Table of ContentsView AllTable of ContentsHome Remedies and LifestyleOver-the-Counter TherapiesPrescriptionsComplementary Medicine (CAM)Frequently Asked QuestionsNext in Chronic Fatigue Syndrome GuideWhat Is Chronic Fatigue Syndrome?
Table of ContentsView All
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Table of Contents
Home Remedies and Lifestyle
Over-the-Counter Therapies
Prescriptions
Complementary Medicine (CAM)
Frequently Asked Questions
Next in Chronic Fatigue Syndrome Guide
There is no standard treatment forchronic fatigue syndrome, clinically known as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). However, there are many options for managingsymptomsand improving quality of life, including lifestyle changes, stress management, therapy, and medications. With the help of your healthcare provider and other caregivers, these can be tailored to your specific symptoms.
Verywell / Brianna Gilmartin
Making lifestyle changes may greatly impact how you feel, and the specific changes you need can depend on the severity of your illness and whether certain activities exacerbate your symptoms.
While some people may see the tremendous benefit just from making changes to the way they eat, for example, others may find that more sweeping changes—such as a job change—may be necessary.
Pacing Activities
Pushing yourself on your good days can result in crashing for the next few days, which is known as the “push-crash cycle.“Learning topace your activitiesmay help you avoid this.
First, get to know your body and keep a journal orsymptom logso you know how much physical or mental activity you can handle, which kinds have the most impact, and any early warning signs that you are nearing your limit.
Tips that can help:
ME/CFS and ExerciseExercise can be beneficial for people living with ME/CFS, but activities like vigorous aerobic exercise are usually not well-tolerated. Even standard exercise recommendations may be harmful. Work with a healthcare provider or physical therapist trained in ME/CFS to help design the appropriate exercise program for you as an individual.
ME/CFS and Exercise
Exercise can be beneficial for people living with ME/CFS, but activities like vigorous aerobic exercise are usually not well-tolerated. Even standard exercise recommendations may be harmful. Work with a healthcare provider or physical therapist trained in ME/CFS to help design the appropriate exercise program for you as an individual.
Improving Sleep Habits
Breathing and Mindfulness
It may sound simple, but breathing deeply may help relieve the depression and anxiety that can come with this illness. A lot of people take short, shallow breaths, which can trigger a “fight-or-flight” response in your autonomic nervous system (ANS). When you consciously slow your breathing, it can have the opposite effect, allowing your body and mind to relax.
Mindfulness is the practice of observing your thoughts, feelings, and physical sensations in a non-judgmental way.
Diet
Often, simplyeating healthiercan make a significant difference.If you need help, you may want to talk to your healthcare provider and get a referral for a dietitian.
There’s no solid evidence that any one diet is helpful for everyone with ME/CFS, and health authorities sayelimination dietsshould be avoided. That said, some people with the condition find that they feel better when they emphasize certain foods.
Heating and Cooling
Heat is a great option for relaxing tight muscles, especially for people who are frequently cold and may have a hard time warming up. You can use a heating pad, hot water bottle, rice bag, or heated socks or slippers.
Finding Support
You can find a list ofME/CFS support groupsfrom the non-profit American Myalgic Encephalomyelitis and Chronic Fatigue Syndrome Society. You can also findlocal and national patient resourcesfrom the California-based non-profit Solve ME.
These products can help you manage some of your symptoms, but be sure to tell your healthcare provider if you are reaching for them often.
Sleep Aids
If you have improved your sleep habits and environment but still have difficulty with sleep, over-the-counter sleep aids may be helpful. Your healthcare provider may recommend short-term use products such as Nytol (diphenhydramine), Unisom (doxylamine), or melatonin.
Topical Pain Relievers
Many pain-relief rubs and patches that are on the market may help relieve some of your aches and pains. Some of the common ones are Capzasin (capsaicin),Tiger Balm(camphor and menthol), Aspercreme (trolamine salicylate), BiOFREEZE (menthol USP), and Salonpas patches (camphor, menthol, and methyl salicylate).
Because they only work where you put them, rubs and patches are best used for localized pain. Always use them as directed. If you have sensitive skin, it’s best to start with small doses to check for reactions.
NSAIDS
These drugs are sometimes used to relieve the pain and fever associated with ME/CFS.Several are available over-the-counter, including:
While healthcare providers prescribe medications for chronic fatigue syndrome, none of them is FDA-approved for treating the condition. Usually, these drugs are intended to manage symptoms.
In addition to the below, some healthcare providers also prescribe ADD/ADHD medications for treating ME/CFS.
Antimicrobials
“Antimicrobial” refers to a variety of drug types, including antivirals, antibiotics, antifungals, and antiprotozoals. Some researchers theorize that chronic fatigue syndrome makes your body constantly act as if it’s fighting an infection.While no specific virus or bacteria has been linked conclusively to ME/CFS, some possibilities that have been considered includeEpstein-Barr virus(which causes mononucleosis),human herpesvirus 6(HHV-6, which causes roseola), andenteroviruses.
Healthcare providers usually only prescribe antimicrobials when you have an active infection.
