Not all energy supplements for fatigue are created equal.
But what vitamins and minerals (and at what doses) are necessary? And which are just marketing hype?
In this post, I do away with all the hype. Here, I focus on exactly which are the best energy supplements for chronic fatigue syndrome. The information I present is based on scientific research, not marketing hype. All of the supplements I list are proven to improve energy production and alleviate chronic fatigue syndrome.
Keep in mind, your body often won’t absorb inexpensive brands found at drugstores. Similarly, very high priced products may have an expensive marketing campaign to support and not offer a superior product. Purchase supplements with price points in the middle of the range. These brands are available online or in-store at health and wellness businesses.
To overcome chronic fatigue syndrome you need specific nutrients that target your fatigue at a cellular level.
You may find a supplement that promises to increase your energy, but when you look at the ingredients list, you see the words ”proprietary blend”.
The term ‘proprietary blend’ is how manufacturers get around listing the actual amounts of vitamins and minerals in their supplements.
Proprietary blends are clever ways to make inferior supplements look legitimate. They are often accompanied by marketing campaigns that promise the world. But they hardly ever work the way they claim.
Focusing on the performance of your mitochondria is how to know you’re using the best energy supplements for chronic fatigue.
The most important energy supplements for chronic fatigue
The root cause of chronic fatigue syndrome is mitochondrial dysfunction. Therefore, the supplements you take should be aimed at improving mitochondrial function. According to research these are the best energy supplements for chronic fatigue.
1. D-Ribose
D-ribose is a simple sugar that was originally discovered in the 1940s. It is incredibly important in your body’s energy production pathways.
In the 1990s researchers discovered D-ribose can improve recovery following cardiac surgery. It can also improve function of the heart in cases of congestive heart failure. And it does all this through improving mitochondrial function. (1)
Capillaries are the smallest blood vessels in the body. They directly deliver oxygen and nutrients to the cells, and collect carbon dioxide and waste. People who suffer from chronic fatigue syndrome have thickened capillary walls.
The thicker walls prevent adequate amounts of oxygen from reaching the tissues. It’s like your cells are never quite able to fully catch their breath. (2)
The lack of oxygen forces the cells to produce energy without oxygen. This is a terribly inefficient way for your cells to create energy. And many think that this is precisely what’s going on in chronic fatigue syndrome.
If your cells aren’t able to produce enough energy, lactic acid builds up. Have you ever felt so tired that it hurt? That’s the build-up of lactic acid in your cells. D-ribose helps your cells to clear out the lactic acid and rebuild their energy stores. Over time, this will help to increase your energy levels. (3)
Dosing:
Those with chronic fatigue syndrome will need to add a d-ribose supplement. I recommend starting with 3-5 grams of d-ribose each day. (4) If you don’t notice a change in your energy levels within a few days, increase your dose. D-ribose is extremely safe to take in high doses. Some trials have done doses of 10-15 grams per day without any negative effects reported. (5)
Ensure you take d-ribose every day. Without it your energy pools will quickly become drained.
For those of you with blood sugar abnormalities, you may find that d-ribose has a negative effect. This occurs because d-ribose is a simple sugar. And simple sugars can cause fluctuations in your blood sugar. A simple trial of this supplement will determine whether or not d-ribose is right for you.
2. Coenzyme Q10
CoenzymeQ10 (coQ10) has been touted as a miracle supplement for preventing heart disease. (6) It works its magic on your heart’s health through the mitochondria. CoQ10 is essential for creating energy from oxygen and food. (7)
Your body naturally produces coQ10 all on its own. However, it’s a lot of work requiring a decent amount of the amino acid tyrosine, a bunch more vitamins, and even some minerals.
As you age (especially after age 30), your body produces less and less coQ10. This is when supplements become essential. Regardless of your age, if you have chronic fatigue syndrome you should be supplementing coQ10. (8)
CoQ10 targets a specific site of your cell’s energy production cycle where the largest amount of free radicals are produced. Supplementation decreases free radical damage and improves cell health.
When your cells and body lack coQ10, your mitochondrial function starts to fail. They become less efficient at making energy and more efficient at producing cell-damaging free radicals. If you’re fighting chronic fatigue syndrome, you need to do everything you can to optimize your mitochondrial function. (9)
Dosing:
Your body will absorb oil-based or liposomal versions of coQ10 the best. Make sure that your coQ10 supplement comes in the form of ubiquinol as this is the most usable form for your body. (10)
Take 600-3000mg of CoQ10 each day. It is completely safe even at the upper range of dosing.
Unfortunately, this is a supplement I recommend taking for life. But the benefits of having healthy levels of coQ10 justify the price tag of lifelong supplementation.
