Written by Cathy Garrard | Reviewed by Patricia Pinto-Garcia, MD, MPH

Published on December 18, 2024print_outlinedemail_outlined

Key takeaways:

• Extreme fatigue is the main symptom of chronic fatigue syndrome, also known as myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS). 
• Vitamin, mineral, and herbal supplements are often recommended to boost energy levels in people who have ME/CFS. 
• Before you take any supplement, speak to a healthcare professional to make sure it’s a safe option for you.

Table of contents

Causes of fatigue

CoQ10

Ashwagandha

Iron

Ginseng

B vitamins

Rhodiola

How-to

Getting help

FAQs

Bottom line

References

da-kuk/E+ via Getty Images

Chronic fatigue syndrome — also known as myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) — can drain people of their energy. Debilitating fatigue is the main symptom of the condition. 

Sometimes, even simple physical and mental activities can feel really demanding, and they can leave people feeling wiped out for days. 

There’s currently no cure for ME/CFS. But there are treatments that can help with some of the symptoms. Certain vitamins and supplements, in particular, have been shown to help people feel less tired and run down. 

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Below is a review of what the science says about six of the best supplements for fatigue.

Why am I always tired?

If you have ME/CFS, fatigue is the most common symptom. Scientists aren’t clear on what causes the exhaustion. But there are several theories on what causes ME/CFS, including: 

• Infections: People may develop ME/CFS after having being infected with a virus. For example, many people with ME/CFS start feeling fatigue after a flu-like illness. Others develop it after contracting the Epstein-Barr virus or COVID-19. 
• Changes to the immune system: Changes in your immune system functions can possibly lead to developing ME/CFS. A result is higher levels of inflammation.
• Stress, both physical and emotional: Stress may be a factor in causing ME/CFS and in triggering flare-ups.
• Problems with energy production: People with chronic fatigue may have mitochondria that don’t work properly. Mitochondria are the “power engines” that help your cells function properly. This could cause you to not produce energy across your whole body.
• Post-exertional malaise (PEM): This is often a symptom of ME/CFS. It’s when you experience exhaustion about 12 to 48 hours after exerting yourself physically or emotionally. This period of exhaustion can last for days or even weeks. 

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Research-backed energy supplements for chronic fatigue 

Studies show that certain supplements — including vitamins and minerals — may help lessen physical and mental fatigue. People with ME/CFS may have low levels of certain nutrients. And even without deficiencies, people with a chronic illness may need more nutritional support. 

More research is needed. But here are some commonly available supplements that may help boost your energy. 

1. CoQ10

Coenzyme Q10 (CoQ10) is one of the most frequently used supplements for fatigue in people with ME/CFS. It also may help with muscle weakness and pain. 

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CoQ10 is an antioxidant that’s found naturally in the body. One of its functions is that it helps produce adenosine triphosphate (ATP), which provides energy to your cells. 

One small study found that people with ME/CFS who had lower levels of CoQ10 experienced more fatigue.

A review of the studies found that taking a CoQ10 supplement reduced fatigue. This was the case for people with general fatigue — and those with ME/CFS. For those with chronic fatigue, it took about 3 months for CoQ10 to have an effect.

Possible side effects include: 

• Nausea
• Diarrhea

2. Ashwagandha

Ashwagandha is an herbal supplement that’s been used in Indian Ayurvedic medicine for thousands of years. It’s considered an adaptogen. This means it may help the body tolerate and adapt to physical and mental stress. Research shows that it may also boost energy by lessening feelings of anxiety and improving sleep.

One small study looked at fatigue in adults who were considered overweight and reported feeling fatigued and stressed. Those who took 200 mg of ashwagandha for 12 weeks were less fatigued. However, more research is needed to confirm the effects of ashwagandha on fatigue.

Other studies have looked into ashwagandha’s effect on stress and anxiety. Those findings suggest that it may indirectly boost energy levels by improving sleep and helping people worry less. 

Possible ashwagandha side effects include:

• Nausea
• Diarrhea
• Drowsiness

Talk to your primary care provider if you’re taking any other medications to make sure ashwagandha doesn’t interact with them.

3. Iron

Iron is an essential mineral needed to make hemoglobin. This is the part of the red blood cells that helps move oxygen around the body. Iron supplements are often recommended for people who have iron-deficiency anemia and iron-deficiency, both of which also cause fatigue.

But if you don’t have anemia or low iron, there’s no evidence that taking iron will help fatigue. It may be helpful to get your iron levels tested. 

Possible iron supplement side effects include:

• Upset stomach and cramps
• Constipation
• Nausea
• Diarrhea

4. Ginseng

Ginseng is another plant-based adaptogen. Ginseng’s active compounds are called ginsenosides. These are thought to have anti-inflammatory and antioxidant effects. 

There are many studies looking at whether ginseng improves energy, but most aren’t high quality. Of the few that are solid, they show that it may help improve fatigue symptoms and general well-being in people who have chronic illness. 

Ginseng can be found in energy drinks and supplements. Taking ginseng is considered safe. It may affect blood pressure and interact with some medications, though. So talk to a healthcare professional before taking it.

Possible side effects include:

• Sleep problems
• Nausea
• Diarrhea

5. B vitamins

If you have fatigue, you’ve probably been asked about your levels of B vitamins. These vitamins are often associated with having low energy. And here’s why: Your body uses several B vitamins to make ATP, which provides energy to your cells. There are eight different B vitamins, which are also referred to as B complex. 

B vitamins include: 

• Thiamine (B1)
• Riboflavin (B2)
• Niacin (B3)
• Pantothenic acid (B5)
• Pyridoxine (B6)
• Biotin (B7)
• Folic acid (B9)
• Cobalamin (B12)

A vitamin B complex supplement can boost energy if your levels are low. But if your vitamin B levels are normal, there’s no evidence that taking B vitamins will make a difference. 

Possible side effects include:

• Flushing
• Stomach discomfort

6. Rhodiola rosea

Rhodiola rosea, or rhodiola for short, is a root that grows in cold parts of the world. It’s an adaptogen. And it’s often taken to increase endurance and treat fatigue and weakness.

There’s not much evidence that rhodiola is helpful for any health issues. But one study of 100 people with prolonged or chronic fatigue symptoms found that taking a rhodiola supplement reduced their fatigue. 

Possible side effects include:

• Dizziness
• Dry mouth
• Excessive saliva production.

How to add vitamins and supplements to your lifestyle

Before taking supplements, talk to your healthcare team. It’s important to make sure the supplements are safe for you to take and won’t interact with any medications you may be taking. It may take some trial and error to figure out which ones work for you. 

Here are some tips for starting new supplements:

• Start one new supplement at a time, rather than several at once. Take the supplement for 3 or 4 days so you can monitor for any sensitivity or side effects. 
• Start with a very low dose to reduce the risk of negative side effects.
• Take the supplement with food. Ideally, you should have a few bites of food, then take the supplement, then eat some more. This can also lower the risk of reactions. 

When to see a doctor for chronic fatigue

There’s no test for ME/CFS, so a diagnosis is based on your symptoms. If you’re experiencing any of the symptoms below, speak to a healthcare professional. They may recommend you see a rheumatologist. This is an expert who specializes in ME/CFS and related conditions. 

Symptoms of ME/CFS may include:

• Ongoing fatigue
• Worsening of symptoms after an activity (PEM)