Dr. Martina Melzer, published: 21.02.2022


The influence of nutrition on fatigue

Our body needs macronutrients - protein, fat and carbohydrates - to produce energy. But it also needs micronutrients - vitamins, minerals and trace elements. If it lacks nutrients, for example because the intestinal mucosa is impaired or we eat an unhealthy diet, then the small energy power plants in our cells, the mitochondria, do not work properly. This leads to fatigue.

In some people with fibromyalgia, for example, a deficiency of amino acids, magnesium, selenium and B vitamins could be detected. Deficiency symptoms can also occur in people with ME/CFS. For example: too little vitamin C, B vitamins, sodium, magnesium, zinc, L-carnitine, tryptophan, fatty acids and coenzyme Q10.
Our food can also rob us of energy by causing blood sugar to spike and then drop rapidly. So first there is an excess of energy suppliers available and then suddenly they are missing. In this way, we go through a roller coaster ride of brief "highs" and then sustained "crashes." Particularly low blood sugar also triggers the autonomic nervous system. The excitatory part, the sympathetic nervous system, is activated. The body goes into a state of alarm - this costs a lot of energy and puts the nervous system out of balance. Stimulants such as caffeine have similar effects.

Any food causes a tiny inflammatory reaction in the gut and activates the immune system. This is quite normal because our body's defenses scrutinize every "guest" before letting them in. If we don't tolerate certain components of our food or have an allergic reaction to them, it can lead to a more pronounced immune response, which can manifest itself in exhaustion. I devote myself to the intestine in more detail in the strategy "gut".

Is there an anti-fatigue diet?

I don't know exactly how many diets there are that are supposed to help with chronic fatigue, but there are certainly a lot. Among them: Paleo, Ketogenic, Autoimmune Paleo, Anti-Inflammatory Diet, No Gluten, No Dairy, Medical Medium, GAPS Diet, Specific Carbohydrate Diet, etc.

Common to most is that we should avoid foods that are not good for us, promote inflammation and keep the immune system busy. The culprit is almost always considered to be gluten, which is found in wheat, rye, barley, spelt, emmer and kamut. So-called amylase trypsin inhibitors (ATI) could also play a role here. Second, dairy products. Then it gets colorful: grains yes or no, eggs yes or no, vegan, vegetarian or regular animal protein? What about nightshade vegetables, legumes, pseudocereals, starchy vegetables? How many carbohydrates, fat, protein?

The recommendations contradict each other and you can go sheer crazy. Alex Howard aptly summarizes this dilemma in his book, „Decode your fatigue“: We're all different. One person's medicine is another person's poison. No one can tell how you'll react to a food but you. So once again, you have to become a detective yourself and listen to your body.

I report about my own "nutrition madness" in the "Blog".

What to think about dietary supplements?

Have you also taken nutritional supplements in your desperation? Maybe even a lot of them? Welcome to the club. As described at the beginning, some people with ME/CFS or the symptom fatigue have nutrient deficiencies. In that case, vitamins, minerals and trace elements in pill form can actually be useful. Ideally, however, you should discuss this with your doctor. In this way, you can also determine a deficiency and find a suitable preparation in a suitable dosage.

In all other cases, the following applies again: It can totally help, it can have no effect at all, it can even harm you. Food supplements interact with food and drugs. They can interfere with each other's absorption in the intestines, form insoluble complexes, etc. People with cancer should be especially careful with vitamin pills.

There are many studies on fatigue and supplements. However, they come to contradictory results. Scientists mostly agree that it is best to consume all important nutrients through a balanced diet and not to add individual substances.

I describe my experiences with dietary supplements in the "Blog".

Tips for a balanced diet

A balanced and anti-inflammatory diet is composed of a lot of vegetables, some fruit, omega-3 fatty acids, fiber and fat, protein and carbohydrates in individual tolerance.

