Chronic fatigue syndrome (CFS)
Supplements studied for chronic fatigue syndrome (CFS).
Overview
Chronic fatigue syndrome (CFS) supplement trials are small and heterogeneous. NADH (five studies) shows the most repeated signal, with roughly one-third to two-fifths of participants reporting symptom improvement versus lower placebo response rates in short trials; NADH with coenzyme Q10 showed slight gains in fatigue and sleep in one study.
Melatonin results are mixed across small sleep-rhythm studies. Panax Ginseng and Acetyl-L-Carnitine have limited or uncontrolled evidence; Astragalus lacks a summary in this dataset. See the heatmap and evidence reviews below.
Effect graph
Relevant supplements
Relevant supplements sorted by DEX Score.
| NADH | ★★★★★ | Medium |
| Melatonin | ★★★★★ | Low |
| Astragalus | ★★★★★ | Low |
| Acetyl-L-Carnitine | ★★★★★ | Low |
| Eleuthero | ★★★★★ | Very Low / None |
| Panax Ginseng | ★★★★★ | Very Low / None |
| Rhodiola | ★★★★★ | Very Low / None |
Studies
Find individual evidence reviews for supplements sorted by DEX Score.
7 supplements for , and rated at least stars. All purchase bands. No minimum star filter.
NADHView supplement →
Consider purchase·★★★★★
How we scored this▸
- Small studies suggest taking NADH by mouth may help improve symptoms of chronic fatigue syndrome (CFS).
- In one study, about 31% of people taking 10 mg NADH daily for 4 weeks felt better, compared to 8% taking a placebo.
- Another study found 42% symptom improvement in people taking 5–10 mg NADH daily over several months.
- Taking NADH with coenzyme Q10 also showed slight improvements in fatigue, sleep, and quality of life after 8 weeks, compared to placebo.
- It’s unclear if the benefits come from NADH, coenzyme Q10, or both together.
- More research is needed to confirm these effects.
Browse 5 studies
Systematic reviewDietary Supplementation for Fatigue Symptoms in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)—A Systematic Review2025n=809
A systematic review of 14 studies (809 ME/CFS patients) found some supplements including L-carnitine showed significant fatigue reductions, but methodological limitations prevent firm conclusions.
- Dose
- 2.4 g/day
- Population
- Women
- Participants
- 809
- Ages
- 10–19
RCTEffect of Dietary Coenzyme Q10 Plus NADH Supplementation on Fatigue Perception and Health-Related Quality of Life in Individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial2021n=104
An 8-week RCT in 104 ME/CFS patients found coenzyme Q10 plus NADH co-supplementation improved fatigue and quality of life versus placebo.
- Effect
- Benefit
- Duration
- 8 weeks
- Dose
- 200 mg/day
- Population
- CFS patients
- Participants
- 104
- Ages
- 18+
RCTDoes oral coenzyme Q10 plus NADH supplementation improve fatigue and biochemical parameters in chronic fatigue syndrome?2015
An 8-week double-blind RCT found oral CoQ10 200 mg/day plus NADH 20 mg/day improved fatigue and some biochemical markers in chronic fatigue syndrome versus placebo.
- Effect
- Benefit
- Dose
- 200 mg/day
- Population
- Patients with chronic fatigue syndrome
RCTComparison of oral nicotinamide adenine dinucleotide (NADH) versus conventional therapy for chronic fatigue syndrome2004n=31
A 24-month RCT in 31 CFS patients found oral NADH did not clearly outperform conventional therapy for fatigue relief.
- Duration
- 24 months
- Population
- ALL patients
- Participants
- 31
RCTTherapeutic effects of oral NADH on the symptoms of patients with chronic fatigue syndrome1999n=26
A 4-week RCT in 26 CFS patients found ENADA (NADH) reduced fatigue symptoms versus placebo.
- Effect
- Benefit
- Duration
- 4 weeks
- Dose
- 10 mg/day
- Population
- CFS patients
- Participants
- 26
AstragalusView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- No summary available.
