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AYURVEDIC APPROACH TO THE MANAGEMENT OF CHRONIC FATIGUE SYNDROME

Chronic fatigue syndrome - aka myalgic encephalitis - and more recently been referred to as systemic exertional intolerance disease (SEID), is a complex disorder characterised by the individual experiencing extreme fatigue lasting for six months or more, and which cannot be fully explained through an underlying medical condition. The fatigue worsens with physical or mental activity, but also does not improve with rest.

Characteristic symptoms of the condition include; sleep that is not refreshing, sore throat, sleep issues, difficulties with memory, focus and concentration, heart palpitations, multiple joint pain, headaches, enlarged lymph nodes – with the severity of symptoms fluctuating day to day. Other symptoms can include gastrointestinal issues, urinary problems, allergies, sensitivity to light/smells/food/sounds/chemicals, marked weight changes and inability to tolerate temperature changes.

The cause is unknown, although there are many current theories, and it may also be caused through a combination of factors, including biochemical abnormalities, digestion issues, viral or other infections, immune/neurological/hormonal changes, and/or the body’s ability to produce and transport energy. CFS can occur at any age, but is most prevalent in young to middle aged adults, and women are more likely to have the condition (or be diagnosed).

Potential triggers can include:

  • Viral infections: Viruses include the Epstein-Barr virus and/or Human Herpes Virus 6.
  • Immune system problems: The immune systems of people who have chronic fatigue syndrome appear to be impaired slightly.
  • Hormonal imbalances: People with CFS also sometimes experience abnormal blood levels of hormones produced in the hypothalamus, pituitary or adrenal glands.
  • Physical or emotional trauma: Some individuals have reported that they experienced an injury, surgery, or significant emotional stress shortly before their symptoms began.

The condition can be:

  • Mild: Daily activity is reduced by at least 50%
  • Moderate: The individual is mostly housebound
  • Very severe: The individual is bed-bound and dependent on others for all daily care


Conventional Treatments:
There is no specific treatment for the condition. Management includes: Daily life/activity management, home remedies, lifestyle changes and medications for depression, insomnia or pain, yoga/tai chi, acupuncture and/or meditation.


Ayurvedic Approach to CFS (Bala kshaya):
CFS, according to Ayurveda is known as a disease of depletion and is seen as a deficiency in the essence of food or plasma (rasa), tissue building blocks (dhatu), and life energy (Ojas – both qualitative and quantitative changes).

According to Ayurveda, causative factors include: Inappropriate diet and lifestyle factors, including inappropriate food combining, which lead to (1) disturbed functioning of doshas (Vata, Pitta and/or Kapha) and (2) undue strain on the digestive fire (Jatharagni), which compromises the functioning in the GI tract, and leads to the formation of Ama (putrefied undigested food matter) in the GI tract, This Ama then leaves the GI tract via the bloodstream and enter the tissues of the body. This has then a domino effect on all other tissue Agni’s (digestive capacity at the individual tissue level) in the body, resulting in subtle weaknesses at the cellular level, leaving the individual to e.g. pathogens and parasites, metabolic disfunction, endocrine disfunction, anaemia, malabsorption, and candida.
Additionally, multiple pregnancies – where there is little time to recover between births can also be a causative factor in CFS.

The disease manifestation itself can and does take different routes according to the individual, thus treatment needs to be fully individualised. However, whilst Pitta dominant type CFS is the most common, it can manifest often in individuals with Vata-Pitta or Pitta-Vata constitutions.

Vata dominant CFS: Low or irregular appetite, lymphatic congestion, cold, fatigue and rising temperature in the evening, anaemia, tics, spasms, twitching, fatigue and tremors, weight loss, cracking joints, low cholesterol, bone issues, neurological symptoms, sexual debility.

Pitta dominant CFS: Strong appetite, with poor digestion, loose stools, malabsorption and fatigue, recurrent fevers, tender/swollen liver, sore throat, tender lymph nodes, alcohol intolerance, migraine headaches, fibromyalgia or fibromyositis, profuse sweating, osteoarthritis, irritability and Pitta depression.

Kapha Dominant CFS: Low appetite, dullness in many variations, swelling of lymph nodes, megaloblastic anaemia, muscle dullness, lipoma / fatty degenerative changes, swelling of joints, Kapha type depression, sexual debility, benign prostatic hyperplasia.


