Traditional recipes

How to Tell if You Have Chronic Fatigue—Plus, What to Eat if You Do

How to Tell if You Have Chronic Fatigue—Plus, What to Eat if You Do

If you’re super tired and getting sick often, it could just mean you’re overworked or a bug is going around. However, if it’s chronic and doesn’t seem to get better with medication or rest, it could actually be a more serious underlying condition known as chronic fatigue syndrome (CFS).

The only problem? CFS is tricky to diagnose and treat. “It is officially recognized as a disease now, but for years, sufferers of CFS were told ‘it's all in your head,’ which was very frustrating. Some doctors still don't believe it exists or are likely to miss the diagnosis, even if they believe it's a real medical problem,” explains Suzanne Dixon, RD a registered dietitian with The Mesothelioma Center in Orlando, Florida. Here's how to know if you have CFS, and what to eat if you do.

Stay up to date on what healthy means now.

Sign up for our daily newsletter for more great articles and delicious, healthy recipes.

Chronic Fatigue Syndrome Symptoms

While symptoms can be hard to pinpoint, they will definitely be severe. “The level of tiredness is so extreme many sufferers are confined to bed for days to weeks and even months. They simply can't even manage to sit up, take a shower, or even move from bed to chair,” says Dixon.

The crushing, severe fatigue can come and go, so people may have periods of time where they feel a bit better, but the feeling isn't relieved by sleep, and those with chronic fatigue might even have sleep problems and insomnia, too, she says. What’s more, you might find yourself feeling dizzy, having lack of focus, and even muscle pain. Ugh.

The good news is that food can help a little bit in managing symptoms. “According to a recent review paper, people with CFS may be more likely than people without the disease to experience specific nutrient deficiencies: vitamin C, B complex vitamins, sodium, magnesium, zinc, folic acid, l-carnitine, l-tryptophan, essential fatty acids, and coenzyme Q10,” says Dixon.

The more severe the deficiencies are, the greater likelihood of CFS symptoms. Yet, this is only a correlation. “It does not tell us if the deficiencies cause worsening ME/CFS symptoms, or perhaps, the disease itself causes drops in levels of these nutrients in the body,” says Dixon. Still, it makes sense to try to correct these deficiencies to find some relief.

Here are the best foods to eat if you have CFS. And in addition to these foods, Dixon recommends protein with every meal and snack to help preserve lean body mass and normalize glucose levels.

Foods High in Vitamin C

If you think you have CFS, look to load up on fresh fruits and veggies that are packed with vitamin C, which can boost your immunity, provide energy, and keep you well. Some great examples include citrus, strawberries, red peppers, kiwi, broccoli, tomato juice, and melon, says Dixon.

Foods Rich in B Vitamins

B Vitamins also help the body maintain its daily functions and boost brain function, to keep you more mentally alert, which is helpful for those with CFS. Plus, it makes you physically energized too, to help you get out of bed and maintain normal activity.

“For folate, eat more green leafy vegetables, spinach, black-eyed peas, fortified plant milks and cereals, romaine lettuce; for other B vitamins, a mix of animal foods (fish, chicken, lean beef), grains and fruits and vegetables will get people plenty of these nutrients,” says Dixon.


Yes, soup is good for those with CFS, but mostly because of the sodium content, so feel free to get a cup that’s a little higher in salt. “Soups and broth are good for both hydration and sodium replacement,” says Dixon. These are excellent options to keep your electrolytes balanced.

Magnesium-Packed Foods

Here’s another reason to eat spinach and legumes when you have CFS. Magnesium alleviates joint and muscle pain, and it can provide energy and mental focus, so it’s a great nutrient to eat when you have CFS, explains Dixon. Try nuts and nut butters (think almonds, cashews, and peanuts), spinach, whole grain cereals, beans, and other legumes, she recommends.

Healthy Fats

Healthy fats, like unsaturated and omega-3 fatty acids, reduce inflammation, which can boost your immunity, relieve muscle pain, and keep your body in healthier shape, all of which is needed when you’re suffering from CFS symptoms. Go for nuts and nut butters (especially walnuts, which have omega-3’s), flaxseeds and chia seeds, and fatty fish, like salmon, Dixon suggests.