3. Acetyl L-carnitine
As you age, your body’s ability to produce L-carnitine decreases. Much like coenzyme Q10, I recommend supplementing it after the age of thirty. Also similar to coQ10, L-carnitine assists with mitochondrial function (albeit differently than coQ10). (11)
L-carnitine acts as a bus driver for your fatty acids. It transports them into the mitochondria in your cells where they produce energy. If you’re low in L-carnitine, your body will struggle to transport fatty acids into the mitochondria. This results in impaired energy production – also known as fatigue. (12)
When your body uses glucose for fuel, one molecule of glucose produces 36 molecules of energy. But 1 molecule of fatty acids results in 128 molecules of energy. If you want to overcome fatigue, you need to make mighty mitochondria. L-carnitine is essential to start your body using fatty acids for fuel. (14, 13)
But that’s not all L-carnitine can do. It also removes lactic acid from your cells. Those with chronic fatigue syndrome often have a buildup of lactic acid in their cells. One study showed that supplementing L-carnitine significantly lowered lactic acid levels compared to controls.
Vegetarians are at increased risk for L-carnitine deficiencies. This is because the highest concentrations of L-carnitine are found in animal proteins. If you have chronic fatigue syndrome, you will not be able to obtain enough L-carnitine from your food. Supplementation is absolutely essential.
Dosing:
For conditions like chronic fatigue syndrome and myalgic encephalitis, I recommend taking one gram of L-carnitine daily. (15)
4. Vitamin B3 and Vitamin B12
All of the B vitamins are important in mitochondrial health. All of them. That’s why taking a supplement of B-complex vitamins will form a solid foundation. But you will need additional support via vitamin B3 and vitamin B12. (16)
Vitamin B3:
Vitamin B3 is more often known as niacin. If you’ve ever taken too much of this vitamin you’ll have experienced redness, or, flushing of your skin with an accompanying itch. This is known as a niacin flush. Fortunately, there are new forms of niacin (which I’ll describe below) that make for happy skin and mitochondria. (17)
As far as energy production is concerned, the most important function of vitamin B3 is making your mitochondria more efficient so they can make more energy.
Dosing:
New forms of vitamin B3 known as nicotinamide riboside seem to be the most efficient at improving mitochondrial and ATP production. If you’re unable to find nicotinamide riboside, opt for niacinamide – but ensure it’s a slow-release formula. This will prevent any of the uncomfortable skin reactions.
Take 500-1500mg daily.
Vitamin B12:
Vitamin B12 is known as cobalamin. This is the form many supplements come in. But for those with chronic fatigue syndrome, you’ll want to take your vitamin B12 in its methylated form – methylcobalamin. (18)
Vegetarians and vegans are at increased risk of vitamin B12 deficiencies, so if you are on either a vegetarian or vegan diet, ensure you are supplementing B12 daily.
Those with CFS tend to have decreased stomach acid, IBS, SIBO, and other gut-related pathologies. A malfunctioning gut will significantly interrupt the absorption of vitamin B12. Chronic fatigue patients should instead opt to get vitamin B12 through monthly or bi-weekly injections.
This vitamin is incredibly safe at high doses and there is no need to worry about overdosing. If you’re unable to obtain B12 injections, sublingual forms of methylcobalamin or hydroxycobalamin are the next best supplemental form. Avoid capsules or tablets as they are poorly absorbed.
Dosing:
Bi-weekly or monthly B12 injections or 5000mcg sublingual on a daily basis.
5. Magnesium
Magnesium is one of the few supplements I recommend nearly all of my patients take indefinitely – especially if they are active or treating conditions like chronic fatigue. We obtain magnesium from food sources like green leafy vegetables, nuts, seeds, and some seafood. However, the levels of magnesium found in these foods are not enough to supply the demand your body requires. This is why adding a supplement is essential for most of us – including me!
Doctors check magnesium levels in blood – but almost all of our magnesium is stored in our cells. (19) Even if the lab test your doctor ran shows your magnesium levels are normal, this may not be the case. Some estimates say about 80% of the developed world could be magnesium deficient!
When it comes to chronic fatigue, magnesium is absolutely essential in the production of energy. Magnesium works in the opposite way of calcium. Put simply, calcium helps your muscles contract. Magnesium helps your muscles relax. When you feel muscle tension you know that it’s much more difficult to relax a muscle than it is to contract one! Part of the reason could be due to all the calcium you’re getting through diet and supplements and the minimal amount of magnesium.
Dosing:
I recommend 200mg twice a day, and if you have sleep issues, take one dose before bed.
Opt for magnesium glycinate or bisglycinate. These forms of magnesium do not pull water into your large intestine. Too much water in your large intestine results in urgent and loose bowel movements.
6. Iron
Do not add an iron supplement until you’ve had your levels – serum iron and ferritin – checked. If your iron levels are within normal ranges, do not add a supplement. One of the main symptoms of too much iron is fatigue – a common symptom in a condition known as hemochromatosis. Other terrible effects of excessive iron include Alzheimer’s and Parkinson’s disease.
But if your iron levels are low, adding an iron supplement can have a dramatic increase in your energy levels. Heme iron is synthesized by your mitochondria. If your mitochondria don’t have enough heme, they start to degrade. (21) Remember, in conditions where fatigue is the main concern, you want to do everything you can to ensure your mitochondria are thriving. Iron also transports oxygen to your body’s tissues.
