Conventional Treatments for ME/CFS:

By Cara Lan, N.D.

If after thorough work-up your practitioner has come to the conclusion that the most likely diagnosis is ME/CFS, you have several options for treatment with conventional (Western) medicine. However, you will note that all the treatments listed here support you and your symptoms, they typically do not address the root cause and getting on medications can lead to long term consequences and adverse effects, making healing from ME/CFS that much more difficult.

But back to treatment options with conventional (Western) medicine:

• Treatment with pharmaceutical medications such as:

  • low-dose naltrexone, duloxetine, gabapentin, or pregabalin for pain

  • Corticosteroids such as fludrocortisone and hydrocortisone, to decrease general inflammation

  • Medications that affect the autonomic nervous system such as midodrine, pyridostigmine, and beta-blockers

  • Stimulants such as modafinil, methylphenidate, and dexedrine for fatigue or brain fog

  • Benzodiazepines or sedating antidepressants such as trazodone, mirtazepine or tricyclic antidepressants for sleep

  • Medications to treat comorbid conditions such as medication for diabetes or hypothyroidism

  • No antidepressant medication has been shown to improve ME/CFS

  • Most medications need to be given in lower than usual dosages as most ME/CFS patients are more sensitive to the adverse effects of medications compared to healthy people

• Non-pharmacologic treatments include:

  • Salt and fluid loading for those with orthostatic intolerance (symptoms appear when going from lying or sitting to standing)

  • Cognitive aids to help with memory

  • Ear plugs, noise-cancelling headphones and eye masks for sound and light sensitivity

  • General sleep hygiene

  • Avoidance of problematic food

  • Meditation[1]

  • Graded exercise (despite the fact that symptoms have not been shown to improve with exercise programs and many symptoms are exacerbated by exercise)[2]

  • Cognitive Behavioral Therapy (CBT) – can help with acceptance of one’s illness and support regarding career or school work, peer group or family issues; be careful to avoid therapists who know little about ME/CFS and would convince you that you do not have an actual physical disorder and/or encourage you to get back to a normal level of function instead of supporting you in resting when you know you need to

Refer to the next 2 sections to learn more about how to treat Chronic Fatigue Syndrome naturally.

[1] ‘Diagnosing and Treating Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)’ by the U.S. ME/CFS Clinician Coalition, Version 2, July 2020.

[2] ‘Chronic Fatigue Syndrome: Assessment and Treatment of Patients with ME/CFS: Clinical Guidelines for Psychiatrists’ by Eleanor Stein, M.D., FRCP(C), ©2005