Chronic Fatigue Syndrome

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Latest Edit: Iva Lloyd, ND 2016-11-11 (EDT)

Chronic Fatigue Syndrome (CFS) occurs approximately four times more often in women than in men, and it occurs in all ethnic and racial groups.[1] CFS is also known as chronic mononucleosis-like-syndrome, chronic Epstein-Barr virus syndrome, post viral fatigue syndrome, and chronic fatigue and immune dysfunction syndrome.

Chronic Fatigue Syndrome

Causes Dietary Factors, Alcohol, Stress, Infections, Environmental Toxins
See Also Other Conditions, Fibromyalgia, Depression
Books Books on Other Conditions
Articles Articles on Other Conditions

Naturopathic Assessment

Check out this book Chronic Fatigue Syndrome: Your Natural Guide to Healing with Diet, Vitamins, Minerals, Herbs, Exercise, and Other Natural Methods
Check out this book The Vitamin Cure for Chronic Fatigue Syndrome
Check out this book Energy For Life: How to Overcome Chronic Fatigue
Article ME - What's that?: Understanding myalgic encephalomyelitis aka chronic fatigue syndrome, IHP, April/May 2009
Article Myalgic encephalomyelitis (chronic fatigue syndrome) is a microcirculatory disorder, IHP, April/May 2009

Causal Factors

Stress is the main factor that contributes to the development of CFS. In the broadest sense of the word, stress means anything that requires the body to expend excess energy to maintain homeostasis. In order to stimulate the innate ability of the body to heal, the causes of stress, or stressors, must be identified and addressed. For treatment purposes, a detailed assessment is required to determine which stressors are effecting the individual with CFS.


  • Refined sugar consumption contributes to sharp rises and falls in blood sugar. When blood sugar rises sharply, it causes an increase in blood lactate leading to muscle pain. Steep drops in blood sugar, which tend to follow steep rises, contribute to or cause feelings of anxiety and panic.[1]
  • It is common for people with CFS to have allergies or sensitivities to foods such as eggs, dairy, wheat (or gluten), corn, and food additives such as benzoates, nitrites, and nitrates.
  • Deficiency of nutrients, protein, minerals and vitamins increases the risk of chronic fatigue.
  • Allergies cause some of the same symptoms as CFS, and are present in up to 80% of people with this condition. Approximately 80% of people with CFS have allergies or sensitivities to foods or food derived compounds. [1]
  • Alcohol consumption is associated with increased risk of CFS.[2]
  • Alcohol also inhibits the production of blood sugar which leads to an increased level of lactic acid in the blood, which is a source of muscle pain and fatigue.[1]


  • High stress levels contribute directly to decreased immune and adrenal gland function and to the onset of CFS. People who develop CFS tend to be those who habitually overwork or overburden their minds and bodies, and who do not take appropriate time to rest and relax.[3] As a result of this, they become more vulnerable to the stressors that they are exposed to.
  • Stress can be induced by: physical, emotional, chemical, and electromagnetic factors. When the body is under stress it must adapt to maintain homeostasis. The more stress one is under the more adaptations the body needs to make. The process of adapting to a stressor requires energy and the longer the stressor is present the greater is the resultant decline in the energy potential and reserves of the person experiencing the stress. Eventually, when the body is no longer capable of dealing with this, its coping potential is exhausted. In essence, CFS is a state of exhaustion that results from the body having to cope with persistent stressors.[3]
  • Physical stressors include: inactivity, toxins, inadequate light, allergens, temperature extremes, and trauma (such as motor vehicle accidents).
  • Emotional stressors include: fear, anger, guilt, anxiety, depression, pain, and inadequate sleep.
  • Chemical stressors include: sugar, infection, nutritional imbalance, nicotine, caffeine, and alcohol.
  • Electromagnetic stressors include: automobiles, refrigerators, televisions, computers, printers, airplanes, fluorescent lights, and cell phones and the microwave transmitters that provide signals for cell phones.


  • The development of CFS is common after an infection or illness from which they neglected to allow their body the care and rest that it needed to heal.
  • The immune dysfunction that is characteristic of CFS also predisposes people with this illness to prolonged underlying infections such as those caused by viruses, bacteria, fungi, or parasites. Such infections tax the immune system, and can contribute to malabsorption of nutrients, and to nutrient deficiencies.[4]
  • Viruses that commonly affect people with CFS include Epstein-Barr virus, herpes simplex virus, human herpes virus-6, rubella, and enteroviruses such as coxsackie virus.
  • Parasitic infections associated with CFS include Giardia and Cyclospora.
  • Candida albicans is a common opportunistic fungal infection to affect people with CFS.
  • Bacterial infections that commonly affect people with CFS include: Lyme disease, teeth abscesses, chronic prostatitis, sinusitis, and gastritis.
  • Nutrient deficiencies further decrease the immune systems ability to fight infections.[1]

Medical Interventions

  • Prescription Medications[4]
  • Antibiotic increases the risk of CFS.
  • The side effects of many drugs can resemble CFS.

Diagnostic Testing

There are no laboratory or diagnostic tests that can confirm or rule out CFS. Instead, the diagnosis of CFS is based on whether or not the patient meets the following diagnostic criteria:

  • Chronic fatigue for greater than six months that is of new onset (not life long), that results in a substantial decrease in prior levels of activity, that is not due to any singular identifiable pathological cause, and that is not due to ongoing exertion, and that is not considerably relieved by rest.
  • Four or more of the following symptoms are present for six months or more:[1]
  • impaired memory or concentration
  • post exertional malaise
  • unrefreshing sleep
  • muscular pain
  • multiple joint pain without swelling or tenderness
  • headache
  • sore throat that is frequent or recurring
  • tender lymph nodes.

