Physiology of Chronic Fatigue Syndrome

Chronic fatigue syndrome (CFS) is a long-term illness with a wide range of symptoms that can’t be explained by any underlying medical condition. Individuals with CFS tend to be hypersensitivity to normal routine regular activities. The fatigue may worsen with physical or mental activity but doesn’t improve with rest. The exact cause of chronic fatigue syndrome is a mystery.


  • The most common cause is age, observed mainly in middle-aged individuals
  • A stressful lifestyle can be an important cause of chronic fatigue
  • A depressed mental state can affect as well
  • Women seem to suffer more from CFS than men due to hormonal changes
  • Infections, mainly viral infections seem to cause CFS
  • Hormonal imbalance one of the main causes of chronic fatigue mainly in women
  • Immunological disorders


  • Loss of interest
  • Fatigue
  • Loss of memory or concentration
  • A sore throat
  • Enlarged lymph nodes in your neck or armpits
  • Unexplained muscle or joint pain
  • Headaches
  • Disturbed sleep
  • Extreme exhaustion lasting more than 24 hours after physical or mental exercise


There is no single test to diagnose CFS.  Diagnosis is based on the symptoms.

  • Counseling, basically offering psychological support
  • Physical therapy  by planning a routine work out regimen
  • Low dose antidepressants can reduce pain and improve sleep

Ayurveda and Chronic Fatigue Syndrome

Chronic fatigue syndrome is addressed as bala kshaya or shosh roga ( a disease of depletion) in Ayurveda and is caused due to the aggravation of vata dosha (vata vyadhi) that generates fatigue at physical and mental levels. It also shares features with Vathika Jwara ( fever caused by Vata dosha ). CFS causes weakening of the nervous system and creates a hypersensitivity to pain and tenderness. In CFS the Ojas of the person is severely reduced.

Treatment of chronic fatigue syndrome in Ayurveda

Detox or Panchakarma, diet changes, lifestyle modification, rejuvenation, rasayana and herbal medicines are used to revitalize the core systems of the patient.

Panchakarma Treatments

Firs,t a detoxification is done through Vamana (emesis),  Virechana (purgation),  and Basti (enema)

Snehana: The oral administration of oil or ghee and external oil massage very beneficial in treating vata imbalance by increasing blood circulation to the tissues and relieving fatigue.

Svedana: It involves oil massages followed by sweating therapy. Warms the body treating vata imbalance and increases blood circulation

Abhyanga: Gentle oil massages are beneficial in treating pain and fatigue which is the main symptom of vata dosha

Mardana: This simple massage helps to  improve blood circulation and ease chronic  pain

Snigdha ushna basti: Enema therapy where warm oil is used to cleanse the large intestine, the main area for vata accumulation. It also helps to improve digestion and absorption of nutrients.

Sukhasheelata:  Providing adequate rest to the patient for treating vata imbalance.

Rasayana: Rasayana is carried out to re-build the attenuated systems and Ojas of the body.

Diet modifications

  • Warm and mildly spicy food at a regular time should be consumed as it is vata pacifying
  • Ginger and garlic are known for their anti-inflammatory property, hence beneficial in adding them  to our diet
  • Smoothly textured food is vata pacifying; hence banana, mango, papaya, and squash are beneficial
  • Sweet, salty and sour are beneficial whereas pungent and bitter are vata aggravating hence better avoided
  • Abstaining from wind producing vegetables like broccoli, cauliflower, cabbage, and others
  • Healthy fats rich in omega 3 fatty acids and butter and ghee are advised.
  • Instead of refined grains, whole grain should be consumed to keep the digestive system healthy

Lifestyle modifications

  • Since Vata is everchanging , a set daily routine helps to control it.
  • Adequate sleep, relaxation, and exercises are beneficial in dealing chronic fatigue syndrome
  • Practising yoga and meditation is beneficial
  • Keeping yourself warm from intense cold and windy weather is advised to calm vata dosha
  • Hydrotherapy can work wonders for people suffering from chronic fatigue syndrome
  • Avoiding stress is key to reducing inflammation in the body

Ayurvedic herbs

Ashwagandha (Withania somnifera): Ashwagandha is beneficial in treating vata imbalance. This herb is known to calm the nervous system hence frequently used in the treatment of chronic fatigue syndrome

Ginger (Zingiber officinale): It is known to have anti-inflammatory and anti-anxiety property often used to treat chronic pain and fatigue and beneficial in managing vata dosha.

