Supplement, diets and other OTC treatments I've tried for CFS/ME
Since you're here, you might be interested in my CFS/ME/fibromyalgia treatment book.
Note: because this list was growing extremely large, I have decided to separate it into two pages. This list contains the over-the-counter treatments I have tried - herbs, vitamins, minerals, amino acids and other supplements as well as diets - while the other page contains medications. Note that I have mostly followed Finnish classification, hence things like melatonin and DHEA are listed here, even though they are considered nutritional supplements in some countries. (I am Finnish and live in the Netherlands now, where the classification is similar).
After I got sick with CFS/ME in 2000 I have tried many different herbs, nutritional supplements and medications in search of relief. This search has not been arbitrary or based on advertisements and anecdotes. I have tried things that have been shown to be helpful for CFS/ME, similar conditions or similar symptoms. Some of these things haven't had that much evidence to back them up, but they are safe and have been very cheap to acquire so I have tried them anyway.
My situation has changed over the years in that, thanks mainly to LDN and some other medications, CFS/ME doesn't bother me much any more, but the panhypopituitarism I got as a complication causes me severe lethargy and poor functionality, even though I'm in an almost normal physical shape. Some or most of it boils down to recalcitrant hypoglycemia, that no supplement, hormone or dietary modification seems to eradicate. So often it's not clear which illness I'm trying to treat, CFS/ME or hypopituitarism.
Peculiarly every single supplement (and most meds) that has ever improved my fatigue or functionality - and there have been quite a few - has always stopped working, sometimes after years, nowadays usually after one month or so. They never start working again even if I wait years before next trying them. Rotating supplements doesn't help, as even things I've taken very irregularly have stopped working. (Things that improve other symptoms, like sleep or stomach problems, luckily don't normally have this issue.) I haven't been able to figure out why. The placebo effect doesn't seem like a likely explanation, since the likelihood of something helping me has never had any correlation to my expectations about it. Since late 2011, when I had the first bout of gastroenteritis (from food poisoning) since my getting CFS/ME in 2000, almost every supplement also causes me stomach upset for a few days after I start taking it.
As a disclaimer, I'd like to remind you that this page exists only for informational purposes. It cannot be used to treat or diagnose any medical condition and it is not intended to substitute or replace professional medical care or advice. I assume no responsibility for any of the information presented here. Always discuss treatment options with your doctor and tell your doctor about every medication, supplement and herbal product you're taking.
If you have any questions, I'd be happy to answer your email, but please read my main CFS/ME page before asking questions. Also, some of the products I have taken are Finnish/Dutch, so you may not be able to find the exact same product. I have had good experience and generally trust Solgar (expensive), NOW (usually very cheap and very good), Doctor's Best (most products fairly inexpensive) and Life Extension Foundation (often expensive, some products very affordable). Also nothing to complain about Source Naturals or Healthy Origins which tend to be quite inexpensive.
I used to recommend iHerb for supplements until recently, when I was scammed by them. They admit I have paid for something I have not received and that their ordering system is unusable, but they refuse to compensate (the order system "may be fixed at some point") and their customer "service" is abysmal. When filing a BBB complaint I found out I was far from the only one! With any decent company the customer is always right. With iHerb the customer is always wrong, even if they are right.
- Remember that people are different and the effects of herbs, supplements and medications vary from person to person.
- Always start out with a small dose, in case of allergy, intolerance or sensitivity.
- Avoid anything sold by MLM chains.
- Don't take anything until you have researched its safety, contraindications, side effects and interreactions with other drugs. There is no excuse not to look it up. Be particularly careful if you suffer from other serious illnesses (e.g. with your heart, liver or kidneys) or if you're taking medications with plenty of possible drug interactions, such as beta blockers, warfarin, epilepsy medications or MAOI drugs. Most products are not recommended for use during pregnancy or breastfeeding.
- Check whether the supplement or medication has to be taken on an empty stomach or with food. For example many amino acids should be taken on an empty stomach, but some supplements can irritate the stomach if taken alone. Also check if you should take it in the morning, at night, or several times a day.
- Examine is a good place for reviewing research and contains even many fairly obscure supplements.
This list is arranged in an alphabetical order. In the Usage field I have listed the dose I have used, which is often the recommended dose. However, doses vary on individual basis so the dose that works for me may be too large or too small for your needs. The Supposed to help field lists conditions and symptoms the supplement is believed to help with, but it does not mean it actually works for them. The field Science lists some the factual information and research, which is not conclusive and mostly pertains to symptoms that have to do with CFS/ME.
My results are listed in the Results field. If there's something you need to be careful about (such as side effects or contraindications), they're listed in Watch out for. Remember that there can always be idiosyncratic side effects, allergic reactions or drug compatibility issues that are not listed here. Finally, the field Recommendation lists my personal opinion about the treatment and whether it's worthwhile to try for CFS/ME. Even if it says I recommend the treatment it doesn't mean it will work for you, but it's something I believe one should try if it's not contraindicated for you (and conversely, even if I don't recommend it it doesn't mean it's bad or that it won't work for you).
Amino acids (and similar substances)
Beta alanine (2014)
Usage: 3 x 750 mg of powder a day, mixed into water
Supposed to help: hypoglycemia, same things as carnosine
Science: The most common use of beta alanine is to increase the levels of carnosine, to which it converts. Beta alanine is much cheaper.
Results: Made my hypoglycemia better for a month, then pooped out as everything does. It also made my skin look better like carnosine, suggesting that it did indeed convert to carnosine.
Watch out for: Beta alanine tends to cause a harmless but rather unpleasant tingling sensation in the extremities. This can be avoided by taking it in small doses, I tolerate about 750 mg of the powder at once, several times a day.
Recommendation: If you suffer from hypoglycemia or want to try a cheaper form of carnosine
Usage: 400 mg a day
Supposed to help: fatigue, muscle endurance, immune system, tolerance to stress, brainfog, heart problems, mood, migraine prevention
Science: Carnosine is a dipeptide composed of the amino acids beta-alanine and histidine. Some of its effects are due to the histidine, but most due to the complex. It is found naturally in the body especially in the muscles and in the brain. Carnosine is a strong antioxidant and can chelate heavy metals. It is touted as an e.g. anti-aging supplement, smart drug and a muscle endurance improver, and there are many studies to back up these claims. It is used to treat e.g. autism. Doses starting from 75 mg may have some effect and doses up to several grams a day are safe.
Results: I didn't notice any benefits at all, except that after taking it for a week or two the skin in my face started to look a lot more lively, as in healthy and rosy instead of pale and almost grayish (and this was in the winter so it couldn't have been the sun). Maybe I'd have got some results with 800 mg a day, but in those doses it would cost more than my LDN does and almost as much as all my other supplements combined, so I don't think it would be worth it. I didn't get any migraines during the two months I was on it, but I don't get migraines very often anyway so it could have well been a coincidence.
Watch out for: Carnosine may deplete the body of magnesium and zinc, which is why it should be taken with them. I wasn't taking magnesium and I did feel like I feel when I'm low on magnesium, so I resumed taking magnesium citrate. Both are good supplements for CFS/ME in general.
Recommendation: Worth a try (though more expensive than most other supplements), but if you don't see any effects in a month or two it's probably no use in continuing for longer. Most of the benefits should be noticeable in a month. Some people may have to go up to 800 mg to get benefits, which gets rather pricey. A Finnish complementary medicine doctor greatly recommends carnosine for CFS/ME - but then again he sells it.
Creatine (2008, 2009)
Usage: first 5 g a day, then 3 g a day
Supposed to help: muscle weakness and endurance, heart, fatigue, brainfog
Science: The amino acid creatine is best known as one of the favorite supplements of body builders, but it can also help the muscles in CFS/ME, including the heart muscle. According to studies it can also help improve and maintain cognitive function. It has been used in the treatment of e.g. Parkinson's disease.
Results: I was fairly sure it would help me, but didn't notice any effects.
Watch out for: If you have kidney problems or risk factors predisposing you to them (such as diabetes or chronic NSAID use), you probably shouldn't take creatine without your doctor's approval. Fluid retention is possible. Large doses may cause diarrhea.
Recommendation: Yes. It is inexpensive and well-tolerated. Creatine pyruvate may be more effective, but is also a lot more costly.
Usage: 2 x 500 mg a day
Supposed to help: fatigue, liver, detox, immune system, skin
Science: Glutathione is a tripeptide formed by three amino acids. It is an important antioxidant and works to detoxify many substances. There is thought to be insufficient glutathione in CFS/ME patients (some deficiencies are genetic and can be tested for). Glutathione is often considered to be absorbed poorly from oral use (though modern products supposedly absorb better) so it is often used as a cream. Taking N-acetylcysteine and undenatured whey can boost glutathione levels and are more commonly used. Vitamin D, lipoic acid, SAM-e, melatonin and milk thistle may also help.
Results: It did seem to help with fatigue and functionality, but stopped working just like everything else. NAC never caused such improvement, only slight relief in muscle problems.
Watch out for: Glutathione is reported to often cause "detox" symptoms initially.
Recommendation: It is somewhat expensive, but if that's not a problem, yes.
Glycine (occasionally 2014-)
Usage: 300 mg-2 g at bedtime
Supposed to help: sleep, liver, hypoglycemia
Science: Glycine is not a well-known supplement at all, which is a shame. It is am amino acid. Glycine is usually sold as a powder, which has an agreeable, mildly sweet taste.
Results: The first time I took perhaps 300 mg at bedtime it totally knocked me out. I was surprised by how powerful the effect was, considering that in some studies people have taken up to 20 g doses. The effect is no longer so powerful, but ~1 g still usually knocks me out when needed. Haven't noticed any other effects.
Watch out for:
Recommendation: Sure, it's safe, fairly inexpensive and can help several things.
DL-phenylalanine (2007, 2008)
Usage: 500-750 mg a day
Supposed to help: pain, fatigue, tiredness, cognitive problems, immune system, depression, weight loss, orthostatic hypotension
Science: DL-phenylalanine (DLPA) is a racemic mixture of the amino acid phenylalanine. It slows down the breakdown of endorphins (which is why it is recommended as an adjunct to LDN) and converts to dopamine and phenylethylamine (a mood elevating chemical also found in chocolate) to some extent.
Results: The first time I tried it for a few weeks I didn't notice anything. The second time I got an irresistible urge to clean up (every day), probably caused by the increased brain levels of dopamine, which is very important for motivation.
Watch out for: Some people believe that phenylalanine is somehow harmful, because aspartame-containing soft drinks have a warning about it. It is actually an essential amino acid, which is only problematic if you have phenylketouria (a rare genetic condition and you would know if you have it). It should also be avoided if you have a history of schizophrenia/psychosis or malignant melanoma or are taking levodopa or MAOI antidepressants. Don't take it without your doctor's approval if you have hypertension or are taking other antidepressants or stimulants. Taking it late in the day may cause insomnia. It can also cause nausea, anxiety, stomach upset and headache.
Recommendation: Yes, if you're taking low dose naltrexone or have chronic pain. Otherwise probably no, unless you've tried just about everything else (or want to try LDN, but cannot get a prescription).
L-carnitine (2006, 2014-present) / acetyl-L-carnitine (2006-2010, 2014-present) / L-carnitine fumarate (2010-2011)
Usage: 1-2 250 mg capsules of L-carnitine / 1-2 500 mg capsules of Acetyl-L-carnitine / L-carnitine fumarate a day on an empty stomach
Supposed to help: fatigue, muscle endurance, immune system, brainfog, arrhythmias, anti-inflammatory, cardiac health, neuropathic pain, weight loss
Science: L-carnitine is a non-essential amino acid found naturally in many foods, particularly meat, dairy, nuts, seeds and legumes. It has an important function in the metabolic processes in the body. It is also one of the few supplements whose effects on CFS/ME have actually been studied and the results have been promising. Acetyl-L-carnitine is supposed to have a better bioavailability than plain L-carnitine and slightly different effects (e.g. more cognitive improvement). There is little research of L-carnitine fumarate, but the fumarate is supposed to improve energy metabolism and there are some very impressive anecdotal reports for conditions other than CFS/ME.
Results: 250 mg doesn't seem to do that much, but 500 mg and 1,000 mg definitely helps with reducing the uncomfortable, heavy feeling I often experience in my muscles and increasing endurance. Acetyl-L-carnitine seems to also help a bit with the brainfog and the fatigue, but I'm not entirely sure about this. Neither of the forms seem to help my heart problems. Some friends with fairly mild CFS/ME have reported significant benefit from 500-1,000 mg of carnitine, even with neurological and flu-like symptoms. After taking acetyl-L-carnitine for almost four years, in 2010 I switched to L-carnitine fumarate and about a week after starting it my fatigability has been greatly reduced, I can get a lot more done. It may also have something to do with other things, like upping my DHEA dose, but I think at least some of it is from the L-carnitine fumarate.
Watch out for: L-carnitine may cause stomach upset. Large oral doses taken for long periods of time can cause problems, but this probably only applies to very high dosages. Larger doses may also increase the risk of seizures, so epileptics shouldn't take L-carnitine without discussing it with their doctor first. Carnitine may interact with a few anticonvulsants (not Lyrica or Neurontin though) and some people have reported it has caused problems with either their hypothyroidism or thyroid medication, while many hypothyroid people take it without problems.
L-glutamine (2007, 2008, 2009, 2012, 2014-present)
Usage: Up to 10 g a day
Supposed to help: stomach problems, ulcer preventon, fatigue, muscle endurance, immune system, brainfog, weight loss
Science: L-glutamine is an essential amino acid and thus naturally found in many foods, especially animal products. It is a popular body builder supplement, because it's supposed to aid recovery of muscles and may decrease healing times in general. It may increase secretion of growth hormone. It helps with the maintainance of gut barrier function, which may be helpful in CFS/ME since increased gut permeability may be a part of the illness. In large doses glutamine is also used to treat IBS in doses up to 30 grams a day.
Results: It makes my stomach tolerate NSAIDs much better, but I haven't noticed other effects.
Watch out for: There should be no side effects with normal doses of L-glutamine. However there have been some concerns from people who believe it may cause problems to those who are sensitive to MSG. People with liver problems probably shouldn't take glutamine without discussing it with their doctor first.
Recommendation: Perhaps not the first recommendation, but if you have already tried quite a few things, L-glutamine is worth a try too. If it helps you should be able to see the benefits fairly quickly and it's one of the inexpensive amino acids.
Usage: 2 x 500 mg a day
Supposed to help: antiherpesviral, chelation, muscle cramps, anxiety
Science: Lysine is an amino acid and a popular treatment for herpesviral infections, especially cold sores. According to studies it reduces recurrence, but there is conflicting evidence whether it relieves the symptoms or speeds up healing. Many herpesviruses have been connected with CFS/ME, which is why lysine may be worth a try for those who do not suffer from herpes simplex. Nuts contain plenty of the amino acid arginine, which "opposes" lysine and may thus reduce its efficacy.
Results: Did not notice anything.
Watch out for: Very large doses can cause stomach upset. Lysine is not recommended for those with kidney or liver problems.
Recommendation: Not sure. At least it is very safe and well-tolerated.
L-theanine (2009-2010, 2011)
Usage: ~100-400 mg as needed
Supposed to help: anxiety, mood, sleep, cognition, stress tolerance, immune system, cancer prevention
Science: L-theanine is an amino acid found in tea, about 20-50 mg per cup. It reduces anxiety and induces relaxation without causing sedation. It can improve cognition, possibly because it increases brain levels of dopamine. It may also increase serotonin levels. L-theanine is neuroprotective and studies have found it also stimulates the immune system, which may help fighting infections, preventing cancer and even boosting the efficacy of the influenza vaccine. It may also have direct antitumor effects. Because of its pharmacological effects it could also relieve pain.
Results: Did not really notice anything. Larger doses possibly make me more calm, but I tend to be calm anyway.