Browse 3 studies
RCTHerbal extract (Cervus elaphus Linnaeus, Angelica gigas Nakai, and Astragalus membranaceus Bunge) ameliorates chronic fatigue: A randomized, placebo-controlled, double-blind trial2024n=80
In 80 adults with chronic fatigue over 8 weeks, a cervus-elaphus, angelica, and astragalus complex improved fatigue scales and exercise time to exhaustion versus placebo.
- Effect
- Benefit
- Duration
- 8 weeks
- Population
- Adults
- Participants
- 80
- Ages
- 30–59
RCTEffect of Lixu Jieyu recipe in treating 75 patients with chronic fatigue syndrome2009n=75
In 75 chronic fatigue syndrome patients over 3 months, Lixu Jieyu decoction including astragalus improved fatigue symptoms and immune cell profiles more than vitamin B, ATP, and oryzanol.
- Effect
- Benefit
- Duration
- 3 months
- Dose
- 100 mL 2×/day
- Population
- Patients with chronic fatigue syndrome
- Participants
- 75
RCTMyelophil, an extract mix of Astragali Radix and Salviae Radix, ameliorates chronic fatigue: a randomised, double-blind, controlled pilot study2009n=36
A pilot RCT of 36 adults with chronic fatigue found that 3 g/day Myelophil (astragalus plus salvia extract) for 4 weeks significantly lowered fatigue severity versus control, with no cytokine changes.
- Effect
- Benefit
- Duration
- 4 weeks
- Dose
- 3 g/day
- Population
- Adults
- Participants
- 36
MelatoninView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Many people with chronic fatigue syndrome (CFS) have problems with their body’s sleep‑wake rhythm. Some small studies have looked at melatonin as a possible treatment, but the results are mixed. In one study, taking 5 mg of melatonin in the evening for 12 weeks helped improve tiredness, concentration, motivation, and activity compared to patients’ own starting levels. However, another study using the same dose found no difference compared with a placebo.
- In one study of women with CFS, taking 1 mg of melatonin plus 10 mg of zinc before bed for 16 weeks made physical tiredness only slightly better. It did not improve mood, memory, sleep quality, or overall quality of life. Some aspects of sleep and quality of life became worse within a few weeks after stopping treatment, suggesting there may have been a small benefit while taking it. It is not clear whether these effects were due to melatonin, zinc, or both.
Browse 3 studies
RCTEffect of Melatonin Plus Zinc Supplementation on Fatigue Perception in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial2021n=26
A 16-week RCT of 26 ME/CFS patients found melatonin plus zinc significantly reduced fatigue perception and improved quality of life vs placebo.
- Effect
- Benefit
- Duration
- 16 weeks
- Dose
- 1 mg
- Population
- Pregnant women
- Participants
- 26
- Ages
- 18–65
Clinical trialInfluence of melatonin on fatigue severity in patients with chronic fatigue syndrome and late melatonin secretion2006n=21
A 3-month study of 29 CFS patients with late melatonin onset found 5 mg/day melatonin significantly reduced fatigue scores, normalizing fatigue in 8 of 27 patients vs 2 of 29 pre-treatment.
- Effect
- Benefit
- Duration
- 3 months
- Dose
- 5 mg/day
- Population
- CFS patients
- Participants
- 21
RCTTherapy of circadian rhythm disorders in chronic fatigue syndrome: no symptomatic improvement with melatonin or phototherapy2002n=30
An RCT of 30 CFS patients found neither 5 mg/day melatonin nor bright-light phototherapy improved fatigue, sleep quality, or circadian temperature/melatonin rhythms vs placebo over 12 weeks.
- Effect
- Benefit
- Duration
- 12 weeks
- Dose
- 5 mg/day
- Population
- CFS patients
- Participants
- 30
Acetyl-L-CarnitineView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It is uncertain if acetyl-L-carnitine helps people with chronic fatigue syndrome.
- Some research shows taking 2 grams daily for 6 months may reduce fatigue in about 6 out of 10 people.
- Taking it along with propionyl-L-carnitine may be less effective.
