Linolenic acid (Omega-3 family) is also found in abundance in fish oils. The best sources are cold water, high fat fish such as salmon, tuna, rainbow trout, mackerel, and eel. Linoleic acid (Omega-6 family) is found in seeds and seed oils. Good sources include safflower oil, sunflower oil, corn oil, sesame seed oil, and wheat germ oil. Many women prefer to use raw fresh sesame seeds, sunflower seeds, and wheat germ to obtain the oils. The average healthy adult requires only four teaspoons per day of essential oils. However, women with chronic fatigue, who may have a real deficiency of these oils, need up to two or three tablespoons per day until their symptoms improve. Occasionally, these oils may cause diarrhea; if this occurs, use only one teaspoon per day. Women with acne and very oily skin should use them cautiously. For optimal results, be sure to use these oils along with vitamin E.

Herbs for Chronic Fatigue
Many herbs can help relieve the symptoms and treat the causes of chronic fatigue. I have used fatigue relieving herbs in my practice for many years and many women have found them to be effective remedies. I use them as a form of extended nutrition. They can balance and expand the diet while optimizing nutritional intake. Some herbs provide an additional source of essential nutrients that help relax tension and ease anxiety. Other herbs have mild anti-infective and hormonal properties in addition to their nutritional content; these help to combat fatigue causing viruses and fungi, as well as provide support for the endocrine system with a minimum of side effects. In this section, I describe many specific herbs useful for relief of chronic fatigue and related problems.

Chronic Fatigue and Depression
For women with fatigue and depression, herbs such as oat straw, ginger, ginkgo biloba, licorice root, dandelion root, and Siberian ginseng (eleutherococcus) may have a stimulatory effect, improving energy and vitality. Women who use these herbs may note an increased ability to handle stress, as well as improved physical and mental capabilities.

Some of the salutary effects may be due to the high levels of essential nutrients captured in herbs. For example, dandelion root contains magnesium, potassium, and vitamin E, while ginkgo contains high levels of bioflavonoids. These essential nutrients help relieve fatigue, depression, PMS, and hot flashes, and they increase resistance to infections.

Siberian ginseng, ginger, and licorice root have been important traditional medicines in China and other countries for thousands of years. They have been reputed to increase longevity and decrease fatigue and weakness. These herbs have been found to boost immunity and to strengthen the cardiovascular system. The bioflavonoids contained in ginkgo are extremely powerful antioxidants and help to combat fatigue by improving circulation to the brain. They also appear to have a strong affinity for the adrenal and thyroid gland and may help to boost function in these essential glands. Oat straw has been used to relieve fatigue and weakness, especially when there is an emotional component. One note of caution: Licorice root should be used carefully and only in small amounts because, over time, it can cause potassium loss.

In modern China, Japan, and other countries, there has been much interest in the pharmacological effects of these traditional herbs. Scientific studies are corroborating the medicinal effects of these plants.

Anxiety, Irritability, and Insomnia
Women suffering from anxiety, irritability and insomnia often have a worsening of their fatigue symptoms because of emotional stress and sleep deprivation. Luckily, a number of herbal remedies relieve such symptoms. Herbs such as passionflower (passiflora) and valerian root have a calming and restful effect on the central nervous system.

Passionflower has been found to elevate levels of the neurotransmitter serotonin. Serotonin is synthesized from tryptophan, an essential amino acid that has been found in numerous medical studies to initiate sleep and decrease awakening. Valerian root has been used extensively in traditional herbology as a sleep inducer. It is used widely in Europe as an effective treatment for insomnia. Research studies have confirmed both the sedative effect of valerian root and its effectiveness as a treatment for insomnia. For women with insomnia, valerian root can be a real blessing. I have used it with patients for the past 18 years and noted much symptom relief. Other effective herbal treatments include chamomile, hops, catnip, and peppermint teas. I have used them all in my practice and many pleased patients have commented on their effectiveness.

Chronic Fatigue Syndrome, Candida Infections, and Allergies
Women with fatigue symptoms caused by severe immune dysfunction may initially have difficulty using any herbs at all because their bodies are too weak. In cases of severe fatigue, I often start the patient on aloe Vera and peppermint. Most women can tolerate these two supportive and soothing herbs. You can take aloe Vera internally as a juice. Buy the cold pressed, nonpasteurized brands. You can take peppermint as a tea or, even better, as an oil in capsules or an herbal tincture in water.

