Herbal Drugs in Chronic Fatigue Syndrome: An Overview

Abstract

Chronic fatigue syndrome (CFS) is a debilitating and complex disorder characterized by profound fatigue of 6 months or longer duration that is not improved by bed rest and that may be worsened by physical or mental activity. It is often age-related and may coexist with other diseases such as multiple sclerosis, Parkinson’s disease, depression, cancer, HIV infection etc. Persons with CFS most often function at a substantially lower level of activity than they were capable of before the onset of illness. Modern medicine has limited therapies and those offered by it have strong side-effects. On the other hand, various traditional systems of medicine such as the Chinese herbal system and Ayurveda offer several botanicals, especially the adaptogens, which have been used to combat chronic fatigue effectively. Literature reports a plethora of animal and clinical studies on the safety and efficacy of these plant drugs. The present article extensively reviews CFS, its pathophysiology, and its pharmacological treatment, with a special emphasis on herbal drugs such as Cat’s claw, Ginseng, caterpillar fungus, ashwagandha, Tulsi, jiaogulan etc. The botanical therapies discussed here are very commonly used drugs with profound data available on them.

Ginseng for the Treatment of Chronic Fatigue Syndrome: A Systematic Review of Clinical Studies

“…Firstly, despite the high prevalence of ginseng usage among patients with fatigue across many different conditions, studies solely dedicated to CFS remain very limited. Though we did identify several other potential articles in our search strategy, most of the these were excluded due to various reasons (utilization of Siberian ginseng, 26 , 35 simply mentioning ginseng in the study, 23 , 24 , 37 ginseng in the control group, 37 , 39 or ginseng used in complex/combined formulations 34 , 36 , 38 ); this information is summarized in Table 2 . These factors prevented us from including these studies in our analysis, since it would have been near impossible to decipher the sole impact of ginseng on fatigue due to various potential confounders.…”

“…Our data synthesis objectively highlighted safety and effectiveness findings to provide current recommendations about the potential use of ginseng in CFS. 34 Prospective study Ginseng in formula Hartz, 2004 35 RCT Siberian ginseng Guo, 2007 36 RCT Ginseng in control and in formula Adams, 2009 37 Systematic review Simply mentioned ginseng Chen, 2010 23 Review Simply mentioned CFS and/or ginseng Alraek, 2011 26 Systematic review Siberian ginseng Semalty, 2012 24 Review Simply mentioned CFS and/or ginseng Son, 2013 38 Case report Ginseng in formula and in combination with other therapies Wu, 2020 39 RCT Ginseng in control group…”

“…Results demonstrated that approximately 70% of participants showed significant improvements in fatigue scores, albeit with modest evidence due to small sample size and sample composition limitations. 21 At present, despite sparse reports of ginseng's potential utility in CFS, [23][24][25][26] there is no systematic review solely assessing the anti-fatigue effectiveness of ginseng in CFS. This systematic review was conducted to evaluate and present up-to-date evidence about the safety and effectiveness of ginseng in patients with CFS.…”