Evidence browser

Dose-effect of long-snake-like moxibustion for chronic fatigue syndrome: a randomized controlled trial.

Luo, Hong, Gong, Rui, Zheng, Rui et al.·Journal of translational medicine·2023

This study tested whether longer sessions of moxibustion (a traditional Chinese medicine heat treatment) might work better than shorter sessions for chronic fatigue syndrome. Sixty women with CFS were treated either 60 minutes or 30 minutes per session, three times per week for four weeks. The 60-minute sessions produced greater improvements in fatigue and other symptoms, and thermal imaging showed better changes in body heat patterns with the longer treatment.

Interventions

Immune SystemPost-Exertional Malaise

Achieving symptom relief in patients with myalgic encephalomyelitis by targeting the neuro-immune interface and optimizing disease tolerance.

Rodriguez, Lucie, Pou, Christian, Lakshmikanth, Tadepally et al.·Oxford open immunology·2023

Researchers tested whether gently stimulating nerve endings inside the nose could help ME/CFS patients feel better. After 8 weeks of treatment, patients showed about a 30% improvement in their overall symptoms. Blood tests showed that ME patients have signs of ongoing immune activation, and those who improved had changes in their immune cells and less inflammation.

E1 ReplicatedTrialPEM requiredRCT

Use of 1-MNA to Improve Exercise Tolerance and Fatigue in Patients after COVID-19.

Chudzik, Michał, Burzyńska, Monika, Kapusta, Joanna·Nutrients·2022

This study tested whether a supplement called 1-MNA (a natural compound made in the liver) could help people recover better from COVID-19 fatigue. Fifty people who had recovered from COVID-19 either received the supplement or no supplement for one month. Those taking 1-MNA walked further in a walking test and reported less severe fatigue than those without it.

Neurovascular Dysregulation and Acute Exercise Intolerance in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Randomized, Placebo-Controlled Trial of Pyridostigmine.

Joseph, Phillip, Pari, Rosa, Miller, Sarah et al.·Chest·2022

This study tested whether a medication called pyridostigmine could help people with ME/CFS exercise better by improving blood flow and heart function. Researchers gave 45 ME/CFS patients either pyridostigmine or a placebo, then measured their exercise capacity twice using specialized heart and lung tests. The group taking pyridostigmine showed improved oxygen uptake and better heart function during exercise, while the placebo group actually got worse, suggesting the medication may help counteract some of the body's dysfunctional responses to exercise in ME/CFS.

Post-Exertional Malaise

Differential Metabolites and Metabolic Pathways Involved in Aerobic Exercise Improvement of Chronic Fatigue Symptoms in Adolescents Based on Gas Chromatography-Mass Spectrometry.

Zhao, Shanguang, Chi, Aiping, Wan, Bingjun et al.·International journal of environmental research and public health·2022

This study tested whether regular aerobic exercise could help high school students with chronic fatigue syndrome (CFS) feel less tired and reduce harmful stress chemicals in their bodies. Over 12 weeks, students in the exercise group ran three times per week for 45 minutes, while others continued their normal routines. The exercising students felt significantly better and had lower levels of oxidative stress markers, suggesting aerobic activity may help repair some of the chemical imbalances that occur in CFS.

[Effect of electroacupuncture at back-shu points of five zang on fatigue status and cortical excitability in chronic fatigue syndrome].

Li, Zhong-Xian, Zhang, Yu, Yan, Lu-da et al.·Zhongguo zhen jiu = Chinese acupuncture & moxibustion·2022

This study tested whether electroacupuncture (a traditional treatment combining acupuncture with mild electrical stimulation) applied to specific points on the back could reduce fatigue and improve quality of life in people with ME/CFS. Seventy-two patients were randomly assigned to receive either real electroacupuncture or fake electroacupuncture (needles placed at inactive sites with no electrical current). After 6 weeks of treatment, the real electroacupuncture group showed greater improvements in fatigue symptoms and quality of life compared to the sham group.

The Qigong of Prolong Life With Nine Turn Method Relieve Fatigue, Sleep, Anxiety and Depression in Patients With Chronic Fatigue Syndrome: A Randomized Controlled Clinical Study.

