Fibromyalgia and Chronic Fatigue Syndrome: A Matter of Boundaries

Fibromyalgia Chronic Fatigue Dr. Eric Viegas Naturopathic Medicine Ottawa

Fibromyalgia and Chronic Fatigue Syndrome: A Matter of Boundaries


Dr. Eric Viegas, ND


Fibromyalgia (FM) affects 1.5% (444, 000) of Canadians over 12 years of age (1). Those who are most affected are women, people over 40, smokers, the obese, low income earners, and the physically inactive (1). However, it is unclear whether or not low income, educational status, smoking, and physical inactivity are consequences or determinants of the disease.


People who suffer with FM have disturbed sleep due to chronic systemic muscular and skeletal pain. Oftentimes FM co-occurs with chronic fatigue syndrome (CFS), a condition characterized by disabling physical and cognitive exhaustion. Unfortunately, 2 out of every 3 people with CFS and/or FM have at least 3 other chronic health conditions (1). As a result, CFS and FM cause significant impairment and stress, both at work and at home.


So how does one develop CFS or FM? About 50% of CFS patients can recall a viral infection triggering their CFS. Others triggers include motor vehicle accidents, surgery, or an unexpected fall (2). Adverse effects of some psychiatric medications may cause overwhelming fatigue.


Some environmental triggers to avoid when living with a diagnosis of CFS and FM include changes in sleep schedule, cold exposure, physical & mental overexertion, sensory & information overload, excessive stress, prolonged driving & air travel, alcohol, and caffeine.


Above all, scheduling “me time” and setting boundaries (both emotional and personal) will help to build energy and reduce the risk of burnout (3).


10 Ways to Kick Fatigue


It is not uncommon for digestive complaints to occur in the presence of CFS and FM (3). Optimizing your digestive function through the use of mindful eating, an elimination diet, and/or hypoallergenic diet may help to lessen digestive burden. Your naturopath may also opt for botanicals and/or supplements to increase digestive function. These interventions may include digestive enzymes, and/or bitters.


In terms of possible vitamin deficiencies in FM and CFS, it is important to know your vitamin B12 status. Deficiency of B12 can lead to anemia, and fatigue (4). Your family doctor, and your naturopath can test for serum values of vitamin B12. Other nutrients shown to be helpful in improving symptoms of CFS and FM target mitochondria and glutathione; the powerhouse of the cell, and your body’s main antioxidant, respectively. These nutrients include N-Acetylcysteine, Alpha-Lipoic Acid, L-Carnitine, and CoQ10.


For more information on what can be done to help your symptoms of FM & CFS, and to find the specific nutritional protocol best suited for you, contact your local naturopath.



  1. Rusu C., Gee M.E., Lagace C., Parlor M. Chronic fatigue syndrome and fibromyalgia in canada: prevalence and associations with six health status indicators. Health Promotion and Chronic Disease Prevention Canada: Research, Policy, and Practice 2015; 35(1): 1-9.
  2. Komaroff AL, Fagioli LR, Geiger AM, et al. An examination of the working case definition of chronic fatigue syndrome. American J Med 1996; 100: 56-64.
  3. Carruthers BM, Jain AK, De Meirleir KL, et al. Myalgic encephalomyelitis/chronic fatigue syndrome: clinical working case definition, diagnostic and treatment protocols. J Chronic Fatigue Syndr 2003; 11: 7-115.
  4. Beck WS. Cobalamin and the nervous system. NEJM 1988; 318: 1752-1754.

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