Can you guess what the main symptom of low oxygen levels in your tissues is?
Yep, fatigue. Get your iron levels tested. And supplement iron if your levels are low. But not if they’re in normal ranges.
Dosing:
I don’t have a recommended dose for iron supplementation. It is entirely dependent on your levels. With that said, I encourage everyone to consume a serving of liver every week. Liver is full of iron and other fat-soluble vitamins. Your mitochondria will love it… even if your palate doesn’t!
Ok, there you have it! These are the best supplements for chronic fatigue. A whole food, ketogenic diet is also essential in the treatment of CFS.
Be sure to check out the best supplements for adrenal fatigue – those of you dealing with CFS will likely have adrenal issues as well. Combining the supplements I list here for CFS with the ones I list for adrenal fatigue will give your mitochondria even more energy!
For more of our writings on how to achieve a fatigue-free body, click here.
Remember, you cannot supplement yourself out of fatigue. You need to incorporate lifestyle changes (like changing your diet) for treatment to be effective.
Now, I want to hear from you!
What supplements have you found to increase your energy?
Share your experiences in the comments section below!
Anne says
Great article! I so appreciate seeing these supplements listed. I will try increasing my D-ribose and CoQ10. Unfortunately I can’t stomach acetyl l carnitine. Would l-carnitine be easier on the stomach? Thanks so much.
mark volmer says
Hi, Anne!
L-carnitine has a different effect than acetyl-l-carnitine. Acetyl-l-carnitine passes through the blood-brain barrier – exerting more of an effect on neurotransmitters (think brain fog improvements). L-carnitine will help your mitochondria utilize fatty acids in energy production. It’s a great support for a keto diet.
I’m not too sure how L-carnitine will affect your guts. But I certainly think it’s a worthwhile experiment!
Let me know how it goes!
M
Yana says
Thanks for this. It’s hard to navigate through the world of supplements. I can only afford “essential” supplements- even that can be tough. Do you recommend a product that covers these ingredients?
Mark Volmer says
Hi, Yana!
I’m inherently skeptical of most blended products. All too often, manufacturers will list proprietary blend on these types of supplements. This allows them to skirt around listing the actual quantity of ingredients in their product.
My thoughts – opt for a high-quality coQ10. You’ll get the most mileage out of this supplement.
Thanks for the comment!
M
Marv says
Hi Mark. Could you recommend a supplement producer that is consistent in high quality? Advertized potency and form seem to be all over the place, even within some well known brands.
Mark Volmer says
Hey, Marv,
Ugh. Isn’t that the truth!
I’ve been really liking AOR these days. Made here in Calgary and always doing a top-notch job with the research.
Worth noting, I have zero conflicts of interest with AOR. I recommend them because they make great products!
M
Cindy says
This information is very helpful, thank you. I am in the US, otherwise I’d love to come to your clinic for an appt. I have either fibromyalgia or CFS. Symptoms for both are very similar. Similar, if not identical supplements are recommended for both conditions. Would you recommend taking all of these supplements? Or are there a few that are not as essential? I tried the D-Ribose last night and it caused bloating and abdominal cramping. My stomach is still upset this morning. I honestly wasn’t expecting to notice any immediate benefits from the D-Ribose, but energy-wise, I felt a huge difference after the first dose. Should I keep taking the D-Ribose? Do you think the GI side effects will lessen/go away? If not, then I will need to stop taking it. I also took my first dose of Acetyl-L-Carnatine last night of 500mg. I had trouble falling asleep, but once I got to sleep, I slept like a rock. I noticed more muscle pain during the night though, and this morning, I feel as though I’ve been drugged. I already take Magnesium Malate. I have been taking that for a couple of years now. I have taken Ubiquinol before and tolerated it well. Will add to my regimen again and the higher dosages you recommended. Will try the B-Vitamins soon. Sorry for the long post but I just want to know if the reactions I am having to the D-Ribose and Acetyl-L-Carnatine are normal/common. Thank you.
Mark Volmer says
Hi, Cindy!
We do virtual appointments 🙂
As I alluded to in the article, you’re not going to supplement your way out of CFS. Make sure you’re looking further into mold illness – https://fatiguetoflourish.com/calgary-mold-clinic/
I wouldn’t recommend taking everything I listed. Try each of them and stick only with the ones that seem to improve your energy.
Let me know how it goes!
M
Laurie Mesch says
I stumbled across this page doing a google search “I need energy”! Lol seriously !
I am 51 years old and suffer from Chronic pain. I am on high doses of pain relievers and have been for over 20 years. I also suffer from massive depression disorder and chronic fatigue. I’ve been taking a multi vitamin for woman over 50 and also B12 Methocobalamine. And I STILL struggle to even get out of bed. I always start out with good intentions, the desire to do the things I love but 90% of the time I’m back in bed. Sometimes sleeping sometimes just laying there. I am desperate for help.