When Joan came to see us, we realized that she was suffering from chronic fatigue syndrome, or CFS, which has been popularized in the media as the "Yuppie Flu", because it often strikes young professionals with busy lives. Chronic fatigue can happen to anyone, however. In a recent article in the Journal of the American Medical Association, 21% of people coming to a large general practice met the criteria for CFS. The syndrome is more common in women than men. 45% of those patients with CFS were periodically bedridden. Up to 73% also have mild fever, swollen lymph nodes, muscle aches, joint pain, night sweats, and difficulty in concentration and sleeping. 50% of the people who have chronic fatigue also complain of chronic depression or anxiety. Some are just extremely frustrated by how the fatigue has interfered with their usually active lives. They are just tired of being tired.

What causes CFS? Doctors have debated in the medical journals over whether the disease even exists. But those who have it know it does. It has been assumed to be a chronic post-viral syndrome, occuring after mononucleosis or influenza infection, or after infection with an intestinal virus. For a number of years it was thought that the Epstein-Barr virus (EBV) was the culprit. This is the virus which causes mononucleosis, the "kissing disease", which affects young adults with extreme tiredness, sore throat, swollen glands and liver inflammation. Although most people recover uneventfully from mononucleosis, in many cases the virus goes underground, and may appear years later as CFS. EBV antibody levels, however, are usually only slightly higher in CFS patients than in healthy controls without chronic fatigue. This means that Epstein-Barr only accounts for some of the chronic fatigue that is so prevalent. Researchers in England have proposed an intestinal virus, Coxsackie B, as the main cause for CFS, or Myalgic Encephalitis (ME), as it is called there. Like EBV, though, Coxsackie B virus antibodies are also found in healthy controls. So although exposure to viral illness often precedes chronic fatigue syndrome, it is not the whole story.

Why does one person recover completely from a viral illness and another go on to develop CFS? The answer is a complex one. The philosophy of homeopathic medicine sheds some light on the subject. According to homeopathic thought, all illness comes about from an imbalance in the vital force. Your vital force is an intelligent energy principle in your body, which organizes and balances the many functions of life, and provides protection from illness. Your vital force can become imbalanced from many factors including stress, poor diet, lack of exercise, exposure to the elements, emotional trauma, and injuries. There can also be hereditary imbalances in the vital force which also lead to increased susceptibility to disease. Infectious agents such as viruses, bacteria and fungi find that the weakness in your vital force and its physical counterpart, the immune system, provides an opportunity to take hold in your body and grow. Whether this creates symptoms of illness or not depends on how well your body-mind is meeting the challenges of life. The vital force produces symptoms such as the fatigue, swollen glands, mild fever and muscle and joint aches typical of CFS as part of its attempt to restore balance to your system. In CFS cases, the vital force is unable to restore the proper balance after an acute illness, the person never recovers their full vitality, and the illness becomes chronic. If your vital force is functioning well, even if the virus is still present, you will not feel sick.

At present, there is essentially no effective treatment offered by orthodox medicine for CFS. No antiviral or antibiotic drugs make any difference in the course of the disease As naturopathic and homeopathic doctors, we see that the issue in treating chronic fatigue syndrome is not about killing viruses or preventing their replication, but to strengthen your vital force. Many people are infected chronically with viruses and bacteria, but suffer no illness whatsoever, because their vital force and immune system are strong and healthy. In fact, it is virtually impossible to be alive and not be infected with some pathogenic organisms. What is important is how your body responds to remain healthy.

You can protect yourself from developing chronic fatigue syndrome as well as treat it effectively with natural treatments if you do get it. It is important in prevention to get adequate rest and not to allow yourself to become chronically stressed in your work or home life. Regular aerobic exercise is important. Nutritionally, daily vitamin C (1000-3000 mg), B-complex, beta carotene (25,000 to 50,000 IU's), and 30 mg. of zinc are helpful in bolstering the immune system against infection. In treating chronic fatigue, we have found overwhelmingly that homeopathic medicine produces the best results. A remedy which matches all of your symptoms will stimulate your vital force to restore balance and health. We use a wide variety of homeopathic remedies in treating CFS, and it is important to see a homeopath for treatment rather than trying to treat yourself. It is also important to remove the stressors, lifestyle factors and nutritional deficiencies which may predispose to weakening the vital force and developing chronic fatigue.

In Joan's case a single dose of the homeopathic medicine Silica 200C restored her energy within several weeks, after five years of chronic fatigue. Her creativity and sexual interest came back as well. She felt let out of prison and able to resume her normal life.

Even though its causes and diagnosis are still somewhat indefinite, there is hope for people with chronic fatigue syndrome to lead vital, happy lives with proper prevention and effective natural treatment.

Drs. Judyth Reichenberg-Ullman and Robert Ullman are naturopathic and homeopathic physicians and cofounders of the Northwest Center for Homeopathic Medicine in Edmonds, WA. They are coauthors of The Patient's Guide to Homeopathic Medicine and Beyond Ritalin: Homeopathic Treatment of ADD and Other Behavioral and Learning Problems. They can be reached at (206) 774-5599.