Chronic Fatigue and The Paleo Diet

Chronic Fatigue and The Paleo Diet | The Paleo Diet

Myalgic encephalomyelitis, commonly called chronic fatigue syndrome (ME/CFS), is an incapacitating condition marked by disabling fatigue of at least six months, accompanied by numerous rheumatological, infectious, and neuropsychiatric symptoms.1 However, in our modern day nearly 4 million people 2 struggle with these symptoms that impact their ability to fully engage in daily activities.  Exercise can help fight common fatigue, while even minor efforts at physical activity lead to a significant worsening of symptoms for ME/CFS patients. This often encourages ME/CFS patients to cope with their illness by completely avoiding physical activity.3,4

Western medicine has offered little support for effective treatments options, which have included self-managed exercise programs and psychotherapy, and many practitioners fail to recognize ME/CFS as having a physical cause, believing the condition is only psychosomatic.5 Fortunately, researchers have just discovered that there are actual plasma biological markers in individuals with early ME/CFS symptoms. Specifically, the data shows a significant activation of both pro-and anti-inflammatory cytokines, the cells aiding in communication of immune responses triggered by inflammation, infection and trauma.6 This data stands to offer both new diagnostic tools, as well as treatment options to reduce the severity of ME/CFS.7


Nutritional deficiencies can contribute to the clinical manifestations of ME/CFS, and also can impact the healing processes.8 The Paleo diet is nutrient dense9 and exceeds the governmental requirements for over 13 nutrients lacking most in the Standard American Diet (SAD).10 Follow the prescriptions in The Paleo Diet, while focusing on the following recommendations to target healing.


Antioxidants have therapeutic potential to reduce oxidative damage, which is often shown to be high in those with ME/CFS.11 Elevated concentrations of inflammatory cytokines might indirectly cause diminished antioxidant capacity by inhibiting albumin transcription in the liver.12 Therefore, it is important to replenish the body with dietary sources of glutathione-rich foods, as glutathione is required to properly utilize other antioxidants such as vitamins C, E, and selenium and carotenoids.13,14


Magnesium is necessary for over 300 biochemical reactions in the body. Stress hormones tend to deplete magnesium levels,15 which have also been shown to be decreased in ME/CFS patients, despite adequate dietary intake of magnesium.16 Magnesium supplementation from naturally rich sources, such as avocados, dark leafy greens, and nuts,17 has been shown to improve energy levels, emotional wellbeing, and reduce pain in ME/CFS patients.18


Low levels of essential fatty acids (EFAs), which are often linked to immune, endocrine, and sympathetic nervous system dysfunctions,19, 20 appear to be common in individuals with ME/CFS.21 The Paleo Diet mimics our hunter gatherer ancestor’s dietary intake of omega-6 to omega-3, with a ratio of 2:1 or 3:1, as opposed to the modern diet, which has been estimated at 10:1 or 25:1.22 Pastured meats and wild fish, as recommended on the Paleo Diet are naturally higher in omega-3 fatty acids and support anti-inflammatory actions within the body.


Stress contributes to the pathology and clinical symptoms of ME/CFS.23 The greater number of stressful life events predicts a worse functional and fatigue symptom profile24 and those who recover from ME/CFS for over one year report lower levels of life stress than those who did not recover.25 The lifestyle choices of hunter-gatherers differ from those of modern man in that there was adequate rest and recovery from both physical endeavors and mental feats. In addition to getting a solid night’s sleep, spend time outdoors each day, turn off technology early and practice mediation or other stress reducing activities to support your Paleo Diet lifestyle.


[1] Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A: The chronic fatigue syndrome: a comprehensive approach to its definition and study. Ann Intern Med 1994; 121:953-959

[2] Jason LA, Richman JA, Rademaker AW, et al. A community-based study of chronic fatigue syndrome. Arch Intern Med 1999;159:2129- 2137. 2. Komarof

[3] Vercoulen JH, Hommes OR, Swanink CM, Jongen PJ, Fennis JF, Galama JM, van der Meer JW, Bleijenberg G: The measurement of fatigue in patients with multiple sclerosis: a multidimensional comparison with patients with chronic fatigue syndrome and healthy subjects. Arch Neurol 1996; 53:642-649

[4] Vercoulen JHMM, Swanink CMA, Fennis JFM, Galama JM, van der Meer JW, Bleijenberg G: Prognosis in chronic fatigue syndrome: a prospective study of the natural course. J Neurol Neurosurg Psychiatry 1996; 60:489-494

[5] Ware, Norma C. “Suffering and the social construction of illness: The delegitimation of illness experience in chronic fatigue syndrome.” Medical Anthropology Quarterly 6.4 (1992): 347-361.

[6] Zhang, Jun-Ming, and Jianxiong An. “Cytokines, inflammation and pain.”International anesthesiology clinics 45.2 (2007): 27.

[7] Hornig, Mady, et al. “Distinct plasma immune signatures in ME/CFS are present early in the course of illness.” Science Advances 1.1 (2015): e1400121.

[8] Werbach, Melvyn R. “Nutritional strategies for treating chronic fatigue syndrome.” Alternative Medicine Review 5.2 (2000): 93-108.

[9] Cordain, Loren, et al. “Origins and evolution of the Western diet: health implications for the 21st century.” The American journal of clinical nutrition 81.2 (2005): 341-354.

[10] Cordain, Loren. “The nutritional characteristics of a contemporary diet based upon Paleolithic food groups.” J Am Neutraceutical Assoc 5 (2002): 15-24.