Watch out for: The effects of theanine and the sensitivity to it varies widely from person to person. Some get distinct effects from 50 mg, others nothing from 1 g. 50-400 mg is a common dose. There are no known side effects even in high doses, but because L-theanine is mildly psychoactive, people who are very sensitive to psychoactive substances might have a negative reaction to it. Some people have reported headaches, others claim these are only caused by "bad" brands. Some people get a feeling of sedation, others have said they get a rebound effect which makes them wake up a few hours after going to sleep. In animal studies reduced appetite has been reported, which could obviously be either a good or a bad thing if it also applies to humans. L-theanine may reduce blood pressure, though this is only likely if you suffer from hypertension.
Recommendation: If you have anxiety or sleeping problems, it might be worth a try.
Usage: one teaspoon (about 3 g) a day dissolved in water
Supposed to help: fatigue, brainfog, immune system, blood sugar, heart, muscle endurance, muscle tension, anxiety, mood, sleep, tolerance to stress, epilepsy
Science: Taurine is a non-essential amino acid. It is a common ingredient in energy drinks (e.g. Red Bull), but it's not really a stimulant. In fact it kind of calms the brain (without being sedative), as it is GABAergic. Additionally it may relieve the effects of stress. It is an antioxidant and supports the immune system. It is antidiabetic and good for the heart. Many people with anxiety, depression and bipolar disorder, even autism report having been helped by taurine. It also lowers cholesterol and has anti-aging properties.
Results: I haven't noticed anything else, but combined with valerian it seemed to result in slightly better sleep than valerian alone (both are GABAergic). My muscles (especially my chronically very tense scalp) get a little more relaxed. A friend who suffered from depression and fatigue caused by psychiatric drugs said that he felt like taurine often gave him a bit more energy.
Watch out for: Taurine has no side effects that I'm aware of, though it may possibly lower blood pressure. Technically it can cause drowsiness due to the GABAergic component, but that's very rare - and then you can take it at bedtime.
Recommendation: Yes. It has many potential benefits, hardly ever causes side effects and is extremely cheap when bought in powder form (which has very little taste), as little as 10 euros for a 300 g jar (100-200 doses).
Tyrosine/acetyltyrosine (2009-2010, 2011, 2015)
Usage: 200 mg - 2 g a day taken on an empty stomach
Supposed to help: fatigue, tiredness, pain, brainfog, mood, weight loss, hypothyroidism, libido
Science: Tyrosine is an amino acid and a precursor to dopamine, which is an important neurotransmitter (for e.g. concentration, alertness, motivation, mood and libido) commonly deficient in CFS/ME. For this reason it is also used to treat e.g. ADHD and depression and many people find it helpful for fibromyalgia. Many people on my forum have found it very helpful. Tyrosine may also increase secretion of thyroid hormones.
Results: The most noticeable benefit was that after a poor night's sleep I didn't feel nearly as bad as I normally would. It also helped some with concentration and libido, perhaps mood too. It has unfortunately did not me with trigger points, as I was hoping for. At first I got some constipation, but it went away. My skin also seemed to have got better, not sure if this is just a coincidence. However, after some months it "pooped out" and I stopped taking it. In 2015 I tried acetyltyrosine, supposedly a better form of tyrosine, and it caused symptoms of hyperthyroidism, which normal tyrosine never did for me, but nothing else.
Watch out for: Some people recommend doses as small as 200 mg while others take as much as 8 g a day. Besides the mentioned constipation, excessive doses can cause nausea, insomnia and cardiac symptoms. Probably should not be taken by those with hyperthyroidism.
Recommendation: Why not.
Agnus castus (Vitex agnus-castus) (2012, 2013)
Usage: 3 capsules a day
Supposed to help: sex hormone deficiencies, gynecological problems, libido, fatigue, cognition, skin
Science: Agnus castus is also known as vitex or chasteberry. Contrary to its name it actually increases sex hormone levels and increases dopamine (both of which may increase libido) by reducing prolactin secretion. The "chaste" effect is only in low doses, which may increase prolactin and hence reduce sex hormones (and libido). Agnus castus is traditionally used for just about all gynecological issues, but may also help men, as it increases testosterone levels.
Results:It definitely did something, as I got some hormonal pimples after starting. Originally I felt like it was helping a bit, but it was very subtle and seemed to subside, so I quit taking it after about two months. When I tried taking it again, it seemed to worsen my hypothyroidism, as estrogenic supplements often do.
Watch out for: Do not take if you have a problem that may be worsened by increased sex hormones (such as breast cancer). Taking too low doses might have negative effects, as explained above.
Recommendation: If you have hormonal/gynecological problems, it may be worth a try, as it is safe and very inexpensive.
Aloe vera (Aloe barbadensis) (2012-2013)
Usage: 15-20 ml liquid 2-3 times a day
Supposed to help: immune system, skin, wound healing, stomach problems, bladder problems
Science: Aloe vera is best known for its use in cosmetics, soothing the skin and speeding up healing, but there is some evidence it can accelerate wound healing and have anti-inflammatory properties in internal use, as well. Some people have claimed it has reduced their CFS/ME fatigue.
Results: No effect on my skin or digestion, but seems to have helped my diabetes insipidus, which may seem weird as central DI is a pituitary condition, but irritated bladder makes my DI worse. Seems to also improved mucosal membranes. Possibly extra energy in the beginning, as well.
Watch out for: Taking poorly prepared aloe vera leaves (or too much) can cause diarrhea. Many products contain preservatives/other additives, which are claimed to make bladder problems worse. There have been concerns that aloe vera may be carcinogenic.
Recommendation: If you have IBS or irritated bladder/interstitial cystitis, it is likely worth a try, as it is inexpensive and rather safe.
Ashwagandha (Withania somnifera) (2008-2014 with some breaks)
Usage: A 750 mg tablet first twice a day, then only at bedtime, later capsules.
Supposed to help: immune system, sleep, thyroid problems, adrenal insufficiency, brainfog, stress tolerance, mood, libido
Science: Ashwagandha is also known as the Indian ginseng, being a very valued adaptogen in the Ayurvedic medicine. It has nootropic and lipid-lowering effects and can improve sleep without inducing daytime drowsiness. It can also stimulate thyroid hormone production.
Results: I did not notice anything else but improved sleep (enabled me to stop taking inositol and still sleep a bit better) and possibly a more relaxed mind and clearer skin. My dreams have also got weirder, but they are not particularly disturbing.
Watch out for: Probably should not be used by those with hyperthyroidism.
Recommendation: Probably yes, especially if you have trouble sleeping.
Astragalus (Astragalus membranaceus) (2006-2007, 2012-2013, 2015)
Usage: depending on the brand
Supposed to help: fatigue, immune system, cold prevention, antiviral, stomach problems, ulcers, cardiac symptoms, sleep
Science: Astragalus is an adaptogen and has been shown to be an effective immunomodulatory and anti-inflammatory herb. It also has some antiviral (at least antiherpesviral) properties.
Results: I'm not entirely sure if it helped, I think it helped my fever some. When I tried it for the second time it was immediately clear it was making me sleep a bit deeper, similar to the prescription immunostimulant/antiviral isoprinosine, which I didn't notice at all the first time around. When I tried it the third time, it made my hypoglycemia worse which I hadn't noticed before and made my stools looser.
Watch out for: Usually well tolerated.
Recommendation: Probably yes. It's not my first-line suggestion, but as far as herbs go it's probably one of the best.
Bacopa (Bacopa monnieri) (2013)
Usage: 1 capsule a day
Supposed to help: memory, brainfog, anxiety, IBS, allergies, joint pain, epilepsy, stress
Science: Bacopa monnieri contains antioxidants and cholinesterase inhibitors and may increase brain circulation. It also has some immunomodulatory effects. It is probably the most recommended herb for memory problems (both long-term and short-term memory), with some studies to support this effect, though some studies have found no or very minor effect. Some people find it also helps learning and concentration. It might be compared with L-theanine: a mental relaxant that makes you more focused, though it can take several weeks or even a few months before the full effects are noticeable.
Results: Gave me bad diarrhea, so I stopped using it. It's possible the diarrhea would have gone away, but I can't really risk that.
Watch out for: See above. Bacopa may boost thyroid function and reduce male fertility. It may lower blood pressure and slow down heartbeat. Some people feel slight sedation/tiredness, but it can then be taken at bedtime (though some people get very vivid dreams, then). A few have reported nausea, depression and headaches. In some sources vacopa is not recommended for people with (or at risk for) ulcers, though in Ayurveda it has actually been used to treat ulcers. Bacopa is also known as brahmi, but brahmi may also refer to gotu kola (this error is unlikely to cause any serious damage, though).
Recommendation: It's pretty cheap in Indian stores, so why not, if the possible side effects don't seem like a dealbreaker for you.
Usage: 2 x 500 mg a day
Supposed to help: depression, anxiety, brainfog, IBS, heart, antibacterial, antiviral, antifungal, anti-inflammatory, diabetes, cancer prevention
Science: Berberine is a constituent of several herbs, such as goldenseal, which is sometimes used to treat CFS/ME. However, berberine is much more concentrated. Most brands contain quite a little, but a Finnish brand contains 500 mg a gram which corresponds to a huge amount of the fresh herb. It has shown efficacy in many studies (mostly lab studies though) against diabetes, cardiovascular disease, cancer and many infectious agents. It works by several mechanisms which may relieve depression and other psychiatric problems. It increases acetylcholine levels in the brain, which may boost cognition.
Results: Didn't notice anything. Later I used it together with andrographis when I had an infected tooth and the infection cleared up completely in a few days (when my dentist performed a root canal, all traces of infection were gone).
Watch out for: Can worsen hypoglycemia and lower blood pressure. Can rarely cause insomnia, headaches, nausea and dyspnea. Some caution against combining it with SSRI drugs.
Recommendation: It seems potentially very useful, but few people have tried it for CFS/ME. I know some who have found it useful for stomach problems. It can be rather pricey.
Boswellia (Boswellia serrata) (2012)
Usage: 2 capsules a day (recommendation 4 capsules a day)
Supposed to help: inflammation, pain, osteoarthritis, cancer prevention
Science: Boswellia/frankincense has been studied for reducing inflammation, especially in osteoarthritis.
Results: It worsened my hypoglycemia even at just half the recommended dose, so I had to stop taking it after just a few days.
Watch out for: It can also cause gastrointestinal upset, acid reflux and skin rashes. Elevated blood pressure has occasionally been reported.
Recommendation: ProHealth's Rich told me he believes the combination of curcumin and boswellia is the best thing to take for CFS/ME pain. I don't have any pain, however, so not sure how much I'd have benefited anyway.
Cat's claw (occasionally 2013-present)
Usage: 1-2 x 500 mg extract capsules a day
Supposed to help: fatigue, immune system, Lyme, antiviral, stomach problems, mood, pain, cognitive problems, detox, cold prevention, osteoarthritis
Science: Cat's claw is an immunomodulatory herb which is especially used in the treatment of Lyme disease, often CFS/ME as well.
Results: Didn't notice anything. However, it seems to help prevent colds - I used to never get colds thanks to effective supplements, but after my pituitary was destroyed (WBCs also need growth hormone) they didn't seem to do much any more. But cat's claw seems to do the trick almost every time.
Watch out for: If you do have Lyme, it's possible to get severe herx. It can also lower blood pressure and cause diuresis. It may temporarily reduce fertility.
Chaga mushroom (Inonotus obliquus) (2009, 2011, 2015)
Usage: A few grams brewed into a tea (for 24 hours) once a day
Supposed to help: immune system, pain, ulcer prevention, cancer prevention
Science: Chaga mushroom is a medicinal mushroom that grows on birches. It has been shown to have anticancer properties in many types of cancer. It is anti-inflammatory and reduces nitric oxide levels, which should be good in CFS/ME. Some healthy people claim Chaga tea works as an "energy drink" for them.
Results: Did not notice anything.
Watch out for: Chaga mushroom may reduce blood levels of uric acid, a mode of action which might be harmful in CFS/ME.
Recommendation: If you can find wild chaga, why not. Otherwise I'm not sure. It is tasty, but quite expensive.
Usage: 3 x 1,000 mg a day
Supposed to help: fatigue, immune system, cold prevention, stomach problems, fibromyalgia, detoxification, chelation, cancer prevention
Science: Chlorella is a genus of green algae, which contains a lot of vitamins and minerals, including some EPA (a long-chained omega-3 fatty acid which beyond some algae can only be acquired from fish). Studies show it may boost the immune system and slow down the growth of cancer. Preliminary studies have also found it useful for fibromyalgia and ulcerative colitis. It is often used for "detoxing" and removal of heavy metals. Many people claim greatly increased energy levels from taking chlorella.
Results: Did not notice anything. Later it seemed to start causing stomach upset, so I discontinued use.
Watch out for: May cause diarrhea and lower blood pressure. Some cases of severe stomach upset and vomiting have been reported.
Recommendation: Not sure.
Cordyceps (Cordyceps sinensis) (2011)
Usage: 1-2 x 750 mg a day
Supposed to help: fatigue, libido, liver, depression, immune system, cancer prevention
Science: Cordyceps is a parasitic fungus growing on a certain larvae, though nowadays it is also grown in laboratories. It is a traditional Asian medicine which is said to help fatigue and boost libido in particular. It reduces inflammation and in animal studies it has demonstrated an antidepressive effect. In lab studies it has also displayed anti-HIV activity.
Results: Did not notice anything.
Watch out for: May cause stomach upset, constipation and menstrual problems. May lower blood sugar.
Recommendation: Perhaps after you have tried many other things.
Usage: 2 capsules a day (Meriva curcumin)
Supposed to help: pain, inflammation, osteoarthritis, stomach problems, menstrual problems, depression, cancer prevention
Science: Curcumin is the active anti-inflammatory ingredient from turmeric, which is studied in numerous different illnesses and conditions, including autoimmune diseases, many types of cancer, Alzheimer's disease and osteorthritis. It is a strong antioxidant and also has some antibacterial and antiviral activity. It can increase glutathione levels, which can be useful in CFS/ME. Curcumin is very poorly absorbed, so a highly absorbed form (e.g. liposomal) is highly recommended.
Results: Did not notice anything.
Watch out for: Curcumin can cause nausea and stomach upset, gallstones and other gallbladder problems. This I was slightly worried about, as I have genetically elevated risk of gallstones (even though no one in my family has ever had them to my knowledge). It also reduces blood clotting, which is important to keep in mind if undergoing surgery. It may also cause iron deficiency (though I've also heard opposite claims, that it can elevate iron levels when they are already too high). Some curcumin products contain piperine from black pepper, which increases the absorption of curcumin, but can also increase the absorption of just about everything else (meds, supplements). Curcumin may interact with drugs that affect blood clotting and may reduce the efficacy of some types of chemotherapy (though others may actually work better).
Recommendation: Definitely, if it's not contraindicated for you.
Desmodium (Desmodium adscendens) (2014)
Usage: 10 g(?) a day brewed into tea
Supposed to help: fatigue, hypoglycemia, pain, asthma, allergies, liver, constipation, diarrhea
Science: Desmodium is a pretty obscure African herb, slightly more popular here in the Netherlands. Traditionally it's mostly been used to treat pain, asthma and liver problems. It may also have anticonvulsant properties. I figured from its one mode of action, blocking a certain type of potassium channels, that it might help hypoglycemia (there is also one study that suggests it does). According to different sources it is used traditionally for constipation or diarrhea. Clinical studies are sorely lacking, however.
Results: It helped my fatigue for some three weeks, then stopped working. You're supposed to bre about 10 grams of the herb into tea per day, which is a huge amount of the leaf matter, but luckily the tea does not taste unpleasant. (Extracts and pills are available but may be difficult to source, plus you'd still need to take a handful of the pills.-)
Watch out for: It may have diuretic action and loosen stools.
Recommendation: Probably not worth it, unless you have asthma.
Echinacea (Echinacea purpurea, Echinacea angustifolia) (2005)
Usage: 20 drops three times a day when needed
Supposed to help: bacterial, viral and fungal infections, immune system, fever, congestion, cold treatment, cold prevention, circulation, orthostatic hypotension
Science: Studies have shown that echinacea may reduce the symptoms and duration of a cold, but it doesn't seem to be helpful in preventing viral infections. It does increase the secretion of erythropoietin (EPO), which may be useful in CFS/ME.