Additionally, you’ll want zinc, as zinc also boosts the immune system to prevent sickness, says Dixon. You can find zinc in shellfish (like oysters and other seafood). And if that’s not your thing, you can also get it in fortified cereals, beef, and liver.

What Are the Symptoms of Chronic Fatigue Syndrome?

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is more than feeling tired all the time. It comes with a lot of other symptoms that can make it hard to handle daily life. Even simple things like walking to the mailbox or writing a letter can make it worse. The fatigue and symptoms can last 6 months, or can go on for years. Sleep and rest don’t make it better, either.

A doctor can help relieve your symptoms, but first you need to get diagnosed.

If you have ME/CFS, you’ll have these three “core” symptoms:

  • Reduced ability to do usual activities for six months or more because of fatigue
  • Worsening of symptoms (difficulty thinking, problems sleeping, sore throat, headaches, feeling dizzy, or severe tiredness). after usual physical or mental activity
  • Trouble falling asleep or staying asleep

Along with the three symptoms, you must have one of these for a diagnosis of chronic fatigue syndrome:

  • Problems with thinking and memory
  • Worsening of symptoms while standing or sitting upright you might feel lightheaded, dizzy or weak, and you may have blurred vision or see spots.


Several factors could be responsible for our sweating, either on their own or in combination. They include:

  • Autonomic nervous system dysfunction  
  • High norepinephrine levels, as a side effect of antidepressants , as a symptom or overlapping condition

The only cause that's "curable" is the medication side effect, and that may not be an attractive option to you if the drug is doing more good than harm.

However, some medications may help control your sweating, so it's worth bringing up with your doctor.

Chronic Fatigue Syndrome Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Causes of Cancer Fatigue

Someone with cancer may experience fatigue for several reasons.

With leukemia and lymphoma, cancer cells in the bone marrow can interfere with the normal production of blood cells. This can lead to anemia, and anemia can then lead to fatigue.

Colon cancer and stomach cancer can cause anemia through blood loss in the bowels, likewise leading to fatigue.

The metabolic processes of tumors can also contribute to fatigue. Cancer cells aggressively compete for nourishment with normal cells.

Some cancers lead to fatigue by disrupting normal hormone functioning. Others secrete substances known as cytokines, which in turn can cause fatigue.  

Fatigue has many causes besides cancer, though. In that respect, fatigue accompanied by unintentional weight loss is more concerning than fatigue alone.

Testing for Chronic Inflammatory Response Syndrome Due to Mold

Some of the biomarkers for the different underlying causes of CIRS overlap, some are different. These are some of the biomarkers seen in mold patients which have been the most common forms of CIRS I’ve found in my practice.

CIRS due to mold exposure has a couple of characteristic markers, including high levels of

  • C4a – An activation protein that can cause inflammation, free radical production, and damage to tissues if too high.
  • TGF–beta1 – A cytokine in the immune system that has both anti– and proinflammatory effects.
  • MMP–9 – An enzyme that helps with tissue repair and is a significant marker of CIRS.
  • ACTH / Cortisol – A hormone that can be elevated and lead to weight gain in CIRS patients.
  • VEGF – A protein that causes blood vessel formation.

CIRS due to mold exposure is characterized by low levels of:

  • MSH – A hormone that is anti-inflammatory and typically low in CIRS patients.
  • ADH – This hormone regulates the amount of water your body removes and is associated with dehydration, frequent urination, and excessive thirst.
  • VIP – A neuroregulatory hormone that is associated with inflammation
  • Visual contrast ability – You can take the VCS test, which is simple and can be done at home.

There are several tests that can help you identify if mold is the cause of your inflammation, and therefore your symptoms. These tests are useful If you suspect you have CIRS, I recommend the following:

  • The Visual Contrast Sensitivity (VCS) test checks for neuroinflammation, which is often caused by mold exposure. The VCS test checks your ability to see differences in colors, a common symptom of CIRS. It’s also only $10 and can be done at home, so it’s a good place to start.
  • There is a Mold CIRS Panel laboratory markers that you can test in the conventional laboratory. This panel tests for MMP9, TGF-beta1, MSH, ADH, and osmolality.

