Nutritional Factors related to Chronic Fatigue

Overview   Immune abnormalities   CNS & hormonal abnormalities
Salt   B vitamins   L-carnitine   NADH   Magnesium   DHEA   NADH   Herbs


If patients with chronic fatigue syndrome also have low blood pressure (hypotension) some medical professional feel they should not limit salt consumption. Some people with CFS have a type of hypotension triggered by posture changes (orthostatic hypotension). These groups have reportedly been helped by higher salt consumption.1 However, if you have chronic fatigue and are considering raising your salt consumption you should consult your doctor first.

Potassium Aspartate - Magnesium Aspartate

Research demonstrates that potassium aspartate, together with magnesium aspartate bring help for those who are fatigued all of the time.8-11 These early trials pre-dated CFS diagnosis standards, so it is not certain whether they were experiencing CFS. Most medical professionals recommend 1 gram/twice a day with results reported in 1-2 weeks.

Vitamin B12, B vitamins

Continuing fatigue is a symptom of vitamin B12 deficiency. Some of the research12-13 demonstrate that all people receiving a series of B12 shots have more energy following the injections. Many medical professionals discourage people who are not B12 deficient from getting B12 shots,14 but some feel B12 is, nonetheless, helpful for chronic fatigue.15 In one study, patients with CFS received 2,500-5,000 mcg B12 shots every 2-3 days. 50-80% of them felt better after a couple of weeks.16 If you are thinking about getting B12 shots you should first consult your medical professional. Note: because the body does not readily absorb large amounts of vitamin B12, supplementing with large doses of B12 by mouth is not very effective.

Another study reports that CFS patients are deficient in other B vitamins, especially B6.17 More research is needed to determine whether general B complex vitamins are effective.


L-carnitine acts as an antioxidant and is utilized by the body to convert fat to energy. This energy producing capacity takes place in the mitochondria, the section of the cells known as the "powerhouse." It has been hypothesized that there is some weakness in the mitochondria in CFS sufferers and additional, carnitine deficiency has been noted in some CFS suffers.18 In one trial 1 gram three times a day was helpful.


Nicotinamide adenine dinucleotide (NADH) is another factor in the production and use of energy in the body. It has several critical functions in metabolism, acting as an oxidation-reducing coenzyme, and acting as a messenger in the process of producing adenosine triphosphate (ATP), the energy carrier in the body. In one double-blind trial, CFS patients were given 10mg daily for 4 weeks.20 31% reported less fatigue and a lessening of other CFS symptoms, when compared to 8% of a placebo group. Confirming research is needed.


Research has demonstrated that levels of magnesium are low in CFS patients (although this evidence is contradictory23-25) and that magnesium shots improved symptoms for most.21 In those people who previously were magnesium-deficient taking supplements was helpful. although shots were sometimes also needed.22 Therefore the recommendation is that you consider supplementing with magnesium that you be checked for such a deficiency. Reportedly, only those with magnesium deficiency benefit from such supplementation.


Dehydroepiandrosterone (DHEA) is a naturally occurring hormone and steroid in the body. One study reported low levels of DHEA in those with CFS.26 Another reported that although levels of DHEA might be normal for people with CFS, their ability naturally raise their DHEA level due to hormonal stimulation was weak.27 More research is needed to determine whether these findings are valid, and DHEA should only be used on the advice of your doctor.

Licorice Root

CFS may partly may develop in part because of poor adrenal function due to mental or physical stress, a viral illness, or other trauma - which, in turn, weakens the ability of the hypothalamus, adrenal gland and pituitary gland to communicate.28 Licorice root stimulates adrenal glands blocks the deterioration of active cortisol in the physiology. A case study reports one patient with CFS whose symptoms improved with taking 2.5 grams/daily.29 Research is insufficient to validate this result, but for some people a trial of 6-8 weeks using 2-3 grams daily might be helpful. Note: licorice root causes fluid retention and high blood pressure in some people. Deglycyrrhizinated (DGL) licorice does not have this side effect, but no longer is as helpful for CFS.

Other herbs

  • Asian ginseng is an adaptogenic herb that may be helpful due to its beneficial effect on the immune system and hormonal stress- response system.31 It may be useful as a follow-up after taking licorice, but there has been no controlled research.
  • Eleuthero is another adaptogenic herb with similar effects as ginseng. Again, there is no research to substantiate its effectiveness.


See footnotes on which the above discussion is based.

Overview   Immune abnormalities   CNS & hormonal abnormalities
Salt   B vitamins   L-carnitine   NADH   Magnesium   DHEA   NADH   Herbs