Results: I used echinacea for a few weeks to see if it helps with CFS/ME, but I didn't notice any effects. It felt like my fever might have been a little lower than usual, but I didn't have a working thermometer at the time. Nowadays I take echinacea if I catch a cold, but I can't say if it actually helps. It seems to help congestion a bit. My husband says it shrinks his apthoid ulcers very quickly.
Watch out for: Echinacea is not recommended for people with an autoimmune disease (in one study it actually helped uveitis, but it may worsen lupus) and it's probably not a good idea for those with a very severe case of CFS/ME. There are claims that echinacea may cause liver damage. Echinacea should not be taken for more than eight weeks in a row.
Recommendation: Yes, if you have a cold/flu. Probably not too helpful otherwise.
Usage: 10 mg once a day
Supposed to help: allergies, asthma, heart, fatigue, stamina, hypothyroidism, weight loss, IBS, urinary frequency
Science: Forskolin is a constituent of the plant Coleus forskohlii. It is primarily used in the treatment of allergies, lung diseases and sometimes as a weight loss supplement and for hypertension. It may increase energy levels and boost thyroid function. Some also claim efficacy for IBS and bladder problems.
Results: I didn't notice anything.
Watch out for: Forskolin may lower blood pressure.
Recommendation: Not a "first-line" recommendation for anything, but if you have several of the symptoms listed above it might be something to consider. It tends to be well-tolerated but it is very rarely used by people with CFS/ME and I probably wouldn't recommend it to people sensitive to medications.
Fo-ti (Ho Shou Wu) (Polygonum multiflorum) (2012)
Usage: 1 capsule twice a day
Supposed to help: autoimmune diseases, fatigue, hair loss, graying of hair
Science: Fo-ti is an important herb in TCM, where it is used to treat e.g. autoimmune diseases, hair loss and graying of hair.
Results: Did not notice anything, except possibly slightly worsened IBS. I have tried it also as a tea, which has a surprisingly agreaable flavour, not at all bitter.
Watch out for: Fo-ti has been associated with the risk of liver damage.
Recommendation: Probably not.
Garlic (Allium sativum) (2006, 2009, 2010)
Usage: raw garlic, garlic powder in foods, garlic pills
Supposed to help: bacterial, viral and fungal infections, stomach problems, cold prevention, cardiac health
Science: Garlic may help with the complications of diabetes and cardiovascular disease. It also has some antiviral and antibacterial properties.
Results: First time I tried garlic pills I got no other effects, but seemed to help the skin, perhaps due to the sulphur compounds in it? The second time I had to discontinue very soon, as it was giving me bad acid reflux. It also caused very weird dreams.
Watch out for: The aforementioned side effects. Garlic may also thin the blood.
Recommendation: I definitely recommend eating garlic in food, but the pills probably aren't needed. If your cholesterol and triglycerides are high, then it might be worth a try.
Ginger (Zingiber officinale) (occasionally 2004-present)
Usage: a small piece of raw ginger, a small cube of candied ginger or some ginger powder in water
Supposed to help: nausea, stomach upset, fatigue, anti-inflammatory, cold treatment, joint problems
Science: Ginger has been proven to help with many different kinds of nausea. It may also relieve pain in some inflammatory conditions. Some people say it improves their fatigue, but I have never noticed such an effect, and I have taken very large doses.
Results: It greatly helps with nausea.
Watch out for: Large doses can cause heartburn or stomach upset
Recommendation: If you suffer from nausea, definitely. I think candied ginger (little cubes that look like sugared jelly candies) is the most convenient form to ingest and it should be easy to find.
Ginkgo (Ginkgo biloba) (2004-2007)
Usage: 20 drops of tincture three times a day
Supposed to help: circulation, mood, brainfog, cancer prevention
Science: Ginkgo has been shown to improve circulation. A recent study also found it prevented ovarian cancer, one of the most deadly cancers in women.
Results: Ginkgo greatly helped me with my brainfog. I had to take it for five weeks before it started working, so be patient in the beginning. But if I missed out just one dose I'll notice it, sometimes even on the next day, which is the downside of this treatment. Tablets might be more convenient and long-acting, but they're more expensive too. I stopped taking ginkgo after three years when I started piracetam, after which taking or not taking ginkgo did not seem to make a difference any more.)
Watch out for: Some people are allergic to ginkgo. Ginkgo thins the blood, so watch out if you have problems with bleeding, are on blood-thinning medication or use several supplements (such as vitamin E or fish oil) that also decrease thinning.
Ginseng (Panax quinquefolium) (occasionally 2006-2011)
Usage: 2 g-4 g, brewed into a concoction, 1-2 tablets with 25 mg ginseng extract
Supposed to help: fatigue, libido, immune system, cold prevention, tolerance to stress, cancer prevention
Science: Ginseng is classified as an adaptogen, something that increases the body's ability to adapt to stress. It has been shown to be effective in preventing viral infections.
Results: Seems to slightly alleviate fatigue, but also lowers blood sugar in larger doses, particularly if taken without food. It is actually the only stimulant that seems to have any effect on me.
Watch out for: Take with food to avoid blood sugar crashes. Be careful if you have problems with hypoglycemia or hypertension. Ginseng may cause overagitation in some people. Some sources advise it shouldn't be taken during the period.
Recommendation: I'd recommend ginseng, whether it's American ginseng or "real" (Chinese/Korean) Panax ginseng. I don't so much recommend ginseng drinks, teas and pills as most of them don't have sufficient quantities of the active ingredients.
Gotu kola (Centella asiatica) (2011)
Usage: 3 x 450 mg a day
Supposed to help: cognitive problems, circulation, anxiety, edema, skin, hair loss
Science: Gotu kola is considered a nootropic and an adaptogen. It also relieves anxiety, reduces inflammation and edema and improves circulation. It has been used to treat e.g. asthma and interstitial cystitis.
Results: Did not notice anything. I was hoping I could replace my horse chestnut with gotu kola (since the latter has many other beneficial effects while horse chestnut just helps edema), but it didn't seem to help edema or at least at this dose was much weaker than horse chestnut.
Watch out for: May elevate blood sugar and cholesterol. Has been suspected of causing cancer.
Recommendation: If you're into nootropics, maybe.
Graviola leaf (Annona muricata) (2013)
Usage: 1 capsule a day
Supposed to help: immune system, cancer treatment, antiviral, detox, gynecological problems, prostate symptoms, fatigue, depression, anxiety
Science: Graviola is widely promoted as an alternative cancer treatment, but there is little evidence to support this claim. It has shown antiviral effects in vitro. Anecdotally some people have reported benefit in menopausal, menstrual and prostate issues. Also benefit in skin infections (both bacterial and fungal) has been reported.
Results: Made my hypoglycemia a lot worse, so I had to stop taking it.
Watch out for: Besides the above, graviola contains annonacin which may be neurotoxic. It's hard to find information about which plant parts contain annonacin in which concentrations - some sources say seeds, others mention both fruits and leaves.
Recommendation: Maybe. If you are a diabetic the hypoglycemic action may be useful, as long as you're careful with your other treatment. Quite a few people claim it has done wonders for their depression. The fruit of this plant, called soursop or guanabana, is absolutely delicious, as is the related annona/cherimoya/custard apple, which I can eat without any ill effects. (And I'm willing to risk potential annonacin exposure, since the fruits are widely eaten in the tropics.)
Green tea extract (2013)
Usage: 1 capsule a day
Supposed to help: fatigue, inflammation, weight loss
Science: Green tea contains EGCG, a very powerful antioxidant. It has been studied in many autoimmune diseases, though mostly in animal studies. It is often recommended for weight loss, for which there is preliminary evidence.
Results: It worsened my hypoglycemia, so I had to stop taking it.
Watch out for: There is preliminary evidence (from population and animal studies) that green tea may increase the risk and worsen IBD. In rare causes green tea supplements have caused liver damage. Green tea may affect blood clotting and interact with blood thinning medications. Many (most?) green tea supplements contain caffeine.
Guggul (Commiphora mukul) (2011)
Usage: 3 x 750 mg a day
Supposed to help: hypothyroidism, arthritis, other hormonal deficiencies, high cholesterol
Science: Guggul is a tree resin commonly used in Ayurvedic medicine. Nowadays it is mostly used in the treatment of high cholesterol and hypothyroidism, sometimes other hormonal deficiencies and osteoarthritis. It has anti-inflammatory activity.
Results: Did not notice anything. Developed some problems a few weeks after starting it (e.g. a bout of several adrenal crises) and decided to discontinue it just in case, even though it was almost certainly unrelated.
Watch out for: Guggul may harmfully interact with some prescription medications and herbs, e.g. statins, acetaminophen/paracetamol and St. John's wort. May reduce blood sugar and blood pressure.
Recommendation: Probably not, unless you have hypothyroidism and insist on trying non-pharmaceutical treatments.
Horny goat weed (2015)
Usage: 1 capsule a day
Supposed to help: fatigue, pain, libido, erectile dysfunction, bone density
Science: Horny goat weed has a similar mode of action as V*agra (PDE-5 inhibitor). Because V*agra is used to treat CFS/ME, I figured I'd give it a try since it was cheap. Horny goat weed may also increase testosterone levels in men and estrogen levels in women and increase bone density. It also has neuroprotective effects.
Results: I noticed slightly elevated libido, nothing else.
Watch out for: It might be expected to lower blood pressure and potentially cause headaches.
Recommendation: Probably not, except for men who have erectile dysfunction. Horse chestnut (Aesculus hippocastanum) (2011-present)
Usage: 2 capsules a day (also including 200 mg rutin each)
Supposed to help: edema, varicoceles, hemorrhoids, weight loss
Science: Horse chestnut has traditionally been used in the treatment of chronic venous insufficiency, which causes leg edema and other symptoms, and there are studies supporting its efficacy in this use. It reduces swelling without being a diuretic. It also appears to have some anticancer and weight loss-promoting properties.
Results: I have edema in my legs, caused by past hypothyroidism and/or other hormonal problems. It causes shin splints and plantar fasciitis, which limit the amount I can walk more than CFS/ME, even though I also treat them with bromelain and ice (which work very well) and occasionally arnica or NSAID creams. Horse chestnut has markedly reduced both the visible edema and these symptoms, especially the plantar fasciitis but also the shin splints. My husband says my face is also less swollen. LDN almost removed my chronic urticaria and the rest went away later, I believe because of horse chestnut, as it probably counteracts the "tissue leaking" effect of histamine. This effect only reached maximum after several months. Since starting horse chestnut I seemed to sleep a bit deeper for a while(probably not due to the horse chestnut but the rutin, which has effects on some neurotransmitters), though it also meant more grogginess in the mornings. But overall productivity/functionality did not seem to be hindered or only by very little.
Watch out for: May cause hypoglycemia (I have bad hypoglycemia, but I don't think it has done that for me).
Recommendation: If you have any edema or varicoceles, definitely, otherwise no. You could also take it as needed, e.g. when flying or when it's very hot.
Jiaogulan (Gynostemma pentaphyllum) (2013)
Usage: 1-2 capsules a day
Supposed to help: fatigue, stamina, immune system, tolerance to stress, heart, cognitive problems, libido, hair loss, stomach problems, sleep, pain, high cholesterol
Science: Jiaogulan or jiao gu lan, also called gynostemma, is an important herb in traditional Chinese medicine, used as a tonic/adaptogen and "anti-aging" substance. Many healthy people claim it increases their energy levels. There is little evidence of its benefits, except for the possible cholesterol lowering effect.
Results: Didn't notice anything, perhaps a slightly elevated libido.
Watch out for: It can cause nausea and diarrhea, but generally is thought to be very well tolerated. It may lower blood pressure and slow blood clotting.
Recommendation: If you have already tried a lot of other things.
Kava kava (Piper methysticum) (2001-2003)
Usage: 1 teaspoon of powder brewed into tea with a bit of oil to dissolve the fat-soluble substances
Supposed to help: anxiety, depression, sleep, brainfog
Science: The kavalactones found in kava kava have anxiolytic properties. A recent study showed that kava may be an effective treatment against leukaemia and ovarian cancer.
Results: I used kava kava with great results back when I still suffered from panic disorder caused by CFS/ME. It really helped my anxiety attacks without any side effects, though once I fell asleep in the middle of the day, which is strange since the other times I used it I experienced no sedative effects of any kind. The effects can be witnessed very quickly, in a matter of minutes. There are sublingual kava sprays available in some countries and their effects should be almost instantenous.
Watch out for: Unless you're using the pills, kava numbs the mouth, but this is harmless. Kava has been associated with a few cases of liver damage, apparently due to some supplements also containing other parts of the plants besides the root. Compared to benzodiazepines kava is very safe, since it doesn't cause dependency while benzodiazepine withdrawal can be even more difficult than opiate withdrawal. Prolonged use of large doses of kava can cause skin problems.
Recommendation: I recommend kava kava to those suffering from generalized anxiety or panic attacks. Unfortunately it isn't available in all countries (I had to get mine abroad).
Licorice root (Glycyrrhiza glabra) (occasionally 2006-present)
Usage: About 1-2 g of dried root brewed into tea as needed.
Supposed to help: fatigue, adrenal insufficiency, orthostatic hypotension, immune system, antiviral, antibacterial, stomach problems, ulcer prevention, aphtous ulcers, cold treatment and prevention, PMS, constipation
Science: Licorice is a broad spectrum antiviral with some antibacterial action as well. It also acts as glucocorticoid and a mineralocorticoid. It is good for preventing ulcers.
Results: It was somewhat helpful for low level adrenal crises, but when my adrenal insufficiency got worse, it was no longer useful. Sucking on licorice candy seems to be an excellent cure for mouth ulcers. Nowadays if I have to take NSAIDs several times in one week I take licorice tea, as it seems to really help with the stomach discomfort I
Watch out for: Excess consumption can cause hypokalemia and hypertension.
Recommendation: Yes, especially if you suspect you have adrenal insufficiency but your doctor refuses to try low dose hydrocortisone on you. It may work particularly help for viral infections when combined with undenatured whey protein.
Lion's mane/yamabushitake (Hericium erinaceus) (2015)
Usage: 2-3 capsules a day
Supposed to help: brainfog, immune system, depression, anxiety, menopause, anti-inflammatory, weight loss
Science: Lion's mane is a medicinal mushroom, also praised as a culinary mushroom. It appears to promote neuronal growth by increasing NGF. There are some studies showing it may reduce anxiety, depression, menopausal depression and cognitive decline, but the evidence is not by any means conclusive. It may lower elevated triglycerides, possibly also cholesterol. Its modes of action may increase fat burning. The cognition-boosting effects likely take a while to set in.
Results: Perhaps slightly improved cognition, but it's hard to say for certain.
Watch out for: Some people have reported (non-allergic) itchiness of skin. I didn't notice this, even though many supplements and meds initially cause me itchiness.
Maca (Lepidium meyenii) (occasionally 2010-2011)
Usage: 1-3 grams a day
Supposed to help: fatigue, libido, sexual problems, mood
Science: Maca is a so-called "superfood" praised for its "tonic" properties. It is also touted as a libido booster and a treatment for sexual dysfunction and limited research has shown its efficacy in this use (in both genders) even though the mode of action is not clear.
Results: No difference in energy levels, but it does seem to boost the libido.
Watch out for: In large doses it may be goitrogenic (bad for the thyroid).
Recommendation: If you have sexual dysfunction, it's worth a try. Probably not the most effective treatment for fatigue, though someone I know said gelatinized maca helps her CFS/ME quite a lot.
Milk thistle (Silybum marianum) (2009)
Usage: 2 x 200 mg of standardized extract a day
Supposed to help: liver, fatigue, brainfog, stomach problems
Science: Milk thistle is a herb traditionally used for "cleansing the liver" and there is a lot of scientific evidence showing that it can protect the liver. It is also a powerful antioxidant, which is why it's sometimes used in CFS/ME even in the absence of liver problems. Some people report it can help IBS and brainfog. It can also reduce cholesterol levels and reduce insulin resistance.
Results: I took it only for five days and then stopped it because I had stomach upset, nausea and poor appetite, which happen to be the only known side effects of milk thistle that I could find. I was surprised, as milk thistle very rarely causes any side effects. I did not notice any positive effects in the very short time I was taking it.