If you believe your symptoms might be caused by chronic inflammatory response syndrome, it’s so important that you make an appointment with a doctor familiar with this condition. I can’t tell you the number of times I‘ve seen patients who have gone from doctor to doctor trying to find the cause of their symptoms.

When CIRS is the suspected culprit of your symptoms, there are a number of things that can be done right away to ease your struggles. Intervention and remedies like eating specialized diets, taking supplements that support natural detoxification, sauna therapy, and mold remediation can help those with CIRS.

If you are in need of a New York functional medicine doctor who is experienced in CIRS, you can request a consultation here. Don’t wait until this condition becomes worse, you can begin the path to relief today.

Super FoodsTo Treat Chronic Fatigue

Chronic fatigue is commonly associated with overuse of the adrenal gland, known as adrenal exhaustion. Stress, the excess use of artificial stimulants (including caffeine), and viruses (including herpes virus 6 and Epstein­Barr virus) can all cause chronic fatigue. But chronic fatigue syndrome is not so simple. It may also be caused by other viruses, immune system disorders, or low blood pressure. In most instances, chronic fatigue is diagnosed when all of the above conditions are ruled out and no other explanation for the symptoms can be found. Typical symptoms include:

  • constant fatigue, no matter how much sleep you get and lasting more than six months
  • difficulty mustering energy for normal functions
  • tenderness of the lymph nodes and muscles
  • depression
  • drowsiness
  • light­headedness
  • mental cloudiness and memory loss
  • decreased libido

You may also experience disturbed sleep patterns, mood swings, headache, and loss of appetite.

What Causes Chronic Fatigue?

The exact cause of CFS remains unknown, making the condition difficult to treat. Following is a summary of the possible causes of CFS:

  • Adrenal Depletion: Drink a lot of coffee? Have a stressful life? Then you may be at risk for adrenal exhaustion, also called adrenal depletion, which often manifests as chronic fatigue.
  • Viruses and Immune System Dysfunction: Epstein­Barr virus and human herpes virus 6 have been linked to CFS, although some say these are not directly responsible for CFS. Excess Candida albicans (a yeast­

like fungus found normally in the body) is also often present in those who suffer from CF

Low Blood Pressure: Studies show that low blood pressure is a common condition in CFS patients and that increasing blood pressure can improve energy in most cases.

Treatments for Chronic Fatigue

The most important thing you can do for chronic fatigue caused by adrenal exhaustion is to support your adrenal glands (see Adrenal Imbalance). If your condition is caused by a virus, then use antiviral herbs and food therapies:

  • Maca root
  • John’s wort
  • Garlic extract
  • Green tea and green tea extract
  • Una de Gato, or Cat’s Claw, from the Amazon (scientific name, Uncaria tomentosa).
  • Refer to Infection (Viral) for more information.

To augment and balance low blood pressure:

  • Take an iron supplement.
  • Eat Spirulina to aid in the body’s absorption of minerals and help balance blood sugar levels.
  • Eat foods rich in bioflavonoids, such as red grapes, green tea, bilberry, hawthorn root, and gotu kola.
  • Eat antioxidant­rich foods.
  • Refer to Blood Pressure (Low) for more details about treating low blood pressure.

Other Considerations

Some experts believe that Chronic Fatigue is as much a neuro­emotional­based problem as it is a physical or biochemical­based problem. When all the other possible explanations have been ruled out, and symptoms remain, then you are diagnosed with Chronic Fatigue, In other words, Chronic Fatigue is the medical establishment saying, “We don’t know what’s wrong with you.” At this point, it would be wise to look into possible causes not associated with typical solutions, including (or maybe especially) emotional and psychological causes. Losing the will to continue, chronic hopelessness, depression, and shock or trauma can all cause the symptoms associated with CFS.

Chronic fatigue is often mistaken for Lyme disease be sure you are tested for this if you are experiencing CFS symptoms.

A Third of Older Adults have Stage 3 Chronic Kidney Disease

Over time, your kidneys may start to work less efficiently than they used to. Those two bean-shaped organs in your lower back are essential to your health, so it&rsquos worth knowing you could have this common condition.