Once you are stronger and less fatigued, you may be able to tolerate herbs that can boost your energy and vitality (see information earlier in this section), as well as herbs that help suppress infections from viruses, candida, and other pathogens. One of the best herbs for this purpose is garlic. Garlic contains a chemical called allicin that is a powerful broad spectrum antibiotic. Studies have shown garlic to be effective against fungi such as candida, as well as the fungus that causes athlete's foot and the dangerous fungus that causes serious cryptococcal meningitis. Garlic also kills bacteria and viruses. In addition, garlic protects the cells through its powerful antioxidant effects.

Two other herbs have strong anti-infective properties and can be used to treat pathogens that cause fatigue. The first is echinacea, a powerful immune stimulant herb. Echinacea helps fight infections by promoting interferon production, as well as activa-tion of the T-lymphocytes (natural killer cells) and neutrophils (the cells that kill bacteria). Native Americans traditionally used this plant as a medicinal agent. I have used echinacea often with patients and have been pleased with its powerful anti-infective properties. The second herb, goldenseal, is also an excellent immune stimulant. Goldenseal contains a high level of chemical called berberine. Berberine activates macrophages (cells that engulf and destroy bacteria, fungi, and viruses). When used in combination with garlic and echinacea, goldenseal is an effective tool for suppressing infections.

Menopause, PMS, and Hypothyroidism
Many plants are good sources of estrogen, the hormone that helps control hot flashes in menopausal women. Blueberries, blackberries, huckleberries, and citrus fruit contain bioflavonoids. Bioflavonoids have weak estrogenic activity (1/50,000 the strength of estrogen), but are very effective in controlling such common menopausal symptoms as hot flashes, anxiety, irritability, and fatigue. Plants containing bioflavonoids may be particularly useful for women who cannot take normal supplements because of their concern about the possible strong side effects of the prescription hormones (increased risk of stroke, cancer, etc.). Other plant sources of estrogen and progesterone used in traditional herbology include Dong Quai, black cohosh, blue cohosh, unicorn root, false unicorn root, fennel, anise, sarsaparilla, and wild yam root. The hormonal activities of these plants have been validated in a number of interesting research studies.

Women with PMS also benefit from herbs that relieve mood swings and anxiety, such as valerian root or passionflower, and those that directly reduce fatigue and depression, such as ginger root, ginkgo biloba, and dandelion. Ginger also helps relieve the bloating and fluid retention symptoms of PMS, as do dandelion and burdock root, which act as mild diuretics. Iodine containing plants, including dulse and kelp, help correct low thyroid function. These sea vegetables are also high in trace minerals, so are excellent for general health and well being. Iodine is used for the production of thyroxin, the thyroid hormone that helps boost metabolism and maintain energy level.

Anemia and Heavy, Irregular Menstrual Bleeding
Plants that contain bioflavonoids help strengthen capillaries and prevent heavy, irregular menstrual bleeding (menorrhagia), a common bleeding pattern in women approaching menopause. Besides controlling hot flashes, bioflavonoids also help to reduce heavy bleeding. Bioflavonoids are found in many fruits and flowers; excellent sources are citrus fruits, cherries, grapes, and hawthorn berries.

According to research studies, they have also been found in red clover and in some clover strains in Australia. Many medical studies have demonstrated the usefulness of citrus bioflavonoids in treating a variety of bleeding problems in addition to those related to menopause, including habitual spontaneous abortion and tuberculosis. Herbs such as yellow dock and pan d'arco are useful for anemia because of their high iron content.

How to Use Optimal Nutritional Formulas for Chronic Fatigue
Good dietary habits are crucial for relief of chronic fatigue, but many women must also use nutritional supplements to achieve high levels of certain essential nutrients. I have included both vitamin and mineral formulas and herbal formulas so that you will have the widest range of supplements to choose from.

I recommend that women with chronic fatigue take all supple-ments cautiously. Start with one-quarter of the daily dose listed in the following formulas. Do not go to a higher dose level unless you are sure you can tolerate the dose you're already using. If you have specific questions, be sure to consult your physician.