Watch out for: See above.
Recommendation: If you take medications that are heavy on the liver or have liver problems from CFS/ME, yes.
Mucuna pruriens (2012)
Usage: 1 capsule (standardized to 100 mg L-dopa) a day
Supposed to help: fatigue, libido, motivation, depression
Science: Mucuna pruriens contains levodopa (L-dopa), which is a precursor to dopamine and used as a prescription drug in the treatment of Parkinson's disease and restless legs. However, the prescription levodopa is always taken with carbidopa, which slows its breakdown. Some people argue that Mucuna pruriens also contain carboxylase inhibitors which do the same.
Results: It made me more tired. Also nausea the first day. I quit after 2-3 days because it was just making me more tired and I've got the impression it is unlikely to improve with time.
Watch out for: Aforementioned side effects and many more. Monitoring of liver enzymes is recommended in long term use. May lose efficacy with time. Do not take with vitamin B6.
Recommendation: Can't really recommend taking it without doctor's monitoring. It can sometimes be very helpful, but carries risks.
Usage: 2 capsules twice a day (as per the label)
Supposed to help: immune system, fatigue, sleep, diabetes, cold prevention
Science: MushRex is a blend of the medicinal mushrooms shiitake (Lentinula edodes), maitake (Grifola frondosa), reishi (Ganoderma lucidum), himematsutake (Agaricus blazei), turkey tail (Coriolus versicolor), chaga (Inonotus obliquus) and Cordyceps sinensis with Camu Camu Berry (Myciaria dubia) extract (natural vitamin C). There are studies showing that most of these mushrooms boost the immune system (and several of them have been used in cancer treatment for this reason), reishi may help with sleep and at least maitake may help with diabetes. Vitamin C may increase the efficacy of reishi.
Results: It made my face and neck break out slightly and caused all-over-the-body itching without hives, which was by far the most severe in my hands (also worse in my feet). The skin in my hands became drier, but the itching wasn't only caused by the dry skin. I figured it was an allergic reaction and stopped taking it, but it took a week for the itching to go away. For some reason oral antihistamine (and most other things I tried, antihistamine creams aren't available here) didn't seem to help. The allergy was likely from from turkey tail, as every other mushroom in the blend I've taken separately with no allergic reactions.
Watch out for: Maitake can also lower blood sugar.
Recommendation: I haven't heard of anyone else getting an allergic reaction from this or a similar product, so it seems safe and could well be helpful.
Neem (Azarichta indica) (2013)
Usage: 2 capsules a day
Supposed to help: diabetes, parasites, antifungal, antiviral, stomach problems, skin problems, body odour
Science: Neem is one of the most popular herbs in India, used both internally and externally (externally for e.g. mouth hygiene, scalp problems and many different skin conditions). Even internally it is supposed to be very good for acne, psoriasis and eczema. It has proven activity against pretty much all parasites.
Results: Didn't notice anything.
Watch out for: It temporarily reduces both male and female fertility.
Recommendation: It is inexpensive and safe, so why not.
Oil of oregano (Origanum vulgare) (2004-present)
Usage: 2-4 drops 2-3 times a day orally and/or 1-2 drops 2-3 times a day externally as needed, usually mixed in canola oil
Supposed to help: bacterial, viral and fungal infections, stomach problems, pain, anti-inflammatory
Science: The chemical carvacrol found in oil of oregano has been shown to have antimicrobial activity against a wide spectrum of different bacteria, Candida albicans (yeast) and norovirus.
Results: I've tried oil of oregano for over 10 bacterial infections now (including stuff like infected lymph nodes, urinary tract infection, cellulitis, sinuitis, abscesses and others) and it has worked every single time. I haven't noticed it helping with any viral infections, though. It also seems to kill canker sores in less than 30 minutes, at least if the sore is only starting to form.
Watch out for: For some reason oil of oregano doesn't seem to cause the same kind of side effects (such as stomach upset) as prescription antibiotics. It appears to be extremely well tolerated even in the seriously ill.
Recommendation: If you suffer from recurrent bacterial infections, definitely. I don't know if it's harmful to take it continuously as a preventative measure or if it loses its efficacy over time.
Oligomeric proanthocyanidins (grape seed extract/pine bark drink) (2013, 2014)
Usage: 1 capsule a day/the liquid according to the instructions
Supposed to help: antioxidant, immune system, anti-inflammatory, asthma, allergies, fatigue, mood, neuropathy, vision, tinnitus, circulation, edema, skin, high cholesterol
Science: Oligomeric proanthocyanidins or OPCs are powerful antioxidants. Grape seed extract and pine bark extract (including pycnogenol and the Finnish liquid supplement I tried) are particularly rich sources. Both have been successfully tried in several autoimmune diseases in small trials. Pycnogenol is particularly used for poor circulation, leg edema and varicose veins, as well as allergic conditions.
Results: Made my face break out and also seemed to cause night sweats, palpitations, poorer sleep and worse hypoglycemia, but I'm not 100% sure. Both sources of OPC did this, so seems to be a class effect for me and that's why I haven't tried pycnogenol.
Watch out for: They can also cause headaches, dizziness, nausea and mouth ulcers. They also thin the blood and can lower blood pressure. The pine drink was okay in taste, but grapefruit seed extract is also sold as a powder and I've heard it tastes awful.
Recommendation: Grape seed extract is a very good source of antioxidants and pycnogenol seems to help many different things, so OPCs are probably worth trying. Don't confuse grape seed extract with grapefruit seed extract.
Olive leaf (Olea europaea) (occasionally 2007-present)
Usage: 1-6 capsules or 2-5 ml a day
Supposed to help: flu/cold treatment, antiviral, antibacterial, antifungal, circulation, sleep, PMS
Science: Olive leaf has been shown to have powerful antibacterial and antiviral (also some antifungal) action, e.g. against HIV, enteroviruses, influenza virus and parainfluenza virus. It is a powerful antioxidant (in one study the most powerful out of 55 herbs). It also reduces platelet aggregation.
Results: No improvement in CFS/ME. Seems very helpful when taken together with some other supplements after catching a cold or after likely exposure. In large doses seems somewhat helpful for shin splints and plantar fasciitis. Also seems to reduce achiness, discomfort edema associated with periods.
Watch out for: My husband says it gives him slight reflux. Olive leaf can cause allergic reactions and lower blood pressure. Someone I know had breathing problems for months before she realized they were caused by the olive leaf she was taking. It can also cause "die-off" reactions.
Recommendation: For flu/cold treatment and prevention after exposure, definitely. May be worth a try for other things, too.
Peppermint (Mentha x piperita) (internally) (occasionally 2005-present)
Usage: enteric-coated capsules, a drop or two of the essential oil mixed in shampoo/conditioner or skin lotion and used as needed
Supposed to help: nausea, headache, digestive problems, antiviral, cold treatment, congestion, muscle pain, itching, irritated skin, menstrual problems
Science: Peppermint oil can relax muscles, act as a counterirritant and block pain via other mechanisms, as well. It is a well-known remedy for relieving itching. It has been shown relieve digestive problems including IBS, but then it needs to be packed into an enteric-coated capsule as it irritates the stomach. It has also demonstrated antiherpesviral activity in studies and thus can help cold sores.
Results: The oil relieves the itching I have from seborrhea and urticaria (both caused by CFS) very quickly and efficiently, but the effects don't last for very long. Peppermint tea works quite well for digestive upset in most cases.
Watch out for: Peppermint relaxes the lower esophageal sphincter and thus can cause belching and isn't recommended for those with acid reflux. It should be avoided in the presence of kidney stones. Peppermint is not recommended to be used regularly in significant quantities. Some people notice that peppermint oil irritates their skin.
Recommendation: Try it if you suffer from any of the listed symptoms it may relieve.
Rehmannia (Rehmannia glutinosa) (2013)
Usage: 1 cup of tea made from rehmannia root a day (3 g?)
Supposed to help: fatigue, immune system, libido, adrenal problems, autoimmune diseases, tinnitus, asthma, hair loss
Science: Rehmannia is an important tonic herb in traditional Chinese medicine. It can boost cortisol and other hormones.
Results: May have slightly helped fatigue.
Watch out for: I was worried it would give me hypoglycemia, as it can apparently do that, and almost everything that can cause hypoglycemia does that for me, but it didn't. It may rarely cause diarrhea, stomach pain and nausea.
Recommendation: It's very cheap in Chinatowns, but I don't know how safe those products really are heavy metal wise etc. The tea was surprisingly pleasant (=not bad) in taste.
Reishi (Ganoderma lucidum) (2013)
Usage: 2 capsules a day
Supposed to help: immune system, sleep, antiviral, antibacterial, cancer prevention
Science: Reishi (lingzhi) is one of the most popular medicinal mushrooms with a long history of use in both China and Japan. It is used in cancer treatment and has been studied in some autoimmune diseases like rheumatoid arthritis and colitis. It also seems to help with sleep by a different mechanism. It has antiviral and antibacterial effects and can reduce cholesterol.
Results: It did improve my sleep and gave me extra energy for about a month. After that the energizing effect pooped out, as happens for me with all supplements these days.
Watch out for: Reishi can lower blood pressure and blood sugar (didn't notice this myself). It also reduces blood clotting.
Rhodiola/roseroot/golden root/arctic root (Rhodiola rosea) (occasionally 2007-2013)
Usage: 1-2 g a day brewed into tea
Supposed to help: fatigue, brainfog, mood, anxiety, immune system, sleep, headaches
Science: Rhodiola is a well-researched adaptogen, which has been shown to boost the immune system, enhance cognitive abilities, relieve fatigue and improve mood and libido. Note that some preparations may contain very low concentrations of the herb. You'd want to use a pure root, a tincture or a standardized product from a reliable manufacturer.
Results: I have only used rhodiola occasionally as a "booster" on bad days, but it has worked well in most cases. It alleviates fatigue and brainfog, let's me "go on for longer" without nasty after effects and seems to have helped headaches in a few cases too. Taking a bit too big a dose has caused short-lived nausea in some cases, but I haven't noticed any other negative effects. A friend who suffers from chronic non-CFS/ME lassitude has improved a lot on rhodiola.
Watch out for: It may interact with antidepressants, so be careful if you're using them. Taken too late in the day it can cause insomnia. Larger doses can cause nausea and restlessness. Probably not recommended for people suffering from bipolar disorder. It should never be combined with MAOIs. Combining it with SSRIs is not recommended, though many people do it without problems. If you're taking a SSRI start out with a very low dose, just in case.
Recommendation: Definitely. It might be one of the best herbs for CFS/ME, as long as you can acquire a decent product. If you can find the dried root, it should also be extremely cheap (and isn't all that expensive in either case).
Schizandra (Schizandra chinensis) occasionally 2013-present
Usage: 2 capsules 1-2 times a day
Supposed to help: cognition, stress tolerance, fatigue, endurance, mood, immune system, allergies, nausea, diarrhea, liver, libido, skin, vision
Science: In TCM schizandra is traditionally used as an immune system and liver tonic. It is considered an adaptogen and nootropic and there is some evidence of cognition boosting and liver regenerating effects. It also appears to boost the immune system and may even improve vision.
Results: It seems to slightly help with my cognition, especially creativity/ideas, which is very useful for me, as I work as a novelist/playwright. Four capsules a day gave me a bit too freaky dreams, though, and possibly worsened trigger points, so nowadays I take just two in the morning, and it still affects my dreams somewhat. It doesn't help sleep; I'm not sure why some cholinergic things make me have weird dreams, other improve my sleep and some do both.
Watch out for: Schizandra tends to be well-tolerated, asides from the really strange dreams. Some people find it makes it hard to sleep if they take it too late in the day. It can increase stomach acid secretion and some warn against its use in epilepsy. Schizandra may interact with several medications, so check with your pharmacist or at least online.
Recommendation: It is safe and fairly inexpensive, so why not. Besides ginkgo it is the only herbal nootropic that has helped my cognition.
Shrubby sophora (Sophora flavescens (2013-2014)
Usage: 100 mg - 2 x 1 g a day of 1:5 extract powder
Supposed to help: cognitive problems, heart problems, sleep, antienteroviral, erectile dysfunction, hair loss
Science: Sophora contains oxymatrine, an antienteroviral compound which some CFS/ME doctors are using as a treatment. It can also help with heart problems. It is a 5-alpha-reductase inhibitor, which can help with prostate problems and hair loss in men. It increases acetylcholine levels.
Results: It acted like an immunostimulant at first, causing fever, which was unexpected. After that I didn't notice anything else but deeper sleep and wilder dreams thanks to the extra acetylcholine. Large doses seemed to possibly worsen my TMJ issues, as acetylcholine can tighten muscles and worsen trigger points. I continued taking a small dose for sleep, but after I started using growth hormone I no longer needed sophora.
Watch out for: 5-alpha-reductase inhibition can lower cortisol levels. However, despite severe adrenal insufficiency I didn't have any problems with this.
Recommendation: It is quite difficult to find, but probably worth trying. Taken in low doses the extract powder is also extremely inexpensive in the long run. (Note that the powder tastes fairly icky.)
Siberian ginseng/eleuthero (Eleutherococcus senticosus) (2007-present)
Usage: 2-3 grams brewed into concoction or one capsule a day containing 1000/1500 mg of extracted Siberian ginseng
Supposed to help: fatigue, brainfog, immune system, cold prevention, vision, tolerance to stress, anti-inflammatory, cancer prevention, PMS
Science: Siberian ginseng (eleuthero) is not a true ginseng, but it has similar adaptogenic and antiviral properties to the plants in the ginseng family. It can prevent viral infections and some cancers and make antibiotics more effective. It also improves the vision, color vision in particular.
Results: Siberian ginseng doesn't seem to have the stimulant effects of real ginseng. In fact I can take it just before going to bed and it doesn't hinder my sleep in any way. It appears to be effective against colds. When I've taken Siberian ginseng I haven't caught any colds despite certain exposure. It also noticeably improves color vision.
Watch out for: No known side effects, interactions or contraindications.
Recommendation: Not one of my first recommendations, but adaptogens tend to be benign and well-tolerated herbs so it's unlikely to do any harm.
Usage: 2-3 grams a day
Supposed to help: fatigue, chelation, allergies, hypothyroidism, high cholesterol
Science: Spirulina is a blue-green algae, often considered a "superfood". It is very high in e.g. iron, iodine and chlorophyll. In one study it helped hayfever. Many people claim it improves their hair, nails and skin and makes the former two grow faster.
Results: Have not noticed anything.
Watch out for: Spirulina may lower blood pressure and blood sugar. There are reports of autoimmune diseases worsening from spirulina use.
Recommendation: Not sure.
Suma (Pfaffia paniculata) (2013)
Usage: 1 capsule a day
Supposed to help: adaptogen, immune system, fatigue, muscle growth and endurance, libido, PMS, diabetes, pain, stress resistance, cancer prevention, circulation, cholesterol, ulcers, skin
Science: Suma is sometimes sold as Brazilian ginseng, but like Siberian ginseng, it's not in any way related to ginseng, it's just a traditional South American adaptogen. It has shown anticancer activity in several studies, though at quite high doses. There is some evidence of benefit in sickle cell anemia, but this is probably not relevant to most people with CFS/ME. Animal studies have suggested analgesic and libido-increasing benefits, as well.
Results: Made my hypoglycemia worse, so I had to stop taking it.
Watch out for: It may have estrogenic effects, so it's not recommended for those with a history of estrogen positive cancers etc.
Recommendation: Seems like a pretty neat plant and quite safe, so why not.
Tinospora/guduchi (Tinospora cordifolia) (2013)
Usage: 1 capsule a day
Supposed to help: immune system, allergies, diabetes, liver
Science: Tinospora is an old Ayurvedic herb which has been mostly unknown in the West, but gaining popularity recently. Several studies show it is an immunostimulant. It may help diabetes both by lowering blood sugar and reducing complications by other mechanisms. It may protect the liver.
Results: Didn't notice anything, possibly slightly worse IBS.
Watch out for: Tinospora may lower blood sugar. It didn't for me, though.
Recommendation: It is fairly inexpensive and seems safe. I'd probably recommend trying even though there seems to be little experience in CFS/ME.
