Disclaimer: This article is for informational purposes only and is not intended to diagnose, treat, or cure any condition or disease. Any mention of people, products, treatments, and resources is for informational purposes only and does not constitute an endorsement or recommendation. People with CFS should consult a doctor or other appropriate medical practitioner for diagnosis, tests, treatments, or remedies.

The main difficulty when it comes to chronic fatigue syndrome (CFS) is that we still don’t know for certain what causes it.

We’re not even sure if it’s a single, consistent illness or a catch-all category for different conditions with similar symptoms.

Sarah Myhill, a British doctor experienced in treating chronic fatigue, says on her website, “Chronic Fatigue Syndrome is a symptom, not a diagnosis, and the name of the game is to identify the underlying causes.”

A variety of physical and psychological/emotional causes have been suggested.

Each related treatment has its own proponents and claims some successes.

Unfortunately, ordinary doctors may not be of much help in treating CFS.

First, they’re often not familiar with the disease and think it’s due to depression or involves simply feeling a little run down.

Second, US doctors now spend an average of 7.5 minutes with a patient.

In such a short time, it’s impossible for them to consider a condition that’s new to them, or even to review all the regimes and remedies patients have already tried.

Third, the fact that CFS is sometimes called “the yuppie flu” shows the contempt in which such an ill-defined illness may be held, and doctors who don’t know much about it may share this attitude.

Chronic fatigue syndrome also offers another complication.

Since patients often suffer from it for years or even decades, it may lead to secondary or “downstream” malfunctions in the body, such as a damaged digestive system.

Once this happens, the condition may become a kind of loop, where the secondary problems put a further burden on the body and may even prevent treatments from working.

Healing, then, may require specialized knowledge, a great deal of research, and patience.

It may not be as simple as what ordinary doctors are trained to see—one root cause, to be cured with a single drug or course of treatment.

Because of this complexity, we’ll look at managing chronic fatigue from two different perspectives: the root causes and the secondary problems.

Part One: Treating Root Causes

In her book Recovery from CFS, Alexandra Barton has collected the stories of people who have managed their symptoms of chronic fatigue syndrome.

At the end of each story the most important points are summarized—the treatment or therapy that worked, helpful books and websites, and so on.

The most striking thing is how diverse the treatments are: traditional or orthomolecular medicine, changes in diet, intensely-targeted psychological or mind-body therapies, herbal treatments, supplements, and more.

Clearly, different solutions work for different people; but, equally importantly, CFS does seem to be manageable.

Most people prefer to get help from mainstream medical doctors, if they can find one who understands CFS.

Jacob Teitelbaum suffered from chronic fatigue when he was in medical school.

He was so sick, he was forced to drop out and became homeless.

Now recovered and a doctor, he’s developed an approach to the disease, as detailed in his book From Fatigued to Fantastic! (or in the condensed version, The Fatigue and Fibromyalgia Solution).

Another excellent protocol is explained in Treating and Beating Fibromyalgia & Chronic Fatigue, by Rodger H. Murphree, another doctor who specializes in this area. Both Teitelbaum and Murphree do telephone consultations.

Teitelbaum sells his own supplement powder, plus other supplements that he recommends, at his website.

Although the two doctors arrange their information differently, much of it covers similar ground.

Sleep and nutrition are major considerations.

Both talk about problems with glands such as the hypothalamus, the adrenals, and the thyroid.

They recommend testing for infections—Lyme disease, yeast overgrowth, parasites, and so on. (Yes, people in advanced countries do get parasites.)

Sarah Myhill, the British doctor quoted above, has laid out her understanding of CFS on her website and in a book called Diagnosing and Treating Chronic Fatigue Syndrome: It’s Mitochondria, Not Hypochondria.

She too talks about sleep, diet, supplements, parasites, and so on, but she believes that the functioning of the digestive system and of the mitochondria in the cells may be primary problems.

She is not at present accepting new patients. She does sell her own supplements online, but they can only be shipped within the UK.

To learn more about Dr. Sarah Myhill please watch the following webinar recorded by Igennus Healthcare Nutrition blog

Some practitioners have less-mainstream theories about chronic fatigue syndrome.

One is that the original cause is prolonged stress or the body responding too often or too forcefully to stress.

This theory builds on the idea that the body has two states, growth/maintenance (our normal state) and stress/protection (the fight-or-flight state).

In the normal state, we digest food, sleep, and perform all the other processes that lead to the growth, maintenance, and regeneration of our bodies.

But when danger threatens (for example, when a human encounters a lion), our body goes into an emergency state, releasing a cascade of chemicals and reactions that shut off processes that aren’t immediately needed, in order to concentrate our resources on the muscles and systems needed for fighting or fleeing. (There is no point in digesting a meal or renewing your cells if a lion is about to eat you.)

If the danger passes promptly, we return to a calm state and pick up our normal life processes again.

If we don’t return to calm, or don’t stay calm for a long enough period, the stress chemicals in our bloodstream can continue to interfere with normal processes.

Our body then can’t do what it needs to for its basic upkeep, such as digest food properly, go into a deep sleep, or maintain itself.

Among those who believe that some type of stress lies at the root of chronic fatigue syndrome is David Mickel, a UK doctor.

He has developed the talk-based Mickel Therapy which focuses on the functioning of the hypothalamus with other brain systems.

Therapy is done individually, by e-mail or phone.

