Natural treatments for chronic fatigue syndrome (CFS)
Chronic Fatigue Syndrome (CFS) is a complex condition characterized by debilitating fatigue that is not alleviated by rest, accompanied by a range of symptoms such as impaired memory, sore throat, and unrefreshing sleep. While the causes of CFS remain poorly understood, many individuals seek natural treatments to alleviate their symptoms. Various natural options have been proposed, including acupuncture, essential fatty acids, and traditional Chinese herbal medicine, though scientific evidence supporting their effectiveness is often limited or inconclusive. Some studies have shown potential benefits from supplements like nicotinamide adenine dinucleotide (NADH) and carnitine, but more rigorous research is needed to confirm these findings. Other remedies, such as dark chocolate and certain herbs like echinacea and Panax ginseng, have also been explored, albeit with mixed results. Additionally, lifestyle changes such as improved diet, yoga, and relaxation techniques may help manage symptoms, as well as pain management approaches like massages. Overall, while there are various natural treatments available, individuals with CFS should approach them with caution and consult healthcare professionals for personalized guidance.
Natural treatments for chronic fatigue syndrome (CFS)
- DEFINITION: Treatment of a chronic disease characterized by debilitating and unexplained low energy, tiredness, and other symptoms.
- PRINCIPAL PROPOSED NATURAL TREATMENTS: None
- OTHER PROPOSED NATURAL TREATMENTS: Acupuncture, beta-carotene, carnitine, chocolate, dehydroepiandrosterone, echinacea, Eleutherococcus, essential fatty acids (gamma-linolenic acid and fish oil), licorice, melatonin, multivitamin/mineral supplements, nicotinamide adenine dinucleotide, Panax ginseng, traditional Chinese herbal medicine
Introduction
Chronic fatigue syndrome (CFS) has been a subject of controversy for many years. Medical authorities were once skeptical regarding whether it even existed. However, in 1988, the Centers for Disease Control and Prevention (CDC) officially recognized CFS. During the early twenty-first century, CFS was defined essentially as follows: unexplained, persistent, or relapsing fatigue with a definite beginning that is not the result of exertion, which is not relieved by rest, and that results in significant reduction of daily activities. Also, a minimum of four of the following symptoms persist or recur for six or more consecutive months of the illness: impairment in short-term memory or concentration; sore throat; tender lymph nodes in the neck or armpits; muscle pain; pain in many joints, without redness or swelling; headache of new pattern or severity; unrefreshing sleep; and malaise following exercise that lasts for more than twenty-four hours. Frequently, symptoms of CFS follow a viral infection; some persons with CFS describe their symptoms as a flu that never goes away.
The cause (or causes) of CFS remains unknown. Because its symptoms somewhat resemble those of mononucleosis (caused by the Epstein-Barr virus), for a time, CFS was called chronic Epstein-Barr syndrome. However, further investigation disclosed that evidence of past or current Epstein-Barr infection is no more common in persons with CFS than in the general population. Nonetheless, this erroneous and misleading term still crops up in the literature on CFS.
Other syndromes with a pattern of symptoms similar to CFS include fibromyalgia, multiple chemical sensitivities, and food allergies; some consider these conditions to be closely related to each other, but there is no real evidence to support this hypothesis.
There is no dramatically effective treatment for CFS. Antidepressants (such as Prozac and Zoloft) may improve energy and mood; older antidepressants (such as amitriptyline) may improve sleep; antihistamines and decongestants can help allergic symptoms that frequently occur in CFS; and nonsteroidal anti-inflammatory drugs (such as ibuprofen and naproxen) may help pain. Other attempted approaches to CFS include magnesium injections, corticosteroid treatment, and a graded exercise program, either alone or with the antidepressant fluoxetine.
For a time, researchers expressed some excitement over initial findings that deliberately raising blood pressure might help persons with CFS. However, a double-blind, placebo-controlled study of twenty-five people given a six-week course of fludrocortisone and increased dietary sodium to raise blood pressure found no improvement in CFS symptoms.
Proposed Natural Treatments
There are some promising natural treatments for CFS, but the scientific evidence for them is not strong.
Essential fatty acids. In a double-blind, placebo-controlled study, sixty-three people were given either a combination of essential fatty acids containing evening primrose oil (a source of gamma-linolenic acid) and fish oil, or liquid paraffin placebo for three months. At one and three months, participants in the treatment group reported significant improvement in CFS symptoms compared with the placebo group. The researchers also found that at the beginning of the study, many participants had abnormal essential fatty acid levels, and these improved with treatment.
