Chronic Fatigue Syndrome (CFS) is constant fatigue that lasts more than six months and is accompanied by symptoms such as:

• pain in muscles and joints;
• headache;
• soreness of the lymph nodes;
• occasional sore throat;
• a significant decrease in concentration and memory;
• sleep problems;
• deterioration after physical or mental stress;
• fatigue does not go away after rest.

CFS is diagnosed only if symptoms persist for at least six months after other causes of fatigue have been ruled out.

The prevalence of CFS is from 0.4 to 2.5%, and the disease is more common in women.

Causes of Chronic Fatigue Syndrome

The causes of CFS are unknown. However, patients with CFS can be divided into two groups:

• Patients with early, often undiagnosed Parkinson’s disease or other degenerative brain diseases;
• Patients with chronic inflammatory diseases or infections, including herpesvirus type 6, Epstein-Barr virus, and enteroviruses.

Chronic Viral Infections

Chronic activation of antiviral defenses plays a major role in the pathogenesis of CFS since the antiviral molecules that the body produces can not only attack viral particles but also damage body tissues. Elevated levels of pro-inflammatory cytokines such as TNF-alpha and IL-1 indicate CFS’s infectious or inflammatory origin.

Immunosuppression supports chronic fatigue syndrome. Chronic bacterial and viral infections and inflammatory processes increase oxidative stress and contribute to the destruction of certain nutrients and immunosuppression. In turn, oxidative stress can lead to the transition of various infections into a chronic forms. The goal of treating CFS is to break this vicious cycle.

Allergy to Nickel and Mercury

Mercury is used in dentistry as part of filling materials. Several studies have shown that removing an amalgam filling reduces hypersensitivity to metals and improves the condition of patients with CFS.

Metals and their compounds that most often cause allergies, in descending order:

• nickel;
• inorganic mercury;
• silver;
• phenylmercury;
• cadmium;

Selenium Deficiency

Insufficient intake of selenium (Se) or high levels of toxic metals, which promote the elimination of selenium from the body, increases oxidative stress, contributing to CFS. Oxidative stress increases the production of prostaglandins, substances that contribute to the development of the inflammatory process and increase pain sensitivity. Prostaglandin E2 suppresses white blood cells, which are important in fighting viral infections. In addition, prostaglandin E2 contributes to the acquisition of immunosuppressive properties by macrophages. These effects are especially pronounced in patients with poor Se status and a high ratio of omega-6 to omega-3 polyunsaturated fatty acids (PUFAs) in the diet.

Nutritional Supplements for Chronic Fatigue Syndrome

Oxidative stress damages the mitochondria, the main task of which is to supply the cell with energy. Chronic disease impairs the ability of mitochondria to produce high-energy ATP molecules and reduces the levels of important nutrients.

Nutritional deficiencies may be the cause of CFS:

• vitamin C;
• B vitamins;
• sodium;
• magnesium;
• zinc;
• folic acid;
• L-carnitine;
• L-tryptophan;
• essential fatty acids;
• coenzyme Q10.

Adequate nutrient levels and antioxidant supplements can reduce oxidative damage to cell membranes and restore mitochondrial function. Antioxidant supplements may help relieve muscle symptoms in CFS.

Table. Nutritional supplements for CFS

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References

• Chronic fatigue syndrome (CFS): Suggestions for a nutritional treatment in the therapeutic approach
• Multivitamin mineral supplementation in patients with chronic fatigue syndrome

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