How to Wake Up from Chronic Fatigue Syndrome

By Michael A. Smith, MD

Chronic fatigue syndrome (CFS) is a mysterious medical condition that affects approximately 500,000 Americans.1 It typically targets women between the ages of 25 and 45, but it can actually affect anyone at any age. Unfortunately, the disease has no known cause, and there aren’t any tests that can measure for it.

CFS is defined as a set of symptoms that include prolonged, overwhelming fatigue that begins when you wake up and lasts the entire day. This fatigue is often amplified when exercising, as your muscles become tired very quickly.

Many people afflicted with CFS have complaints that extend well-beyond fatigue. Mood swings, muscle spasms, pain, headaches, sleep disturbances, and loss of appetite are all common complaints that come along for the ride. And some experts now believe it may run in families.2

Many researchers believe that CFS is triggered by a number of factors including infectious agents, mental or physical stress, nutrient deficiencies, immune system abnormalities and maybe even allergies.2,3

How is Chronic Fatigue Syndrome Diagnosed?

A diagnosis of CFS can be made only when a patient has suffered from persistent, unexplained fatigue for at least six months. In addition to the fatigue, four of the following symptoms must also be present for a diagnosis:1

  • Disrupted, non-restful sleep
  • Lack of short-term memory or concentration
  • Sore throat and cough
  • Tender lymph nodes
  • Aching or stiff muscles
  • Multi-joint pain without swelling or redness
  • Headaches of a new type, pattern, or severity
  • Post-exertion fatigue lasting more than 24 hours
  • Persistent feeling of illness for at least 24 hours after exercise
Remember: No one knows for sure what causes CFS or how to diagnose it. So we won’t get bogged down in all of that in this post. Instead, we’ll focus on helping people who are suffering from it to feel better.

Below are our top nutritional suggestions for anyone dealing with CFS. They’ve helped a lot of our members, and they may help you too.

Fighting Fatigue with CoQ10

The first place to start is with coenzyme Q10 (CoQ10). This is a potent antioxidant that aids in metabolic reactions, including your cellular energy formation.

One particular study measured CoQ10 levels in people afflicted with CFS. The authors compared CoQ10 plasma levels in 58 people who had CFS and 22 healthy individuals. What they found was that CoQ10 plasma levels were significantly lower in the CFS group.4

The researchers also reported that there were significant and inverse relationships between CoQ10 and the total score on the test used to measure fatigue. Patients with very low CoQ10 suffered significantly more from concentration and memory disturbances.4

The average CoQ10 dose for healthy individuals is between 100 and 200 mg/day. So, if you suffer from CFS, you might want to target your dose at the upper end of this average range.

DHEA is a Powerful Fatigue Buster

DHEA is a hormone. It plays a role in boosting immune function, maintaining healthy metabolism, and promoting testosterone balance. It’s also been singled out for its ability to help CFS patients. As it turns out, people afflicted with CFS typically have low blood levels of DHEA.5,6

In a study of 15 subjects with CFS, 15 subjects with major depression, and 11 healthy subjects, DHEA levels were significantly lower in the CFS subjects compared to the healthy group. As a result, the authors concluded that DHEA has a potential role both therapeutically and as a diagnostic tool in CFS.6

Another study of DHEA levels in 22 CFS patients found normal DHEA levels but a blunted serum DHEA response to adrenocorticotropic hormone (ACTH) injection. This means that people dealing with CFS are unable to produce DHEA when they need it. The authors concluded that this blunted response represents an endocrine abnormality in CFS.7

However, before taking DHEA yourself, we suggest a blood test. From there, our Health Advisors will be happy to suggest an appropriate daily dose for you.

Additional Energy Boosters to Help Manage CFS

A number of nutrients have been studied for their ability to boost cellular energy in people with CFS. Let’s take a look at three important ones.


NADH is essential for optimal cellular energy production. A well-designed, placebo-controlled clinical study examined the use of NADH in 26 CFS patients. They received either 10 mg of NADH or placebo for a four-week period. The results showed that 31% of those who took NADH felt more energy, compared to only 8% for the placebo group.8

2. L-Carnitine

Researchers have found that people who have CFS are often deficient in the energy-boosting amino acid L-carnitine. 9 Studies show that carnitine given as a supplement to CFS patients results in better functional capacity and lessening of disease symptoms.10 Life Extension suggests a daily dose of 1,000–2,000 mg of L-carnitine.

