Chronic fatigue syndrome, or CFS, was not even officially considered an illness until 1988. It is a complex illness that has a vague combination of symptoms and unknown cause. CFS symptoms can include: fatigue that returns for at least six months, fever, muscle and joint pain, sore throat, swollen lymph nodes, headaches, memory loss, and inability to concentrate. Besides the theory that CFS is caused by a viral infection (described below), there are other proposed causes for CFS, including: anemia, sleep disorders, arthritis, yeast overgrowth, mercury and other heavy metal toxins, hypo-thyroidism (low-functioning thyroid gland), and hypoglycemia (low blood sugar) (1). Many people with CFS also have allergies and/or food sensitivities. CFS often affects younger adults, coining the term “the yuppie disease”. The percentage of people that have CFS is hard to calculate, since its symptoms can resemble depression, influenza, mononucleosis, or fibromyalgia. One estimate puts the percentage of Americans with CFS at only 0.2% (2), but that figure may in reality be much higher.

Many experts think that a virus such as Epstein-Barr Virus (EBV) can contribute or even cause CFS. However, this opinion is controversial, since the about 90% of Americans have EBV antibodies in their blood (3), indicating that they have been exposed to the virus in the past, but only a very small percentage of them have CFS. Dr. Jensen and others believe that conditions like CFS are caused by an environmental overload of stress on the body. Lack of exercise, poor eating habits, long work hours, lack of sleep, alcohol and/or drug use, pollution, etc., all add up to put an enormous burden on the body. This may allow a normally dormant (resting) virus in the body, like EBV, to overcome the now weakened immune system. Most viruses come and go, but some, like EBV, a member of the herpiesvirus family, stay in a person forever. With a permanently-entrenched virus and a weak immune system, the result is CFS symptoms, like sore throat, fatigue, and swollen lymph nodes.

Whatever the underlying causes, CFS is certainly a stress-related disease. There are many different kinds of stress, including: relationship and spiritual-related stressors, physical stressors (ex. hard labor), traumatic (ex. infection, burns), chemical (environ-mental pollution), nutritional (ex. vitamin deficiencies), mental (ex. perfectionism), and emotional (4). When confronted with stress, the brain releases a chemical called adrenocorticotropic hormone (ACTH). This hormone sends a signal to the adrenal glands to produce adrenaline, a similar hormone called noradrenaline, and the master stress hormone cortisol. Adrenaline and noradrenaline act to raise blood pressure and shut down digestion. This is one of the reasons why many people get indigestion when they feel stressed. Adrenaline also raises blood sugar levels. This is helpful for short term “fight-or-flight” stress responses, but very harmful over the long term, since it can lead to insulin resistance and diabetes.

As mentioned above, cortisol is a very important hormone that helps the body deal with stress. Symptoms of cortisol deficiency include: hypoglycemia (low blood sugar), weakness, fatigue, hypotension (low blood pressure), anorexia, vomiting, and nausea (5). Unfortunately, the hormone cortisol can suppress the immune system, which can lead to chronic infections. This can produce a vicious cycle of stress followed by illness. Eventually, under constant and chronic stress, the adrenal glands can become exhausted. Blood pressure and blood sugar may drop to below-normal levels. Fatigue and depression can then set in. Other stress-related symptoms can include: sexual problems, irritability, weight changes, muscle tension, loss of appetite, back pain, diarrhea or constipation, indigestion, and insomnia. Diseases that can have stress as a major contributor include: atherosclerosis, allergies and asthma, high blood pressure, depression, diabetes, arthritis, irritable bowel syndrome, cancer, and ulcers.

Exercise, good mental attitude, and proper diet, including the elimination of yeast-containing foods and dairy products, may greatly improve CFS symptoms. Adequate protein in the diet is needed to help combat stress. Protein is broken down to amino acids, which are then used to make stress hormones and neurotransmitters. Supplements can be helpful as well. One study found that people with CFS had magnesium levels below normal (6). Magnesium supplementation has proven beneficial for 70-80% of CFS and fibromyalgia sufferers (3). A combination of evening primrose oil (EPO) and concen-trated fish oil was very effective in treating multiple CFS-related symptoms in patients (7). The supplement NADH may help symptoms of CFS (8). Vitamin B12 is required to make adrenaline (9), and vitamin B5 is required to make a group of stress-fighting hormones called glucocorticoids (9). Cortisol is one of the glucocorticoids, so obviously the B-vitamins are very important to help fight stress.

One of the illnesses related to CFS is fibromyalgia, or fibrositis disorder. It is classified under the rheumatic disorders, but it is not an autoimmune disease, as far as experts know. There is chronic muscle pain for three months or more, and also stiffness that is usually greater in the morning. Other symptoms can include: temporomandibular joint syndrome (TMJ), headaches, irritable bowel syndrome, impaired memory, impaired coordination, fatigue, depression, and insomnia. The diagnosis is often made when a doctor applies pressure at 18 “tender points” at different areas of the body. If at least 11 of the 18 tender points cause pain after pressure is applied, then the patient probably has fibromyalgia.