Some drugs are being studied for the treatment of ME/CFS:
Antidepressants
While antidepressants are a common treatment, it doesn’t mean all people taking them are depressed or have a psychiatric condition. Many people with chronic fatigue syndrome are clinically depressed, but that’s generally considered aresultof the symptoms and change in lifestyle and nota causeof the illness itself. The most common types of antidepressants prescribed for treating ME/CFS are SSRI/SNRIs and tricyclic agents.
Selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) raise levels of importantneurotransmittersthat are low in some people with ME/CFS.Serotoninhelps process pain signals and is also important to your sleep-wake cycle, whilenorepinephrine(a type of adrenaline) is involved in the stress response and bursts of energy.
Examples of SSRIs and SNRIs are:
Low doses of tricyclic antidepressants sometimes improve sleep and relieve mild, widespread pain in people with ME/CFS.
Some examples are:
Be sure you’re familiar with the side effects of any antidepressants that you’re taking, especially since many of these drugs come with a warning of a heightened risk of suicidal thoughts and behaviors.
If you would like to stop taking an antidepressant, talk to your healthcare provider first about how to properly wean yourself from it. Going cold turkey can lead to what’s known as antidepressant discontinuation syndrome.
Brain Zaps When Discontinuing Antidepressants
Anti-Anxiety Drugs
Healthcare providers sometimes prescribe anti-anxiety drugs for those ME/CFS patients with co-occurring anxiety disorders.
They include:
Common side effects of anti-anxiety drugs include sedation and cognitive effects. Stopping them abruptly can lead to potentially serious withdrawal symptoms.
Pain that can’t be managed with OTC options or other measures may prompt your healthcare provider to prescribe NSAIDs that are stronger than off-the-shelf medications. It’s important not to combine different drugs in this class.This can put you at risk of developing dangerous side effects, including kidney damage and gastrointestinal bleeding.
Blood Pressure Medications
Although often managed non-pharmacologically, some people diagnosed with this symptom take Florinef (fludrocortisone) to increase blood volume or other medications that can impact blood vessels or stress hormones.
Sleep Medications
If you continue to have sleep problems, your healthcare provider may start you on prescription sleep medication at a low dose or for a short time period. Klonopin (clonazepam), Lunesta (eszopiclone), Rozerem (ramelteon), Sonata (zaleplon), or Ambien (zolpidem) may be considered.
Most complementary/alternative treatment methods aren’t well researched for ME/CFS. Some people report success with them, while others do not.
These treatments include:
Supplements
Your healthcare provider may recommend a nutritional supplement to address a deficiency and its related symptoms, but there is little solid evidence that supplements help alleviate symptoms of ME/CFS.Self-reported results are highly mixed, with different supplements working for different people. Some supplements have gone throughdouble-blind, placebo-controlled clinical trialsand have had mixed results, while others haven’t been scientifically tested at all.
Before you start a supplement regimen, be sure to talk to your healthcare provider to make sure the options you are interested in are safe for you.
Your pharmacist is a great resource for spotting possible negative interactions between supplements and your medications. Keep in mind that just because a product is natural, that doesn’t ensure that it’s safe.
When considering supplements, think about what symptoms impact you most and then look for the ones that help with those specific symptoms. The following lists break commonly used supplements into categories related to common chronic fatigue syndrome concerns. Note that some supplements fall into more than one category. This may help you decide which ones to try.
Some healthcare providers and other healthcare providers, such as homeopaths and chiropractors, have developed experimental protocols for ME/CFS. Two of the better-known include thePall protocolandGlutathione protocol. While some of these treatments are based on established or emerging science, many are not. Be sure to thoroughly research any treatments you’re considering and talk to your medical professional about the possible benefits and risks.
Chronic Fatigue Syndrome Healthcare Provider Discussion GuideGet our printable guide for your next healthcare provider’s appointment to help you ask the right questions.Download PDFEmail AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
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If you suspect you may have chronic fatigue syndrome, see your regular general practitioner or family healthcare provider. They may send you to see a specialist who can evaluate your symptoms to either help diagnose ME/CFS or to rule it out in favor of another condition that’s causing your symptoms. You may be referred to see a sleep specialist, rheumatologist, or neurologist, for example.
Overall, it’s important to eat a diverse diet that’s rich in nutrients and low in saturated fats and empty calories if you have ME/CFS (and even if you don’t). Beyond that, there’s little evidence to support eating certain foods or avoiding others to manage ME/CFS. That said, you may want to make sure your diet includes ample quantities of vitamin A (a good source is lean protein) and vitamin E (found in vegetable oils, eggs meat and poultry). In some research, both vitamins have shown potential for alleviating symptoms.
You can, but it’s important to choose your activities carefully. According to the Centers for Disease Control and Prevention (CDC), “patients with ME/CFS do not tolerate” vigorous aerobic exercise. The CDC emphasizes the importance of working with your healthcare provider to formulate any sort of exercise routine and not to overdo physical activity even on days when you’re feeling especially energetic.
Armodafinil, the generic name for the prescription medication Nuvigil, is approved to treat a number of conditions associated with sleepiness‚narcolepsy, shift work sleep disorder, and sleep apnea. It sometimes is prescribed off-label for chronic fatigue, but there is no research to show that it’s effective.You should discuss with your healthcare provider whether armodafinil might be helpful for you.
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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