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Doctors recommend the following changes:

• Exercise: Patients should gradually increase activity while keeping within limits and avoiding overexertion. Patients should determine the level of physical therapy that accommodates their energy levels. Although exertion such as exercise can increase fatigue levels, studies show that aerobic exercise, reported improvement in fatigue, normal functioning, and fitness after a year.
  
• Diet: Patients should maintain a healthy diet low in animal fat and high in fiber, with plenty of fruits and vegetables. Fish oils contain a polyunsaturated fatty acid known as gamma linolenic acid, which seems to block the release of cytokines and prostaglandins—substances that play significant destructive roles in inflammatory diseases. These oils may benefit those who have CFS.
  
• Stress Reduction Techniques: A number of relaxation techniques, including deep breathing exercises, muscle relaxation techniques, meditation, hypnosis, biofeedback, and massage therapy may also help relieve the symptoms.

• Medications: Doctors may prescribe antidepressant and antianxiety drugs such as Elavil is known to relieve many of the symptoms of CFS including sleeplessness and low-energy levels. Patients with CFS normally respond to much lower doses than those used to treat people with other disorders. Many CFS patients cannot tolerate the high doses prescribe to those suffering from depression. For muscle aches or pains nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen (Advil, Motrin), or acetaminophen (Tylenol). Some patients have been known to abuse these pain relievers, as a common symptom of CFS is muscles or joint stiffness and pain.
  

Last updated: 01-Jan-00