  • As few processed foods as possible, ideally you still recognize the basic product
  • no fast digesting carbohydrates to avoid the blood sugar roller coaster
  • As little caffeine as possible to avoid irritating the stress nerve (sympathetic nervous system) and to spare the adrenal glands
  • Eat the rainbow: Lots of vegetables in different colors every day, including leafy green vegetables and sulfur-containing vegetables like cabbage as often as possible; fruits contain lots of healthy pigments and antioxidants, but don't eat them in raucous amounts because of the fructose
  • Locate potential intolerances and allergies and avoid the triggers for as long as you react to them. With allergies this can be for life, with intolerances the tolerance threshold often changes again.
  • At every meal, fat, protein, carbohydrates - depending on individual tolerance. Whether the protein is best from animal or plant sources is again something very individual
  • chew thoroughly (until a porridge is formed in the mouth), eat in silence and do not talk too much, don't drink too much directly with the meal, but between meals drink enough, preferably water and unsweetened tea
  • whether one or six meals a day is best for you, you have to find out for yourself. Many doctors and scientists recommend that you take a break from eating for 12 to 16 hours a day (intermittent fasting), real fasting can be extremely beneficial for one person, but for another it can be harmful
  • as much organic as possible

Tip: "The Wahls Protocol" by Dr. Terry Wahls and "Food - what the heck should I eat (new: The Pegan Diet)" by Dr. Mark Hyman have taught me a lot about healthy eating.

Can I afford that?

I very often hear the argument that people cannot afford such a diet. Especially those who have ME/CFS or another disease associated with chronic fatigue often can no longer work and have to live on a small pension. This is indeed a big problem. I, too, am reaching my limits there.

Here are some suggestions: It doesn't always have to be organic. There is an annual list from the US Environmental Working Group of which vegetables and fruits are most contaminated with pesticides. They talk about the "Dirty 12." In addition, they name the least sprayed, the "Clean 15." Admittedly, the results come from the USA and even more is sprayed there than in the EU. But I assume that certain fruits and vegetables are simply more susceptible to pests, and that the results can therefore be transferred.


Therefore, try to buy the "Dirty 12" as organic.

Second suggestion: do you eat mostly processed foods and convenience foods? If so, compare prices between a ready-made frozen pizza and a few individual groceries. The same goes for restaurant meals, bakeries or home delivery services. Even to-go coffee can cost a small fortune. In addition, Mark Hyman asks the valid question: doesn't it make more sense to spend more money on healthy food now than to spend vast amounts on medications and other therapies later in life?

Third suggestion: gluten-free products are incredibly expensive and often unhealthy. To test whether you tolerate wheat and its relatives poorly (from the gut or overall), avoid it completely for two to three weeks. Do you feel a difference? If so, consider how you can change your diet to use fewer wheat products or what you can prepare yourself. If giving up gluten doesn't make a difference, then reintroduce the foods and watch again. I recommend the same for giving up dairy. I've moved to making a lot of things myself for cost reasons and because I also enjoy it. Ideally, of course, you should discuss any dietary changes with your doctor.

Fourth suggestion: Think about how much money you spend on supplements and how many organic foods you could afford to buy.

PS: Of course, I research and check everything I write here as well as possible. Nevertheless, I am only human and make mistakes. In addition, I may draw completely different conclusions as someone else would. Simply because they fit my story. But every story is different.

Important: The content on this page is for informational purposes only and is not a substitute for talking to your doctor or other therapist. The content reflects my personal experiences, research and findings that have helped me and that I therefore want to share. However, in your personal case, completely different things may play a role and other things may help. Please talk to your doctor or therapist before making any decisions that affect your physical or mental health. Also important: I don't want to convince anyone of anything here. Rather, I want to point out possible ways that hopefully can help some people to improve or overcome their Fatigue or ME/CFS.



G Bjorklund et al: Fibromyalgia and nutrition: Therapeutic possibilities?  Biomed Pharmacotherap 2018
SM Zick et al: Fatigue reduction diet in breast cancer survivors: a pilot randomized clinical trial. Breast Cancer res treat 2017

U Haß et al: Anti-Inflammatory Diets and Fatigue. Nutrients 2019

G Bjorklund et al: Chronic fatigue syndrome (CFS): Suggestions for a nutritional treatment in the therapeutic approach. Biomed Pharmacotherap 2019

N Campagnolo et al: Dietary and nutrition interventions for the therapeutic treatment of chronic fatigue syndrome/myalgic encephalomyelitis: a systematic review. J Hum Nutr Diet 2017
Alex Howard: Decode your fatigue

Dr. Terry Wahls: MS erfolgreich behandeln

Fatigue Super Conference 2021