Triphala: Triphala is a herbal blend made from amalaki (Emblica officinalis), haritaki (terminalia chebula) and bibhitaki (terminalia bellerica). The herbs comprising of triphala have potent healing, purifying and anti-inflammatory property very beneficial in treating chronic fatigue syndrome

Yoga and Pranayama for Chronic Fatigue Syndrome

Chronic fatigue can be reduced by practising yoga asana which relaxes the body and rejuvenates the mind such as Sirsasana (head stand) and Sarvangasana (shoulder stand), forward bending postures such as Padahastasana (hand under foot pose), Paschimottanasana (seated forward bend) and Adho mukha svanasana (downward facing dog pose) and backward bending postures such as Ustrasana (full camel pose), Chakrasana (wheel pose) and Bhujangasana (cobra pose) are helpful in relieving stress .

Pranayama such as Nadi Shodhana or Anuloma-Viloma (alternate nostril breathing) and Bhramari (humming bee breathing) open up the chest and lungs and reduces the tension in the diaphragm, which makes the body lighter and minds stress-free.

Naturopathy and Chronic Fatigue Syndrome

Naturopathy regards Chronic Fatigue Syndrome as a systemic disease that involves multiple causes. The causes of CFS may lie in a weak digestive system, compromised immunity, stress, and inflammation.

Treatment of CFS in Naturopathy

The successful treatment of CFS lies in following multifactorial approach involving detoxification, strengthening the digestive and immune system, diet modification, stress management, herbal medicines and Yoga and Pranayama.


A good detox is the first line of treatment in Naturopathy. Generally, a build-up of toxins in the body causes inflammation at the cellular level. Medicated enema, Colon hydrotherapy, sauna, steam bath, liver pack, kidney pack, mud bath and other hydrotherapies are commonly used for detoxification of the body. In case of heavy metal build-up, chelation is carried out. Massages also help in detoxification and relaxation of the body and mind.

Apart from detox, oxygen therapy using ozone, intravenous hydrogen peroxide, and Coq10 have been tried in treating chronic fatigue syndrome but the efficacy of this treatment protocol is still to be established.

Acupuncture is also beneficial in treating CFS.

Diet modifications

  • The first goal is to correct nutritional deficiencies and improve the absorption of nutrients. This can be achieved by consuming a good portion of raw vegetables (salads), fruits, legumes, dairy products, and meat.
  • Vitamin B6 and B12 are particularly vital in the treatment of CFS, Vitamin B6 rich food include banana, tuna, salmon, sweet potatoes, garlic, spinach, and hazelnut. Vitamin B12 is largely found in dairy products and meat.
  • Also, increase the consumption of Potassium and Magnesium in the diet. Magnesium rich food items include spinach, pumpkin seeds, almond, figs, beans, and bananas. Potassium is found in large amount in spinach, sweet potato, coconut water, avocado, and squash.
  • Include in diet plenty of antioxidants mostly found in varied colored fruits and vegetables.  
  • Avoid preserved and carbonated products as it increases the inflammation in the body
  • Keep yourself hydrated is very important for repair of the injured cells and optimal functioning of the body tissues.

Lifestyle modifications

  • Regular exercise, especially early morning sessions are better to reduce joint stiffness and body aches. Also exercise outdoors as fresh air and sunlight help in energizing the body and mind.
  • Regular sound sleep is essential for the  normal functioning of the circadian cycle which in turn is necessary for dealing with fatigue
  • Art therapy, music therapy, hydrotherapy, and aromatherapy are beneficial in alleviating mood and reducing stress.
  • Reduction in electromagnetic exposure is also known to be beneficial in treating chronic fatigue syndrome

Botanical herbs

Avenal-oat straw, Jamaican dogwood, hops, and valerian are muscle relaxants known to be beneficial in treating chronic fatigue syndrome

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