What it is, what it isn’t, how to help

If someone complains of constantly being too tired to do anything, don’t discount it as a psychological problem. Chronic fatigue is real and Chronic Fatigue Syndrome (CFS) is a debilitating illness.

CFS is not a psychological issue – it isn’t depression. If in doubt, the key to remember is the difference:

  • A depressed person will not have the enthusiasm to do something.
  • A person with CFS will have the enthusiasm but not the energy!

Chronic fatigue versus Chronic Fatigue Syndrome?

Chronic fatigue is exhaustion or lack of energy that lasts 6 months or more. It can be a symptom of many auto immune diseases such as rheumatoid arthritis or can be caused by long term stress, prolonged sleep depravation, lack of activity, nutritionally poor diet or medications.

CFS, or Myalgic Encephalomyelitis (ME), and Systemic Exertion Intolerance Disease (SEID) tend to cross over in their diagnosis. In all three, Post Exertional Malaise is the cardinal symptom. This is severe exhaustion and may come immediately after physical, mental or emotional exertion or can be delayed a day or two.

There are other criteria for an official diagnosis of CFS and SEID. For CFS, an individual must present with at least four of the following four or more of the following symptoms:

  • Sore throat
  • Headaches
  • Post-exertion malaise lasting more than 24 hours (severe exhaustion)
  • Unrefreshing sleep
  • Significant impairment of short-term memory or concentration
  • Muscle pain
  • Joint pain
  • Tender lymph nodes in the neck or armpit

SEID has less defining requirements with post-exertion malaise, cognitive impairment and orthostatic intolerance as the main criteria.

Now, before everyone who is very tired starts self diagnosing with CFS, it’s important to remember that CFS is also a symptom of some major health issues! Therefore, if you tick four or more of the above, go to the GP first and get a blood test to discount anything more serious.

What causes CFS?

Officially there is no exact cause. Stress, infections, nutrient deficiency or emotional factors are often cited as causative factors. In addition, Giloteaux et al found in a 2016 study that people with CFS had significantly lower diversity of gut flora. These scientists also discovered that people with CFS had higher blood levels of lipopolysaccharides. Lipopolysaccharides are inflammatory molecules that may indicate that bacteria have moved from the gut into the bloodstream, where they can produce various symptoms of disease. This study yet again links the health of the gut to overall wellbeing.

In addition, as exhaustion is the main symptom in those with CFS there has been a link made with mitochondrial dysfunction (2009) and the Krebs cycle.

What is mitochondrial dysfunction?

Mitchondria are the powerhouses of our cells. They move around the cell and release ATP (energy) and this provides the energy we need to function. When the mitochondria are damaged they are

  1. susceptible to an infection, and
  2. work slower and give out less energy meaning your body does not have the energy it once did.

Mitochondrial dysfunction may be caused by a ‘wearing down’ of the mitochondrial mechanism until it finally ‘falls over’. This may happen over time. For example; years of being under physical or mental stress plus a low nutrient diet will start to damage the functioning and when that individual is hit with an infection the whole system just falls over and can’t recover. Or perhaps an infection combined with a low nutrient diet have caused damage and the individual no longer has the physical resources to cope with emotional stress. Lastly, it may be directly impacted from an infection such as from ticks in Lymes disease which is why it’s important to get blood tests done.

When looking at CFS, I look at several factors:

  • Diet
  • Gut health
  • Stress levels
  • Emotional factors
  • Sleep patterns
  • Past infections
  • Nutritional deficiencies

How to help someone with chronic fatigue?

  • Pacing

Pacing means don’t push yourself beyond your limit and especially don’t exercise beyond your ability. In chronic fatigue patients, the mitochondria have a limited ability and if you push yourself over your limit it does not help your recovery and in fact you are likely to feel worse. Work with what you have an in combination with other changes you will SLOWLY be able to increase your energy levels.

  • Diet

Our diet today is more acidic which is very bad for your health. More studies every day link the major diseases (and not just CFS) to a more acidic environment in the body.

Sugar and processed foods all produce a more acidic environment. Vegetables, particularly greens, produce a more alkaline environment. Fresh food, vegetables and salads and less meat and alcohol. If you feel less certain regarding the right choices then speak to a health practitioner or dietician.

  • Stress and underlying emotional factors

Stress is very individual. ‘What one man may thrive off can drain another’s soul’. Therefore there is no shoe that fits all. However, know your limits and take a BIG step back from them. Make time for yourself and practice time away from technology. Re-evaluate what is important to you. Once people on the right path for their own personal values then stress tends to lessen.

