Chronic Fatigue Syndrome/ME

Chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME), is a condition that involves a variety of different symptoms which can make it difficult to diagnose. One of the most common symptoms is extreme tiredness and brain fog.

If you have CFS and are unsure of what and when you should be eating, you may benefit from the additional help and support from a qualified nutrition professional who is experienced in the management of CFS/ME.

Diet and lifestyle changes can help to manage symptoms. A nutrition professional will be able to work with you to develop strategies and create a personalised diet plan. These strategies aim to minimise any related complications such as nausea, eating and swallowing problems or difficulties buying and preparing food. Here we take a closer look at CFS, the role nutrition plays and how a nutritionist can support you.

What is CFS/ME?

Chronic fatigue syndrome is a long-term condition that has a number of symptoms, the most common of which is persistent exhaustion. Other typical symptoms of CFS include:

The symptoms can vary day-to-day and can resemble other illnesses, so it is important to speak to your doctor for a diagnosis.

The condition can affect a sufferer’s everyday life and can lead to long-term illness and disability. It can also take its toll on a person's mental health and overall well-being. Many people (children and young people in particular) do find symptoms improve over time.

This short animation helps to explain how CFS can affect sufferers.

Stress and CFS

"One of the key components in understanding chronic fatigue syndrome/ME is to understand the role of the autonomic nervous system (ANS) and how an altered or dysfunctional ANS may be creating and/or exacerbating the symptoms associated with CFS/ME," explains Nutritional therapist, Susan Woodward, Dip CNM mBANT rCNHC.

"The ANS comprises two antagonistic sets of nerves - the sympathetic nervous system and the parasympathetic nervous systems. When our brain perceives a threat, the sympathetic branch of our nervous system kicks in, pumping blood to our muscles, heart, and brain so we are ready to fight or run for our lives; often referred to as the 'fight or flight' mode."

In this Sympathetic Nervous System dominance, the functioning of all the body's systems are either up or down regulated leading, over time, to the wide-ranging number of random symptoms experienced in CFS/ME. Getting out of Sympathetic Nervous System Dominance is crucial in order to get symptom reduction and also to allow the body to rebalance and regain its natural levels of homeostasis - only then can the body start healing.

- Read more in Susan's article, the role of the autonomic nervous system in CFS/ME.

Treatment for chronic fatigue syndrome

The treatment you're recommended will depend on how CFS affects you as an individual. CFS can last a long time, which is why maintaining good health and seeking nutritional advice can be beneficial. There are other treatment options, however, which can help to manage certain symptoms.

Cognitive behavioural therapy (CBT) is a type of therapy that can help you cope with symptoms and their impact. It aims to reduce the severity of distress related to CFS by breaking problems down into more manageable parts. The treatment will often be tailored to your needs. A CBT session may include:

  • discussing the diagnosis
  • accepting the diagnosis
  • recognising feelings that may prevent recovery
  • working to increase control over symptoms

Some people find CBT helpful, while others prefer approaches such as activity management or complementary therapies. See how you get on with the approach your doctor recommends and if you don't find it helpful, ask them if you can try an alternative.

I was introduced to ‘reverse therapy’ – an approach based on the idea that illnesses like mine were the result of ignoring your body’s warning signals for too long. By reconnecting my body and mind, I could start to heal.

- Read Vikki's story of ME.

Common dietary issues

People with CFS/ME may seek nutrition advice due to weight change. CFS sufferers can gain weight as a result of being unable to exercise due to exhaustion, muscle pain or other symptoms. Some sufferers will lose weight. They may have lost their appetite, feel nauseous or lack energy to buy and prepare meals. A nutrition professional will help you to manage these symptoms and discuss strategies that will help to maintain weight and ensure a nutritious diet.

People with CFS may also experience symptoms of irritable bowel syndrome (IBS), including wind, bloating, abdominal pain, diarrhoea and constipation. If you are experiencing these symptoms, you may benefit from following an IBS diet plan (low FODMAP diet).

Chronic fatigue syndrome diet

The body needs a balanced diet to improve strength, keep it functioning and maintain good health. Many people with CFS/ME find eating little and often helpful, aiming to eat every three to four hours. A nutritionist will help you create a CFS diet plan tailored to easing symptoms and boosting well-being.

What can I eat?

While everyone is different, there are some common food groups that can be effective in managing symptoms of CFS/ME. Starchy food - particularly slow releasing types with a low GI (glycaemic index) - are recommended as these help to keep energy levels stable. This includes porridge, potato, rice and wholegrain pasta and bread.

A balanced diet includes plenty of fruit and vegetables (aim to get at least five portions a day), dairy products such as cheese and yoghurt, as well as meat, fish, eggs, nuts, beans and pulses.

bowl of vegetables

Restrictive diets

Restrictive diets are not recommended unless there is evidence of specific food allergy or intolerance and then it should be under the care of a dietitian or healthcare professional.

Many people with CFS/ME also suffer from IBS symptoms, and can see an improvement with removal of problem foods. One way to identify problem foods is by following an elimination or exclusion diet under the supervision of a healthcare professional.

Food sensitivity

Some people with CFS suffer from food intolerances. Rashes, heart palpitation, migraines and muscle weakness are some of the symptoms associated with food sensitivity.

The first thing to do is visit your GP, where they may refer you to a nutrition professional. A dietitian may suggest changing your diet to help learn which foods are causing the sensitivity. An assessment will be made using a food and symptom diary, as well as your medical history, to aid the identification of possible food intolerances.

It is usually recommended that you remove a suspected food for a limited period of time, followed by a ‘challenge’ of the food to gauge tolerance. Your nutrition professional will ensure you are getting all the nutrition you need during any periods of food exclusions.

How can nutrition help manage symptoms of CFS?

Symptoms will vary from person to person and may fluctuate in severity. There may be times where symptoms improve. At other times, they may worsen, making daily tasks difficult. A nutrition professional can help make these activities easier by creating a supportive CFS diet plan.

So often I see someone pushing themselves too hard, overriding the signs from their body telling them to slow down, but if help from a nutritional therapist specialising in this area can be sought in time, then tipping over into chronic fatigue can certainly be prevented and, going forward, strategies for managing stress can be successfully implemented.

- Vanessa May BSc Nut Med, CNHC and BANT reg.

Where can I find a nutritionist near me?

When looking for a nutritionist, it is important to find someone who resonates with you and who is sufficiently experienced. On Nutritionist Resource, we have a proof policy that ensures everyone we list has provided proof of qualifications and insurance or membership with a professional body. We also encourage our members to provide as much information on their profiles as possible. This way you can learn more about the way they work and what they can help with.

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