Fatigue is one of the most common complaints of Britons today. At least 20 percent of all patients report fatigue as a significant problem in their lives. It is estimated that in Britain alone at any one time there are around 150,000 people who suffer from CFS. Women are the most affected by the disease; as many as 70 percent of CFS cases are female. Millions more may suffer in silence, as this disease is sometimes difficult to diagnose. Although CPS has only recently been defined, the condition is not new. Medical literature from the 1860s describes a similar condition. Other names for CPS include chronic fatigue and immune dysfunction syndrome (CFIDS) and chronic Epstein-Barr virus (CEBV).

Considering the hectic lifestyles of most westerners, it's not surprising that so many of us are tired. However, CPS is more serious than simply a lack of rest. Researchers are only beginning to target possible causes for CFS. Many suspect that it is caused by thyroid, adrenal, liver, or immune system dysfunction. Author and women's health expert Susan Lark, M.D., explained that when a woman identifies fatigue as a key concern, one or more of the following body functions may be weak:
· The immune system.
· The endocrine or glandular system.
· The nervous system.

Another theory is that CPS is caused by a virus similar to the herpes virus. Existing physical conditions, such as anaemia, diabetes, heart disease, lung disease, liver disease, or cancer may make the body vulnerable to CFS. In addition, prescription drugs, such as anti-hypertensives, birth control pills, or sedatives may trigger chronic fatigue.

In an article in the Journal of Orthomoleculor Medicine (Vol. 9, No. 1, 1994), Dr. Emanuel Cheraskin explained, "However viewed, it is safe to conclude that fatigue is one of the, or the most, common signal in the health/sickness spectrum."

"However viewed, it is safe to conclude that fatigue is one of the, or the most common signal in the health/sickness spectrum."

Disabling symptoms
CFS is characterized by debilitating fatigue and loss of stamina. For many individuals suffering from CFS, everyday tasks become physically overwhelming. Household chores, or even a short walk, can be exhausting or impossible for individuals with CFS. These patients often lack the energy to interact with friends and family.

The symptoms of chronic fatigue often mirror those of depression, making CFS difficult to diagnose. Patients with CFS may sleep for long periods; however, extended bed rest does not appear to improve their symptoms. Ironically, some patients with chronic fatigue may also experience insomnia. Other physical symptoms of CFS include:
· muscle or joint pain;
· headache;
· sore throat;
· lymph node pain;
· blurred or double vision;
· fever or night sweats;
· rash;
· diarrhoea or constipation; and
· dizziness.

In addition to disabling physical symptoms, some CFS patients suffer from mental and emotional symptoms, such as:
· Short term memory loss;
· inability to remember specific names and places;
· difficulty in performing complex mental work; and
· depression.

Exercise and diet can help
Although the idea of exercising may seem overwhelming to someone suffering from chronic fatigue, most experts agree that moderate exercise can help boost the immune system and improve CFS symptoms. However, patients should not over-exert themselves. Individuals with CFS should avoid strenuous exercise and rest as soon as they begin to feel fatigued.

Diet can also play an important role in CFS treatment. Patients often discover that by modifying their diet, they can greatly improve their CFS symptoms. By choosing nutrient rich foods that are easily digested, CFS patients can begin to take control. Good dietary choices include:
· Vegetables;
· Fruits;
· Starches;
· Legumes;
· Whole grains;
· Seeds and nuts

CFS patients may also find that certain foods intensify their symptoms. Foods that require more energy to digest may increase fatigue in CFS patients. Some foods that CFS patients may want to avoid include:
· Dairy products;
· Red meats and pork;
· Alcohol;
· Sugar; and
· Caffeine, including soda, coffee, and chocolate.

Stress reduction
Most experts agree that stress is a factor in CFS. Stress reduction can play an important role in CFS recovery. According to the Chronic Fatigue Self Help Book by Susan Lark, M.D., key ways to reduce stress include:
· Meditation induces relaxation; try thinking affirmative thoughts.
· Visualization can be combined with calming music to reduce stress. Focus on positive imagery.
· Yoga can improve circulation and may increase energy.
· Massage can also improve circulation and reduce stress.

Herbal symptom relief
The most debilitating symptom of CFS is a complete lack of energy. Some herbs used for energy enhancement include:

· Siberian ginseng (Eleuthemcoccus senticosus) and Licorice root (Glycyrrhiza glabra) to support adrenal function and help the body cope with stress;
· Ginkgo (Ginkgo biloba) to enhance blood flow to the brain;
· Dandelion root (Taraxacum officinale) to support liver function and detoxification.

