Chronic Fatigue Syndrome and Fibromyalgia: Custom Compounding the Pain and Fog Away

Chronic Fatigue Syndrome and Fibromyalgia: Custom Compounding the Pain and Fog Away

custom compoundingSeveral years ago, I met a lady by the name of Kathleen who was suffering from chronic fatigue syndrome. She was a vibrant woman in her 30s who used to be a kayaker, gardener, and professional swimmer. She was still active when I first knew her—not up to her usual rigorous schedule, but still getting out there when she could. You could always tell when it was going to be a good day by the twinkle in her eye. But when the bad days came, she couldn’t answer the phone, much less get out of bed. In those days, patients like her were advised to take it easy and accept what they could and couldn’t manage with grace. Thankfully, there are more options for treatment today and custom compounding plays a significant role in giving each patient the medicine needed to get back on his or her feet.

Chronic Fatigue Diseases Are Not Easy to Describe

Chronic fatigue syndrome (CFS) is loosely defined as a condition of profound disabling fatigue lasting at least six months and often accompanied by other chronic flu-like symptoms, such as loss of memory, pain that moves from one joint to another, and enlarged lymph nodes.1 Fibromyalgia (FM) is sometimes considered a similar or overlapping disease because it also causes extreme fatigue and muscle pain.2

There is no known cause for both CFS and FM, nor tests that can confirm their diagnosis. Treatment is symptom-based, which means that developing a unique treatment regimen for each patient is key.

This Is Where Custom Compounding Can Help

Custom compounding strategies to treat CFS and FM should focus on medicines as well as behavioral changes for each patient. The best strategy is to focus on the worst symptom first and work down the list3. Pain management is key and may also be related to problems with sleep. Depression may further add to symptoms. Other common symptoms include:

  • Debilitating fatigue
  • Extreme sleep or sleeplessness
  • General malaise
  • Feverishness
  • Dizziness
  • Headache and joint aches
  • Sore throat and muscle weakness
  • Numbness and tingling
  • Memory loss, confusion and forgetfulness
  • Irritability and depression

Standard treatment typically focuses on the fatigue aspect of the disease, along with pain, as the two are often related. Most doctors start with over-the-counter pain relief options, such as aspirin or acetaminophen, but these often don’t work. Pharmacists should keep a variety of analgesics stocked so they can work with their patients to see which ones work best for them. Another strategy that works for many patients is to use antidepressants to minimize pain and get them up on their feet. Helping patients return to a regular sleep pattern is yet another strategy that works best in some situations. Developing a treatment plan hinges strongly on listening to what disturbs each patient the most and custom compounding a solution based on those symptoms. It may take a few tries to get it right, but the pharmacist is best equipped to give each patient the time and consideration to develop the right solution for him or her.

Other areas of treatment to consider include focusing on:

  • The immune system: New evidence shows that infection and changes in the immune system might not only be symptoms of CFS, but also a predictor, too4—early treatment of infection may help mitigate symptoms as the disease progresses;
  • Hormonal imbalance: An imbalance of hormone production in the adrenal gland, causing low levels of cortisol, is also associated with CFS, and further leads to fatigue, hypotension, hypoglycemia, decreased immune function, allergies, and stress. Treatment can come in the form of dietary supplements or hydrocortisone injections;
  • Thyroid disorders: Imbalances in the pituitary gland can lead to thyroid problems that also contribute to sleep problems, as well as temperature change intolerance, depression, poor memory and concentration, joint pain, headaches, and increased chance of infection.

In addition to treatment through over-the-counter and prescribed medicines, some patients are keen on trying natural therapies and supplements, such as magnesium, omega-3 fatty acids, Vitamin B12, and melatonin to decrease fatigue. Pharmacists should also suggest to patients the value of a slow exercise treatment, complementary medicine such as acupuncture, and counseling to help work through depression and feelings of helplessness.

CFS (and FM) can be all consuming, like it was for Kathleen, but it doesn’t have to be. Personalized treatment through custom compounding is key. Recovery will take a lot of little steps and a careful regimen of both treatment and changes in daily activities, but active people don’t have to give up everything they love. They just need a healthcare team that focuses their treatment based on their symptoms. This can lead to a much better quality of life.

Chronic fatigue and pain saps away the energy and will to live the good life. Luckily, custom compounding can provide the relief these patients desperately need. Pharmaceutica North America wants to be part of the solution you offer your patients. We offer safe and high-quality compounding materials that you can be confident in. Please contact us today to learn more about how we can help you help your patients.

Show 4 footnotes

  1. “Chronic Fatigue Syndrome: A Review,” February 2003,
  2. “CFS versus FM: Twins, Cousins, or Just Acquaintances?”
  3. “Chronic Fatigue Syndrome (CFS),” February 14, 2013,
  4. “‘Robust’ Evidence Found That Chronic Fatigue Syndrome Is a Physical Illness,” February 27, 2015,

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