As an internal medicine physician, Alina Livshits, MD, at Fairview Clinics &ndash Andover, says Stage 3 chronic kidney disease is one of the more frequent topics she gets asked about. Here she answers your questions and offers some advice.

Q: What is chronic kidney disease?

A: The kidneys filter blood, remove waste products from the body and recycle useful materials. So chronic kidney disease is the gradual loss of those functions. It&rsquos described in stages. For example, when someone has Stage 3, it means their kidneys are filtering about half of what they should be, allowing for some fluids, electrolytes and waste to build up in your body. People with Stage 5 often require dialysis several times a week to filter their blood.

Q: Who is most at risk to develop chronic kidney disease?

A: The primary causes are high blood pressure and diabetes. If you have either of those, I recommend talking to your doctor about your risk for developing chronic kidney disease.

Q: How do I know if I have it?

A: Chronic kidney disease often starts to develop without you noticing it. Symptoms may appear in Stage 3. For those that do experience symptoms, they may include fatigue, swelling around the ankles or eyes, unusually light-colored urine, urinating more frequently or loss of appetite.
Fortunately, some simple tests can help us measure kidney function and diagnose kidney disease.

Q: Is it treatable?

A: Once you get to Stage 3, it&rsquos generally considered to be irreversible. The good news is that the majority of Stage 3 patients do not progress to the more severe stages. But it&rsquos important to work with a doctor to manage this condition.

Additional Symptoms

In addition to these core symptoms, one of the following two symptoms is required for diagnosis:

  • Problems with thinking and memory. This is commonly known as brain fog.
  • Worsening of symptoms while standing or sitting upright. This is known as orthostatic intolerance and is caused by a dysfunction in the autonomic nervous system. In my case, I suffered from postural orthostatic tachycardia syndrome (POTS). With this syndrome, one’s heart rate will raise at least 30 bpm in at least 10 minutes after standing from a sitting position. See here.

Those are some bad symptoms, right? Well, it gets worse. Many ME/CFS sufferers also can experience the following symptoms in varying degrees:

  • Muscle pain and aches (For years it felt as if I had clamps affixed to my arms and legs)
  • Joint pain without swelling or redness (Several of my finger joints were inflamed for years)
  • Headaches, either new or worsening
  • Tender lymph nodes in the neck or armpits
  • A sore throat that happens often
  • Digestive issues, like irritable bowel syndrome (IBS)
  • Chills and night sweats
  • Allergies and sensitivities to foods, odors, chemicals, or noise

In my case, I hit the jackpot. Over the span of 28 years I experienced every single one of these symptoms to a greater or lesser degree. My worse symptoms were extreme fatigue, PEM, muscle aches, joint pain, headaches, and POTS. I also had an endoscopy done because of IBS.

Note that ME/CFS is considered only after everything else that could cause chronic fatigue is ruled out.

One question still remains unanswered: Why did I get ME/CFS?

15 Tips for Eating Healthily With Chronic Illness

When it comes to eating healthily when living with a chronic illness, you may find yourself in a bit of a quandary. We know that eating healthily can help us feel somewhat better, but we simply don’t have the energy to spend ages in the kitchen. Hmmm. Some days cooking anything at all just isn’t manageable. Many also rely on others to prepare and cook their meals (if they’re fortunate enough to have that support).

So I thought I’d dig out my old nutrition hat (I’ve previously worked as a Personal Trainer and I’m also qualified in Holistic Nutrition!), and come up with some simple ideas on how we can still eat healthily when living with a chronic illness. Even if you’re unable to do these yourself, it can help those we may depend upon to spend less time in the kitchen. That has to be a good thing, right?

I’m very aware that we all have our own individual nutritional needs. People may also struggle with a lack of appetite and/or nausea which can make food seem unappealing. Plus, in the complex world of chronic illness, all sorts of different allergies and intolerances can come into play. I’ve come a long way, but I’m still learning what works best for me as I go! I have found that (pretty much) cutting out dairy and substantially reducing gluten in my diet has made a big difference for a lot of my gut issues. Plus I try and eat a higher proportion of plant-based meals – though I still have some meat in my diet. We’re all so different though, and what works for me may not work for you.

