of the most frequently used supplements for the treatment of fatigue associated with CFS because of its significance in the production of adenosine triphosphate, the cellular source of energy.  Also, CoQ10 may relieve pain and muscle weakness and enhance the immune responses in patients with CFS.
  • Essential Fatty Acids are indispensable in maintaining the function and structure of cell membranes, particularly in the nervous system.  They also act as immune system modulators; enhancing immune system activity where needed and inhibiting it when there is an unregulated immune response.  Essential fatty acids are; Omega-3, Omega-6, EPA, DHA, Fish Oil, Flaxseed Oil, Evening Primrose Oil, Borage Seed Oil.

Lifestyle Suggestions

  • Avoid stressful conditions
  • Avoid caffeine, sugar, alcohol and sweeteners
  • Avoid any drink and food you're sensitive to
  • Eat small regular meals to help reduce any nausea
  • Pacing- may be a helpful way of managing CFS symptoms.  It includes balancing periods of activity with periods of inactivity.  It implies not overdoing it or pushing yourself exceeding your limits.  If you do more than you are capable of, this could reduce your progress in the long term. Over time, you can slowly increase your periods of activity while making sure they are equal to your relaxing time.


Chronic Fatigue Syndrome

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