Muscling Up with Magnesium
Some people with CFS have benefited from taking supplements of magnesium, a mineral that is involved in the cells’ energy production.

One British study found that people with CFS had below-normal blood levels of magnesium. After receiving injections of magnesium, 80 percent reported improvement in their symptoms.

But even if their blood tests don’t show magnesium deficiencies, people can still benefit from extra doses of the mineral, according to Dr. Cheney. “Their blood levels of magnesium may be normal, but that doesn’t tell the whole story,” he says. “Magnesium, like potassium, is pumped into the cell, so normally there’s a higher concentration inside the cell than there is in the blood. And that pump mechanism may not work very well in people with CFS, so their magnesium levels can be normal in the blood and low in the cell.”

Dr. Magaziner also finds that most people with CFS notice improvement in their symptoms after starting magnesium supplements. “It doesn’t work for everyone,” he says. “But many of my patients find it eases their muscle aches and makes them feel less fatigued.”

This is probably because people with CFS have enzyme deficiencies that hamper the cells’ ability to convert food into energy, according to Dr. Cheney. And extra magnesium improves enzyme function, which results in greater energy production on the cellular level.

If you’re interested in trying magnesium, Dr. Magaziner recommends starting with 500 milligrams a day. “This level is perfectly safe, although occasionally a person will develop loose bowels or diarrhea,” he says. “If that happens, I would simply reduce the dose to the point where the diarrhea goes away.” If you have heart or kidney problems, however, you should check with your doctor before taking magnesium supplements.

Dr. Cheney recommends a chelated form of magnesium called magnesium glycinate. “It’s rapidly absorbed in the gastrointestinal tract, so it doesn’t cause digestive problems,” he explains. “And it tends to be drawn into the cell, where it’s needed.”

And because taking more magnesium increases the body’s need for calcium, Dr. Magaziner suggests taking calcium supplements as well. “I usually recommend taking them in a two-to-one ratio—1,000 milligrams of calcium if you’re taking 500 milligrams of magnesium,” he advises.

A Boost from B-Complex

The B-complex vitamins help support the adrenal glands, which are among the major organs in the body connected with stress, says Dr. Magaziner. “B vitamins also support the central nervous system, to help us cope with stress in general,” he explains. “We lose a lot of B vitamins when we’re stressed, so we need to replenish them.” These nutrients are also involved in energy production, which makes them essential for people with CFS.

Dr. Magaziner recommends a supplement containing the entire B-complex. thiamin, pantothenic acid and vitamins B6 and B12 are especially important for people with CFS, he says.

You can get the B-complex vitamins in most 6 and 50 micrograms of vitamin B12. He also recommends taking a separate B-complex supplement whenever you’re under stress.

Higher doses of vitamin B12, given through injection by a physician, can also be helpful in cases of enzyme deficiency, says Dr. Cheney. Injected B12 doses may be 1,000 times higher than the normal daily dose.

Fighting Back with Coenzyme Q10
Coenzyme Q10 sounds like something that might be prescribed in sick bay on Star Trek. But for those doing daily battle with chronic fatigue syndrome (CFS), they just might hear about it from their doctors, according to Paul Cheney, M.D., a CFS specialist and director of the Cheney Clinic in Charlotte, North Carolina.

Coenzyme Q10 is available in supplement form in drugstores and health food stores. This little-known nutrient isn't exactly a vitamin, although its chemical makeup is similar to that of vitamins E and K. Experts believe that like vitamin K, coenzyme Q10 can be manufactured by the body, though it's also found in soybeans, vegetable oils and many meats.

Like vitamins C and E and beta-carotene, coenzyme Q10 is a member of the antioxidant family, a group of nutrients that protect your body's tissues from everyday wear and tear by disarming destructive free radicals. Free radicals are unstable molecules that wreak havoc at the cellular level by stealing electrons from your body's healthy molecules to balance themselves.

Besides being a potent antioxidant, coenzyme Q10 has an important function in energy production: It reacts with another enzyme to let cells convert protein, fat and carbohydrates into energy.

While people with CFS aren't deficient in coenzyme Q10, they seem to have functional shortages of the enzyme it reacts with, explains Dr. Cheney. Taking extra coenzyme Q10 prompts the body to improve the function of this partner enzyme. And the better the partner enzyme works, the better the body's ability to convert food into energy.

Dr. Cheney prescribes large doses of coenzyme Q10 for his patients, who are under his close medical supervision. For people with CFS who'd like to try coenzyme Q10 on their own, he recommends a daily dose of 200 milligrams, taken in divided doses under the tongue. And since this nutrient is fat-soluble, it should be taken with a little bit of fat or oil (although some supplements are in an oil base, similar to vitamin E capsules).

Arm Yourself with Antioxidants

Also helpful in treating CFS are the so-called antioxidant nutrients, which include vitamin C, vitamin E, beta-carotene and the mineral selenium.

These nutrients form a veritable SWAT team that helps defend your cells against free radicals, unstable molecules that occur naturally in the body and that are also produced by bad habits such as smoking, sunbathing and drinking alcohol. Free radicals steal electrons from your body’s healthy molecules to balance themselves, damaging cells in the process. Antioxidants neutralize free radicals by offering their own electrons, protecting healthy molecules from harm.

“Antioxidants protect the body from deterioration, degeneration and environmental stresses,” says Dr. Magaziner. “And since many people with CFS are unusually sensitive to environmental factors such as household chemicals, food additives and artificial fragrances, taking antioxidants makes sense.”

Damage from free radicals is such an important factor in CFS that some researchers consider CFS a free radical–generated disease, says Dr. Cheney. “I don’t think it’s caused by free radical damage, but that seems to be one of the factors that maintains it,” he says.

To help bolster the immune system and improve stamina, both doctors recommend an antioxidant-complex supplement, available in most drugstores and health food stores. Because dosage varies widely from brand to brand, read the label to make sure you’re getting at least 500 milligrams of vitamin C, 25,000 international units of beta-carotene, 400 international units of vitamin E and 50 micrograms of selenium.

People with CFS may also want to try a vitamin C supplement in the form of ester-C, says Dr. Cheney. “Ester-C is much more bioavailable than regular vitamin C,” he explains. “Your body absorbs twice as much. People with CFS can take 2,000 milligrams of ester-C twice a day; it’s very safe.” Taking more than 1,200 milligrams of vitamin C can cause diarrhea in some people, however, so it’s a good idea to check with your doctor before exceeding that amount. Ester-C is available in health food stores
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