Triphala (mix of herbs) (2014)
Usage: 1 capsule a day
Supposed to help: immune system, fever, bacterial infections, weight loss, IBS, constipation, asthma, diabetes
Science: Triphala an Ayurvedic herbal formula consisting of equal parts of amla or amalaki (Emblica officinalis), bibhitaki (Terminalia bellirica) and haritaki (Terminalia chebula). They are all shown to have beneficial effects, like Terminalia chebula can break down bacterial biofilms and they all contain antioxidants, but the formula hasn't been studied much in humans. There is some evidence it stimulates the immune system.
Results: Didn't notice anything, except slightly (but not markedly) looser stools.
Watch out for: May lower blood sugar. It didn't for me, though.
Tulsi/holy basil (Ocimum tenuiflorum) (2012)
Usage: 2 capsules a day
Supposed to help: fatigue, brainfog, depression, anxiety, stress, sleep, hypoglycemia, diabetes, weight loss
Science: Tulsi is one of the most valued herbs in Ayurveda and also gaining popularity in the west. It is considered an adaptogen but especially used for anxiety and to reduce stress. Its constituents may reduce the absorption of starch and sugars, thus helping with weight loss, diabetes and hypoglycemia.
Results: Didn't notice anything.
Watch out for: May worsen hypoglycemia (but can also help it). I didn't notice any difference in mine.
Recommendation: Why not, it's not very expensive. Some people find it rather helpful. Tulsi also makes for a very tasty tea and is delicious in cooking, preferably as a fresh herb.
Valerian (Valeriana officinalis) (2007)
Usage: 1-2 300 mg tablets as needed (almost every night)
Supposed to help: sleep, anxiety, pain, migraine prevention, epilepsy
Science: Valerian is GABAergic just like most sedative drugs and some anticonvulsants. It has been shown to be fairly effective as a sleep aid in many studies.
Results: It did somewhat help with sleep as long as I didn't have too much stress. Combining it with taurine seemed to make it a bit more effective, though the effects were mild compared to some other sleep aids I've tried. No daytime sleepiness or other adverse effects.
Watch out for: Valerian is touted as free of side effects, but of course it is not. It can cause morning drowsiness in some people. Someone I know who has severe CFS/ME got a nasty reaction to valerian, even though she can tolerate benzos without problems. It may cause mild discontinuation syndrome if long-term use is abruptly stopped. But in general most people handle valerian just fine. Just don't abuse it (e.g. combine it with alcohol or go driving when you have taken it).
Recommendation: For sleeping problems and anxiety it's a rather good choice, though if melatonin is OTC in your country (it isn't here) it's probably better to try it as the first sleep aid. Pay attention to the valerian content of the pills - some of them are more like homeopathic preparations with next to no active ingredient. Even with the strongest pills you may have to take 2-3 to get decent effects.
Zyflamend (proprietary herbal blend) (2011)
Usage: 2 capsules a day (as recommended on the package)
Supposed to help: pain, arthritis, cancer prevention, allergies
Science: Zyflamend is a proprietary blend of various anti-inflammatory herbs like holy basil, turmeric, ginger, skullcap and barberry. Some work somewhat similar to NSAIDs, others have different anti-inflammatory action and some are also adaptogens.
Results: I only took it for a week (free sample) but I didn't notice any beneficial effects or side effects, except possibly slight relief from plantar fasciitis/shin splints, but less than from bromelain. Many people have reported benefit from Zyflamend within 1-2 days.
Watch out for: Some herbs in Zyflamend may interfere with prescription drugs. Others may irritate the stomach and/or cause problems in people who are very sensitive to everything.
Recommendation: It is somewhat expensive, but could well be worth it if you have fibromyalgia or arthritis pain.
Vitamins, minerals and similar
Usage: 80-150 mg a day
Supposed to help: neuropathic pain, diabetes, fatigue, fibromyalgia
Science: Benfotiamine is a fat-soluble form of thiamine, vitamin B1. It is mostly used in the treatment of diabetes, especially diabetic neuropathy. It has also been used to treat other forms of neuropathic pain, including sciatica. Benefit in fibromyalgia pain has occasionally been reported. Thiamine has been used, and also studied, in the treatment of fatigue caused by e.g. autoimmune diseases.
Results: My already good cholesterol levels (HDL, LDL and triglycerides) were improved noticeably - however, I also started testosterone so it's hard to know what caused the improvement.
Watch out for: Side effects are very rare, but sometimes there may be hypersensitivity to all forms of thiamine.
Recommendation:If you have neuropathic pain or fibromyalgia, probably worth a try considering it's extremely safe.
Usage: Five 6 mg tablets a day for three weeks, taken with fat-containing food (as it is fat soluble).
Supposed to help: fatigue, immune system, vision, skin
Science: Betacarotene is a precursor to vitamin A and has immunomodulating properties. Some doctors have suggested that taking a three-week course of 50,000 IU (30 mg) of betacarotene daily helps some people with CFS/ME. After three weeks it is discontinued whether it helped or not. The possible benefit should continue for some time. Another course can be taken after six months.
Results: It didn't seem to do anything at all.
Watch out for: Even though vitamin A is toxic in overdoses, the body will never convert too much of betacarotene to vitamin A. Betacarotene is considered to be safe and doesn't cause any harmful side effects, but it is not recommended for smokers as there is some evidence it might increase their cancer risk. Large doses of betacarotene can cause carotenemia (skin turning orange, which is completely harmless), but it's not supposed to happen during this short course and it didn't happen to me.
Recommendation: It didn't help me, but it's very safe and very cheap, so it's worth a try.
Usage: 3-6 mg a day
Supposed to help: arthritis, osteoporosis, estrogen deficiency, magnesium and calcium utilizationb
Science: Boron has mostly been used in the treatment of arthritis and osteoporosis and in improving utilization of some minerals, but it also appears to be helpful in estrogen deficiency.
Results: Didn't notice anything.
Watch out for: Boron should be very safe.
Recommendation: Maybe if you have one of the aforementioned conditions.
Usage: 400-800 mg a day in different forms
Supposed to help: bone density, muscle aches and tension, PMS, sleep
Science: Calcium was thought to improve bone health, but research has since found that exercise and vitamin D intake are much more important than your calcium intake - not to mention that calcium can't be absorbed without the help of many vitamins and minerals. But it also has many other functions in the body.
Results: No positive effects. I've noticed that doses of 800 mg a day cause muscle aches almost invariably, even if I take magnesium with them. Doses of 400 or 500 mg seem to cause no problems.
Watch out for: Some people with CFS/ME say that calcium citrate has made them feel worse, but calcium carbonate has improved their condition. However calcium carbonate can cause constipation for some. Don't waste your money on coral calcium, it's not in any way better than other forms of calcium.
Recommendation: Probably not, though I guess it's worth a try due to the cheap price and low risk. If you want to improve your bone density, vitamin D (and K2) is a better bet.
Calcium EAP (2012)
Usage: 2 x 100 mg a day
Supposed to help: neurological inflammation
Science: Calcium 2-aminoethylphosphate is used in the treatment of multiple sclerosis (supposedly it is officially approved for MS in Germany?), so some people have suggested it might be useful in CFS/ME. Other 2-aminoethylphosphat salts are also used (potassium and magnesium EAP).
Results: I wasn't convinced about the efficacy of calcium EAP, but I tried it out just in case, as it was inexpensive and seems quite safe. I did not notice anything.
Watch out for: No idea.
Recommendation: There is very little evidence of its efficacy, so probably not, though it's unlikely to hurt.
Chromium (2011, 2014-present
Usage: 2-3 x 500 mcg day (GTF chromium)
Supposed to help: blood sugar, fatigue, mood, weight loss, depression, skin
Science: Chromium is essential in the sugar metabolism. It's believed to stabilize blood sugar and reduce carbohydrate cravings, even help with weight loss and fatigue, but there's no clear evidence of this. It has been used to treat atypical depression.
Results: Earlier I tried chromium at most at 400 mcg a day and noticed no effects. In 2014 my doctor told me to start taking it at a larger dose. 2 x 500 mcg has a noticeable effect, though it doesn't help my hypoglycemia very much - it has reduced my fasting insulin secretion by some 30%, but also improves insulin sensitivity by roughly the same amount. Occasionally I've taken even 4 x 500 mcg.
Watch out for: Chromium picolinate, one of the most common forms of chromium in supplements, may be carcinogenic.
Recommendation: Not particularly, but since it's fairly cheap you could try it if you have problems with sugar cravings or if your blood sugar levels fluctuate too much.
Colloidal minerals (2011, 2012)
Usage: 5 ml a day
Supposed to help: hypoglycemia, mood, fatigue, pain, hair loss, skin, muscle cramps
Science: Alternative/functional doctors often recommend colloidal minerals for various ailments. E.g. rubidium and vanadine are supposed to help with hypoglycemia.
Results: I wasn't very convinced, but it was cheap enough to try so I did. Didn't notice any effect.
Watch out for: Some products may contain harmful heavy metals. They also frequently contain preservatives, which some people are allergic to.
Recommendation: Probably not.
Inositol (2007-2008, 2012, occasionally 2013-present)
Usage: 500/650/750 mg at bedtime, or 1 g as needed
Supposed to help: sleep, depression, anxiety, muscle endurance, neuropathy, liver, blood sugar, PMS, weight loss, hyperlipidemia, skin, hair, keeping other treatments effective
Science: Inositol is a kind of sugar that acts a secondary messenger in many human metabolic processes. It is sometimes counted as a B group vitamin. It has been shown to be effective in many psychiatric conditions, such as depression, panic disorder, bipolar disorder and OCD, but the mode of action in these uses is not known. While this use has not been studied many people claim inositol helps them stay asleep at night. In the use of most psychiatric disorders the doses are usually very large, up to 20 g or more, but as a sleep aid much smaller doses (often 500 mg) appear to be sufficient. Inositol may also be helpful in polycystic ovary syndrome. According to CFS/ME expert Jay Goldstein inositol can be helpful if treatments help your CFS/ME at first but then cease working, he uses 1 g a day to keep the treatments effective (hasn't helped me with this, though).
Results: I tried melatonin and found that it puts me to sleep, but I stayed up at night even more than before. I had heard that inositol might be helpful for this so I tried it - and as a really nice surprise I found it really works. So now I sleep better than in well over a decade - not great by any means, I still have e.g. nightmares and nocturia, but very well for my standards. Sadly it has not improved my daytime functionality much, but at least I no longer have the horrible days caused by very bad sleep, and in general my quality of life is better, of course. Perhaps I wouldn't even need the melatonin now, but I want to keep taking it for its beneficial effects. I haven't noticed anything negative. Some people say inositol makes their hair and skin better and it may relieve hair loss, but I haven't noticed anything to that effect. In 2012 I tried inositol again since some people say it helps hypoglycemia. It is clear that 500 mg at bedtime doesn't help my nighttime hypos, but I'm not yet fully sure about 1 g (since I don't have the hypos nearly every night).
Watch out for: Inositol is very low on side effects. Most people never experience any. Some people have reported possible reduced libido and some bipolar disorder sufferers have reported induction of mania, which may suggest that inositol acts at least in part by serotonergic mechanisms. I have not seen reports of daytime drowsiness or any parasomnias.
Recommendation: Definitely, if you have any of the problems mentioned here. I wouldn't deny the possibility that inositol could even work for fatigue or brainfog because it's such an important substance for the body. Inositol is often recommended to be taken together with choline.
Usage: up to 7 mg a day (potassium iodide)
Supposed to help: hypothyroidism, weight loss, cancer prevention
Science: Iodine is a very important mineral for the thyroid. Both deficiency and excessive intake can cause hypothyroidism. In the Western world the recommendation is about 150 mcg a day, yet the Japanese eat about 10-50 mg a day (100 times more!) and aren't exactly unhealthy. Some people take iodine in low doses, others say they have only noticed an (immediate) improvement in hypothyroid symptoms in doses close to 10 mg. Some doctors believe iodine may prevent cancer.
Results: I started from 300 mcg using drops and progressively increased to about 7 mg. After a few days on that dose I had to quit, as it was causing diarrhea, gas and stomach cramps. During the time I tried it (about two weeks) I didn't notice anything. Perhaps a slight improvement in some hypothyroid symptoms, but could have been just wishful thinking.
Watch out for: See above. Some doctors believe iodine worsens autoimmune thyroid problems while many people with autoimmune hypothyroidism consider themselves improved on it, but best to be careful.
Recommendation: Perhaps if you have hypothyroidism, with the aforementioned caveats.
Usage: 200-500 mg a day (I've tried many different forms of magnesium as well as magnesium oil)
Supposed to help: bone density, muscle aches and tension, arrhythmias, migraine prevention, PMS, sleep, constipation, night sweats, epilepsy, allergies, anxiety, mood, Raynaud's phenomenon
Science: Magnesium is very important for many things, e.g. for muscle function (including the heart) and energy production. Even most healthy people are likely to be deficient and unusually magnesium deficiency actually decreases its absorption. Magnesium is also needed to properly utilize vitamin D, something many people neglect in their supplementation.
Results: Sometimes I get a feeling which I believe is due to a slight magnesium deficiency, which manifests itself as muscle aches, increased palpitations and sometimes even a migraine. Taking magnesium relieves these symptoms, but it doesn't seem to help them in other cases. Magnesium also alleviates my night sweats, which I already noticed years ago, but only recently found out why it works. If I've taken large doses of magnesium (400-500 mg a day) I've felt that the vasodilatatory effect can cause flushing of the face and my urinary frequency is increased.
Watch out for: Large doses of magnesium may cause diarrhea and upset the balance of other electrolytes.
Recommendation: Definitely, it's inexpensive and helps a lot of people with CFS/ME. Magnesium citrate, magnesium malate and the amino acid chelates are supposed to be the best forms in terms of absorption. Malate is the form usually recommended for CFS/ME.
Manganese (2011, 2012)
Usage: 5-10 mg a day
Supposed to help: fibromyalgia, muscle cramps, tinnitus, diabetes, osteoporosis, hair loss, arthritis, thyroid problems, epilepsy, allergies, asthma, PMS
Science: Manganese deficiency is a condition mostly recognized in alternative medicine, which is purported to increase the risk of various conditions, including musculoskeletal, hormonal, sexual, psychiatric, neurological and allergic ones.
Results: Worsened my hypoglycemia even taking just half a capsule (5 mg) a day.
Watch out for: See above. Many multivitamins or products with multiple vitamins added (such as dieting products) contain several milligrams of manganese, which could be a problem if it lowers your blood sugar like mine.
Recommendation: Probably not, unless you also have several of the aforementioned conditions or have a reason to suspect manganese deficiency.
Methylfolate (2010, 2012, 2013-present)
Usage: from 1/3 of a 400 mcg tablet to 2 x 800 mcg
Supposed to help: sleep, depression, cognitive problems, fatigue, restless legs, hair loss
Science: Metafolin (also known as levomefolic acid, L-methylfolate, 5-MTHF and mefolin) is the biologically active form of folate. Almost all supplements with folate actually contain synthetic folic acid, which isn't found in food and some 40% of people cannot utilize it properly. Folate has been used as a CFS/ME treatment and many find it helpful for depression, especially for making antidepressants work better. It can often help restless legs.
Results: The first time I tried it it seemed to make me sleep deeper, but made me groggier during the day and at that moment that wasn't an option. I tried it for the second time when I was trying B12 injections. After I got two migraines in less than a week (normally I get that many in a year or so) I figured folate was the likely culprit and discontinued it. The migraines seem to have stopped. There was also some initial itching, so I suspect folate worked as a vasodilator for me (as anything that improves circulation tends to make me itch and vasodilators tend to cause me migraines). After finding out I had a heterozygote mutation at MTHFR C667C (as I suspected) I decided to stop taking folic acid and switch to methylfolate. This time I got a much stronger reaction (e.g. feeling cold, migraines, fatigue) to even just 1/3 tablet and I've been slowly building up. Initially it helped my fatigue, but after I upped the dose from 400 to 500 mcg too quickly, it very abruptly stopped working. It does make me sleep a bit deeper.
