Without B vitamins our bodies would lack energy. These eight nutrients are indispensable for yielding energy compounds from the foods we eat. Many B vitamins serve as helpers to enzymes that release energy from fat, protein and carbohydrates. Compared to healthy people, patients with CFS often have lower levels of B vitamins in their blood. One study also found that enzymes dependent on B vitamins were less active in people with CFS. I could not find any published studies that tried to determine if taking vitamin B supplements could improve fatigue symptoms. For information on the family of B vitamins—how much you need and where to look for it—see the table on page 4 in chapter 1.

To ensure you are getting your fair share of B vitamins, take a good quality multivitamin and mineral supplement each day. If you’re over 50, you should be getting your B12 from a supplement anyway. That’s because as we age we become less efficient at producing stomach acid, a necessary aid for B12 absorption from food.

If you’re looking for more B vitamins than a regular multi gives you, choose a “high potency” or “super” formula that contains 30 to 75 milligrams of B vitamins (or micrograms in the case of folic acid). You can also take a B complex formula that gives you all eight B vitamins, often combined with vitamin C. If you supplement with these products, you should know that niacin might cause flushing of the face and chest when it’s taken in doses greater than 35 milligrams (this is easily avoided if you take your supplement just after eating a meal). This symptom is harmless and goes away within 20 minutes, but some people find it uncomfortable. To avoid flushing, look for a formula that contains niacinamide instead of niacin. Niacinamide is a non-flushing form of niacin.


More than 300 enzymes rely on a steady supply of magnesium for optimal activity. Magnesium is part of adenosine triphosphate (ATP), the active energy compound that’s used by every cell in your body. It’s believed that a deficiency in magnesium can lead to the decreased energy and weakness seen in CFS. Some investigations have found low levels of magnesium in the red blood cells of patients with CFS. When these patients are regularly given magnesium by injection, they report more energy, less pain and more balanced emotions. Other studies have found evidence of a magnesium deficiency in people afflicted with CFS.

Although there is no concrete evidence to support the use of extra magnesium in CFS, there is no harm done by increasing your intake of this mineral. In fact, research suggests that only 25 percent of the population is meeting their daily magnesium needs. I am sure we could all use a magnesium boost in our daily diet. To see what you should be striving for each day, see the RDA table on page 21 in chapter 1. Also see the Magnesium in Foods chart on page 21 for the foods that will help you meet these daily targets.

Magnesium Supplements

There is no definite dose of magnesium for the treatment of CFS. Doses of 200 to 300 milligrams have been used to reduce the muscle pain and joint tenderness associated with fibromyalgia. If you want to take a supplement, buy magnesium citrate.

Compared to other forms of the mineral (e.g., magnesium oxide), magnesium citrates are more easily absorbed by your body. You can also get supplemental magnesium from your calcium pills if you buy one that has magnesium added.

The daily upper limit for magnesium has been set at 350 milligrams from a supplement. That’s because doses higher than this can cause diarrhea and stomach upset, common side effects of magnesium supplementation.


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