Chronic fatigue syndrome

Marked by profound and persistent exhaustion, chronic fatigue syndrome (CFS) affects more women than men, most younger than age 50. Patients feel weak and listless much of the time and often have difficulty sleeping, concentrating, and performing daily tasks; many also have underlying depression. Doctors disagree about whether CFS is a specific condition or a group of unrelated symptoms not attributable to a single cause.

The specific cause of CFS is unknown, but an impaired immune response may play a role in its onset. People with CFS have other immune disturbances as well: About 65% are allergy sufferers (versus only 20% in the general population), and some have autoimmune disorders such as lupus, in which the immune system attacks the body's own healthy tissues.

Doctors aren't sure what triggers CFS. Many patients remember a flu like illness before their fatigue began, and CFS symptoms do suggest a lingering viral illness. Suspected infectious agents have included Epstein-Barr (the virus causing mononucleosis) and candida (the cause of yeast infections). Other theories suggest that CFS is caused by low blood pressure, brain inflammation, or abnormal levels of certain hormones. Nothing conclusive has been proved, however.

Supplements and herbs

Supplement therapy aims to restore a healthy immune system, so begin with vitamin C and carotenoids. A powerful immune enhancer, Echinacea can be added to the mix; it can be alternated with the herbs astragalus, which has antiviral and immunity-enhancing effects, pau d'arco, which fights many microbes (especially the yeast infections so common in those with low immunity), or goldenseal. For muscle pain, use magnesium too.

In addition, you can safely include the herbs Siberian ginseng and licorice and the B vitamin pantothenic acid to bolster the adrenal glands, which secrete hormones, such as cortisol, that counteract stress and boost energy. Allow a month for these supplements to take effect.

What else you can do

• Try behavioral counseling and relaxation techniques, such as hypnosis or meditation, to manage stress and treat any underlying depression.
• Get a good night's sleep. If needed, use supplements for insomnia, such as valerian or kava.

How much to take

Vitamin C

2,000 mg 3 times a day.
Reduce dose if diarrhea develops.

Carotenoids

2 pills mixed carotenoids a day with food.
Each pill should supply 25,000 IU vitamin A activity.

Magnesium

400 mg once a day.
Take with food; reduce dose if diarrhea develops.

Echinacea

200 mg twice a day.
Standardized to contain at least 3.5% echinacosides. Limit consecutive use to 3 weeks or rotate with other herbs.

Siberian ginseng

100-300 mg twice a day.
Standardized to contain at least 0.8% eleutherosides.

Licorice

200 mg 3 times a day.
Standardized to contain 22% glycyrrhizin or  glycyrrhizinic acid; can raise blood pressure.

Pantothenic acid

500 mg twice a day.
Take with meals. Provides adrenal gland support.

Astragalus

200 mg standardized extract twice a day.
Rotate in 3-week cycles with Echinacea and pau d'arco.

Pau d'arco

250 mg twice a day.
Standardized to contain 3% naphthoquinones.

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