Watch out for: Never take folate without B12 unless you can be certain you are not deficient in B12. Some methylfolate products are very strong, e.g. 7.5 mg or 15 mg. Some people with CFS/ME, even those with MTHFR mutations, don't get any side effects even from large doses, others find they have to titrate the dose slowly (Solgar tablets are easy to split and good for this) and may not be able to tolerate more than 1 mg. Taking enough magnesium and potassium may reduce the possible side effects. An adverse reaction may also mean a deficiency in B12.
Multivitamin (2003-2013, 2014-present)
Usage: currently LEF's two-a-day, but one pill a day
Supposed to help: immune system, general well-being
Science: Vitamins and minerals are essential for life and one might not get sufficient amounts of them from the diet, especially when sick. Many people with CFS/ME also suffer from malabsorption. Many vitamins and minerals can be beneficial even when doses exceed the required daily amount.
Results: I haven't noticed anything special, but it seems like I'm less suspectible to viral infections. Also, once I was without a multivitamin for several weeks and seemed to be more achy during this time.
Watch out for: Multivitamins differ widely in their ingredients. Usually they should be safe, but watch out for the vitamin A content, as vitamin A can decrease bone mass. Preferably take a multivitamin without any vitamin A (beta carotene should be safe, despite the study with a positive link to lung cancer in smokers). This is also the reason why you should take fish oils instead of fish liver oil. Other vitamins shouldn't cause problems even if you're taking a separate, stronger supplement. Some people claim to get headaches from multivitamins.
Recommendation: Multivitamins are generally inexpensive and I recommend them for everyone with CFS/ME.
NADH (Enada) (2011, 2013)
Usage: first 5 mg, then 20 mg (sublingual) in the morning
Supposed to help: fatigue, stamina, mood, cognition, heart, immune system, pain, weight loss
Science: NADH is a derivative of niacin (vitamin B3) which is supposed to be very good for the mitochondria and thus increasing energy levels. Many CFS/ME patients swear by it and some even claim improved immune function (demonstratable by lab tests). Some people notice the effects immediately, but it can take 2-4 weeks.
Results: I didn't notice anything, except getting no headaches (but I rarely get headaches anyway). One day I missed a dose and got a headache, but after quitting I didn't get them so it wasn't a rebound/"withdrawal" effect. Perhaps a little stomach upset in the first days.
Watch out for: Some people feel NADH makes them overstimulated, impairs sleep and/or causes "false energy", some even with low 2.5-5 mg doses.
Recommendation: It is somewhat pricier than most supplements (nothing ridiculous though), but many benefit greatly, so yes.
Niacinamide (vitamin B3) (2012, 2013, 2014)
Usage: 500-1,000 mg a day
Supposed to help: fatigue, cognition, sleep, anxiety, psychosis, edema, circulation, skin, osteoarthritis, hypoglycemia
Science: Niacinamide (or nicotinamide) is a form of vitamin B3 (niacin). Niacin gets converted to niacinamide in the body. Niacinamide has been used to treat a variety of medical conditions, some with more evidence than others (but generally not too much). It cannot be used to improve cholesterol values, like niacin, but also does not cause the "flush" reaction typical of niacin.
Results: I primarily started niacinamide to help my hypoglycemia. It did help a bit initially, especially daytime blood sugar. Perhaps a slight improvement in fatigue/functionality, but no difference in sleep. It seemed to initially cause foot pain, which one website explains is supposedly common when treating joint problems (apparently niacinamide fixes the joint issues and muscles have to adapt to a new position, or something?) - though I don't have joint problems I am aware of. Initially a larger dose of 2 x 500 mg day caused a bad migraine. I'm quite sure it was because of vasodilating effects, even though niacinamide isn't supposed to cause them (only niacin). Vasodilators often cause me migraines, especially during the night.
Watch out for: Niacinamide may elevate blood sugar levels and large doses may cause liver damage.
Recommendation: Possibly. It is safe and very inexpensive.
Niagen (niacinamide riboside) (2014)
Usage: 2 capsules a day
Supposed to help: fatigue, anti-aging
Science: Niacinamide riboside is a form of niacin, vitamin B3. It is considered a mitochondrial nutrient and is very popular in anti-aging/life extension circles. Some healthy people feel they have got huge benefits, though some are also taking very large doses. There are some studies where Niagen has successfully been combined with Q10 in CFS/ME, but it's hard to say which one is the most important psrt of the combination.
Results: Did not notice anything.
Watch out for: ?
Recommendation: Niagen is very expensive, but it can also be very helpful and is unlikely to do any harm.
Pantothenic acid (vitamin B5) (2012)
Usage: 2-4 x 500 mg a day
Supposed to help: adrenal insufficiency, skin, fatigue, sleep, anxiety, autoimmune diseases
Science: Pantothenic acid is a B complex vitamin. Deficiencies are very rare, but in large doses of several grams it is used mainly in the treatment of adrenal problems and acne. Some people say it also helps fatigue, even if they do not have adrenal problems.
Results: I didn't notice anything. My skin got worse if anything, but it was likely just a coincidence. I thought it gave me some itching and wild dreams, but they persisted even after discontinuation, so it was probably just a coincidence, too.
Watch out for: Side effects are rare. Some people get headaches or insomnia.
Recommendation: It is inexpensive, so if you have adrenal insufficienc or acne, why not.
Selenium (2007, 2010)
Usage: earlier Brazil nuts, later 200-400 mcg of selemethionine a day
Supposed to help: immune system, cancer prevention, thyroid function, mercury chelation
Science: Selenium helps the immune system and even prevent cancer. Brazil nuts are very high in selenium and just a few nuts contain the recommended daily dose.
Results: I haven't noticed anything, but it's clear that most effects of selenium aren't easily perceived.
Watch out for: Should be safe in reasonable doses.
Recommendation: Yes, unless you live in an area with high selenium content in the soil.
Vitamin B complex (mega strength) (2006, 2011, 2013)
Usage: at first one pill a day, then half a pill a day
Supposed to help: fatigue, brainfog, tiredness, immune system, mood, allergies, asthma, nausea, migraine prevention, skin
Science: The B group contains a number of different water-soluble vitamins (even though B12 is stored in the body) that have numerous important functions in the body. Deficiencies can cause all kinds of issues from anaemia to neurological problems. The requirements of these vitamins may be larger in people with CFS/ME due to increased usage and decreased absorption. Riboflavin can help in migraine prevention.
Results: I haven't noticed any benefit for my CFS/ME symptoms nor any other things the B group vitamins are supposed to help, including the skin. The only thing I have noticed is that I have more vivid dreams and I can always remember them with plenty of detail, which is due to pyridoxine (vitamin B6) - kind of cool, but not very helpful.
Watch out for: Niacin can cause a harmless but unpleasant flush reaction in some people. Riboflavine can color the urine, which is also harmless. Pyridoxine can cause insomnia for some people and also neuropathy in very large doses.
Recommendation: Hard to say, it hasn't helped me, but they're cheap and many people feel they are helped. It's probably worth a try at least since some people have observed effects after just one pill.
Vitamin B12 (2007, 2011, 2013-present)
Usage: various, see below
Supposed to help: immune system, fatigue, brainfog, tiredness, neuropathic pain, stomach problems, breathlessness, circulation, depression, skin problems, hair loss
Science: B12 is a vitamin mostly (but not exclusively, unlike many people think!) available in animal based food. However, even if you eat meat every day, you can be deficient in B12. In general it's all about the absorption. Additionally high doses of B12 in injection form (up to 20 mg a day, some 10,000 times the normally recommended dose!) are often used to treat CFS/ME with great results, apparently because it scavenges peroxynitrite, which can cause brainfog and other nasty symptoms. Sublingual tablets are a good alternative, as they're much cheaper and bypass the gastrointestinal system similar to injections. Even many healthy people notice an energizing and cognition enhancing effect when consuming large doses of B12.
Results: I've tried various different forms of B12. Initially, in 2007, even one 1,000 mcg (1 mg) sublingual cyanocobalamin lozenge reduced tiredness significantly, but the effect vanished in a few months and never returned even if I had a break of over a year (B12 was the first supplement that pooped out for me, eventually all the fatigue-reducing ones would). Later 2 mg or 5 mg sublingual methylcobalamin tablets did nothing. 3 mg cyanocobalamin injections helped my sleep, but did othing else. B12 Extreme (35 mg of B12, including all the four forms) helped my sleep pretty much the same amount. Then I tried 1 mg methylcobalamin from Enzymatic Therapy which also helped sleep (unlike those 2 mg and 5 mg lozenges from other brands); it is said to be the most effective brand with major differences between different methylcobalamin products. 10 mg adenosylcobalamin (dibencozide) from Source Naturals also helped my sleep. The most effective combination - more effective than the 35 mg lozenges - seems to be 1 mg of that methylcobalamin combined with 5-10 mg of that adenosylcobalamin. Still, even that only helps my sleep.
Watch out for: B12 rarely has any side effects, in fact it doesn't even have LD50. Taking thousands of times the daily dose appears to be entirely safe even in the long term. Still, some people can be sensitive to the effects, but it is very rare (it made my severely ill friend more anxious for some reason). Allergic reactions are possible, though they are supposed to only affect cyanocobalamin and hydroxocobalamin.
Recommendation: Definitely. One of the cheapest supplements and the effects are often noticeable right away.
Vitamin C (2005-present)
Usage: usually 2 x 500 mg a day, more if I either have a cold or consider myself particularly likely to catch a cold (e.g. after social gatherings)
Supposed to help: immune system, brainfog, cold treatment, cold prevention, urinary tract infections, allergies, pain
Science: Vitamin C is essential for humans, with the recommended daily allowance being about 60 mg. However much larger doses up to tens of grams a day have been claimed to have benefits. Vitamin C also improves the absorption of iron. It can prevent urinary tract infections and is often used for treating them.
Results: Vitamin C really seems to decrease the incidence of viral infections for me. Many people say it helps them with brainfog, but I haven't noticed any effect even when taking several grams a day.
Watch out for: Some people take very large doses of vitamin C, up to tens of grams a day, sometimes intravenously. Large doses can irritate the stomach and cause diarrhea. Vitamin C may also irritate the bladder, especially if you're prone to bladder problems. There are non-acidic forms of vitamin C available in many countries.
Recommendation: Definitely, probably in the range of 500 mg to 2 g a day, perhaps up to 5 g in case of an acute infection.
Vitamin D (2004-present)
Usage: 100-150 mcg (4,000-6,000 IU) a day
Supposed to help: bone density, aches, immune system, cold prevention, cancer prevention, mood
Science: Vitamin D was thought to be important only for bone health, but recent studies have shown it benefits the immune system as well. It appears to effectively prevent diabetes, autoimmune illnesses and cancer. The recommended daily allowances are likely way too small. Many leading scientists recommend amounts of 100-150 mcg a day.
Results: I haven't noticed anything special. When I increased the dose from 50 mcg to 100 mcg and soon afterwards 150 mcg I felt more feverish (and actually had a little more fever) for about a week, but it could have been a coincidence. Now I am taking 125 mcg and have very good blood levels.
Watch out for:
Recommendation: Most people living in higher latitudes are deficient in vitamin D in the darker time of the year and people with CFS/ME may not go out often even in the summer. I definitely recommend vitamin D and particularly the D3 form, which is more effective. Vitamin D intake is much more important for your bone health than calcium intake. Everyone should take vitamin D to prevent chronic illnesses.
Vitamin K2 (2014-present)
Usage: 50 mcg a day, several kinds
Supposed to help: bone density, cardiovascular prevention, inflammation
Science: Vitamin K1 (from green vegetables) is mostly for blood clotting, but K2 is important for the bones and may reduce atherosclerosis - it has been described as "taking the calcium where it should be" (bones, not walls of arteries). It also has some anti-inflammatory properties, reducing the secretion of inflammatory cytokine IL-6. There are several types of vitamin K2, the most important ones being MK-4 and MK-7. They have slightly different properties and people disagree which is the better one.
Results: Haven't noticed anything.
Watch out for: I also tried natto, which is a good source of K2, but it gave me migraines, probably from the biogenic amines created in the fermentation process. If you can tolerate natto, it's extremely healthy.
Recommendation: It's good for cardiovascular and bone health, probably not a CFS/ME treatment as such.
Zinc (2007, 2011, 2014-present)
Usage: up to 60 mg a day (+ 15 mg in multivitamin), currently 50 mg
Supposed to help: immune system, fatigue, cold treatment and prevention, brainfog, antiherpesviral, libido, high cholesterol, hair loss, neuropathic pain, tinnitus, skin
Science: Zinc has been used to treat numerous different conditions involving the immune system, from the flu to rheumatoid arthritis and leukemia. It is helpful for many different kinds of skin problems and may also help neuropathic pain. In some studies it has been helpful for suppressing Herpes simplex infection, but it is not known whether it works similarly for other herpesviruses. Zinc raises the blood levels of testosterone, which may be beneficial for libido (and sexuality in general) and may also explain some of the immunomodulatory effects.
Results: I haven't noticed much. If I take 100 mg a day it improves my skin, but 50 mg doesn't. In 2013 I noticed that if I take neither zinc nor a multivitamin, my legs tire more easily. In 2014 I was found to have low zinc levels and even 50 mg (+ 15 mg from multi) of a well-absorbable a day doesn't bring them very high.
Watch out for: Large doses of zinc impair copper absorption, if using large doses for a longer while, you should also supplement with copper (many multivitamins and zinc supplements also contain copper), unless you have high copper levels. Very large doses can also hinder the absorption of iron, which may be of concern if you tend towards anemia.
Recommendation: It is definitely worth a try. I also use zinc oxide cream (diaper rash cream) as a deodorant, it lasts for up to 72 hours.
Other supplements and non-pharmaceutical treatments
Bio-Strath yeast extract (2006)
Usage: 30 drops three times a day
Supposed to help: fatigue, immune system
Science: ? Possibly similar to Epicor?
Results: I bought this supplement just because I got it for practically free of cost and it's supposed to help with chronic fatigue. It didn't seem to do anything.
Watch out for: Considering that this is yeast extract it can probably cause problems if you are sensitive to yeast, even though the package says the product contains no live yeast cells.
Recommendation: No, though I don't deny the possibility that it may help some people.
Usage: 3-6 capsules a day (each containing 125 mg of bromelain and 250 mg of quercetin) or 500-1,000 mg of bromelain a day
Supposed to help: immune system, pain, sinusitis, asthma, cold prevention, cancer prevention, urinary tract problems, prostatitis, allergies, osteoarthritis, depression, anxiety (quercetin) diarrhea, weight loss, osteoarthritis, sinusitis, circulation, digestion, muscle aches, increased efficacy of antibiotics, cancer prevention, candida (bromelain)
Science: Bromelain is not a single substance, but a combination of protein digesting enzymes that comes from pineapple. It can be used as a digestive enzyme, but if used for the anti-inflammatory effects it should be taken on an empty stomach so that it isn't "used up" digesting your food. It also destroys fibrinogen, a substance which may be implicated in a subset of CFS/ME caused by chronic hypercoagulation. Quercetin is a flavonoid found in many foods, but supplements can provide much larger doses. It has antioxidant, anti-inflammatory, neuroprotective and antihistamine-like effects and has been shown to lower the risk of getting a viral infection.
Results: I mostly tried this product for my chronic post-nasal drip, in combination of twice daily nasal irrigation and topical echinacea and oil of oregano. Unfortunately I didn't get any relief. I'd have also liked to get some relief for my urinary frequency, but there was no effect. The only effect I noticed at the time was improved digestion, even though I took the capsules on an empty stomach. Later I took the capsules when I injured my foot and it seemed to heal extremely quickly (bromelain is recommended for sports injuries). It has been a great help for shin splints and plantar fasciitis. It also seems to prevent muscle aches caused by excessive activity very well. It works much better if you take it before exertion, the optimal seems to be 1-3 hours before.
Watch out for: Quercetin doesn't have known side effects, but bromelain can cause nausea, diarrhea, heavy periods and stomach upset. Very large doses of bromelain (e.g. well over 1 gram a day) appear to increase the heart rate. Bromelain may interact with blood thinning medications. Some people are allergic to bromelain.