Ashok Gupta, a doctor with a London medical practice who also once had CFS, sees the hyper-arousal of the amygdala as the problem.

He teaches the Gupta Programme at his office, on DVD, or in webinars, aiming to reduce the too-frequent triggering of the amygdala.

John Eaton’s Reverse Therapy examines conflicts between what he calls the Critical Mind (centered in the frontal lobes; the reasoning and judgmental mind) and the Bodymind (located partly in the limbic system; the emotional, intuitive, and adaptive mind) and their effects on the body.

He offers one-on-one sessions in person or via Skype.

As you can see, ideas about the root causes of chronic fatigue syndrome vary and involve different mental and physical systems.

But there’s an additional complexity to be aware of wen it comes to management.

Part Two: Dealing with Secondary Problems

One problem with chronic fatigue syndrome is that the body may be in a malfunctioning state for a long time—months, years, even decades.

During this time, the malfunctions can lead to secondary problems.

These additional problems then hinder the body from getting well or even from showing signs of improvement. Dr. Myhill states, “Many patients come to me having tried thyroid medication or B12 injections, for example, but unless the diet, sleep, pacing, and micronutrients are in place and correct, they may not see the benefit.”

For example, when you are stressed, your adrenals secrete cortisol.

Stress that goes on for a long time can deplete your adrenals. (This is true whether it’s the original stress that caused the CFS or a later stress of, say, being unable to work.) Depleted adrenals can lead to excessive fatigue, difficulty in coping with stress, and a lack of sleep.

The last is particularly difficult to cope with because with adrenal fatigue you are often tired in the morning but get a second wind right around bedtime that keeps you from falling asleep; and when you do, your sleep may be too shallow to allow your body’s repair processes to take place.

Imagine, then, that you obtain a wonderful supplement, an antibiotic against infection, or a course of stress-lowering talk therapy.

How good will you feel after it? Better, perhaps, but it won’t make up for the sleep deprivation. As long as you are sleep-deprived, you will continue to feel terrible.

Another problem that can occur is damage to the digestive system.

This can lead to leaky gut (where food molecules or particles escape through a damaged intestine wall into the body) or malabsorption (where you can’t absorb the full goodness of food, supplements, or medicine).

Imagine, then, that your doctor discovers that your blood counts are low and gives you iron pills to take, but your intestines are too damaged and exhausted to absorb them.

Neither the pills nor iron-rich food seems to have an effect.

In fact, you feel exhausted and sick after eating and wonder if a parasite is consuming all this iron you’ve been taking. (In the meantime, your lack of iron is making your legs twitch at night, which keeps you from sleeping…)

For another example, imagine that the root cause of your CFS is a period of high stress.

You can’t sleep well; you can’t think straight; and you even have to quit your job.

That leads to more worry because you don’t know how you’re going to support yourself or pay for treatment.

Stress becomes a loop: The mental stress keeps you from sleeping.

The lack of sleep puts physical stress on your body the next day, so that you feel even worse than the previous day.

You then worry about how you’re declining, further jacking up the mental stress.

So secondary problems can prevent proper responses to management approaches. No medicine can make up for lack of sleep.

No food or supplement can be truly effective if you can’t absorb it.

No therapy can restore balance to your adrenals or other organs if your stress is still constant.

It’s important, then, to take stock of your mind and body, to see the effects of your condition, and to approach them in the way that works best for you.

It may even help to draw them as a diagram: the original source of sickness, exhaustion, or mental or physical stress; the physical and mental results that followed; and how these might prevent remedies from working or feed back into your condition.

They may include things such as poor digestion and malabsorption; adrenal fatigue; insomnia or shallow sleep; lack of iron; lack of energy to prepare healthy food; mental and physical stress; and other effects. Still other effects may be individual.

For example, impatience may add to stress or make you unwilling to rest or to stay the course with multiple remedies.

Or, if you have too little strength to clean your home, the dirt and disorder may be depressing or stressful, or it may lead you to try to do more than you’re capable of.

Either way, it will create another loop or bad effect, prolonging your illness and further depleting your body.

In order to manage your symptoms, then, you must find ways to interrupt the loops and diminish the secondary problems.

You’re likely to have to approach each one individually.

For example, if you think you have malabsorption, you may want to replace one meal per day with an easy-to-absorb smoothie, made from a blend of fruits and veggies or the “essentials shake” powder sold by Alejandro Junger’s Clean Program.

Your practitioner might also prescribe a gut-repairing supplement, such as the glutamine complex supplement from Physica Energetics.

If you are having trouble sleeping, you may want to try melatonin, herbal remedies such as valerian, or a quiet period before bed with low lighting and no electronics.

Both stress and difficulties with sleep may be helped by special heating mats or pads which use warmth, far infrared rays, and negative ions to relax the body, improve its functioning, and give it a sense of well-being.

In summary, with chronic fatigue syndrome, not all treatments work for all people, and some very good treatments don’t work as long as other problems are hampering the body’s functioning.

You’ll want to avoid becoming discouraged and to remain willing to apply as many remedies as are needed, all at once, to return your body to its full functioning.

It’s important to consult experienced doctors or other practitioners who can test and monitor you, prescribe medicines or supplements, and judge the interactions of body systems or remedies.

You’ll also need to get proactive, by thinking about your individual symptoms, and researching and trying remedies, until you find the combination that works for you.

It is possible to get better.