Chronic Fatigue Syndrome (CFS) and Essential Fatty Acids (EFAs)

Essential Fatty Acids are extremely important for a well-functioning body. They are termed "essential" because our bodies need them, but cannot make them and must receive them through diet and/or supplements. The most noted essential fatty acids include omega-3s and omega-6s.

EFAs can help to reduce inflammation, aid in cellular function and help with mood disorders (via different mechanism). Depending on the individual's specific CFS symptoms, essential fatty acids would help in varying ways.

For example, for someone who didn't have adequate omega-3s or omega-6s in their diet, the mere fact that they raised these to an appropriate level may help their cognitive functioning.

For someone experiencing the aching muscles and/or joints that can be characteristic of Chronic Fatigue Syndrome, essential fatty acids might well help to reduce the inflammation causing these symptoms.

Read more details about Essential Fatty Acids (EFAs).

In a double-blind, placebo-controlled study, 63 people were given either a combination of essential fatty acids containing evening primrose oil (a source of GLA) and fish oil, or liquid paraffin placebo over a 3-month period.¹⁵ At 1 and 3 months, participants in the treatment group reported significant improvement in chronic fatigue syndrome symptoms as compared to the placebo group. The researchers also found that at the beginning of the study many participants had abnormal essential fatty acid levels, and these improved with treatment.

However, in 1999, researchers tried to replicate this study with 50 other people, using more precise means of measuring CFS symptoms.¹⁶ The results showed no difference between individuals given essential fatty acids and those given placebo (sunflower oil). These researchers also found no difference in fatty acid levels between individuals with CFS and individuals without CFS who served as controls.

Simply making sure your diet has enough omega-3s and omega-6s can often be enough. These substances are found in nuts, fish, eggs, avocados and many more. Supplements, like fish-oil tablets or omega-3s supplements specifically can also be taken, but it is almost always better to try and get these nutrients through a rich diet, than extrapolated in a synthetic form.

EFAs and their sources are generally regarded as harmless, except when there might be a food allergy involved (such as an allergy to shellfish). One concern with fish and fish-oil supplements involves the accumulation of mercury, PCBs, and other environmental toxins. For information that can help you make safe fish choices, see the Environmental Working Group's "Fish List." For fish oil supplements, look for products that are certified to not contain high levels of environmental toxins.

Fish oil has a mild blood-thinning effect;² in one case report, it increased the effect of the blood-thinning medication warfarin (Coumadin).³ Fish oil does not seem to cause bleeding problems when it is taken by itself⁴ or with aspirin.⁵ Nonetheless, people who are at risk of bleeding complications for any reason should consult a physician before taking fish oil.

Fish oil does not appear to raise blood sugar levels in people with diabetes.⁶ Nonetheless, if you have diabetes, you should not take any supplement except on the advice of a physician.

Fish oil may modestly increase weight and lower total cholesterol and HDL (“good”) cholesterol levels.⁷ It may also raise the level of LDL ("bad") cholesterol; however, this effect may be short-lived.⁸ If you decide to use cod liver oil as your fish oil supplement, make sure you do not exceed the safe maximum intake of vitamin A and vitamin D . These vitamins are fat soluble, which means that excess amounts tend to build up in your body, possibly reaching toxic levels. The official maximum daily intake of vitamin A is 3,000 mcg for pregnant women as well as other adults. Look at the bottle label to determine how much vitamin A you are receiving. (It is less likely that you will get enough vitamin D to produce toxic effects.)

15. 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.

16. Warren G, McKendrick M, Peet M. 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 EFA. Acta Neurol Scand. 1999;99:112-116.