BENEFICIAL AYURVEDIC HERBS FOR CFS:
Vata Pitta Balancing: Guduchi, turmeric, shankapushpi, triphala, fresh ginger, jatamansi, brahmi, shankapushpa, aloe vera juice, shatavari, licorice
Vata Kapha Balancing: Guduchi, turmeric, shankapushpi, triphala, fresh ginger, jatamansi, brahmi, shankapushpa, aloe vera juice, shilajat, guggulu, chitraka, ashwaganda
Pitta Vata Balancing: Guduchi, turmeric, shankapushpi, triphala, fresh ginger, jatamansi, brahmi, shankapushpa, aloe vera juice, shatavari, licorice
Pitta Kapha Balancing: Guduchi, turmeric, shankapushpi, triphala, fresh ginger, jatamansi, brahmi, shankapushpa, aloe vera juice, katuka, manjista, ashoka, madhuashini
Kapha Vata Balancing: Guduchi, turmeric, shankapushpi, triphala, fresh ginger, jatamansi, brahmi, shankapushpa, aloe vera juice, shilajat, guggulu, chitraka, ashwaganda
Kapha Pitta Balancing: Guduchi, turmeric, shankapushpi, triphala, fresh ginger, jatamansi, brahmi, shankapushpa, aloe vera juice, katuka, manjista, ashoka, madhuashini

Traditional Ayurvedic Treatment(s) for CFS:
Ayurvedic treatment approach(es) are individualised and are fully dependant on a full consultation with an individual, the current imbalances, their age, strength, severity of the condition, and if other conditions are also present. Treatment approaches can include:


General Ayurvedic Nutritional Guidelines for CFS:
Ayurvedic nutritional approach(es) are individualised and are fully dependant on a full consultation with an individual. One should eat compatible foods, and in accordance to one's imbalances. Some additional general guidelines include:

  • One should eat the foods that one does not react to.
  • One should eat according to the digestive capacity, keeping meals light, cooked, warm moist and easy to digest. As a guide, eat to fill the stomach 1/3 with solid food, 1/3 with liquid and leaving 1/3 empty to allow room for digestive secretions in the stomach.
  • One should eat at regular times/intervals. Avoid skipping meals.
  • One should eat wholegrains and non-processed foods.
  • Foods to avoid: Cold foods, raw foods, leftover foods (24 hours), frozen foods, cold water, processed and packaged foods, soft drinks, high fat foods, greasy foods. Minimise the intake of hot chilli type foods.
  • Organic bone brother can be highly beneficial, either on their own or as a base in cooking soups or stews.
  • One should avoid overeating. Allow 6 hours between meals and snack 3 hours after a meal and eat only if hungry. If digestion is poor, then 4 light meals per day is advisable in place of three regular meals.
  • Breakfast should be easy to digest, lunch the main meal, and dinner should be lighter than lunch.
  • A small amount of buttermilk consumed after meals is advisable.
  • Eat home cooked meals, preferably made on the same day as being prepared.
  • Water should be drunk warm in the cooler months and room temperature in the summer months. Avoid chilled water.
  • Use all of the five senses at mealtimes. Savour the food that you are eating.
  • Eat in a pleasant environment. Eat seated and try to avoid TV and electronic devices whilst eating.
  • Eat slowly, eat with respect/reverence for what you are eating, chew thoroughly. 


General Ayurvedic Lifestyle Guidelines for CFS:
Ayurvedic lifestyle approach(es) are individualised and are fully dependant on a full consultation with an individual. Some general guidelines include:

  • Allow for sufficient rest and sleep. Go to bed at a regular time each day, and best before 10pm. Avoid also sleeping during the day.
  • Keep to a routine as much as possible during the day.
  • Get sufficient daily activity and exercise, but where it does not leave one exhausted. This needs to be explored by each individual – as the capacity for exercise differs with each person with respect to CFS. Deep breathing for 10 minutes a day is very beneficial. Meditation, yoga and pranayama can also be highly beneficial.
  • Avoid stress, anxiety, fear and tension. 
  • Deep breathing for 10 minutes a day is very beneficial.
  • Make sure to be well rugged up in winter, especially when going outside.
  • Avoid smoking and minimise alcohol and caffeine intake.
  • One should avoid constipation and supressing natural urges (passing stools, gas, burping etc).
  • Look at counselling for self-care and working through any stress, anxiety, anger or any other mental health and/or emotional issues.
  • Look at increasing self-care practices, as well as fostering creative pursuits.
  • Set up a solid support network and work to be around friends and family.


If you have any concerns about your health please be sure to consult an Ayurvedic Practitioner or your local health physician. See our Ayurvedic Practitioner Services and Consultation Page for more information.

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Disclaimer:
The above information is for information and educational purposes. As such we are not, diagnosing, treating, curing, mitigating, or preventing any type of disease or medical condition. Before taking any form of natural, integrative or conventional treatment regimen, it is advisable to seek the advice of a licensed healthcare professional.

 

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