Charcoal binds to toxins in the digestive tract, and can eliminate excess bacteria. It can however also absorb nutrients

Calcium supplemented in the natural form (such as Pure Plant Source Green Calcium, which also contains significant amounts of magnesium and iodine, as well as trace selenium & boron) can be taken with food to assist with oxalate issues which may result from SIBO or leaky gut. Calcium binds to oxalates- which otherwise bind to iron and zinc ingested in the diet, and can cause fibromyalgia, joint and muscle pain.

Electrolytes help overcome mineral loss or low blood volume (which may occur from low of ADH in CIRS). Use a naturally sweetened mix which contains magnesium, such as S.O.S Hydration, or if tolerated, make your own. The WHO formula includes potassium and magnesium. Potassium can be linked to cramping and seizures.

Diatomaceous earth (silica) can be used to eliminate parasites if taken with water in the morning. May irritate the gut lining in individuals with colitis. Bentonite clay may be used alternatively with adequate water to protect against constipation. Best done under practitioner supervision.

Magnesium: types include malate, glycinate, chelates and orotate. Citrate may deplete ceruloplasmin and cause diarrhoa. Topical magnesium in the form of spray or moisturiser, or absorbed via Epsom salt bath can be used. A review of supplements and pharmaceutical treatments for CFS found magnesium the only treatment with good quality proof of efficacy. Magnesium needs to be taken in combination WITH b-complex vitamins in a holistic form, or methylated. Examples if tolerated include bee pollen (can cause migraines, allergenicity) or molasses (can cause sinus issues from cane). Magnesium may also cause cramping and deplete potassium. All minerals and cofactors need to be balanced.

Vitamin c is best taken in wholefood form, such as camu camu, if tolerated. Vit c can degrade into oxalates.

Digestive enzymes or digestive stimulants can be used to support digestion and prevent reflux. These can be synthetic enzymes, natural enzymes from ox bile, digestive bitter herbs such as gentian, HCL (betaine hydrochloride/ hydrochloric acid) or zinc (see below for notes on zinc). It’s worth noting however that reflux in ME/CFS is not likely due to enzyme insufficiency, and appropriate pacing and dietary management will often alleviate it.

Protein supplementation may assist, as recent metabolomics studies show amino acids being used as a primary energy source, though dietary deficiency is not indicated

L-Glutamine for gut intergrity

EPA/DHA Essential fatty acids (omega 3) can reduce inflammation and assist gut healing. Fish oil may be problematic due to rancidity, and chia and linseeds contain only AA plant-based omegas, which have a poor conversion rate (5%). Wild-caught dietary salmon or algae based supplements (although expensive) can be used.

Maes et al reported significantly increased ω6 lineolic and arachidonic acids in ME/CFS, driving a reduced ω3 to ω6 polyunsaturated fatty acids (PUFAs) ratio versus controls, contributing to inflammation.

D-ribose for energy. D-ribose is a sugar which can aggravate IBS

Chlorphyll can eliminate heavy metals. Needs to be from pure source.

Study quote: ‘Lowered levels of coenzyme Q10, zinc and glutathione have been reported in ME/CFS… decreased vitamin C and E will impact mitochondrial function, increasing lipid peroxidation’.

Dr Myhill & Jason Tietlebaum have excellent books on CFS supplementation.


Probiotics can feed bacterial overgrowth in the small intesting

Beneficial yeast such as SB may trigger immunity and cause coldsore or ulcer outbreaks. This is because SB elicits a Th1 immune response. This study shows that the etiology of mouth ulcers involves a T1 response, as does that for herpes simplex virus type 1 (HSV-1) infection (“delayed-type hypersensitivity). HSV lesions demostrate Th1 pattern where induction of MCH-II on epidermal cells and the activation of CD8+ T cells through IL-12 and IFN-y”. This is significant as ME/CFS disturbs both T1 & T2 immunity, and t-helper cells can become exhausted.

Zinc assists with adequate secretion of digestion enzymes to improve hypochloria, leaky gut and nutrient absorption. Supplementation may deplete ceruloplasmin and disturb copper regulation. It may also reduce iron levels.

Iron supplementation can be problematic, as it may feed bacteria or cause oxidative stress. Some believe anemia symptoms are actually a wholefood vitamin C deficiency (old studies did show this).