Browse 1 study
RCTExploratory open-label, randomized study of acetyl- and propionylcarnitine in chronic fatigue syndrome2004
An open RCT in 90 chronic fatigue syndrome patients found acetyl-L-carnitine 2 g/day for 24 weeks improved mental fatigue and propionyl-L-carnitine improved general fatigue; combined treatment was less effective.
- Effect
- Benefit
- Duration
- 24 weeks
- Dose
- 2 g/day
- Population
- Chronic fatigue syndrome patients
EleutheroView supplement →
Do not purchase·★★★★★
How we scored this▸
- Taking eleuthero root extract daily for 2 months helped reduce fatigue symptoms in people with chronic fatigue syndrome compared to before treatment, but it was no better than a placebo.
- More research is needed to know if eleuthero really helps with chronic fatigue.
Browse 1 study
RCTRandomized controlled trial of Siberian ginseng for chronic fatigue2004n=96
In 96 adults with chronic fatigue, Siberian ginseng did not significantly reduce fatigue overall, though a subgroup with moderate fatigue and illness ≥5 years showed a trend toward benefit (P = 0.09).
- Effect
- No Benefit
- Duration
- 2 months
- Population
- Adults
- Participants
- 96
Panax GinsengView supplement →
Do not purchase·★★★★★
How we scored this▸
- It is not clear if Panax ginseng helps people with severe chronic fatigue syndrome.
- In one study without a placebo group, people taking ginseng reported feeling more energetic, clearer mentally, and sleeping better after one month.
- The study mostly included women, and its design means the results should be interpreted cautiously.
- People took different doses of ginseng in capsule or chewable tablet form with similar results.
Browse 2 studies
Open-labelAn Open-Label, Pilot Trial of HRG80™ Red Ginseng in Chronic Fatigue Syndrome, Fibromyalgia, and Post-Viral Fatigue2021n=188
An open-label trial of 188 patients with chronic fatigue syndrome or fibromyalgia taking HRG80 red ginseng (200–400 mg/day for 1 month) found 60.1% self-rated improved, with composite scores rising from 11.9 to 18.8 (p<0.001).
- Effect
- Benefit
- Duration
- 1 month
- Dose
- 400 mg/day
- Population
- Patients with chronic fatigue syndrome
- Participants
- 188
RCTEfficacy of Korean red ginseng (Panax ginseng) for middle-aged and moderate level of chronic fatigue patients: A randomized, double-blind, placebo-controlled trial2019n=50
A randomized trial of 50 chronic fatigue patients found 3 g/day Korean red ginseng for 6 weeks did not significantly reduce fatigue VAS versus placebo on primary or secondary outcomes.
- Effect
- No Benefit
- Duration
- 6 weeks
- Dose
- 3 g/day
- Population
- Adults
- Participants
- 50
- Ages
- 50+
RhodiolaView supplement →
Do not purchase·★★★★★
How we scored this▸
- Rhodiola has insufficient evidence for Chronic fatigue syndrome.
Browse 1 study
Open-labelRhodiola rosea in Subjects with Prolonged or Chronic Fatigue Symptoms: Results of an Open-Label Clinical Trial2017n=100
In elderly inpatients on antibiotics, S. boulardii did not significantly prevent antibiotic-associated diarrhea versus placebo.
- Effect
- No Benefit
- Duration
- 8 weeks
- Dose
- 400 mg/day R. rosea
- Population
- Older adults
- Participants
- 100
Evidence visualised
Same ratings as above, aggregated so you can see coverage and imbalance.
| Supplement | DEX | Studies | Meta-analyses | Share |
|---|---|---|---|---|
| NADH | ★★★★★72% | 5 | 0 | 31% |
| Astragalus | ★★★★★48% | 3 | 0 | 19% |
| Melatonin | ★★★★★48% | 3 | 0 | 19% |
| Panax Ginseng | ★★★★★28% | 2 | 0 | 13% |
| Acetyl-L-Carnitine | ★★★★★44% | 1 | 0 | 6% |
| Eleuthero | ★★★★★32% | 1 | 0 | 6% |
| Rhodiola | ★★★★★24% | 1 | 0 | 6% |