However, researchers tried to replicate this study with fifty other participants, using more precise means of measuring CFS symptoms. The results showed no difference between persons given essential fatty acids and those given placebo (sunflower oil). These researchers also found no difference in fatty acid levels between persons with CFS and persons without CFS who served as controls.
Nicotinamide adenine dinucleotide. Nicotinamide adenine dinucleotide (NADH) is a naturally occurring chemical that plays a significant role in cellular energy production. NADH supplements have been tried in hopes that they might improve energy levels in athletes and persons with chronic fatigue.
A double-blind, placebo-controlled crossover trial that followed twenty-six people given 10 milligrams of NADH for a four-week period showed some improvement in symptoms during NADH treatment compared to the period of placebo treatment (31 versus 8 percent). However, larger studies will have to be performed to prove the benefit of this supplement.
Carnitine. Carnitine is a substance the body uses to convert fatty acids to energy. Early studies reported decreased carnitine levels in people with CFS. Based on these studies, an unblinded crossover trial (eight weeks with each treatment and a two-week “washout” period between) enrolled thirty persons with CFS to evaluate the potential benefits of carnitine supplements. The results suggest potential benefits with this supplement.
This study, however, was severely flawed. Rather than use a placebo group for comparison, researchers chose to investigate the antiviral drug amantadine. This drug has no proven efficacy in CFS, and it caused so many side effects that more than one-half of the participants dropped out during the period when they were taking amantadine. This high dropout rate makes statistical interpretation of the results unreliable. In addition, the lack of blinding in the study reduces the trustworthiness of the results.
Other herbs and supplements. Traditional Chinese herbal medicine is part of a comprehensive and unique approach to healing developed through many centuries in Asia. A double-blind, placebo-controlled study of twenty-nine people suggests that the use of an herbal formula originating in this system may be helpful for CFS. Another double-blind, placebo-controlled study reportedly found dark chocolate helpful for CFS, and another study performed in Hong Kong provides weak evidence that acupuncture might be helpful for chronic fatigue syndrome.
A test-tube study of echinacea and Panax ginseng found that both increased cellular immune function in cells taken from people with CFS. However, many herbs and supplements can cause measurable changes in immune function, and such observations do not prove that there will be an actual benefit in people with the disease.
Both beta-carotene and dehydroepiandrosterone have been suggested as treatments for CFS, but the evidence that they work remains extremely preliminary at best. Based on the theory that CFS might be related to low blood pressure, the herb licorice has been recommended for CFS by some herbalists. Licorice raises blood pressure (and causes other potentially harmful effects) when taken in high doses for a long time. However, there is no evidence that licorice works for CFS, and other treatments to raise blood pressure have proven ineffective for CFS.
Although some authorities have suggested that CFS might be caused by deficiencies of multiple vitamins and minerals, a double-blind, placebo-controlled study of forty-two people found no significant improvement in CFS symptoms when a vitamin-mineral supplement was given four times daily after meals for three months. Another trial failed to find benefits with multivitamin/mineral supplements.
A fairly substantial (ninety-six-participant) double-blind, placebo-controlled study failed to find Eleutherococcus senticosus (Siberian ginseng) helpful for people with CFS. During the two-month study period, both Eleutherococcus and placebo reduced fatigue symptoms, but there was no statistically significant difference. Another study failed to find melatonin helpful for CFS. A special bran extract marketed for enhancing immunity failed to prove more effective than placebo for CFS symptoms (although placebo was quite effective).
People with CFS may, at times, attribute their symptoms to chemical exposures, thereby relating chronic fatigue syndrome to another loosely defined condition known as multiple chemical sensitivities. One study evaluated people with chronic fatigue syndrome who believed that certain chemical triggers affected their mental function, causing mental sluggishness and confusion. The results showed decreased mental function on testing following exposure to supposed chemical triggers; however, the decrease was the same whether the actual chemical or a substitute placebo was used. In other words, it was the belief that a substance causes harm, rather than actual harm caused by the substance, which produced the symptoms.
Homeopathic Remedies
A six-month double-blind study failed to find constitutional, or classical, homeopathy convincingly more effective than a placebo for the treatment of chronic fatigue syndrome. However, homeopathic consultation itself proved to have a dramatically beneficial effect, regardless of whether participants were subsequently given a placebo or the actual prescribed homeopathic treatment.
Many patients with CFS seek to alleviate problems arising from poor-quality sleep and consult with specialists in this area. Others opt to undergo lifestyle changes to seek relief. Several examples include dietary improvements, such as restricting the intake of salt or drinking more fluids. To counter the anxiety brought on by CFS, patients have engaged in yoga or other forms of meditation or relaxation techniques. Acupuncture, massages, and other forms of pain management treatments are also safe options.
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