3. Magnesium

Magnesium plays an important role in energy metabolism as well. The body vigilantly protects blood magnesium levels, in part because 350 enzymatic processes depend on magnesium for activation. A placebo-controlled clinical study was conducted on CFS patients who were found to have low magnesium levels.

Thirty-two patients received either a placebo or intramuscular magnesium injections every week for six weeks. Patients treated with magnesium reported improved energy levels, better emotional state, and less pain.11

Traditional Medicine Offers No Hope for Chronic Fatigue

A diagnosis of CFS often leaves people feeling alone and pretty helpless. Since traditional medicine doesn’t have any treatment options to offer, conventional doctors usually prescribe antidepressants as a Band-Aid. We think this should be a last resort though.

A targeted nutritional approach is really a much better place to start. Supplementing with the right nutrients can at least improve your energy levels and offer you a path toward returning to a normal life. So please consider this route when weighing your options.

Have you or a loved one been diagnosed with chronic fatigue syndrome? What has helped? Please share your story in the comments.


  2. Am J Psychiatry. 2003 Feb;160(2):221-36.
  3. J Allergy Clin Immunol. 1998 Aug;102(2):222-30.
  4. Neuro Endocrinol Lett. 2009;30(4):470-6.
  5. Van Rensburg SJ et al 2001
  6. J Affect Disord. 1999 Jul;54(1-2):129-37.
  7. Horm Metab Res. 1999 Jan;31(1):18-21.
  8. Ann Allergy Asthma Immunol. 1999 Feb;82(2):185-91.
  9. Neuropsychobiology. 1995;32(3):132-8.
  10. Neuropsychobiology. 1997;35(1):16-23.
  11. Lancet. 1991 Mar 30;337(8744):757-60.


Anonymous said...

Antidepressants are only helpful if there is depression accompanying the disease, and that goes for any disease.

Patients dealing with the situational depression experienced by many patients with severe diseases may also choose to see a sympathetic therapist who can help the patient cope with the many losses and changes involved in contracting an incurable disease. It's not a cure by any stretch of the imagination, but it can lessen the stress that exacerbates any disease.

For patients with ME/CFS, doctors may also prescribe pain medications, as well as medications to assist with enhancing sleep. If orthostatic problems are present, and if you actually have ME/CFS they almost always are, you can add salt to your diet or doctors may prescribe midodrine.

Patients taking supplements should always let their doctor know what they are taking as supplements can interact with diet or drugs.

Life Extension said...

Anonymous, thanks for your insight and the encouraging words and advice.

Mary said...


Saying that antidepressents only work for depression is like saying that aspirin can help a headache but it won't help a fever or work as a blood thinner to prevent heart attacks. Most medications have multiple uses.

Antidepressents can be a non-addictive alternative to sleeping pills and pain killers. Considering the number of people who are caught into a cycle of addiction I don't think this alternative should be discouraged.

Your ignorant comment plays into the misconception that if a doctor prescribes an antidepressent that he thinks the symptoms are "all in your head". This only makes the patient less likely to seek treatment.

Please get your facts straight before posting misleading comments.

Life Extension said...

Mary, you brought up some very good points as well. However, we don't believe that the comments you're referring to are misleading. They are the opinion of one of our readers. We respect everyone's opinion and encourage our readers to make comments. Thanks for reading our blog posts!

FloridaSusan said...

Words are everything, and I believe that you all are incorrectly using one word. You say that "traditional" medicine has nothing to offer -- I think you really mean "CONVENTIONAL" medicine (as in mainstream Western bio-medicine). I am an herbalist and I practice a form of "traditional" medicine that has been practiced for thousands of years and is still practiced by 80% of the world's people. We "traditional" herbalists have MUCH to offer people suffering from CFS/CFIDS!

Life Extension said...

Hi FloridaSusan. Thanks for your insight and we do apologize if we've caused you any confusion. For us (and most of our readers) the word "traditional" is used interchangeably with the word "conventional" and both refer to allopathic medicine here in the US. But you make a good point and we will use conventional moving forward. Thanks!

Anonymous said...

L-carnitine helps a lot with mood, fatigue, weight loss, but it's way too stimulating (like speed) for me. 120 mg per day is too much. I suspect others will have the same problem. Even if it doesn't speed you up, anything stimulating may interfere with sleep, and make you worse in the long run. I needed to concentrate on calming supplements (even though I was tired). In the long run, I got calm enough to sleep better, then had more energy during the day. CoQ10 is good, though, because it doesn't stimulate... it just provides the raw materials to betteer make energy. Good luck, everyone! Elaine

Life Extension said...

