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Condition

Myalgic Encephalomyelitis (Chronic Fatigue Syndrome)

ME/CFS is a long-term illness in which deep exhaustion does not ease with rest and often flares after exertion, possibly tied to disrupted cellular energy and immune signaling. Among supplements, L-carnitine and D-ribose drew the most interest, and small studies found attention improved with carnitine and fatigue eased with D-ribose. The evidence is limited, though, since those studies were small, with 90 and 36 people.

Sources: PMID 15039515; PMID 17109576

Supplements studied
7
Graded outcomes
6
Trials
9
People studied
463

Evidence by supplement

  • Strong
  • Moderate
  • Limited
  • Very limited

7 supplements

Fish Oil

Fish Oil: outcomes studied for Myalgic Encephalomyelitis (Chronic Fatigue Syndrome)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Depression Symptoms

Moderate Improvement

Improves (the measure goes down)Moderate effect14 studies50 people

Studies that measured depression symptoms

and 11 more on the Fish Oil page

Fatigue SymptomsImproves (the measure goes down)50 people

Coenzyme Q10

Coenzyme Q10: outcomes studied for Myalgic Encephalomyelitis (Chronic Fatigue Syndrome)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Depression Symptoms

Moderate Improvement

Improves (the measure goes down)Moderate effect2 studies48 people

Studies that measured depression symptoms

Fatigue SymptomsImproves (the measure goes down)3 studies48 people

Studies that measured fatigue symptoms

L-Carnitine

  • Attention: improves
  • Fatigue Symptoms: improves
L-Carnitine: outcomes studied for Myalgic Encephalomyelitis (Chronic Fatigue Syndrome)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Attention

Small Improvement

Improves (the measure goes up)Small effect1 study90 people

Studies that measured attention

Fatigue SymptomsImproves (the measure goes down)174 people

Panax Ginseng (Korean Ginseng)

  • Depression Symptoms: improves
  • Insomnia Signs and Symptoms: improves
  • Fatigue Symptoms: improves
Panax Ginseng (Korean Ginseng): outcomes studied for Myalgic Encephalomyelitis (Chronic Fatigue Syndrome)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Depression Symptoms

Small Improvement

Improves (the measure goes down)Small effect1 study50 people

Studies that measured depression symptoms

Insomnia Signs and SymptomsImproves (the measure goes down)1 study50 people

Studies that measured insomnia signs and symptoms

Fatigue SymptomsImproves (the measure goes down)50 people

D-Ribose

  • Fatigue Symptoms: improves
  • Subjective Well-Being: improves
  • Fibromyalgia Symptoms: improves
D-Ribose: outcomes studied for Myalgic Encephalomyelitis (Chronic Fatigue Syndrome)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Fatigue Symptoms

Small Improvement

Improves (the measure goes down)Small effect36 people
Subjective Well-BeingImproves (the measure goes up)1 study36 people

Studies that measured subjective well-being

Fibromyalgia SymptomsImproves (the measure goes down)36 people

Rhodiola Rosea

  • Fatigue Symptoms: improves
  • Social Functioning: improves
  • Stress Signs and Symptoms: improves
Rhodiola Rosea: outcomes studied for Myalgic Encephalomyelitis (Chronic Fatigue Syndrome)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Fatigue Symptoms

Moderate Improvement

Improves (the measure goes down)Moderate effect101 people
Social FunctioningImproves (the measure goes up)1 study101 people

Studies that measured social functioning

Stress Signs and SymptomsImproves (the measure goes down)1 study101 people

Studies that measured stress signs and symptoms

Spirulina

  • Fatigue Symptoms
Spirulina: outcomes studied for Myalgic Encephalomyelitis (Chronic Fatigue Syndrome)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Fatigue Symptoms

Key findings

  • Depression SymptomsFish OilImproves (the measure goes down)
  • AttentionL-CarnitineImproves (the measure goes up)
  • Fatigue SymptomsD-RiboseImproves (the measure goes down)

The Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS) protocol

2 primary supplements · 7 supporting supplements

See the full protocol

Studies cited

25 studies from PubMed

  1. Effects of Coenzyme Q10 Supplementation on Depressive Symptoms and Fatigue: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.J Clin Psychopharmacol, 2026 · PMID 41294251
  2. Rhodiola rosea in Subjects with Prolonged or Chronic Fatigue Symptoms: Results of an Open-Label Clinical TrialComplement Med Res · PMID 28219059
  3. The influence of adaptogens on ultraweak biophoton emission: a pilot-experimentPhytother Res · PMID 19170145
  4. Efficacy of Korean red ginseng (Panax ginseng) for middle-aged and moderate level of chronic fatigue patients: A randomized, double-blind, placebo-controlled trialComplement Ther Med · PMID 31987248
  5. Effects of a standardized ginseng extract on quality of life and physiological parameters in symptomatic postmenopausal women: a double-blind, placebo-controlled trial. Swedish Alternative Medicine GroupInt J Clin Pharmacol Res · PMID 10761538
  6. The role of essential fatty acids in chronic fatigue syndrome. A case-controlled study of red-cell membrane essential fatty acids (EFA) and a placebo-controlled treatment study with high dose of EFAActa Neurol Scand · PMID 10071170
  7. Fish oil supplementation in the treatment of major depression: a randomised double-blind placebo-controlled trialProg Neuropsychopharmacol Biol Psychiatry · PMID 17659823
  8. A dose-ranging study of the effects of ethyl-eicosapentaenoate in patients with ongoing depression despite apparently adequate treatment with standard drugsArch Gen Psychiatry · PMID 12365878
  9. Omega-3 fatty acids in major depressive disorder. A preliminary double-blind, placebo-controlled trialEur Neuropsychopharmacol · PMID 12888186
  10. Ethyl-eicosapentaenoic acid for the treatment of psychological distress and depressive symptoms in middle-aged women: a double-blind, placebo-controlled, randomized clinical trialAm J Clin Nutr · PMID 19116322
  11. Efficacy of omega-3 for vasomotor symptoms treatment: a randomized controlled trialMenopause · PMID 23982113
  12. Omega-3 fatty acids and supportive psychotherapy for perinatal depression: a randomized placebo-controlled studyJ Affect Disord · PMID 18206247
  13. The Mothers, Omega-3, and Mental Health Study: a double-blind, randomized controlled trialAm J Obstet Gynecol · PMID 23531328
  14. Supplementation of a low dose of DHA or DHA+AA does not prevent peripartum depressive symptoms in a small population based sampleProg Neuropsychopharmacol Biol Psychiatry · PMID 18955102
  15. Omega-3 fatty acids for major depressive disorder during pregnancy: results from a randomized, double-blind, placebo-controlled trialJ Clin Psychiatry · PMID 18370571
  16. Omega-3 fatty acids as a treatment for perinatal depression: randomized double-blind placebo-controlled trialAust N Z J Psychiatry · PMID 18247194
  17. Omega-3 fatty acids for a better mental state in working populations - Happy Nurse Project: A 52-week randomized controlled trialJ Psychiatr Res · PMID 29627596
  18. Effect of maternal docosahexaenoic acid supplementation on postpartum depression and information processingAm J Obstet Gynecol · PMID 12748510
  19. The effect of omega 3 fatty acid supplementation on premenstrual syndrome and health-related quality of life: a randomized clinical trialJ Psychosom Obstet Gynaecol · PMID 28707491
  20. The use of D-ribose in chronic fatigue syndrome and fibromyalgia: a pilot studyJ Altern Complement Med · PMID 17109576
  21. Coenzyme Q10 as a treatment for fatigue and depression in multiple sclerosis patients: A double blind randomized clinical trialNutr Neurosci · PMID 25603363
  22. Antifatigue effects of coenzyme Q10 during physical fatigueNutrition · PMID 18272335
  23. The effects of coenzyme Q10 supplementation on performance during repeated bouts of supramaximal exercise in sedentary menJ Strength Cond Res · PMID 19644406
  24. Evaluating the Effect of Coenzyme Q10 Augmentation on Treatment of Bipolar Depression: A Double-Blind Controlled Clinical TrialJ Clin Psychopharmacol · PMID 30106880
  25. Exploratory open label, randomized study of acetyl- and propionylcarnitine in chronic fatigue syndromePsychosom Med · PMID 15039515

Supplement stack for Myalgic Encephalomyelitis (Chronic Fatigue Syndrome)