Recommendation: Bromelain is well worth a try for muscle aches. Quercetin is perhaps more of a general "tonic" and "life extension drug" than something that helps specific symptoms.
Usage: 3 tablets a day
Supposed to help: stomach problems
Science: Butyrate is a short-chained fatty acid found in butter, as its name suggests, and also produced by beneficial gut bacteria. There is some evidence of benefit in Crohn's disease and ulcerative colitis. Since gut problems are thought to be important in CFS/ME, butyrate might be a helpful treatment.
Results: It seemed to increase my functionality a bit at first, but it caused me reflux and worsened my hypothyroidism symptoms (not sure why, of course I didn't take it at the same time as my thyroid medication), so I had to quit taking it.
Watch out for: It can cause stomach upset. Butyrate is used as magnesium, calcium and/or sodium butyrate and since it is often used in large doses, the mineral content should be kept in mind (e.g. 3 g of sodium butyrate corresponds to the sodium content of 2 g sodium chloride, probably not a big issue for most CFS/ME patients, but some may be on salt-restricted diets).
CLA (conjugated linoleic acid) (2012-2013, 2014-2015)
Usage: 2-3 x 750 mg a day
Supposed to help: hypoglycemia, weight loss, inflammation
Science: Conjugated linoleic acids (CLA) are fatty acids found in food, but also used as a supplement, mainly for weight loss and improving body composition. Despite being a trans fatty acid it also has some anti-inflammatory and anticancer properties.
Results: I got the idea that CLA might help my hypoglycemia, since Indian food seemed to make me much more satiated than anything else. When I first tried it for a month I didn't notice any effect. However, when I tried it for a second time it did seem to help with hypoglycemia for a while. Not sure what makes the difference, I actually used two different products the first time, both supposed to reliable. I don't think it has helped me lose any weight. It seems to make my stools a bit more regular/smooth.
Watch out for: CLA has been implicated in causing fatty liver (though there is also evidence to the contrary, that it can actually help fatty liver). It can also cause or worse insulin resistance.
Recommendation: Probably not.
Coenzyme Q10 (ubiquinone) and ubiquinol (2006-present)
Usage: one 100 mg capsule a day (at one point one 400 mg capsule every other day)
Supposed to help: fatigue, brainfog, muscle endurance, blood sugar, immune system, heart symptoms, migraine prevention
Science: Coenzyme Q10 is a vitamin-like substance that can be produced by the body, but not necessarily always in sufficient quantities. It is used as an "anti-aging" supplement and to treat mitochondrial diseases. It's one of the most widely recommended supplements for CFS/ME, some doctors think it helps almost everyone and a small study also showed very promising results.
Results: I was expecting a lot from this since so many people say Q10 helps them and so many doctors recommend it (my friend's neurologist even recommended it even though she didn't know anything about CFS). Sadly during the first months I was on it my CFS/ME worsened considerably and instead of improved exercise tolerance I lost most of the mobility I had. Of course it's possible that I'd be worse off without it, as I haven't really had much fatigue, just tiredness and muscle weakness. The only result I can confirm is that I hardly ever get tachycardia or other bothersome heart symptoms any more, which is of course great, but not nearly what I was hoping for. I have also tried ubiquinol, the more active form of Q10, for three weeks (100 mg a day), but I'm not sure if it made a difference. I felt better after the first 7-10 days or so, but it could have been something else.
Watch out for: Q10 is very safe. For some illnesses people may take up to several grams a day without any side effects. Still some sources report possible nausea, insomnia, rashes, dizziness, fatigue and abdominal pain as possible side effects, but I have not heard of anyone actually experiencing these symptoms. Diabetics should discuss the supplementation with their doctors, as Q10 can reduce the need for insulin.
Recommendation: Definitely. And everyone who's taking statins (a class of cholesterol lowering drugs) should definitely take it, CFS/ME or not, as statins can greatly lower the amount of Q10 produced in the body.
Digestive enzymes (with betaine hydrochloride) (2011)
Usage: 1 tablet halfway through a meal twice a day
Supposed to help: GERD, IBS, fatigue, food intolerances, weight loss
Science: People with CFS/ME are thought to often be low on digestive enzymes and stomach acid (the latter is called hypochlorhydria). While conventional medicine insists that heartburn/GERD (acid reflux) is caused by excessive stomach acid secretion, many alternative doctors believe the problem is actually more often low acid. And betaine hydrochloride supplements which increase stomach acid do often help people. Many people claim that taking betaine Hcl and/or digestive enzymes has helped them lose weight and tolerate foods they previously could not. Most digestive enzyme products contain enzymes for carbohydrates (amylase), fats (lipase) and proteins (protease). Some digestive enzymes like bromelain and pancreatin are also taken outside of mealtimes for anti-inflammatory and other benefits, but betaine Hcl should never be taken on an empty stomach.
Results: At first they seemed to help my stomach problems a bit, but I started to get heartburn sometimes. Some doctors say that if you get heartburn you just need to increase the dose, but I'm not fully convinced. I might try a brand without betaine Hcl.
Watch out for: Do take betaine before finishing a meal or it may cause nasty heartburn. Some people find that betaine gives them loose stools. Others find that one brand of enzymes works great while another doesn't or causes side effects.
Recommendation: At least if you have gas, indigestion, heartburn or acid reflux or suspect problems absorbing food. Especially recommended for those with Celiac or who've had their gallbladder removed.
Usage: 1 capsule every other day
Supposed to help: GERD, liver, sleep, cancer prevention
Science: D-limonene is made from lemon peels. It is mainly used to treat acid reflux, of which there is one unpublished study. The recommended protocol is to take one capsule every other day for 20 days. That is supposed to help for months.
Results: It didn't help my reflux. I found it somewhat sedative.
Watch out for: Can cause orange-flavored burps (definitely not the worst flavor for burps).
Recommendation: Probably not, unless you suffer from reflux.
D-ribose (2008, 2011)
Usage: 8-10 g a day
Supposed to help: fatigue, muscle endurance, heart
Science: D-ribose is a mitochondrial nutrient. It should work particularly well together with carnitine and creatine. There is a study which showed it was helpful in reducing fatigue in CFS/ME (at a large dose of 15 grams a day)
Results: From the very first time I took it I've noticed a marked improvement in fatigue and tiredness. However, after some weeks of use the effects seemed to completely disappear. In 2011 I tried ribose again in a lower dose (samples I got for free) and this time it seemed to boost my cognitive function, especially creativity, but I'm not completely sure.
Watch out for: Can keep you up at night if you take it too late in the day. It is a sugar, so keep that in mind if you are a diabetic or on a hypoglycemia diet or something. It's usually well tolerated, but a few people I know with CFS/ME have got worse from it.
Recommendation: It is quite expensive, but if you can afford it, it could be well worth the price.
Usage: 1 capsule a day
Supposed to help: fatigue, immune system, allergies, antiviral, antibacterial, cold prevention
Science: EpiCor is essentially fermented baker's yeast (Saccharomyces cerevisiae). Several people have told me that EpiCor has really helped their CFS/ME. Epicor supposedly starts working very quickly and they have also noticed the benefits in a matter of hours.
Results: I didn't notice any benefit. If anything, I felt a bit worse. Also many people praise that they haven't got a cold for years thanks to EpiCor, but I managed to catch one in the month I was taking it.
Watch out for: It can probably cause allergic reactions, especially for those with mold/yeast allergies. Probably not suitable for those on candida diets.
Recommendation: It seems safe, has markedly helped some people and is relatively inexpensive, so probably yes.
Usage: 3 x 500 mg on Monday, Wednesday and Friday, 500 mg on other days
Supposed to help: fatigue, muscle endurance, immune system, antiviral
Science: Inosine is a purine derivative that turns into the antioxidant uric acid in the body. It also has antiviral and immunostimulatory properties. Inosine has been used in the treatment of multiple sclerosis. The related molecule inosine pranobex (isoprinosine) is thought to be one of the best medications for CFS/ME, though there is disagreement whether inosine has similar effects or not.
Results: About five days since starting inosine I started noticing improvement in fatigue, being able to do more (especially general stuff that wasn't physically or mentally very demanding) yet suffering less afterwards. The dosing protocol I used has been modeled after the inosine pranobex protocols, though they usually have breaks of taking zero tablets (but people have complained they then have too many bad days). Varying the dose is said to keep it more effective. Using this protocol I did not notice any difference whether I took one or three capsules that day. However, after some months inosine stopped working and thus I discontinued it. When I was later able to start inosine pranobex, the effects were completely different.
Watch out for: Inosine should not be used by people with a history of gout or kidney stones. It could theoretically worsen allergic symptoms like chronic urticaria, but I didn't notice anything like that (and I get urticaria very easily).
Recommendation: Definitely, at least if you cannot afford inosine pranobex or it is not available in your country.
MSM (methylsulphonylmethone) (2009, 2014, 2015-present)
Usage: up to 4 x 1,500 mg a day
Supposed to help: aches, fatigue, detoxification, chelation, fungal infections, osteoarthritis, allergies, asthma, snoring
Science: MSM is a popular over-the-counter anti-inflammatory (and peculiarly some people nowadays consider it a "superfood"), though there isn't that much scientific evidence about its properties. Paul Cheney and some other CFS/ME doctors recommend MSM started at very low doses and increased up to 9-12 grams a day.
Results: I did not really notice anything. Some possible "detox"/"die-off" reactions, which could have been entirely coincidental, and perhaps a slight relief in fatigue. In 2014 I my too-low(!) homocysteine normalized, which I feel was probably due to MSM.
Watch out for: MSM is very safe, as long as it's pharmaceutical grade. Cheney warns that starting with a high dose could really intensify the symptoms for a while due to detox/die-off reactions.
Recommendation: Probably. It's quite cheap and safe. If Cheney is right, taking high doses for a while could even provide permanent relief.
Usage: 3 capsules a day
Supposed to help: cholesterol, fatigue, neurological illnesses
Science: Octacosanol is a natural fatty alcohol usually derived from sugarcane, which has mostly been studied to lower cholesterol (as policosanol), but many alternative doctors also recommend it for MS. Some people have theorized it might also help CFS/ME.
Results: It gave me stomach upset initially, but I didn't notice anything else.
Watch out for: ?
Recommendation: Probably not.
Omega-3 fatty acids (flax seed oil or vegan EPA/DHA) (2002, 2013-present)
Usage: capsules or oil
Supposed to help: fatigue, mood, immune system, brainfog, arrhythmias, hair, skin, anti-inflammatory
Science: Omega-3 fatty acids are polyunsaturated fatty acids essential for the human body. It has anti-inflammatory effects and it has been shown to help in some cognitive and psychiatric conditions (including depression and bipolar disorder).
Results: From ALA I haven't perceived any effects. Vegan EPA/DHA product made my hypoglycemia much worse so I had to stop taking it. It also thinned my blood noticeably: larger and more bruises and subcutaneous injections and blood tests caused bleeding.
Watch out for: Flax seed oil in a bottle goes rancid very quickly. Omega-3 fatty acids thin the blood, so watch out if you have problems with bleeding, are on blood-thinning medication or use several supplements (such as vitamin E or ginkgo) that also decrease clotting. Fish oil supplements can contain traces of heavy metals.
Recommendation: Yes. Fish oil is probably more effective than flax seed oil.
Usage: 2 tablets a day
Supposed to help: fatigue, muscle endurance, muscle recovery, circulation, pain
Science: ATP (adenosine triphosphate) is the power source of every cell. PeakATP is a form of ATP used as a supplement, with some positive studies about its use, e.g. in lower back pain and muscle recovery after exercise. It may increase uric acid levels, which is thought to be helpful in CFS/ME.
Results: It helped my fatigue for a month but then pooped out, as things tend to do.
Watch out for: Elevated uric levels might be bad in gout, though C
Recommendation: Could be worth a try. There are big differences in prices among different brands.
Phosphatidyl serine (2012)
Usage: 2 x 100 mg a day
Supposed to help: sleep, muscle endurance, muscle recovery, weight loss, stress, cognition, thyroid, autoimmunity
Science: Phosphatidyl serine is a phospholipid, present in some animal foods, soy and white beans, which has been used to boost cognition. It increases the levels of acetylcholine in the brain. It may help prevent Alzheimers and boost muscle recovery. It may reduce excessive secretion of cortisol and thus in some cases help with weight loss. Some doctors use it for autoimmune and thyroid conditions.
Results: PS gave me really bad stomach upset for a few days, but that went away. Also initially caused a skin breakout. Caused strange dreams (cinematic, fragmented, emotional - often unpleasantly, but not nightmares - and often featuring people I hadn't seen for years). Increased the amount of headaches I get, usually not too many but up to 2-3 a week with PS. Did not notice anything beneficial.
Watch out for: PS is supposed to be well-tolerated, I probably experienced all the side effects it has.
Recommendation: Probably no, it is quite expensive (I only bought it because it was 75% off).
Usage: 2 x 50 mg a day (if I remember correctly)
Supposed to help: brainfog, mood, fatigue, sleep, neurological symptoms, anxiety, migraine, other headaches, orthostatic hypotension
Science: Picamilone is a nootropic (cognition enhancing drug). The molecule combines GABA, an inhibitory neurotransmitter, with niacin, orv vitamin B3 that acts as a vasodilator, improving cerebral circulation. Despite the addition of GABA it is not thought to be sedative, but more like a mild stimulant. It also has anxiolytic effects.
Results: I didn't notice anything, but I was already taking piracetam and other nootropics at the time.
Watch out for: Cerebral vasodilators can cause headaches. Picamilone may be a mild MAO-A inhibitor, so it should not be combined with antidepressants or serotonergic supplements (like St. John's wort).
Recommendation: Maybe, but try other nootropics first, if possible.
Usage: 1 x 10 mg a day
Supposed to help: fatigue, stamina
Science: PQQ is a relatively new mitochondrial nutrient. There isn't much research about it, but some CFS/ME patients have found it gives them more energy similar to other mitochondrial nutrients like carnitine, ribose and Q10.
Results: The first time I took it on an empty stomach, as there was no warning about it. Bad idea, resulted in violent vomiting. Taking it with food didn't cause any side effects. If it helped any, the effect was very mild.
Watch out for: As above.
Recommendation: It really helps some people I know. It is somewhat pricey, though.
Usage: 10 mg a day
Supposed to help: fatigue, libido, pain, anti-aging, cognition
Science: Pregnenolone is a precursor to many important hormones, but also has effects of its own, especially in the brain, somewhat similar to DHEA (of which it is also a precursor). It used to be studied in rheumatoid arthritis in 1940s and 1950s.
Results: It gave me palpitations and possibly other side effects too.
Watch out for: Be careful, as some pregnenolone products contain 50 or even 100 mg, which is likely a much too big dose for most people.
Recommendation: Possibly, but only starting at a low dose.
Usage: one capsule a day
Supposed to help: stomach problems, fatigue, immune system, anti-inflammatory, cancer prevention, cold treatment and prevention, depression, skin, allergies
Science: Probiotics usually refers to lactic acid bacteria, but it can also mean other types of bacteria and even some types of yeast. There is no evidence that probiotics will be able to provide lasting help if the original gut flora has been damaged, but they can offer at least temporary relief by forming colonies in the gut. Long-term use may also prevent colon cancer. Lactic acid bacteria may also help with lowering cholesterol. In one study people with CFS/ME were found to have too little bifidobacteria in their intestine.
Results: Probiotics have definitely helped my IBS like symptoms quite a bit, no other benefit that I'm aware of. Out of multi-strain products brands that work for me include PB8, Source Naturals Life Flora and Solgar Multi-Billion Dophilus. Most other brands I have tried had no effect, even if they are much stronger. L. paracasei seems to be important for me. Kombucha has a noticeable effect on my IBS, wayer kefir doesn't. Of single strains I've tried Lactobacillus plantarum (seemed to help IBS some), Bacillus coagulans (initially caused constipation, after that no noticeable effect) and Saccharomyces boulardii (I use it in case of diarrhea or if there is risk of food poisoning, no other effects).
