Chronic Fatigue Syndrome: Therapy

General measures

Nicotine restriction (refraining from tobacco use).
Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day).
Limited caffeine consumption (max 240 mg of caffeine per day; equivalent to 2 to 3 cups of coffee or 4 to 6 cups of green/black tea).
Aim for normal weight!Determination of BMI (body mass index, body mass index) or body composition using electrical impedance analysis.
- BMI ≥ 25 → participation in a medically supervised weight loss program.
- Falling below the BMI lower limit (from the age of 19: 19; from the age of 25: 20; from the age of 35: 21; from the age of 45: 22; from the age of 55: 23; from the age of 65: 24) → Participation in a medically supervised program for the underweight.
Review of permanent medication due topossible effect on the existing disease.
Avoidance of psychosocial stress:
- Bullying
- Mental conflicts
- Social isolation
- Stress
Avoidance of environmental stress:
- Chemical substances such as amalgam or mercury.
- Environmental toxins such as lead, cadmium or ozone.
If environmental toxins are responsible for the symptoms, relief can be achieved by avoiding the triggering substances (exposure prophylaxis)

The following vaccinations are advised:

Nutritional counseling based on nutritional analysis
Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
- A total of 5 servings of fresh vegetables and fruit daily (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
- Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
- High-fiber diet (whole grains, vegetables).
Observance of the following special dietary recommendations:
- Diet rich in:
  - Vitamins (folic acid)
  - Omega-3 fatty acids (marine fish)
  - Linoleic acid
  - Gamma-linolenic acid (GLA)
  - L-carnitine, coenzyme Q10 (CoQ10)
Selection of appropriate food based on the nutritional analysis
See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
Detailed information on nutritional medicine you will receive from us.

Endurance training (cardio training) and strength training (muscle training) – for therapy.
The affected person should be encouraged to moderate athletic training, which does not overwhelm him, as it is considered proven that physical sparing and inactivity worsens the symptomatology of chronic fatigue syndrome.
Preparation of a fitness or training plan with appropriate sports disciplines based on a medical check (health check or athlete check).
Detailed information on sports medicine you will receive from us.

Specific physical therapy (graded exercise therapy, GET) showed good long-term results.

Behavioral therapy is designed to resolve or reduce anxiety related to the disease.
Cognitive behavioral therapy (CBT) showed good long-term results.
Detailed information on psychosomatics (including stress management) can be obtained from us.