Beating chronic fatigue syndrome

Tired or being tired all the time? Study shows NADH may provide relief.

For more than six months now, you've been exhausted, more tired for a longer period of time than you've ever been before. In addition to this extreme fatigue, you've had inexplicable pains in your muscles and joints, headaches, difficulty concentrating, and a sore throat.

If this symptom picture sounds familiar to you, you may be among the estimated 200,000 to 500,000 Americans with Chronic Fatigue Syndrome (CFS), also known as Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS), according to The CFIDS Association of America, Charlotte, N.C. Although there are many theories on the cause of CFS, at this point in time, its cause -- and treatment options -are still up for debate.

NADH for Chronic Fatigue Syndrome
Recent research conducted at Georgetown University School of Medicine published in the Annals of Allergy, Asthma and Immunology, shows that the dietary supplement NADH may be helpful to people with CFS.

NADH is short for the reduced form of "nicotinamide adenine dinucleotide," a coenzyme which plays a role in the body's cellular energy-producing function.

This 12-week study involved 26 patients who fulfilled the Centers for Disease Control and Prevention criteria for CFS and completed the study. The patients' medical histories, physical examinations, laboratory studies, and questionnaires were obtained at baseline, 4, 8, and 12 weeks.

Participants were randomly assigned to receive either 10 mg of NADH, or a placebo, for the first four weeks. For the next four weeks, they took neither NADH nor the placebo, and for the last four weeks, the participants who originally took the NADH took the placebo, and vice-versa.

Among these 26 patients, eight, or 31 percent, responded favorably to NADH, and no severe adverse effects were observed. In their paper, the authors say, "Collectively, the results of this pilot study indicate that NADH may be a valuable adjunctive therapy in the management of the chronic fatigue syndrome and suggest that further clinical trials be performed to establish its efficacy in this clinically perplexing disorder."

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Why NADH may improve CFS
In an interview with Better Nutrition, the study's lead researcher, Joseph A. Bellanti, M.D., explained the premise on which he and his colleagues embarked on this study, saying, "Our basic hypothesis was that patients with CFS ultimately suffer from their symptoms because of a lack of the chemical that stores energy. That chemical is called ATP, and it stands for adenosine triphosphate. It is the ultimate product from sugar metabolism." He noted that the theory that patients with CFS have a deficiency of ATP is supported by published data. "Their cells are literally starved of ATP, and that affects their brain cells and their muscle cells, and that's why we see the difficulty in thinking and the difficulty in muscle activity."

Who gets CFS?
While CFS discriminates against no one, women between the ages of 25 and 45 are the most likely to suffer from it. As to why this is so, Bellanti says it's not clear; however, he says, most likely it's hormone-related. He speculated that it's quite possible that CFS is a type of autoimmune disease, as are lupus and rheumatoid arthritis, which are also more common among women.

CFS and allergies
In addition to women, people with allergies seem to be more likely to develop CFS. Bellanti said that, at this time, why the two seem to occur together is basically speculative, but one probable reason why may be related to a deficiency of the immune system.

Can NADH benefit healthy people?
If you don't have CFS, "it's theoretically possible" that NADH may be of benefit to you, too, said Bellanti. He noted that this is especially true for people who do not eat a good, nutritious diet. He also noted that the main food sources of NADH are fish, poultry, and meat, so vegetarians are not likely to get much, if any, NADH in their diets.

NADH for depression?
While this study was designed to determine if NADH could help people with CFS, Bellanti said that they found that NADH may possibly benefit people with depression. It seems to help regulate levels of the neurotransmitter, serotonin, low levels of which are seen in depression.

Future research
Bellanti says that he and his colleagues hope to do a larger study on NADH and CFS later this year, in which patients will take the supplement for a longer period of time. The researchers also want to vary the dosage according to body weight, with heavier patients taking more, and lighter patients taking less, rather than a fixed dosage of NADH for all.

On a cautionary note, Bellanti says, "I should add a word of recommendation here. Anyone suffering from fatigue of any protracted nature should consult their physician first before going on NADH because they might have some other condition, such as anemia or low thyroid function, which would require another form of therapy."

He also notes that if it is determined that you do indeed have CFS, NADH is only one part of a "multi-pronged therapy program," one which includes stress reduction, control of infection and allergic disease, exercise and rehabilitation, stretching exercises, and proper nutrition.


"Chronic Fatigue Syndrome." U.S. Department of Health & Human Services. Public Health Service, Atlanta, Ga. October 1998.

Forsyth, Linda M., M.D., et al. "Therapeutic effects of oral NADH on the symptoms of patients with chronic fatigue syndrome." Annals of Allergy, Asthma, and Immunology 82(2):185-191, February 1999.


CFS is a perplexing disease. As with any disease, diagnosis is the first step toward getting help. Here are the symptoms which characterize CFS:

Severe chronic fatigue for six months or longer with other known medical conditions excluded by clinical diagnosis.
Concurrently having four or more of the following symptoms: substantial impairment in short-term memory or concentration; sore throat; tender lymph nodes; muscle pain; multi-joint pain without swelling or redness; headaches of a new type, pattern, or severity; unrefreshing sleep; and postexertional malaise lasting more than 24 hours. The symptoms must have persisted or recurred during six or more consecutive months of illness and must not have predated the fatigue.

Other common symptoms. From 20 to 50 percent of CFS patients report experiencing the following: abdominal pain, alcohol intolerance, bloating, chest pain, chronic cough, diarrhea, dizziness, dry eyes or mouth, earaches, irregular heartbeat, jaw pain, morning stiffness, nausea, night sweats, psychological problems (depression, irritability, anxiety, panic attacks), shortness of breath, skin sensations, tingling sensations, and weight loss.


By Patricia Andersen-Parrado

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