When it comes to chronic illnesses like ME/CFS, it really can be a case of trial and error until you work out an eating pattern that suits you best.

My tips here are not about telling you what you should or shouldn’t eat. I’m merely just giving you some ideas to hopefully make your life a little easier! Feel free to adapt them to suit your needs!

1. Use frozen veggies to save time and energy by not having to chop. I honestly couldn’t live without frozen onions! I use them in soups, stews, pasta dishes, curries, etc.! I also love frozen peppers, and I’ve even recently discovered frozen, chopped garlic! Bonus! Frozen sweet potato and butternut squash chunks are also wonderful for making easy stews/soups or roasting them to add to salads.

2. Use frozen fruit to add to smoothies. I always have a supply of frozen berries and mango in my freezer. You can also chop up bananas and freeze them in bags. Handy for those over-ripe ones!

3. Staying with smoothies, I love my smoothie maker! I tried juicing for a while, but I found the chopping (and washing up afterwards) far too labor-intensive! I like to have smoothies to add some extra nutrition into my day while giving me a little energy boost. They’re also handy if you struggle with poor appetite or nausea, as it can sometimes feel easier to drink something. Be sure to sip them slowly though as otherwise it can be difficult to digest! The smoothie maker I use comes with two sports bottles (not used for sports of course these days!) and you just add your ingredients to this and blend! Then add your cap and voila, it’s ready to drink! Easy to make and easy to wash up! No fuss – phew!

4. Sprinkle seeds onto cereals, salads, soups, etc. Seeds are little nutritional powerhouses! They contain natural fiber, iron, protein, good fats and plenty of vitamins and minerals. You can use sunflowers seeds, pumpkin seeds, linseeds, chia seeds or sesame seeds, to name a few! I often buy a bag of mixed seeds to make life even easier! Happy sprinkling!

5. Add a little fruit or vegetables to each meal to be sure you reach your five servings a day! This is as easy as adding banana or berries to your breakfast, having some avocado or tomatoes with your sandwich at lunch, and having a side salad with dinner.

6. Add herbs to your meals. Fresh herbs are great but dried are good too (and easy!). Herbs have been used for centuries and have a whole host of nutritional benefits. These include strengthening the immune system, lowering blood sugar and cholesterol, anti-inflammatory properties and reducing the risk of some diseases. Think oregano/basil with pasta, coriander with curry, parsley/rosemary with stews. Often I’ll add herbs to salads for extra flavor and goodness. Or why not brew up some mint tea – any excuse for a cuppa!

7. Spice it up a little! Like herbs, spices are historically known for their wide range of health benefits. They are full of antioxidants, they can help to reduce inflammation, help digestion, reduce the risk of certain diseases, strengthen nails/skin/hair, etc.! Like herbs, each spice has its own specific benefits – there’s loads of info out there if you fancy learning more! So apart from the obvious like making a curry – why not sip some ginger tea (good to help with nausea too), add some cinnamon to your porridge and, if you’re feeling a little more adventurous, try making a turmeric latte! Or if you’re anything like my husband you’ll just add chili to everything!

8. Use tinned pulses such as chickpeas, black beans, kidney beans, lentils. They are handy to use (no soaking required!) and are a good source of protein, fiber, vitamins and minerals. Plus they’re inexpensive and count towards your five a day! These can be your friends for making easy stews, soups and curries!

9. Drink plenty of water. Don’t underestimate the benefits of being well hydrated! You could always keep a jug on hand to make this easier.

10. Use a slow cooker/crockpot. I recently dug out mine from the back of the cupboard and I’m so glad I did! Throw in all the ingredients in the morning, and you have a healthy, tasty dinner ready for that evening! Fab! I especially love recipes where you don’t need to brown anything first! If you have any tried and tested recommendations I’d love to have a peek please! I usually adapt recipes and use chopped, frozen vegetables to make life easier.