Elaine, thanks for your insight into a very difficult condition for many people. Take care.

Michael Abiff said...

Standard western medicine falls short when treating chronic fatigue syndrome because they are attempting to treat a subtle energy problem with bio medications. I agree with Florida Susan but would add that energy healing, particularly chakra work and chi energy supplementation, offers a great deal for the treatment of chronic fatigue syndrome and all illnesses where the immune system and inflammation are at issue.

Life Extension said...

Michael, it's amazing that our readers know more about CFS than doctors. You guys are awesome!

Anonymous said...

I was diagnosed with CFS about 25 years ago when not much was known about it. What seemed to go hand in hand with CFS was Epstein-Barr Virus as well as hypoglycemia. The treatment I went on was the same for all three. Severe diet changes--no sugar, no refined, processed foods. In addition, I took numerous supplements which included GTF chromium, magnesium. My level of CFS was quite advanced as I was experiencing chronic bronchitis for which I had to go on antibiotics. I took a lot of probiotics. I am now healthy and continue to follow a strict diet. There is hope! As long as I behave myself and follow a strict regimen, I feel great! There is hope!! It is a long process, but the rewards are worth it all.

Hip Replacement Recovery said...

I am very well informed of Chronic fatigue from this blog. Glad to stop by and waiting for such more informative blogs.

Anonymous said...

CFS is very strange health issue. Indeed some patients found that Lauric acid with the combo of Beta glucans and Aloe was very helpful to overcome the symptoms of the CFS.Indeed a very well design immunomodulation diet proved to be beneficial in order to modulate our immune system

Anonymous said...

Eliminating of food allergies was the first step, I had several, especially milk, corn, wheat, peanuts, etc. Digestive enzymes and probiotics. Fish oils, chelated minerals for Kreb's cycle, heavy metal detox, and glandular support especially for adrenal. I used several types of herbs and supplements for sleep, such as Ashwaganda, l-Theonine, tryptophan. Don't expect overnight results, stick with it, get help from a good Natural medicine doc, if you can afford it, if not, read up get as much info as you can, give your supps a good trial before you give up.

sparticus said...

As one who has dealt with CFS for 8 years now, I am so tired of all the pills. For me, some have a great effect, but only for a short time before sliding back down crap mountain. I think the cutting edge of research may now be on to some kind of bacterial pathogens as the cause and there have been major strides in other countries. I go back online every year or so to see if we can somehow get past the pill cocktails and on to curing the cause. As for anti-depressants, we are not depressed - we so angry that our quality of life has been taken from us. It is a real reaction to a real travesty. I'm sorry, but there is no pill for that. I have noted that people on antidepressants become very defensive when you question their use. I think it is another band-aid.

LifeExtension said...

sparticus - We hear you! You can always check our CFS protocol for any cutting edge information on this disease. We update our protocols every so often. Here's a link to the page:

jbcliff said...

I have struggled with CFS for 30 years now. I was doing great, but hit a major set back. I've now been sick for one month. I'm just getting started on the CoQ10 today, so wish me luck.

I am hoping this page is still active because I thought it was very helpful.

Life Extension said...

jbcliff - Good luck with the CoQ10 and keep us posted. We're still here. :-)

Anonymous said...

I've had CFS for 30 years. I suffered greatly in the beginning as no one knew what I had or how to fix it. I have found through the years that a multivitamin is crucial for energy, that a low dose anti depressant (I take 50 mg of doxepin) helps me fall into a deep sleep at night AND reduces a lot of the aches and pains, that daily vitamin C helps with the constant barrage of germs resulting in continuous year round colds. I tried ribose which really improved energy but made my legs swell so I had to discontinue. My daughter also has CFS and says CoQ10 is almost as good as ribose for energy. I have hair loss but no solutions for that. I've worked part time during part of my illness but full time would still be too much. None the less, I can function a lot better than I did in the beginning even tho my life isn't as good as I would have been had I never been ill.

Life Extension said...

Anonymous - Thanks for the feedback. We're sure some of the tips provided can help other sufferers of CFS. Have you looked into your thyroid function? Perhaps this may be a culprit of your hair loss and energy loss.

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