Many CFS patients also suffer from depression. The following herbs are known to enhance mood and a sense of well being:
· Chamomile
· Valerian root (Varleriana officinalis);
· Passionflower (Passiflora incarnata); and
· St. John's wort (Hypericum perforatum).

In a study at the University of California Department of Medicine (Immunopharmacology 35[3]:229235, January 1997), echinacea (Echinacea purpurea) and ginseng (Panax ginseng) extracts enhanced cellular immune function in both healthy individuals and patients with depressed immune systems. Other herbs that are recognized for immune system enhancement include:
· Shiitake mushrooms (Lentinus edodes);
· Garlic (Allium sativum); and
· Goldenseal (Hydrastis canadensis).

"Dietary supplements can provide great relief to individuals suffering from CFS."

Important supplements
Dietary supplements can provide great relief to individuals suffering from CFS. In a study of fibromyalgia and CFS, patients reported a significant improvement in symptoms after taking nutritional supplements. Experts recommend the following nutritional supplements for CFS patients:
· Vitamin C is an important antioxidant known to enhance immune function. Under stressful conditions, the body needs additional vitamin C to help the immune system function normally. Vtamin C promotes healthy adrenal function, which is especially helpful for women who suffer from stress. In one study of 411 married couples, researchers found a clear correlation between fatigue and low levels of vitamin C. Dr. Cheraskin describes the correlation between vitamin C and fatigue as the "new scurvy," citing evidence that vitamin C deficiency can contribute to CFS.
· Magnesium is important for energy production, protein formation, and cellular replication. Most westerners are deficient in this mineral.
· Iron deficiency can lead to chronic fatigue and anemia. Liver extracts are considered one of the best sources of iron.
· Vitamin B complex consists of 11 B vitamins, including folic acid, vitamin Bs, and vitamin B12. Vitamin B6 deficiency has been implicated in anaemia and fatigue. Vitamin B12 deficiency is believed to contribute to elevated homocysteine levels. High levels of homocysteine are believed to contribute to heart disease. In addition, increased levels of homocysteine are characteristic of CFS patients. Researchers have also discovered that CFS subjects have lower levels of B vitamins than healthy patients.
· Vitamin E, an important antioxidant, protects cells against damage from toxins. It can enhance immune function and has antihistamine properties.
· Potassium deficiency has been linked to fatigue and muscle weakness. Potassium may help restore energy in some CFS patients.
· The amino acid L-carnitine has also demonstrated promise in providing relief for people with CFS. In a study featured in Neuropsychobiology (Vol. 35, No. 1, 1997), researchers found a statistically significant improvement in CFS symptoms after eight weeks of treatment.
· NADH is a coenzyme available as a nutritional supplement. A clinical study presented at the 1998 meeting of the American College of Allergy, Asthma & Immunology and later published in the Annals of Allergy, Asthma & Immunology, tested NADH in a double-blind, placebo controlled, crossover fashion featuring patients with CFS. More than 73 percent of the patients showed significant improvement in clinical symptoms and energy levels. According to NADH developer Georg D. Birkmayer, M.D., "It (NADH) is the only compound where you can clearly demonstrate that it increases energy production on the cellular level."
· Essential fatty acids in the form of flax oil and evening primrose oil have been shown to be beneficial to the cardiovascular and immune systems, as well as help ease depression and hormonal imbalances. Two quality human studies demonstrated that high doses of essential fatty acids can positively benefit individuals with CFS (Acta Neurol Scan Vol 99, 1999).
· Iodine and tyrosine have been shown to help alleviate fatigue caused by low thyroid function.

A word about fibromyalgia
CFS and fibromyalgia have a lot in common. Muscle-aches, fatigue, headaches, sleep disturbances, psychological complaints, and weak adrenal function can accompany either of these conditions. The main difference, however, between the two disorders is that muscle pain is typically the overriding feature in fibromyalgia, while prolonged, debilitating fatigue is the leading complaint of CFS. According to Canadian family physician, David Saul, M.D., people suffering with fibromyalgia may find symptom relief by using methylsulfonylmethane (MSM), malic acid, and noni juice.

Final thoughts
Lack of energy and a diagnosis of chronic fatigue syndrome can affect a person's quality of life. While you may think you must simply endure the hectic pace and live with your fatigue, remember that chronic fatigue does not have to be a way of life. If you are having trouble making it through each day, and if your fatigue is affecting your quality of life, you need to see a healthcare professional. You can take steps to take the fatigue out of your fife and put the fun back in. By making some dietary and lifestyle changes, and incorporating specific nutrients and herbs into your daily routine, you may just be able to conquer your chronic fatigue.