Other symptoms associated with CFS include:[1], [2]

  • Problems with concentration and short term memory
  • General weakness or malaise
  • Abnormal skin, hair, or nail changes
  • Anxiety
  • Depression.
  • Intestinal discomfort
  • Low grade fever

Related Symptoms and Conditions

Chronic Fatigue Syndrome and Fibromyalgia are very similar conditions, which share many symptoms as well as causal factors. The key difference between the two is that the most dominant symptom of CFS is unrelenting fatigue, and the most dominant symptom of Fibromyalgia is muscle pain. However, both of these symptoms are often experienced to some degree by people suffering from either disease, and most of the other symptoms of CFS are also present in Fibromyalgia and vice versa.[1]

Conditions associated with CFS include:

Naturopathic Treatment

The goal of naturopathic treatment is to support and work in tandem with the healing power of the body and to address the causal factors of disease with individual treatment strategies. CFS is typically a chronic disease, however, much can be done in the way of treatment. The process of reducing stress should be an evolution, not an all out revolution,[3] in other words, lifestyle changes should be implemented gradually so that the changes themselves don't cause additional stress.

It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.



  • Identify and control food allergies and food sensitivities is a critical step.
  • Consume sufficient amounts of protein in the diet.
  • Consume high quantities of fresh, organic fruits and vegetables. These contain phytonutrients which strengthen the immune system and protect against free radical damage.[3] They also contain functioning enzymes that aid digestion. Enzymes are destroyed by cooking with high heat, microwaving, and pasteurization.[4]
  • Eliminate consumption of refined sugars, caffeine and alcohol.
  • Restoring proper digestive function is key to recovery.
  • Ensure you drink adequate water.
  • Diets which have been helpful include:
  • Emotional Stress
  • Focusing on positive emotional states like love, optimism, and joy; and trying to laugh as much as possible, are also ways of reducing mental/emotional stress. So is establishing a routine of asking ones self positive questions such as: what am I most excited about, what did I do well today, and what am I grateful for? Meditation and prayer can also help to calm the mind and reduce stress. It is important to do such things regularly, in the same way that it is important to exercise regularly.[2]
  • Meditation can be an effective way of relieving stress.
  • An appropriate regular exercise routine has been shown to improve the symptoms of CFS in the long term. Activities that are found to be enjoyable are ideal. Regular exercise has been shown to improve the body's ability to deal with stress, and to decrease symptoms of depression, anxiety, and malaise.[5]
  • Deep breathing is beneficial as it decreases physical and mental stress.[1]
Establishing regular sleep times can make sleep more restful, and falling asleep easier.
  • Periods of intense activity should be balanced by periods of rest and relaxation.
  • Wash hands before preparing food, or eating finger food. People with CFS tend to be more susceptible to bacterial and viral infections, and so should take precautions to avoid them.

Naturopathic Therapies

The prescribing of naturopathic therapies requires the guidance of a naturopathic doctor as it depends on a number of factors including the causal factors, a person's age, prescription medications, other conditions and symptoms and overall health. It is always advisable to work with a naturopathic doctor prior to taking any natural therapies.

Many of the pathological processes that are involved in CFS can both contribute to it and be worsened by it. For this reason CFS is often self perpetuating. The goal for naturopathic treatment is to intervene therapeutically in some or all of these processes in ways that help to reverse them.

Naturopathic Therapies for CFS include:

  • A detoxification program is typically helpful for CFS patients. This is especially important for those who have been exposed to environmental toxins.[1], or who are affected by mercury toxicity (mercury exposure may be minimized if amalgam fillings are removed before detoxification protocols begin).
  • Homeopathy Constitutional homeopathic treatment can aid significantly in resolving CFS.
  • Acupuncture appears to be beneficial in the treatment of CFS.
  • Physical Medicine
  • Body work such as Rolfing or Heller work can help to resolve emotional conflicts, can improve breathing and posture, and can lead to higher energy levels by releasing tension.


Co-Authored by:

Dr. Iva Lloyd, BScH, RPE, ND[1]
Dr. Raymond Trott, ND
  1. 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 Prousky J (2010) The Vitamin Cure for Chronic Fatigue Syndrome Basic Health Publications
  2. 2.0 2.1 2.2 Murray M (1994) Chronic Fatigue Syndrome: Your Natural Guide to Healing with Diet, Vitamins, Minerals, Herbs, Exercise, and Other Natural Methods Prima Health.
  3. 3.0 3.1 3.2 3.3 Redmon George (2000) Energy For Life: How to Overcome Chronic Fatigue Vital Health Publishing.
  4. 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 Goldberg Burton (1998) Chronic Fatigue, Fybromyalgia, and Environmental Illness. Future Medicine Publishing.
  5. 5.0 5.1 5.2 Murray Michael (1996) Encyclopedia of Nutritional Supplements, The Essential Guide for Improving Your Health Naturally Prima Publishing.
  6. Godfrey Anthony, Saunders Paul Richard, Barlow Kerry, Gilbert Cyndi, Gowan Matthew, Smith Fraser (2010) Principles and Practices of Naturopathic Botanical Medicine, Vol 1: Botanical Medicine Monographs, CCNM Press, Toronto.
  7. Boon Heather, Smith Michael (2004) The Complete Natural Medicine Guide to the 50 Most Common Medicinal Herbs, Robert Rose, Toronto
  8. Hershoff Asa 2000 Homeopathic Remedies, A Quick and Easy Guide to Common Disorders and their Homeopathic Treatments, Avery Publishing Group, New York
  9. Ullman Robert, Reichenberg-Ullman Judyth 1997, Homeopathic Self-Care, the quick and easy guide for the whole family. Prima Publishing