Xie, Fangfang, You, Yanli, Guan, Chong et al.·Frontiers in medicine·2022

This study tested whether a traditional Chinese exercise called Qigong (specifically the Prolong Life with Nine Turn Method) could help people with ME/CFS feel less tired, sleep better, and experience less anxiety and depression. Ninety patients tried either the Qigong exercise or cognitive behavioral therapy (a talk-based treatment) for 12 weeks, and both groups improved significantly, with Qigong showing slightly better results.

Ginger-indirect moxibustion plus acupuncture versus acupuncture alone for chronic fatigue syndrome: a randomized controlled trial.

Tingting, M A, Jie, W U, Lijie, Yang et al.·Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan·2022

This study tested whether ginger-indirect moxibustion (a traditional Chinese medicine technique using heated ginger) combined with acupuncture works better than acupuncture alone for chronic fatigue syndrome. Over 290 people received either the combination treatment or acupuncture alone for 8 weeks, with follow-ups for 12 weeks afterward. Both groups improved, but the combination treatment showed slightly faster relief of fatigue and physical symptoms in the first few weeks.

Effects of the Prolong Life With Nine Turn Method (Yan Nian Jiu Zhuan) Qigong on Brain Functional Changes in Patients With Chronic Fatigue Syndrome in Terms of Fatigue and Quality of Life.

Xie, Fangfang, Guan, Chong, Gu, Yuanjia et al.·Frontiers in neurology·2022

This study tested whether a traditional Chinese exercise method called Qigong could help people with chronic fatigue syndrome (ME/CFS). Researchers used brain imaging to see how the method changed activity in different parts of the brain, and measured whether patients felt less tired and had better quality of life. The Qigong group showed improvements in fatigue and quality of life, with specific changes in brain activity patterns.

Cognitive Behavioral Therapy Improves Physical Function and Fatigue in Mild and Moderate Chronic Fatigue Syndrome: A Consecutive Randomized Controlled Trial of Standard and Short Interventions.

Gotaas, Merethe Eide, Stiles, Tore C, Bjørngaard, Johan Håkon et al.·Frontiers in psychiatry·2021

This study tested whether two types of talk therapy called cognitive behavioral therapy (CBT) could help people with mild to moderate ME/CFS feel less tired and function better physically. One group received 16 weeks of standard CBT, another received 8 weeks of a shorter version, and a third group was waitlisted. Both therapy groups improved in physical function compared to the control group, and the standard CBT group also showed fatigue reduction. These improvements lasted for a full year after treatment ended.

Effect of Dietary Coenzyme Q10 Plus NADH Supplementation on Fatigue Perception and Health-Related Quality of Life in Individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial.

Castro-Marrero, Jesús, Segundo, Maria Jose, Lacasa, Marcos et al.·Nutrients·2021

This study tested whether taking two supplements together—coenzyme Q10 and NADH—could help reduce fatigue and improve quality of life in people with ME/CFS. Over 200 patients took either the supplements or a placebo for 12 weeks. The group taking the supplements reported feeling less mentally tired, slept better, and experienced improvements in their overall quality of life compared to the placebo group.

Effect of Melatonin Plus Zinc Supplementation on Fatigue Perception in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial.

Castro-Marrero, Jesús, Zaragozá, Maria-Cleofé, López-Vílchez, Irene et al.·Antioxidants (Basel, Switzerland)·2021

This study tested whether taking melatonin (1 mg) and zinc (10 mg) together could help reduce fatigue in ME/CFS patients. Over 16 weeks, people taking the supplement reported feeling less physically tired compared to those taking placebo, and they also reported better overall quality of life. The supplements appeared to be safe with no serious side effects reported.

[Ginger-separated moxibustion for chronic fatigue syndrome and its effect on intestinal flora].

Lin, Yu-Fang, Jin, Xiao-Qing, Zhu, Jian-Fang et al.·Zhongguo zhen jiu = Chinese acupuncture & moxibustion·2021

This study tested whether ginger-separated moxibustion (a traditional Chinese medicine technique involving heat applied to the skin over specific points) could help reduce fatigue in ME/CFS patients. Over 4 weeks, patients receiving moxibustion treatment along with normal diet and exercise showed significantly greater improvements in fatigue symptoms compared to those receiving diet and exercise alone. The treatment also appeared to change the types of bacteria in patients' guts in ways that might support better intestinal health.