Watch out for: Many cheap probiotics may contain totally ineffective strains, so it's probably worth it to stick with a product from a known manufacturer - even though that doesn't guarantee the efficacy. Just the species of the bacteria isn't a guarantee of anything, the specific strain is what matters, but even a strain that helps other people can be harmful for others, so it all boils down to experimentation. Recommendation: Yes, especially if you have stomach problems (primarily in the gut instead of heartburn-like symptoms) or are taking antibiotics (don't take them at the same time of the day, of course). You can often notice a difference in a matter of a few days. If it doesn't help, try a different brand. Instead you can use probiotic yoghurts or other similar products. Sauerkraut, kefir and kombucha tea are other sources of probiotic bacteria.
Raspberry ketone (2012-2013)
Usage: ~100-600 mg a day, divided into 2-3 doses
Supposed to help: weight loss, fatigue, brainfog
Science: Raspberry ketone is one of the things that gives raspberries their taste, though it is too expensive and as such the supplements are made synthetically. It is a recent weight loss supplement. There is no evidence from human studies that it actually helps with weight loss, but many people swear by it. Some also say it makes them more alert (which makes sense, since the brain can run on both ketones and glucose).
Results: I only tried it because I could get a pure powder very cheap. At first it dramatically reduced cravings for sweets, especially chocolate, without affecting actual appetite much. Later the effect has subsided and is only minor. It also does nothing to alleviate physical symptoms of hypoglycemia, like the feeling of hunger I have almost constantly. No side effects or any effect on energy levels
Watch out for: Raspberry ketone hasn't been studied in humans, so technically its safety record is unknown. Side effects are thought to be rare.
Recommendation: Probably not, unless sweet cravings are a major problem for you.
Resveratrol (2011, 2013)
Usage: 300/400 mg a day
Supposed to help: fatigue, anti-inflammatory, anti-aging, antiviral, heart, skin, diabetes, arthritis, cancer prevention, skin
Science: Resveratrol is a popular "life extension" supplement, which is thought to possibly extend human life span. It is found in e.g. red wine, cocoa and peanuts, but in low quantities and the absorption is very low, so many question whether it has anything to do with the "French paradox". Resveratrol is neuroprotective and cardioprotective. It also has antiviral activity against several viruses, including several herpesviruses. It may increase testosterone and glutathione levels.
Results: Did not notice anything the first time. Later I tried a stronger 400 mg product (I had got both for free), which gave me stomach upset.
Watch out for: May lower blood sugar and blood pressure. It is thought to boost the Th2 side of the immune system, which may already be overly active in CFS/ME. Some resveratrol products are made with knotweed, which also contains laxative substances and people have complained about diarrhea and stomach cramps.
Recommendation: It's more of an anti-aging supplement than a CFS/ME treatment. Somewhat expensive, too.
R lipoic acid (the active isomer of alpha lipoic acid) (2007-present)
Usage: one 100 mg capsule a day (corresponds to a much larger amount of ALA)
Supposed to help: fatigue, brainfog, immune system, blood sugar, liver, heart, muscle endurance, neuropathy, detoxification, cancer prevention
Science: Lipoic acid has many important functions in the body. It is a very strong antioxidant and improves glucose tolerance. It has been shown to be helpful in the treatment of neuropathies and liver problems. Many people with MS swear by it, especially in combination with ALC, for its ability to relieve fatigue. Many bodybuilders use it in large doses. The R lipoic acid is the active isomer of alpha lipoic acid and it appears that the S isomer actually decreases the efficacy of the R isomer, which is why it's more effective to take R lipoic acid than alpha lipoic acid.
Results: I had suddenly lost a lot of the use of my legs and a bit later I developed very uncomfortable "gnawing" feelings in my legs at night, which could have been neuropathic pain. When I started taking RLA the pain went away very quickly and hasn't come back. Fatigue and muscle weakness were also significantly improved.
Watch out for: Some people don't recommend ALA/RLA for those with amalgam fillings. Diabetics may need to adjust their medication due to improved blood sugar control. High doses can cause insomnia, nausea, stomach upset or hypoglycemia. Lipoic acid may deplete the body of biotin, which may cause hair loss unless you're supplementing with it (found in most multivitamins and B complex vitamins).
Recommendation: Definitely. It has many different beneficial functions. Even if you don't notice a benefit it's probably still a good idea to take it.
Royal jelly (2011)
Usage: 1-2 x 1,500 mg (freeze-dried) a day
Supposed to help: fatigue, immune system, mood, antibacterial, antifungal, skin
Science: Royal jelly is a bee product which contains vitamins, minerals, antioxidants and immunomodulating substances. It is particularly beneficial for the skin, but many people also claim increased enmergy levels. There are some preliminary lab studies showing efficacy in autoimmune diseases (SLE, rheumatoid arthritis and colitis). It may help heal wounds, including mouth ulcers and stomach ulcers.
Results: I seemed to get an energy boost the day I started it and the day I upped the dose to 2 capsules, but after that nothing. After increasing the dose my post-nasal drip worsened (it certainly wasn't a cold) and a few days after stopping the royal jelly it went away (I don't have hayfever or any food allergies). A few weeks later I tried taking just one capsule and the post-nasal drip immediately returned. It really seems like an alleric reaction.
Watch out for: A few anaphylactic reactions (severe allergic reactions) have been reported even in people not allergic to other bee products. Royal jelly may lower blood sugar and possibly blood pressure. It may have some estrogenic effects, so not recommended for those with a history of estrogen-receptive cancers or such.
Recommendation: Hard to say. Possibly.
Usage: 2-4 capsules a day
Supposed to help: muscle soreness, arthritis, sinusitis, uterine fibroids
Science: Serrapeptase is a proteolytic enzyme similar to bromelain, though it is supposed to be better for sinusitis and especially uterine fibroids. There is, however, much less evidence to support its efficacy.
Results: Seemed to work similar to bromelain, but didn't notice any advantage compared to bromelain.
Watch out for: People have reported nausea, allergic reactions and rarely worsening of fibromyalgia. May worsen congestion at first.
Recommendation: Probably not, unless you can't tolerate bromelain (pineapple allergy?).
Usage: 1-2 capsules a day
Supposed to help: fatigue, cognition, sleep, pain, anxiety, stress tolerance
Science: Shilajit/mumijo is a substance found on rocks in certain mountains. It is not clear what it even is, biological or geological, but likely it contains plant matter. It has been studied in some inflammatory conditions and it has shown cholinergic properties.
Results: Seemed to help with sleep a bit, didn't notice anything else.
Watch out for: Some brands may contain heavy metals. In general shilajit is not well studied.
Recommendation: Probably no.
Usage: 2-3 tablets a day
Supposed to help: antioxidant, fatigue, immune system
Science: Superoxide dismutase (SOD) is an antioxidant also produced by the body. It is used as a supplement for e.g. MS. There are small studies done in a dozen different autoimmune diseases.
Results: Helped my fatigue/functionality, but as all such supplements do for me nowadays, pooped out in a month or so.
Watch out for: Some CFS/ME patients are very sensitive to antioxidants and may get e.g. anxiety from them.
Recommendation: Definitely. It's quite inexpensive too. Note that some SOD products contain gluten.
TMG (trimethylglycine/betaine) (2011, 2012)
Usage: ~600-1,000 mg a day
Supposed to help: fatigue, depression, cardiovascular prevention, liver, skin
Science: Trimethylglycine (TMG) or betaine is a methyl donor, which should not be confused with betaine Hcl (hydrochloride) which is taken to create stomach acid and improve digestion. Poor methylation has been suggested to contribute to CFS/ME, autism, depression and other ailments. It is also a known risk factor for cardiovascular problems and can be measured from elevated homocysteine. Of the two most important methylation pathways one needs TMG and one needs B12 and folate.
Results: Haven't noticed anything except for the notorious "maybe I feel a little bit better". I plan to try a larger dose at some point.
Watch out for: Can initially worsen symptoms when the body starts to detoxify better etc. Some people have reported that they initially feel better and after a little while get worse. Actual side effects are non-existent in low doses.
Recommendation: It's very cheap and low on side effects, so why not?
Undenatured whey protein (2008-2009)
Usage: 20-25 g a day mixed into water, taken on an empty stomach
Supposed to help: immune system, stomach problems, muscle endurance, headaches, antiviral, antibacterial, antifungal
Science: Undenatured whey protein is used in CFS/ME for its immunomodulatory and antimicrobial properties. Besides containing some directly antimicrobial substances it also increases the amount of glutathione in the body, which may be decreased in CFS/ME and adversely affecti the immune system. In a small study conducted by Paul Cheney all patients improved on undenatured whey protein and most (formerly positive) even tested negative for chronic bacterial and viral infections at the end of the study.
Results: I have noticed a moderate benefit in my overall feeling. I have less "off" days (days when I can't really do anything at all). It only seems to help my stomach problems (slightly) when I take it, but not later in the day. However I am fairly sure I have got some kind of a "die-off" reaction (joint pain, muscle pain, feverishness, swollen lymph nodes, night sweats etc - normally I don't have these symptoms since I've been on LDN), which has never happened to me with any other antimicrobial substance. For several months these symptoms returned every time I drink licorice tea (according to one study licorice and whey protein may have synergistic antiviral effects).
Watch out for: Not suitable for those allergic to milk. Large doses may also cause problems to people with lactose intolerance. Can cause "die-off" reactions. Someone I know experienced tingling and burning in palms a few days after starting to take whey, and it hasn't gone away. I don't know what mechanism could be this or whether it's just a coincidence.
Recommendation: Yes, especially if you know/suspect that you have a chronic viral infection and cannot get/afford antiviral medication.
Elimination diet (2011)
Usage: eliminating possibly offending foods
Supposed to help: fatigue, brainfog, allergies, headaches, pain, congestion, stomach problems, bladder problems, skin
Science: Elimination diets eliminate foods that commonly cause intolerances. Which foods that includes depends on the diet, but the one I was instructed to use by my doctor eliminated e.g. dairy, soy and most other beans, eggs, all nuts, most seeds, most vegetables, fruits and berries, gluten and some other grains, corn, mushrooms and yeasts, virtually all spices, sugar, cocoa, coffee and tea (and I don't eat corpses anyway), but not latex fruits. Besides intolerance-causing foods also e.g. goitrogenic foods (those bad for the thyroid) were excluded. If symptoms improve, foods are slowly introduced back one by one.
Results: I did not notice any change in any symptom.
Watch out for: At first the symptoms can get worse, especially headaches. If elimination diet is followed for a while, nutritional deficiencies can develop.
Recommendation: Probably, if there is any suspicion of food intolerances.
Gluten-free diet (2007)
Usage: only gluten-free food for six weeks
Supposed to help: fatigue, brainfog, allergies, headaches, epilepsy, hypothyroidism, congestion, stomach problems, skin
Science: Gluten is a mixture of the proteins gliadin and glutenin, found in wheat (including spelt), rye and barley. A very similar protein is also contained in oats. Gluten-free diet is required for people with coeliac disease, which isn't allergy but an autoimmune disease. It is also possible to be intolerant to gluten without having coeliac disease. Many people with CFS/ME report that a gluten-free diet relieves their symptoms, especially brainfog, congestion and stomach problems. Effects are often noticed after a week or two, but doctor Sarah Myhill recommends trying the diet for six weeks to assess the benefits.
Results: I noticed nothing at all, except for a urinary tract infection I got which I believe may have been related (e.g. due to changed pH of urine). My fatigue, brainfog, congestion, stomach problems and skin stayed just the same. When I reintroduced gluten back to my diet there was no change either.
Watch out for: Many gluten-free baked products are made out of fairly low nutrition ingredients such as corn, potato, rice and tapioca. Try to eat things like buckwheat, quinoa and amaranth, which are gluten-free and very nutritious.
Recommendation: If you have a significant amount of allergies/intolerances, congestion and stomach problems, it may be worth a try. If you are very sensitive to medications and supplements this is a good candidate to try, as it should not cause any side effects.
Usage: oxygen from an oxygen concentrator, delivered via a nasal cannula, usually at flow rate 3l/min.
Supposed to help: fatigue, sleep, recovery, circulation, pain, vision, headaches
Science: At large flow rates oxygen is used to treat migraine and some other headache types.
Results: Helps improve sleep and reduce need for sleep. Makes my eyes and vision feel better and my eyes actually look very different, bright and moist instead of dull. Also significant effect on edema, even though I'm already taking horse chestnut. Improves mental clarity and muscle recovery. Has increased my circulation so much that I needed to cut down to my transdermal estrogen and testosterone doses to half. When I started using oxygen it boosted my sympathetic nervous system so much I couldn't sleep if it was at 3l/min. Nowadays that is no problem.
Watch out for: Very rarely someone has reported hyperventilation.
Recommendation: Definitely, if you can afford
TENS (transcutaneous electric nerve stimulation) (occasionally 2011-present)
Supposed to help: muscle pain, joint pain, neuropathic pain, myofascial trigger points, TMJ, headaches, muscle stiffness
Science: TENS can help pain essentially with two mechanisms: by relaxing the muscles (which deactivates myofascial trigger points) and by competing with pain signals. The former effect can give lasting relief, the second usually only works while the machine is being used. It can also help other symptoms caused by myofascial trigger points (which can include anything from vision disturbances to projectile vomiting). In most cases TMJ and tension headaches are at least mostly caused by trigger points.
Results: I don't have chronic pain, but I have myofascial trigger points everywhere in my body. If the placement is right, TENS usually completely or mostly relaxes a muscle within 20-40 minutes. It's a shame it cannot be used on the chest and the scalp, as some of my worst trigger points are located in those areas.
Watch out for: Not to be used on the scalp, across the forehead, the chest or the front of the neck, though the exact contraindicated areas depend on the unit. Some people cannot tolerate any form of electrical currents, including TENS.
Recommendation: If you have any kind of pain, definitely. I got my unit for about 30 euros, so it is not a big investment.
Tiger balm (occasionally 2003-present)
Usage: Spread on the affected part of the skin as needed or exhaling vapours from the jar
Supposed to help: muscle pain and tension, headaches, congestion
Results: I've used tiger balm successfully for sore and tense muscles. Even in case when muscle relaxants haven't worked, tiger balm has noticeably relaxed the muscles in just a few hours.
Watch out for: Tiger balm contains many types of essential oils, so it may cause problems for people with allergies or chemical sensitivities.
Recommendation: Yes. You should be able to find it for just a few euros/dollars for a jar, which lasts for quite a while.
Whiplash treatment (2011)
Usage: one-time treatment for whiplash injury (misaligned C5 and C7? vertebrae were realigned by hand by a doctor)
Supposed to help: headaches, neck pain, arm pain, neurological symptoms, dizziness, fatigue
Science: Whiplash injury is caused by sudden distension of the neck, most often in a car accident. It is a non-medical term and can refer to various types of injuries: muscle and ligament microtrauma, misaligned vertebrae and myofascial trigger points.
Results: I never thought I might have whiplash, as I haven't been in a car accident and our family didn't even have a car. I was told the problem may have originated in my childhood and I can believe that. The first week was quite awful. At first I had a weird headache and feeling in my neck. My neck and shoulders had bad stiffness in ways I had never experienced before. Also, I felt completely "comatose" for a while. Should have used TENS, but instead I had my husband massage my neck - which did bring relief but as is usual for trigger point massage, made the problem worse for the next two days. After that I felt better than before the adjustment, but it could have been a coincidence. After a few weeks things got worse than before the adjustment, with my neck making clicking sounds and feeling weird, possibly other symptoms too (can't prove causation). I was told they would get better and after some weeks my neck returned to being okay, but three months after the adjustment I cannot say for sure whether it has helped any. I still get headaches infrequently, about 1-2 times a month. Already the day of the adjustment or the next day my husband noticed that the weird "lump" on my neck he had commented about for years disappeared.
Watch out for: As I described, the problem may get worse for a while. I wouldn't recommend having the procedure done before any important events or deadlines (I wasn't warned about anything other than a headache for 1-3 days).
Recommendation: Manual adjustment by a skillful practitioner should be very safe (provided you don't have a bleeding disorder, connective tissue disorder, ankylosing spondylitis or anything like that). I didn't even pay anything for mine (it was done in the course of a normal 1-hour appointment, not charged extra). So I guess it can't hurt?