Chronic fatigue syndrome is characterized by debilitating fatigue with associated muscle aches, tender lymph nodes, joint pain, chills, feverish feelings, and postexertional malaise. Diagnosis of chronic fatigue syndrome is primarily by exclusion with no definitive laboratory test or physical findings. Medical research continues to examine the many possible etiologic agents for chronic fatigue syndrome (infectious, immunologic, neurologic, and psychiatric), but the answer remains elusive. It is known that chronic fatigue syndrome is a heterogeneous disorder possibly involving an interaction of biologic systems. Similarities with fibromyalgia exist and concomitant illnesses include irritable bowel syndrome, depression, and headaches. Therefore, treatment of chronic fatigue syndrome may be variable and should be tailored to each patient. Therapy should include exercise, diet, good sleep hygiene, antidepressants, and other medications.  For more up to date ribose research.

D Ribose for chronic fatigue
The use of D-Ribose in chronic fatigue syndrome and fibromyalgia: a pilot study.
J Altern Complement Med. 2006 Nov;12(9):857-62. Teitelbaum JE, Johnson C, St Cyr J. Fibromyalgia and Fatigue Centers, Dallas, TX, USA.
Fibromyalgia and chronic fatigue syndrome are debilitating syndromes that are often associated with impaired cellular energy metabolism. As D-ribose has been shown to increase cellular energy synthesis in heart and skeletal muscle, this open-label uncontrolled pilot study was done to evaluate if D-ribose could improve symptoms in fibromyalgia and/or chronic fatigue syndrome patients. Forty-one patients with a diagnosis of fibromyalgia and/or chronic fatigue syndrome were given D-ribose, a naturally occurring pentose carbohydrate, at a dose of 5 grams three times a day for a total of 280 g.  D-ribose supplements improved all five visual analog scale categories: energy; sleep; mental clarity; pain intensity; and well-being, as well as an improvement in patients' global assessment. Approximately 66% of patients experienced significant improvement while on D-ribose.

Chronic Fatigue Syndrome study
Exploratory open label, randomized study of acetyl- and propionylcarnitine in chronic fatigue syndrome.
Vermeulen RC, Scholte HR. Research Center Amsterdam, Amsterdam, Netherlands.
Psychosom Med. 2004 Mar-Apr;66(2):276-82.
We compared the effects of acetylcarnitine, propionylcarnitine and both compounds on the symptoms of chronic fatigue syndrome (CFS). In an open, randomized fashion we compared 2 g/d acetyl-L-carnitine, 2 g/d propionyl-L-carnitine, and its combination in 3 groups of 30 CFS patients during 24 weeks. Effects were rated by clinical global impression of change. Secondary endpoints were the Multidimensional Fatigue Inventory, McGill Pain Questionnaire, and the Stroop attention concentration test. Scores were assessed 8 weeks before treatment; at randomization; after 8, 16, and 24 weeks of treatment; and 2 weeks later. RESULTS: Clinical global impression of change after treatment showed considerable improvement in 59% of the patients in the acetylcarnitine group and 63% in the propionylcarnitine group, but less in the acetylcarnitine plus propionylcarnitine group (37%). Acetylcarnitine significantly improved mental fatigue (p =.015) and propionylcarnitine improved general fatigue (p =.004). Attention concentration improved in all groups, whereas pain complaints did not decrease in any group. Two weeks after treatment, worsening of fatigue was experienced by 52%, 50%, and 37% in the acetylcarnitine, propionylcarnitine, and combined group, respectively. In the acetylcarnitine group, but not in the other groups, the changes in plasma carnitine levels correlated with clinical improvement. CONCLUSIONS: Acetylcarnitine and propionylcarnitine showed beneficial effect on fatigue and attention concentration. Less improvement was found by the combined treatment. Acetylcarnitine had main effect on mental fatigue and propionylcarnitine on general fatigue.

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