Everyone experiences fatigue from time to time, whether due to poor sleep or a busy day. While inconvenient, this fatigue is not life-disrupting and can usually be resolved with a good night’s rest. Chronic Fatigue Syndrome (CFS) is much different. This complex condition is characterized by profound feelings of tiredness that do not improve, regardless of rest, for at least six months. The fatigue is so severe that it gets in the way of daily activities at work and home, making everyday life difficult.
Experts believe that about 2.5 million Americans are affected by Chronic Fatigue Syndrome. While CFS can affect anyone, it tends to be most common among women between 40 and 50.
In conventional medicine, there is still uncertainty about what exactly causes CFS. No underlying medical condition has been identified as a cause, though there are some leading theories, including psychological stress, viral infection, and inflammation. As a functional medicine practitioner, I now know that most of these cases can be attributed to Adrenal Fatigue, also known as HPA (hypothalamic-pituitary-adrenal axis) dysfunction. The good news is that if you work with a practitioner who recognizes this as a possible cause, it is easy to test for and treat.
However, most conventionally trained doctors believe Chronic Fatigue Syndrome is notably difficult to diagnose. Doctors aim to rule out other possible causes of fatigue before making a diagnosis of CFS. When left undiagnosed and untreated, Chronic Fatigue Syndrome leads to decreased stamina and concentration, along with emotional distress and strained relationships.
Continue reading to learn more about this chronic illness, including its symptoms, risk factors, and treatment options.
Symptoms: What Does Chronic Fatigue Syndrome Feel Like?
The most obvious symptom of this disorder is fatigue, not moderate fatigue, but severe enough to interfere with daily life. For a diagnosis of Chronic Fatigue Syndrome, patients must show a significantly reduced capacity to complete everyday tasks due to fatigue that is not improved by rest. This must last for at least six months.
People with CFS experience extreme tiredness, especially after physical or mental activities. This is called post-exertional malaise and can last more than 24 hours after the activity.
Additional physical symptoms are:
- Muscle pain
- Enlarged or swollen lymph nodes
- Frequent headaches
- Joint pain but without redness or swelling
Chronic Fatigue Syndrome also typically involves sleep issues, including:
- Chronic insomnia
- Feeling unrested despite sleeping
- Night sweats
Other symptoms may include:
- Poor concentration
- Difficulty remembering things
- Orthostatic intolerance (feeling light-headed, dizzy, or faint when moving from seated to standing positions)
People who suffer from CFS also tend to experience frequent alterations in levels of irritability, mood swings, panic attacks, anxiety, and depression. The emotional and mental side effects of CFS are significant, making integrative mind-body treatment essential.
What Causes Chronic Fatigue Syndrome?
As mentioned, there is no known cause of Chronic Fatigue Syndrome in conventional medicine. As a family doctor, I didn’t have much to offer these patients that I saw in my office regularly. As a functional medicine practitioner, I always look to the adrenals, the thyroid, hormones, and the mitochondria. It isn’t normal to feel this tired. If you do, there is a reason!
Risk factors for Chronic Fatigue Syndrome are:
- Age. CFS is most frequently diagnosed amongst people in their 40s and 50s.
- Sex. Women are two to four times more likely to experience CFS than men.
- Genes. Chronic Fatigue Syndrome has been seen in members of the same family. Studies on twins suggest that genes and environment play a role in CFS, though more research is needed.
- Stress. Patients with Chronic Fatigue Syndrome often report that it began following a period of extreme emotional or physical stress, such as after surgery. This stress affects the hypothalamic-pituitary-adrenal axis (HPA axis), which controls the body’s reaction to stress and regulates various bodily processes, including the immune response, digestion, energy usage, and mood.
- Immune System. Some researchers believe that a person’s immune system may cause CFS, and how it responds to stress or infection. CFS shares some features with autoimmune illnesses, in which the immune system attacks healthy tissues in one’s own body.
- Gut/nutritional imbalances. A growing body of research suggests that celiac disease and food sensitivities or food allergies may be a cause of Chronic Fatigue Syndrome. In many studies of CFS patients, almost all of them report digestive problems.
Some risk factors, such as age and sex, are unavoidable. But no matter your demographic, you can work to support a healthy immune system, lower your stress levels, and eat a balanced diet. Doing so will help protect you not only from CFS but also from numerous other health issues.
How To Overcome Chronic Fatigue Syndrome
Most treatments aim to reduce symptoms, which can vary greatly. Individuals need to work with a healthcare practitioner to find the root cause and determine what works for them – I can help!
Conventional treatments typically include sleeping pills for fatigue and antidepressants to help with mood. However, the prescription route often produces side effects that can be worse than the condition itself. Instead, I recommend identifying the root cause and fixing it. In addition, lifestyle changes, nutraceuticals, and other natural treatments can help reduce symptoms and heal the mind and body.
The best diet for CFS
One method of treating chronic fatigue syndrome is through diet. Since there appears to be a link between digestive issues and CFS, it is essential to eliminate potential food sensitivities, allergens, and intolerances that may inflame the body and lead to fatigue. If any nutritional deficiencies are found, a healthcare professional may recommend making dietary changes or taking supplements.
Dietary interventions for treating chronic fatigue include:
- Reduction of refined sugars, carbohydrates, alcohol, caffeine, and saturated fats. Instead, enjoy protein-rich foods, fresh vegetables, whole grains, and legumes. Eating a healthy, well-balanced diet helps improve your overall energy levels.
