Chronic Fatigue Syndrome

Chronic fatigue syndrome (CFS) is fatigue that is not eased by rest and is not caused by another health problem. People with CFS may also have joint and muscle pain, headaches, and other problems that get in the way of their daily routine.

There is no cure. CFS symptoms are managed with changes to lifestyle habits, diet, counseling, and medicine. Some people turn to natural therapies to further ease symptoms.

Natural Therapies

May Be Effective

These therapies may help ease fatigue:

  • Acupuncture uses thin needles in specific body locations to improve health.A1-A4
  • Dietary changes D2
  • Exercise therapy C1
  • Moxibustion burns dried mugwort on points on the body to improve health.A3
  • Nicotinamide adenine dinucleotide (NADH) is a compound that the body uses to produce energy.B1-B3
  • Qigong combines body poses, movement, meditation, and breathing to balance the body.D6

Not Enough Data to Assess

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Herbs and Supplements to Be Used With Caution

Talk to your doctor about any supplements or therapy you would like to use. Some can interfere with treatment or make conditions worse.



A1. Ng SM, Yiu YM. Acupuncture for chronic fatigue syndrome: a randomized, sham-controlled trial with single-blinded design. Altern Ther Health Med. 2013;19(4):21-26.

A2. Lu C, Yang XJ, et al. [Randomized controlled clinical trials of acupuncture and moxibustion treatment of chronic fatigue syndrome patients]. Xhen Ci Yan Jiu. 2014;39(4):313-317.

A3. Wang T, Xu C, et al. Acupuncture and moxibustion for chronic fatigue syndrome in traditional Chinese medicine: a systematic review and meta-analysis. BMC Complement Altern Med. 2017 Mar 23;17(1):163.

A4. Kim JE, Seo BK, et al. Acupuncture for chronic fatigue syndrome and idiopathic chronic fatigue: a multicenter, nonblinded, randomized controlled trial. Trials. 2015 Jul 26;16:314.

Herbs and Supplements

B1. Alegre J, Rosés JM, et al. [Nicotinamide adenine dinucleotide (NADH) in patients with chronic fatigue syndrome]. Rev Clin Esp. 2010;210(6):284-288.

B2. Castro-Marrero J, Cordero MD, et al. Does oral coenzyme Q10 plus NADH supplementation improve fatigue and biochemical parameters in chronic fatigue syndrome? Antioxid Redox Signal. 2015;22(8):679-685.

B3. Castro-Marrero J, Sáez-Francás N, et al. Effect of coenzyme Q10 plus nicotinamide adenine dinucleotide supplementation on maximum heart rate after exercise testing in chronic fatigue syndrome – A randomized, controlled, double-blind trial. Clin Nutr. 2016;35(4):826-834.

B4. Corbitt M, Campagnolo N, et al. A Systematic Review of Probiotic Interventions for Gastrointestinal Symptoms and Irritable Bowel Syndrome in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME). Probiotics Antimicrob Proteins. 2018 Sep;10(3):466-477.

B5. Wang YY, Li XX, et al. Traditional Chinese medicine for chronic fatigue syndrome: a systematic review of randomized clinical trials. Complement Ther Med. 2014 Aug;22(4):826-833.

Exercise Therapy

C1. Larun L, Bruberg KG, et al. Exercise therapy for chronic fatigue syndrome. Cochrane Database Syst Rev. 2017;4:CD003200.

Other Therapies

D1. Mikolasek M, Berg J, et al. Effectiveness of Mindfulness- and Relaxation-Based eHealth Interventions for Patients with Medical Conditions: a Systematic Review and Synthesis. Int J Behav Med. 2018 Feb;25(1):1-16.

D2. Jones K, Probst Y. Role of dietary modification in alleviating chronic fatigue syndrome symptoms: a systematic review. Aust N Z J Public Health. 2017 Aug;41(4):338-344.

D3. Campagnolo N, Johnston S, et al. Dietary and nutrition interventions for the therapeutic treatment of chronic fatigue syndrome/myalgic encephalomyelitis: a systematic review. J Hum Nutr Diet. 2017 Jun;30(3):247-259.

D4. Smith ME, Haney E, et al. Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Systematic Review for a National Institutes of Health Pathways to Prevention Workshop. Ann Intern Med. 2015 Jun 16;162(12):841-850.

D5. Courtois I, Cools F, et al. Effectiveness of body awareness interventions in fibromyalgia and chronic fatigue syndrome: a systematic review and meta-analysis. J Bodyw Mov Ther. 2015 Jan;19(1):35-56.

D6. Ho RT, Chan JS, et al. A randomized controlled trial of qigong exercise on fatigue symptoms, functioning, and telomerase activity in persons with chronic fatigue or chronic fatigue syndrome. Ann Behav Med. 2012 Oct;44(2):160-170.

D7. Alraek T, Lee MS, et al. Complementary and alternative medicine for patients with chronic fatigue syndrome: a systematic review. BMC Complement Altern Med. 2011 Oct 7;11:87.

D8. Reid S, Chalder T, et al. Chronic fatigue syndrome. BMJ Clin Evid. 2011 May 26;2011. pii: 1101.

Last reviewed November 2019 by EBSCO NAT Review Board Eric Hurwitz, DC

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