Gut Microbiome

Guided graded exercise self-help for chronic fatigue syndrome: Long term follow up and cost-effectiveness following the GETSET trial.

Clark, Lucy V, McCrone, Paul, Pesola, Francesca et al.·Journal of psychosomatic research·2021

This study followed up with CFS patients one year after they received either guided graded exercise self-help (a structured program to gradually increase activity) or standard medical care. While the exercise program showed better results after 12 weeks, by 15 months both groups had improved similarly, with the exercise group maintaining their gains and the standard care group catching up. The exercise program cost slightly more but was considered cost-effective based on quality of life improvements.

Compression Stockings Improve Cardiac Output and Cerebral Blood Flow during Tilt Testing in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Patients: A Randomized Crossover Trial.

van Campen, C Linda M C, Rowe, Peter C, Visser, Frans C·Medicina (Kaunas, Lithuania)·2021

Many ME/CFS patients experience dizziness and other symptoms when standing up (called orthostatic intolerance). This study tested whether compression stockings—tight socks that squeeze the legs—could help. Researchers found that when ME/CFS patients wore compression stockings during a standing test, their heart pumped blood more effectively and their brain received better blood flow compared to when they wore regular socks.

Autonomic Nervous System

A Botanical Product Containing Cistanche and Ginkgo Extracts Potentially Improves Chronic Fatigue Syndrome Symptoms in Adults: A Randomized, Double-Blind, and Placebo-Controlled Study.

Kan, Juntao, Cheng, Junrui, Hu, Chun et al.·Frontiers in nutrition·2021

Researchers tested whether a supplement containing two plant extracts (cistanche and ginkgo) could help adults with ME/CFS. Over 60 days, people taking the supplement reported improvements in fatigue, memory, sleep quality, and ability to exercise compared to those taking a placebo. The treatment also lowered certain chemicals in the blood (ammonia and lactic acid) that may be linked to fatigue.

Post-Exertional Malaise

Effectiveness a herbal medicine (Sipjeondaebo-tang) on adults with chronic fatigue syndrome: A randomized, double-blind, placebo-controlled trial.

Shin, Seungwon, Park, Soo Jung, Hwang, Minwoo·Integrative medicine research·2021

This study tested whether a traditional Korean herbal medicine called Sipjeondaebo-tang could help people with ME/CFS feel less tired. Ninety-six patients took either the herbal medicine or a placebo (fake medicine) for 8 weeks. While the herbal medicine did not meet the study's main success measure, it did help reduce fatigue severity on several fatigue rating scales and was safe to use.

Recruiting Adolescents With Chronic Fatigue Syndrome/Myalgic Encephalomyelitis to Internet-Delivered Therapy: Internal Pilot Within a Randomized Controlled Trial.

Anderson, Emma, Parslow, Roxanne, Hollingworth, William et al.·Journal of medical Internet research·2020

This study tested whether teenagers with ME/CFS could successfully receive specialist treatment through the internet instead of traveling to hospitals. Researchers recruited 89 young people across the UK and offered them two types of online treatment: a cognitive behavioral therapy program with messaging support from a psychologist, or activity management sessions over Skype with a physiotherapist. Most participants completed the study and found the online treatment acceptable, showing that remote delivery of ME/CFS care is workable.

The effectiveness of cupping therapy on chronic fatigue syndrome: A single-blind randomized controlled trial.

Meng, Xiu-Dong, Guo, Hao-Ran, Zhang, Qing-Ying et al.·Complementary therapies in clinical practice·2020

This study tested whether cupping therapy—a traditional treatment where cups create suction on the skin—could help people with ME/CFS feel less tired. Researchers divided 112 patients into three groups that received different levels of suction and compared the results. After 10 sessions over 5 weeks, all groups reported improvements in fatigue and sleep, with 10 sessions working better than 5 sessions, though the pressure levels didn't make much difference.