- A candida cleanse diet can help treat chronic fatigue syndrome (CFS). Research indicates that overgrowth of Candida and the bacteria H. Pylori contribute to chronic fatigue. It is recommended that you work with a healthcare practitioner to rule out any potential bacterial imbalances.
- Supplementation: Many vitamins and minerals linked to energy levels may help treat CFS. Of course, not all supplements are right for every patient, so speak with a healthcare practitioner before starting any of the following.
- Vitamin B12 has been shown to improve energy in people who are deficient. It is a critical nutrient that supports the methylation cycle, which is responsible for immune function, energy production, and mood. It can help stimulate mood with increased energy and improved cognitive function.
- Omega-3 fatty acids, found in fish oil, may also help reduce fatigue. Studies have shown that people with CFS have lower levels of omega-3 fatty acids.
- Magnesium has also been shown in studies to be lacking in chronic fatigue sufferers. Patients were found to have low magnesium levels, which accounted for a low red blood cell count. After taking magnesium supplements, they reported improved energy and more balanced emotions.
Supporting mental health
Along with proper diet, treating the mental aspect of chronic fatigue syndrome is also highly important.
I suggest:
- Relaxation techniques, such as deep breathing, meditation, and yoga, can help you relax and manage stress. Stress tends to worsen CFS, so it’s essential to incorporate these into your daily routine.
- Move your body! Exercise has been shown to help improve fatigue, mental clarity, and depression among CFS patients, but it’s essential to listen to your body. Overdoing it can worsen symptoms, so work with your healthcare practitioner to create a program that works for you and start slowly.
- Establish a sleep hygiene routine. This includes going to bed consistently each night and allowing yourself time to physically and emotionally wind down. Turn off all electronics and ensure your bedroom is at a comfortable temperature.
- Talking with a professional therapist or counselor can help individuals cope with the impacts of their CFS on their daily life and relationships.
Chronic fatigue syndrome can be challenging both physically and mentally. However, there are numerous ways to treat symptoms and improve energy levels. Reducing stress and eating a proper diet are two major ones. Many people also benefit from working closely with a healthcare practitioner. If you live with CFS, work with a practitioner to help identify the root cause and create a treatment plan that meets your unique needs. The time to revive your energy levels and take charge of your life is now!
Sources
“Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 15 Sept. 2022, https://www.cdc.gov/me-cfs/l.
Avellaneda Fernández A, Pérez Martín A, Izquierdo Martínez M, Arruti Bustillo M, Barbado Hernández FJ, de la Cruz Labrado J, Díaz-Delgado Peñas R, Gutiérrez Rivas E, Palacín Delgado C, Rivera Redondo J, Ramón Giménez JR. Chronic fatigue syndrome: aetiology, diagnosis and treatment. BMC Psychiatry. 2009 Oct 23;9 Suppl 1(Suppl 1):S1. doi: 10.1186/1471-244X-9-S1-S1. PMID: 19857242; PMCID: PMC2766938..
Schur E, Afari N, Goldberg J, Buchwald D, Sullivan PF. Twin analyses of fatigue. Twin Res Hum Genet. 2007 Oct;10(5):729-33. doi: 10.1375/twin.10.5.729. PMID: 17903114; PMCID: PMC2953372.
Sotzny F, Blanco J, Capelli E, Castro-Marrero J, Steiner S, Murovska M, Scheibenbogen C; European Network on ME/CFS (EUROMENE). Myalgic Encephalomyelitis/Chronic Fatigue Syndrome – Evidence for an autoimmune disease. Autoimmun Rev. 2018 Jun;17(6):601-609. doi: 10.1016/j.autrev.2018.01.009. Epub 2018 Apr 7. PMID: 29635081.
Lakhan SE, Kirchgessner A. Gut inflammation in chronic fatigue syndrome. Nutr Metab (Lond). 2010 Oct 12;7:79. doi: 10.1186/1743-7075-7-79. PMID: 20939923; PMCID: PMC2964729.
Cater RE 2nd. Chronic intestinal candidiasis as a possible etiological factor in the chronic fatigue syndrome. Med Hypotheses. 1995 Jun;44(6):507-15. doi: 10.1016/0306-9877(95)90515-4. PMID: 7476598.
Maes M, Mihaylova I, Leunis JC. In chronic fatigue syndrome, the decreased levels of omega-3 poly-unsaturated fatty acids are related to lowered serum zinc and defects in T cell activation. Neuro Endocrinol Lett. 2005 Dec;26(6):745-51. PMID: 16380690.
Cox IM, Campbell MJ, Dowson D. Red blood cell magnesium and chronic fatigue syndrome. Lancet. 1991 Mar 30;337(8744):757-60. doi: 10.1016/0140-6736(91)91371-z. PMID: 1672392.
Larun L, Brurberg KG, Odgaard-Jensen J, Price JR. Exercise therapy for chronic fatigue syndrome. Cochrane Database Syst Rev. 2017 Apr 25;4(4):CD003200. doi: 10.1002/14651858.CD003200.pub7. Update in: Cochrane Database Syst Rev. 2019 Oct 02;10:CD003200. PMID: 28444695; PMCID: PMC6419524.