There are at least five million Americans that have fibromyalgia, the majority of whom are women (1). Many people that think they have CFS actually have fibromyalgia (10). The cause of fibromyalgia is unknown. Factors that can contribute to fibromyalgia include: allergies and sensitivities, infections (especially chronic yeast infections), digestive enzyme deficiencies, immune dysfunction, environmental toxicity, endocrine imbalances, stress and psychological issues, and nutritional deficiencies (11). Although fibromyalgia is a chronic condition and can be very painful, it is not a progressive or life-threatening condition (12). People with fibromyalgia need to drink plenty of spring water (at least eight glasses a day), since water hydrates the muscles, reducing pain, and also helps to remove toxins from the muscles and the rest of the body. If you have CFS or fibromyalgia and plan to start exercising, start slowly. Notify your physician that you intend to have a long-term exercise plan. You may want to consult a physical therapist, especially if you have fibromyalgia.

Below is a list of commonly-used supplements for treating CFS and Fibromyalgia. Pregnant and nursing women should not take the supplements below unless otherwise directed by their physician. Everyone should notify their physician before taking the supplements listed below.

Herbs

Licorice Root

High blood pressure, liver and kidney problems, low potassium levels, multiple drug interactions

Echinacea

Anaphylaxis, multiple drug interactions

Ginseng

Hypertension, hypotension, possible carcinogen, multiple drug interactions

Astragalus (Huang-Qi)

Possible heart problems, respiratory depression, interaction with blood-thinning drugs

Pau 'd Arco

Internal bleeding, anemia, high toxicity in general

St. John's Wort (Hypericum)

Mania, anxiety, psychosis in susceptible people, infertility, multiple drug interactions

(Wild) Yam

May interact with anti-inflammatory and estrogenic drugs

Garlic

Anaphylaxis, internal bleeding, liver toxicity, interaction with blood-thinning drugs

Vitamins

Vitamin C

Relatively safe

Carotenoids (Beta-Carotene)

Should not be taken by heavy smokers or drinkers

Vitamin A

Relatively safe at 10,000 IU/day or under

Vitamin E

Relatively safe at 200 IU/day or under, should not be used with blood-thinning drugs

Pantothenic Acid (B5)

Relatively safe

Minerals

Chromium(polynicotinate for CFS and Fibromyalgia)

Relatively safe under 200 ug/day

Magnesium

Should not be taken by people with kidney problems

Manganese

Should not be taken by people with liver problems

Accessory Supplements

Proteolytic Enzymes(Pancreatic for CFS and fibromyalgia)

Use only under medical supervision

Adrenal glandular

Relatively safe

Chlorella (Green algae)

Blood thickener, allergic reactions

5-HTP (5-Hydroxytryptophan)

Generally high toxicity: serotonin syndrome (can be fatal), difficulty breathing, heart problems, multiple drug interactions

Grape seed extract (Proanthocyanidins)

Relatively safe

CoEnzyme Q10

May mildly alter blood sugar levels, may interact with blood-thinning drugs

Melatonin

Drowsiness, depression, seizures in susceptible people, multiple drug interactions

Malic Acid

Relatively safe

Acidophilus(Probiotic)

Relatively safe

Lecithin (Phosphatidyl Choline)

Relatively safe

NADH

Relatively safe for adults

Evening Primrose Oil (EPO)

May be immunosuppressive, seizures in susceptible people

Fish Oil

Should not be taken with blood-thinning drugs

Amino Acids

L-Tyrosine

Possible worsening of hypertension or melanoma cancer, cannot be used with MAO inhibitor drugs

References:

1. Balch, P.Prescription for Nutritional Healing, 3rd Ed. Avery Books/Penguin Putnam Inc., 2000.

2. Feinstein, A.Healing with Vitamins. Emmaus, PA: Rodale Books, Inc., 1996.

3. Dean, C.The Magnesium Miracle. New York, NY: Random House / Ballantine Books, 2007.

4. Haas, E.Staying Healthy with Nutrition. Berkeley, CA: Celestial Arts, 1992.

5. Greenspan, F., & Gardner, D.Basic & Clinical Endocrinology, 6th Ed. New York, NY: Lange Medical Books/McGraw-Hill Medical Publishing Division, 2001.

6. Cox, I., Campbell, M., & Dowson, D. Red blood cell magnesium and chronic fatigue syndrome.Lancet(1991) Mar 30, 337(8744): 757-760.

7. Behan, P., Behan, W., & Horrobin, D. Effect of high doses of essential fatty acids on the post viral fatigue syndrome.Acta Neurologica Scandinavica(1990) 82(3): 209-216.

8.PDRfor Nutritional Supplements. Montvale, NJ: Thomson PDR, 2001.

9. Holford, P.The Optimum Nutrition Bible. Berkeley, CA: Crossing             Press/Ten Speed Press, 1999.

10.The Healing Power of Vitamins, Minerals, and Herbs. Pleasantville, NY: Reader’s Digest Association, 1999.

11. Kristal, H., & Haig, J.The Nutrition Solution. Berkeley, CA: North Atlantic Books, 2002.

12. Litin, S., ed.Mayo Clinic Family Health Book, 3rd Ed. New York, NY: HarperCollins Books, 2003.