Natural Treatment Options for Chronic Fatigue Syndrome

Tired woman suffering from chronic fatigue

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Chronic fatigue syndrome is a complex illness affecting the brain and multiple body systems. It is defined by incapacitating fatigue that is not relieved by rest, and at least four of the following symptoms for at least six months:

  • The impaired short-term memory of concentration which significantly affects normal activities
  • Sore throat
  • Tender lymph nodes in the neck or underarms
  • Muscle pain
  • Pain in multiple joints with no joint swelling or redness
  • Headaches of a new type or severity
  • Unrefreshing sleep
  • General malaise following physical exertion that lasts more than 24 hours

Other common symptoms include: bloating, nausea, diarrhea, night sweats or chills, brain fogginess, dizziness, shortness of breath, chronic cough, visual disturbances, allergies or sensitivities to foods, alcohol, chemicals, irregular heartbeat or palpitations, jaw pain, or eyes or mouth.

Chronic fatigue syndrome is more common in women than in men. The majority of people affected are in their 30s.


The cause of chronic fatigue syndrome is unknown and there are no specific lab tests to diagnose this condition. Multiple triggers may be involved, such as viral infection, stress, nutrient deficiency, toxins, and hormone imbalances.

  • Viral Infection: Chronic infection with viruses, such as Epstein-Barr virus, human herpesvirus 6, and cytomegalovirus, may contribute to the development of chronic fatigue syndrome in some people.
  • Immune Dysfunction: Another factor thought to be involved in chronic fatigue syndrome is immunologic dysfunction, such as the inappropriate production of inflammatory cytokines. This results in excessive amounts of nitric oxide and peroxynitrite and produces fatigue.
  • Hormone Imbalances: Some studies have found that people with chronic fatigue syndrome have lower levels of the hormone cortisol, which is secreted by the adrenal glands. Lowered levels of cortisol may promote inflammation and activate immune cells. Thyroid disorders have also been implicated in chronic fatigue syndrome.

Alternative Treatment Options

Although alternative medicine use is quite popular among people with chronic fatigue syndrome, keep in mind that so far, scientific support for the claim that any form of alternative medicine can treat chronic fatigue syndrome is lacking.


Ginseng is an herb that has been used in Asia for centuries to increase energy and combat fatigue. A survey of 155 people by researchers at the University of Iowa with persistent fatigue found that ginseng was considered one of the most helpful treatments, with 56 percent of people who used ginseng rating it as effective.

Another study found that Panax ginseng significantly enhanced cellular immune function by peripheral mononuclear cells (blood cells that are a critical component in the immune system to fight infection) in people with chronic fatigue syndrome or acquired immunodeficiency syndrome (AIDS).

A double-blind study published in the journal Immunopharmacology reported that Siberian ginseng was no better than a placebo in relieving fatigue in 96 adults with chronic fatigue syndrome.

Nicotinamide Adenine Dinucleotide

Nicotinamide adenine dinucleotide (NADH) is a naturally occurring molecule formed from vitamin B3 (niacin) that plays an essential role in cellular energy production.

A double-blind, placebo-controlled trial evaluated the effectiveness of NADH in 26 people diagnosed with chronic fatigue syndrome. Participants received either 1 mg of NADH or a placebo for 4 weeks. At the end of the study, 8 out of 26 (31%) responded favorably to NADH in contrast to 2 out of 26 (8%) who responded to the placebo. No severe adverse effects were reported.

Although promising, larger studies are needed to prove the effectiveness of this supplement.


Carnitine, found in nearly all body cells, is responsible for transporting long-chain fatty acids into mitochondria, the energy-producing centers of cells. It allows these fatty acids to be converted into energy.

Some studies have found that carnitine levels in the body are decreased in people with chronic fatigue syndrome and it has been linked to muscle fatigue and pain and impaired exercise tolerance. However, other studies haven't found an association between carnitine deficiency and symptoms of chronic fatigue syndrome.

A study examined the use of L-carnitine in 30 people with chronic fatigue syndrome. After 8 weeks of treatment, there was a statistically significant clinical improvement in 12 of the 18 parameters, with the greatest improvement occurring after 4 weeks of treatment.

