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By Suzanne D. Vernon, PhD

Research Director
Bateman Horne Center
Salt Lake City, UT

Created: 04/09/2013
Last Updated: 04/09/2013

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Q: How is chronic fatigue syndrome treated?

If your health care professional has diagnosed you with chronic fatigue syndrome (CFS), your treatment will be focused on relieving symptoms, improving function and restoring quality of life. A variety of therapies may help patients with CFS, which is also known as myalgic encephalomyelitis or chronic fatigue and immune dysfunction syndrome. Treatment is based on individual symptoms. Your treatment plan may include the following: symptom-based treatment; education about the disease; regular follow-up visits to rule out alternative diagnoses and assess response to therapy; and lifestyle changes to make life with CFS more manageable and enjoyable. Your health care professional may recommend increased rest, use of stress reduction and management techniques, energy conservation techniques, dietary restrictions, nutritional supplementation and exercise based on personal abilities.

Cognitive behavior therapy also is sometimes used together with graduated exercise to help people with CFS identify negative beliefs and behaviors that may be getting in the way of their recovery and to help maintain or improve physical condition. It has been shown to help reduce symptoms of CFS. With the help of a mental health provider, cognitive behavior therapy helps you replace negative thoughts with positive, healthy ones.

Some medications may help you manage your symptoms. For aches and pains, you may be told to try over-the-counter medicines including nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Motrin), naproxen (Aleve), acetaminophen (Tylenol) and the prescription drug piroxicam (Feldene). Deep massage, stretching, an activity program designed with the help of a physical therapist or chiropractic treatment may also help minimize these symptoms.

For sleep problems, your health care professional may first suggest you change your sleep habits and stick to a regular bedtime, skip daytime naps and avoid substances like alcohol and caffeine. If this doesn't help, you may get a prescription for a short-term dose of sleep medication.

For depression, antidepressants are often used. It often takes several weeks to see benefits with antidepressants or to identify side effects, so be patient and work with your health care professional to find the medication that is best for you.

You may also benefit from keeping an energy/activity diary. Keep a log for several weeks, noting the times when you feel the most fatigued and what activities you performed during the day. This can help you identify patterns in your illness and factors that contribute to your fatigue or other symptoms, such as headaches.

Also schedule rest periods and adjust your schedule to fit your energy patterns. Making time to relax and meditate during certain times of the day may be helpful, as will avoiding situations you know to be physically or psychologically stressful.

Work with your health care professional to develop an activity plan based on your capabilities. Some CFS sufferers experience profound fatigue even after very minimal exercise, so start slowly and build up gradually. Many people find exercise such as stretching, walking, swimming, biking, water aerobics and relaxation exercises to be helpful in easing their symptoms. A physical therapist may help you put together an exercise program you can do at home.

Diet may also be an effective way to take control of your illness. Research suggests that CFS patients benefit from a basic healthy diet low in animal fat and high in fiber with plenty of fresh fruits and vegetables. Talk with your health care professional about foods that may help increase your energy levels and relieve symptoms. If you lack the stamina to prepare well-balanced meals, let your health care provider know. Services may be available to assist with obtaining meals. A visit with a dietitian may be needed if you've lost or gained weight or been unable to eat a balanced diet.

You should also avoid certain triggers that aggravate CFS symptoms, such as a chemical, pesticide, household cleaning product or other potential environmental toxin. To identify your triggers, remove all suspected toxins from your environment, then reintroduce them one by one to pinpoint what may be aggravating your symptoms.