11. If you want to be a little more fancy you could stock up on a few nutritional powders! These are handy if you’re struggling to get enough vitamins and minerals in your diet or you just want a bit of a boost. For example, wheatgrass is high in iron. They can be used in cooking/baking, added to smoothies or even just stirred into water as a shot! Who needs vodka?! Just kidding! I’m not suggesting you go out and spend a fortune. It can be very easy to get caught up in thinking you need x, y and z when you probably don’t! Maybe just talk to your doctor and try a couple if you both think they’re necessary. I couldn’t live without cacao these days as I use it to make hot chocolate and energy balls.

12. Try healthy recipes with only a few ingredients listed. If you’re anything like me then a long list of ingredients will put you off! Again, you can adapt recipes and use frozen instead of fresh vegetables if it makes life easier. As you can probably tell, I’m not a fan of chopping!

13. Save the links (or take a pic if it’s in a book) to any easy, healthy recipes you like. If you’re like me, you’ll forget them otherwise! Pinterest is also great for finding new recipes. Check out my “Healthy Eating” board!

14. Graze on healthy snacks throughout the day to try and help manage your energy levels. Think nuts, seeds, fruit, energy balls, smoothies.

15. Double up the ingredients of a recipe to make enough for a couple of nights. My husband always makes a big batch of something at the beginning of the week, and it’s great to have something handy for the following night! Or if you’re using fresh (rather than frozen) ingredients you could always freeze batches.

Try to make healthy eating fun and remember it’s OK to have a treat. Phew! Some days it will all go out the window and you just have to eat whatever is convenient to get by. That’s life with a chronic illness! However, I find that by making some little tweaks to my diet, I can still manage to eat healthily the majority of the time.

We want to hear your story. Become a Mighty contributor here.

The next steps to eating right

As your kidney function goes down, you may need to eat foods with less phosphorus and potassium. Your health care provider will use lab tests to check phosphorus and potassium levels in your blood, and you can work with your dietitian to adjust your meal plan. More information is provided in the NIDDK health topic, Nutrition for Advanced Chronic Kidney Disease.

Step 4: Choose foods and drinks with less phosphorus

Why? To help protect your bones and blood vessels. When you have CKD, phosphorus can build up in your blood. Too much phosphorus in your blood pulls calcium from your bones, making your bones thin, weak, and more likely to break. High levels of phosphorus in your blood can also cause itchy skin, and bone and joint pain.

  • Many packaged foods have added phosphorus. Look for phosphorus—or for words with “PHOS”—on ingredient labels.
  • Deli meats and some fresh meat and poultry can have added phosphorus. Ask the butcher to help you pick fresh meats without added phosphorus.
  • Fresh fruits and vegetables
  • Breads, pasta, rice
  • Rice milk (not enriched)
  • Corn and rice cereals
  • Light-colored sodas/pop, such as lemon-lime or homemade iced tea
  • Meat, poultry, fish
  • Bran cereals and oatmeal
  • Dairy foods
  • Beans, lentils, nuts
  • Dark-colored sodas/pop, fruit punch, some bottled or canned iced teas that have added phosphorus

Your health care provider may talk to you about taking a phosphate binder with meals to lower the amount of phosphorus in your blood. A phosphate binder is a medicine that acts like a sponge to soak up, or bind, phosphorus while it is in the stomach. Because it is bound, the phosphorus does not get into your blood. Instead, your body removes the phosphorus through your stool.

Step 5: Choose foods with the right amount of potassium

Why? To help your nerves and muscles work the right way. Problems can occur when blood potassium levels are too high or too low. Damaged kidneys allow potassium to build up in your blood, which can cause serious heart problems. Your food and drink choices can help you lower your potassium level, if needed.

  • Salt substitutes can be very high in potassium. Read the ingredient label. Check with your provider about using salt substitutes.
  • Drain canned fruits and vegetables before eating.
  • Apples, peaches
  • Carrots, green beans
  • White bread and pasta
  • White rice
  • Rice milk (not enriched)
  • Cooked rice and wheat cereals, grits
  • Apple, grape, or cranberry juice
  • Oranges, bananas, and orange juice
  • Potatoes, tomatoes
  • Brown and wild rice
  • Bran cereals
  • Dairy foods
  • Whole-wheat bread and pasta
  • Beans and nuts

Some medicines also can raise your potassium level. Your health care provider may adjust the medicines you take.

View tips for people with chronic kidney disease:

This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.