One person was unable to complete the 8 weeks of treatment due to diarrhea. There was no placebo group in this study and it wasn't blinded, so more clinical trials are needed.

Supplemental L-carnitine is generally well tolerated, however, high doses of L-carnitine may cause digestive upset and diarrhea. Occasionally, increased appetite, body odor, and rash may occur.

On rare occasions, L-carnitine has been known to cause seizures in people previously undiagnosed for epilepsy or seizure disorders.

Coenzyme Q10

Coenzyme Q10 (CoQ10) is a compound found naturally in the mitochondria, the energy-producing center of our cells. CoQ10 is involved in the production of ATP, the main energy source of body cells. CoQ10 is also an antioxidant.

A survey of 155 people with persistent fatigue found that the percentage of users who found a treatment helpful was greatest for CoQ10 (69% of 13 people).

Dehydroepiandrosterone (DHEA)

Studies have shown that DHEA levels are abnormal in people with chronic fatigue syndrome. DHEA is a hormone secreted by the adrenal glands and in smaller amounts by the ovaries and testes. DHEA can be converted in the body to other steroid hormones, such as estrogen and testosterone. It is also involved in memory, mood, and sleep. Levels of DHEA in the body peak when a person is in his or her mid-20's and then slowly declines with age.

Little is known about the long-term safety of DHEA. Adverse effects of DHEA include high blood pressure, lowered HDL ("good") cholesterol, and liver toxicity. DHEA can increase testosterone in women and result in male pattern baldness, weight gain, acne, deepening of the voice, and other signs of masculinization.

Because DHEA is converted in the body to estrogen and testosterone, people with hormone-sensitive cancers (such as breast, ovarian, prostate, or testicular cancer) should avoid DHEA.

DHEA can interact with certain medications. For example, it has been found to increase the effect of the HIV medication AZT (zidovudine), barbiturates, the cancer medication cisplatin, steroids, and estrogen replacement therapy.

DHEA is not recommended unless lab tests indicate there is a deficiency. Treatment should be closely supervised by a qualified health practitioner.

Essential Fatty Acids

Essential fatty acids have been used in the treatment of chronic fatigue syndrome. One theory about how they work is that viruses reduce the ability of cells to make 6-desaturated essential fatty acids and supplementing with essential fatty acids corrects this disorder.

In a double-blind, placebo-controlled study of 63 people, participants were given either a combination of essential fatty acids from evening primrose oil and fish oil (eight 500 mg capsules a day) or a placebo. After 1 and 3 months, people taking essential fatty acids had significant improvement in chronic fatigue syndrome symptoms compared to those taking the placebo pills.

More studies are needed, however, because a later 3-month study of 50 people with chronic fatigue syndrome found that a combination of evening primrose oil and fish oil did not result in a significant improvement in symptoms.

Traditional Chinese Medicine

Chronic fatigue syndrome is believed to be related to the following syndromes in traditional Chinese medicine:

  • Spleen qi deficiency
  • Kidney yin deficiency
  • Essence deficiency
  • Kidney yang deficiency


A typical approach in Ayurveda, the traditional medicine of India, maybe to improve digestion and eliminate toxins with a detox program.

Ayurvedic herbs may also be used, such as ashwagandha, amla, bala, triphala, and lomatium, which are combined according to the patient's dosha, or constitutional type. The vata dosha is thought to be susceptible to chronic fatigue syndrome.

Other Natural Treatments

These are a few other natural treatments for chronic fatigue syndrome to consider:

  • Digestive enzymes
  • Probiotics
  • Vitamin C
  • Magnesium
  • Beta-carotene
  • Licorice
  • Melatonin
  • Glutamine
  • Whey Protein
  • Folic Acid
  • Tyrosine


Supplements haven't been tested for safety and due to the fact that dietary supplements are largely unregulated, the content of some products may differ from what is specified on the product label.

Also keep in mind that the safety of supplements in pregnant women, nursing mothers, children, and those with medical conditions or who are taking medications has not been established.

Research the safe use of supplements, and if you're considering the use of any remedy for chronic fatigue syndrome, talk with your primary care provider first. Self-treating a condition with alternative medicine and avoiding or delaying standard care may have serious consequences.

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