Proven stress reduction techniques include acupuncture, mindfulness and meditation. It may be necessary talk to a psychologist or councillor to get back on track.

  • Gut health

With more research linking gut health to disease it’s important to mend the gut, lower inflammation and increase the good flora in your gut. You will need more than diet initially to get this to an optimal condition again and so talking to a professional will help.

  • Mitochondrial functioning

There are no specific tests for day to day mitochondrial functioning that are in the realms of affordability or viability. Therefore we work with what we know. When someone is exhausted and lacking energy we can work to improve mitochondrial functioning and the krebs cycle through three areas: supplementation, rest and electro-acupuncture.

  • Supplements

No two people are the same and no two cases of chronic fatigue are the same. Therefore, it is always better to talk to a health practitioner than buying off the shelf. Saying that, mitochondrial functioning and the krebs cycle can be improved with correct dosing of specific nutrients such as B vitamins, Co enzyme Q10 and Magnesium.

These alone will not clear out any virus or bacteria that involved which cause toxicity and continued inflammation in the body. Patients may require herbs to deal with this. Chinese herbs have some excellent results in this area and treatment should commence along with changes in the lifestyle and diet to assist with overall recovery.

At ben&biao we provide assistance with both supplementation and herbs.

  • Acupuncture

Thanks to modern research and development, our understanding of how acupuncture works is becoming clearer. Functional MRIs and other scanning techniques are helping to build a clearer picture of how the insertion and gentle manipulation of very fine needles can correct pathology by changing the neurophysiology locally, along nerve pathways, in muscles and joints and in the brain and spine, depending on where the needles are placed and how they are manipulated.

In cases of fatigue, studies have shown that electro-acupuncture can be beneficial in directly increasing ATP levels. As previously mentioned, ATP is the main energy source for metabolic function within our cells, so increasing ATP levels will help restore our energy at the deepest levels of our body.

Additionally, electro-acupuncture may offer CFS/ME/SEID patients help with other common symptoms such as headache, muscle and joint pain, depression and or anxiety. By selecting specific points and using precise electrical frequencies individual neural pathways. And by using specific electrical frequencies we can we can influence specific neural tissues to illicit particular changes in the ‘chemical soup’. These changes occur at the location of the needles, in the spine and /or the brain. Studies show that this can benefit such symptoms.

What does electro acupuncture fee like? Now before you get concerned about the idea of “manipulation” the key is the practitioner and the electro-frequencies used. At ben&biao we assure you that our needle techniques are gentle and manipulation is done with e-stim, or electro-acupuncture.

At ben&biao our protocols use the latest electro-acupuncture machines which have been manufactured to provide safe, accurate stimulation specifically for use in electro-acupuncture. This way we achieve the desired clinical outcomes which can be repeated.

Our patients report that they feel a slight buzzing or tapping, a warmth or nothing at all. Many patients find it relaxing and fall asleep. Our machines have timers and will automatically switch off when the desired ‘dosage’ has been achieved.

Lastly … time

Recovery will not take place in a week. It’s likely that it has taken years for the body to reach a point where it can’t function properly anymore and it will definitely take time to recover. Talk to a professional regarding expectations.


  1. Giloteaux, et al, 2016. ‘Reduced diversity and altered composition of the gut microbiome in individuals with myalgic encephalomyelitis/chronic fatigue syndrome’, Microbiome, https://microbiomejournal.biomedcentral.com/articles/10.1186/s40168-016-0171-4
  2. Myhill,S. Booth, NE. MacLaren-Howard J. Chronic fatigue syndrome and mitochondrial dysfunction, Int J Clin Exp Med, 2009; 2 (1) 1-16
  3. Lin D, De La Pena I, Lin L, Zhou S-F, Borlongan CV, Cao C. ‘The Neuroprotective Role of Acupuncture and Activation of the BDNF Signaling Pathway’, International Journal of Molecular Sciences. 2014;15(2):3234-3252. doi:10.3390/ijms15023234
  4. Corradino, M., 2017, Neuropuncture: A Clinical Handbook of Neuroscience Acupuncture, Singing Dragon. London.
  5. Xia,Y., Ding, G., Wu, G., (editors), 2013, Current Research in Acupuncture, Springer, New York
  6. Cheng, N. et al, 1982. ‘The Effects of Electric Currents on ATP Generation, Protein Synthesis, and Membrane Transport in Rat Skin’, Clinical Orthopaedics and Related Research, 1982 Nov-Dec;(171):264-72