What is the Best Treatment for Chronic Fatigue Syndrome?

Conflicting Advice Leads to Confusion



"After a few years of feeling like I had the flu all the time, I finally got a diagnosis -- chronic fatigue syndrome. I've been trying to research treatments, but every place I go seems to offer different advice. I'm really confused! Should I be taking anti-virals? Anti-depressants? Exercising and seeing a therapist?

I'm really at a loss and my doctor isn't offering much guidance. What is the best treatment for chronic fatigue syndrome?"


Unfortunately, at the moment there's no simple, definitive answer to that question. As you've found, a lot of treatments are available, based on different theories of the causes and underlying mechanisms of chronic fatigue syndrome. However, none of them is shown to be effective for every case of this illness. Many doctors do agree that the best approach is to tailor the treatment regimen to each individual case.

The crux of the problem is that chronic fatigue syndrome can vary greatly from one person to another. You could probably compare your set of symptoms and symptom triggers to dozens of other people's without finding a case exactly like yours. Many researchers believe the term "chronic fatigue syndrome" currently covers multiple subgroups, each requiring its own treatment regimen.

Until subgroups are clearly identified, each person with this illness needs to experiment with different treatments to see what works best.

It's unlikely that one single treatment will get you feeling like your old self, but you may be able to find multiple treatments that each help some. Added together, they can make a significant difference in your functionality and quality of life.

What are the Options?

You've got a lot of options to consider:

  • Prescription drugs: So far, the FDA hasn't approved any drugs for chronic fatigue syndrome, but doctors prescribe a lot of drugs off-label for the condition. Not all of them work for everyone, though, and side effects can be a problem.
  • Supplements: Some people with chronic fatigue syndrome have good luck with supplements. We have good scientific evidence for some, but it's lacking for others. Even though supplements are "natural," you do still need to be aware of side effects and possible drug interactions.
  • Dietary changes: Eating a healthier diet may help ease some of your symptoms. Also, food sensitivities are common, so you may want to track what you eat and see if certain things make you feel worse.
  • Cognitive behavioral therapy: This psychological treatment is extremely controversial in the chronic fatigue syndrome patient community. However, we know it can help with a lot of physiological illnesses, especially for people who need help making positive lifestyle changes and those who have trouble coping with chronic illness.
  • Appropriate exercise: Exercise is another hotly debated area. You've likely learned that over exertion can trigger a crash, and that makes it hard to see how exercise could help you. The important thing is making sure the effort and intensity level are appropriate for you.
  • Stress management: Learning how to reduce your stress and cope with it better can be a big help, as stress can be a major symptom trigger.
  • Lifestyle changes: This can be overwhelming, so try breaking it down into categories and looking at one at a time.

You may need to combine treatments from multiple categories to get substantial improvement in symptoms and quality of life.

The experimentation process can take a lot of time, energy, and often, money. You should also expect setbacks along the way. The pay off may be worth it, though, if it allows you to feel better and return to the activities you enjoy.


Arroll M, Arroll B. Australian family physician. 2013 Apr;42(4):191-3. Chronic fatigue syndrome--a patient centred approach to management.

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