[11] Fulle S, Mecocci P, Fano G, et al. Specific oxidative alterations in vastus lateralis muscle of patients with the diagnosis of chronic fatigue syndrome. Free Radic Biol Med 2000;29:1252-1259.

[12] Werbach, Melvyn R. “Nutritional strategies for treating chronic fatigue syndrome.” Alternative Medicine Review 5.2 (2000): 93-108.

[13] Mårtensson, J., J. C. Lai, and Alton Meister. “High-affinity transport of glutathione is part of a multicomponent system essential for mitochondrial function.” Proceedings of the National Academy of Sciences 87.18 (1990): 7185-7189.

[14] Bounous, G., and J. Molson. “Competition for glutathione precursors between the immune system and the skeletal muscle: pathogenesis of chronic fatigue syndrome.” Medical hypotheses 53.4 (1999): 347-349.

[15] Seelig M. Presentation to the 37th Annual Meeting, American College of Nutrition, October 13, 1996.

[16] Grant JE, Veldee MS, Buchwald D. Analysis of dietary intake and selected nutrient concentrations in patients with chronic fatigue syndrome. J Am Diet Assoc 1996;96:383-386.

[17] Manuel y Keenoy, Begoña, et al. “Magnesium status and parameters of the oxidant-antioxidant balance in patients with chronic fatigue: effects of supplementation with magnesium.” Journal of the American College of Nutrition19.3 (2000): 374-382.

[18] Cox, I. M., M. J. Campbell, and D. Dowson. “Red blood cell magnesium and chronic fatigue syndrome.” The Lancet 337.8744 (1991): 757-760.

[19] Gray JB, Martinovic AM. Eicosanoids and essential fatty acid modulation in chronic disease and the chronic fatigue syndrome. Med Hypotheses 1994;43:31-

[20] Behan PO, Behan WM, Horrobin D. Effect of high doses of essential fatty acids on the postviral fatigue syndrome. Acta Neurol Scand 1990;82:209-216.

[21] Howard JM, Davies S, Hunnisett A. Magnesium and chronic fatigue syndrome. Letter. Lancet 1992;340:426.

[22] Cordain, L., et al. “Original Communications-The paradoxical nature of hunter-gatherer diets: Meat-based, yet non-atherogenic.” European journal of clinical nutrition 56.1 (2002): S42.

[23] Logan, Alan C., and Cathy Wong. “Chronic fatigue syndrome: oxidative stress and dietary modifications.” Alternative medicine review: a journal of clinical therapeutic 6.5 (2001): 450-459.

[24] Buchwald DS, Rea TD, Katon WJ, Russo JE, Ashley RL. Acute infectious mononucleosis: Characteristics of patients who report failure to recover. The American Journal of Medicine.2000;109(7):531–537.

[25] Lim BR, Tan SY, Zheng YP, Lin KM, Park BC, Turk AA. Psychosocial factors in chronic fatigue syndrome among Chinese Americans: A longitudinal community-based study. Transcultural Psychiatry. 2003;40:429–441.

About Stephanie Vuolo

Stephanie VuoloStephanie Vuolo is a Certified Nutritional Therapist, an American College of Sports Medicine Personal Trainer, and a Certified CrossFit Level 1 Coach. She has a B.A. in Communications from Villanova University. She is a former contributor to Discovery Communications/TLC Blog, Parentables.

Stephanie lives in Seattle, WA, where she is a passionate and enthusiastic advocate for how diet and lifestyle can contribute to overall wellness and longevity. She has been raising her young daughter on the Paleo Diet since birth. You can visit her website at

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“4” Comments

  1. Guys, I love your work and I have been Paleo for almost 5 years and loving it. But this article is just wrong. First, it is completely totally incorrect that exercise in any shape and form can somehow “fix” people from true chronic fatigue syndrome. Exercise will make CFS worse, not better. It is an inflammatory condition caused by exposure to modern toxins. Hunter gathers did not have that problem. Diet will not fix it (although it certainly helps to have better nutrition). Only removal from the toxic environment will help: It’s caused by toxic mold, VOC gasses from carpets, furniture etc and poor indoor air quality. As for the biomarkers for CFS, you should really look into the work of Dr Ritchie Shoemaker on toxic mold. Check out Chris Kresser’s podcasts with him. He has had those biomarkers for CFS / biotoxin illness for many years and his protocol has helped thousands of people.

  2. “Hunter gatherers couldn’t afford to suffer from myalgic encephalomyelitis” is really offensive to people with this disease, we can’t afford to suffer from it now either. It has been documented throughout history. It is not preventable by diet or curable by diet (believe me). Please change the wording.

    • Hi, We certainly did not mean to offend anyone with that statement, and per your request we have amended the sentence in the blog post. In regards to whether a Paleo diet can help someone with ME/CF, my own clinical experience is that it is very individualistic. Some of my clients have seen an improvement and others have not, which emphasizes the complexity of human physiology. However, what is always worth pointing out to individuals with chronic disease is that adopting a Paleo diet has zero down side which is easily demonstrated by an analysis of a Paleo diet template. A Paleo diet has zero nutritional deficiencies but, rather, improves the government guidelines of nutritional requirements. It is always interesting to me that the Paleo nay-sayers critique the Paleo diet without conducting the most obvious analysis of the diet. That fact that they do not do so, should suggest to anyone the validity of the diet.

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