Chronic Fatigue Syndrome Treatment

Because there is no cure for chronic fatigue syndrome, treatments for the disease are aimed at alleviating discomfort and improving symptoms. Patients, families, and healthcare providers may work together to come up with the most effective treatment plan. This plan is generally determined by identifying which symptoms should be treated first (in most cases, the symptoms that have had the biggest negative impact on the patient’s life). The most effective treatment^[15] for chronic fatigue syndrome has proven to be the combination of physical therapy and cognitive training (counseling). However, a variety of treatments^[16] may be used to address the following signs and symptoms caused by CFS:

• Post-exertional malaise (PEM): PEM refers to the period of worsened symptoms that can follow even minor mental, physical, or emotional exertion in people with CFS. PEM is often addressed with pacing, a type of activity management that aims to help patients with CFS balance activity and rest.

Pacing helps patients find their individual limits for physical and mental activity (sometimes called staying within the “energy envelope”). Working with a rehabilitation specialist, exercise physiologist, or physical therapist with an understanding of CFS can help a patient modify everyday activities to make them less draining (such as sitting while showering and taking frequent breaks). While it’s not always possible to avoid crashes altogether, activity management can help patients with CFS stay within their individual activity limits.

• Pain: CFS often causes deep muscle and joint pain. Some patients also have headaches or skin that’s sore to the touch. Mild-to-moderate pain may first be treated with over-the-counter pain relievers, such as acetaminophen (generic Tylenol), aspirin, or ibuprofen (generic Advil, Motrin).

Physical therapy and pain management techniques can also provide relief. These may include stretching, water therapy, hot/cold therapy, and massage.

• Sleep problems: Many patients with CFS struggle with difficulty falling or staying asleep, extreme tiredness or sleepiness, intense and vivid dreams, nighttime muscle spasms, and restless leg syndrome. If practicing healthy sleep habits doesn’t help improve these symptoms, a healthcare provider may recommend over-the-counter or prescription sleep medications.

If medications aren’t sufficient in helping a patient get a more restful night’s sleep, they may be referred to a sleep specialist for sleep therapy. In some cases, however, not all sleep-related symptoms of CFS can be resolved.

• Orthostatic intolerance: Some people with CFS experience dizziness or weakness after standing or sitting up (called orthostatic intolerance). Healthcare providers will likely monitor the heart rate and blood pressure of patients with orthostatic intolerance.

Patients with this symptom may also be referred to a specialist, such as a cardiologist or a neurologist. If the patient doesn’t have an underlying heart or blood vessel disease, they may be recommended to increase their fluid and salt intake and use compression socks or stockings to help maintain blood flow. Prescription medication may be necessary if these treatments fail to improve orthostatic intolerance.

• Cognitive difficulties: Patients with CFS that have problems with memory may find that memory aids, such as to-do lists and daily planners, help keep track of everyday tasks.

Some people with CFS-related concentration issues have been prescribed stimulant medications, such as typically used to treat attention deficit hyperactivity disorder (ADHD). While these may help improve focus and productivity, they can also contribute to a “push-and-crash” cycle (a patient has a high-energy day, causing them to push themselves to do more than they normally would, resulting in a crash), which can ultimately worsen symptoms.

• Mental health problems: Living with a chronic, incapacitating disease like chronic fatigue syndrome can take a considerable toll on an individual’s overall well-being. Many patients with CFS develop mental health issues, such as depression and anxiety, over the course of their illness.

While it is not a cure for CFS, treating mental health issues can help a patient more effectively manage their illness on a daily basis. Conditions like depression and anxiety may be treated with therapy, medication (such as antidepressants or anti-anxiety medications), or a combination of the two.

Chronic fatigue syndrome medication

There is no one medication used to treat chronic fatigue syndrome. Because the disease’s symptoms can vary so substantially, patients with CFS may have to work with their healthcare providers to decide which symptoms to address with medication. Some patients may find temporary relief of muscle and joint pain by taking pain relievers. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (generic Advil, Motrin) and naproxen sodium (generic Aleve), can help with mild-to-moderate pain, while prescription medications may be required when pain is severe. Sleep problems, which are commonly seen in patients with CFS, may also be treated with medication. While it is generally recommended that a patient begins with over-the-counter treatments (such as melatonin), prescription sleep aids, including zolpidem (generic Ambien) and eszopiclone (generic Lunesta), may be used when insomnia becomes a problem. Your provider may prescribe the following medications for the symptoms of or conditions associated with chronic fatigue syndrome:

Chronic fatigue syndrome diet

According to the American ME and CFS Society, roughly two-thirds o f patients with CFS^[17] experience gastrointestinal (GI) symptoms, such as nausea, heartburn, gas, cramps, diarrhea, and constipation. These symptoms can often be attributed to food sensitivities, but may also result from malabsorption or disruptions in cell metabolism caused by CFS. Food sensitivity can result in varied symptoms and responses, including restlessness, anxiety and panic attacks, insomnia, rashes, migraine, and joint pain. Because the normal spectrum of symptoms experienced by patients with CFS is so broad, the problems caused by food sensitivity may not be immediately apparent as resulting from a separate (but related) issue. There is no single “best” diet for patients with CFS: individuals respond differently to certain foods just as they do different medications. However, many healthcare professionals advise that the following foods may cause adverse symptoms in people with CFS:

• Stimulants: Foods and drinks that contain stimulants, such as coffee and tea, cause the adrenal glands to work harder, potentially worsening the fatigue seen in CFS. Caffeine can also contribute to insomnia, one of the most difficult symptoms of CFS.
• Alcohol: Almost all patients with CFS exhibit alcohol intolerance. This is due to the multitude of effects alcohol has on the body, including the fact that alcohol affects the central nervous system (which is hyperactive in people with CFS) and acts as a vasodilator (dilates the blood vessels), which, in turn, worsens vascular symptoms.
• Sugars and sweeteners: It’s common for people with CFS to crave sugar and sweets—particularly in the late afternoon when blood sugar (glucose) levels fall. Research has proposed that this can be attributed to problems with the metabolism of carbohydrates and resulting low levels of blood glucose and adenosine triphosphate (ATP, an organic compound that provides the body with the energy needed to complete many different processes).

These cravings may drive people with CFS to consume foods that contain sugars and sweeteners, such as corn syrup, glucose, fructose, and aspartame. After eating these simple carbohydrates, the body increases its production of serotonin. This neurotransmitter inhibits the release of cortisol, consequently increasing inflammation in the body.

• Animal fats: Both the liver and the gallbladder play vital roles in the breakdown of fats. These organs’ functioning can be impaired in patients with CFS—particularly those with low blood volume. Compounded with the fact that CFS patients have been shown to be deficient in acylcarnitine (a transport molecule that allows the body to use fats at the cellular level), it may be difficult for people with CFS to break down and effectively use fats.
• Additives: It’s common for patients with CFS to have sensitivities to petrochemicals and their byproducts (from which many food additives are derived). These additives, which include artificial colors and flavorings, preservatives, and monosodium glutamate, can contribute to flare-ups in CFS symptoms. They may also cause allergic reactions, including itching, pain, inflammation, insomnia, hyperactivity, depression, and headache.

If you have chronic fatigue syndrome, it will likely take trial and error—as well as consultation with your healthcare provider or a specialist, such as a dietician—to identify which foods are “safe” and which exacerbate your symptoms.