Fatigue is a feeling of extreme tiredness. It can make it hard for you to focus and do daily tasks.

Therapy and healthy habits can help prevent it. Natural therapies have also been used to ease feelings of fatigue.

Natural Therapies

Likely Effective

Supplements that can help:

  • Iron is an essential nutrient that is vital for blood blow. It is likely to improve fatigue in those with low iron levels. (Note: It should not be taken by people who have problems with their heart.) C11, C13

Other therapies that are likely to ease fatigue are:

May Be Effective

These herbs and supplements may help ease fatigue:

Yoga is a type of mind-body exercise that may ease cancer-related fatigue. B1, B3, B6

May Not Be Effective

  • Carnitine is a nutrient in the body that may not ease cancer-related fatigue. C6, C12

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Herbs and Supplements to Be Used With Caution

Talk to your doctor about any supplements or therapy you would like to use. Some may get in the way of treatment. They can also make illness worse or cause new problems. Examples include:

  • Astragalus may make the immune system more active. Talk to your doctor before taking it if you have problems with your immune system. C
  • Guarana should not be taken by those taking medicine for depression.C
  • Iron should not be taken by people with heart problems.C


REFA Acupuncture

REFA1 Deare JC, Zheng Z, et al. Acupuncture for treating fibromyalgia. Cochrane Database Syst Rev. 2013 May 31;(5):CD007070.

REFA2 He XR, Wang Q, et al. Acupuncture and moxibustion for cancer-related fatigue: a systematic review and meta-analysis. Asian Pac J Cancer Prev. 2013;14(5):3067-3074.

REFA3 Ng SM, Yiu YM. Acupuncture for chronic fatigue syndrome: a randomized, sham-controlled trial with single-blinded design. Altern Ther Health Med. 2013;19(4):21-26.

REFA4 Lu C, Yang XJ, et al. [Randomized controlled clinical trials of acupuncture and moxibustion treatment of chronic fatigue syndrome patients]. Xhen Ci Yan Jiu. 2014;39(4):313-317.

REFA5 Zeng Y, Luo T, et al. Meta-Analysis of Randomized Controlled Trials of Acupuncture for Cancer-Related Fatigue. Integr Cancer Ther. 2014 May;13(3):193-200.

REFA6 Lau CH, Wu X, et al. Acupuncture and Related Therapies for Symptom Management in Palliative Cancer Care: Systematic Review and Meta-Analysis. Medicine (Baltimore). 2016 Mar;95(9):e2901.

REFA7 Tao WW, Jiang H, et al. Effects of Acupuncture, Tuina, Tai Chi, Qigong, and Traditional Chinese Medicine Five-Element Music Therapy on Symptom Management and Quality of Life for Cancer Patients: A Meta-Analysis. J Pain Symptom Manage. 2016 Apr;51(4):728-747.

REFA8 Wang T, Xu C, et al. Acupuncture and moxibustion for chronic fatigue syndrome in traditional Chinese medicine: a systematic review and meta-analysis. BMC Complement Altern Med. 2017 Mar 23;17(1):163.

REFA9 Zhang Y, Lin L, et al. Effects of acupuncture on cancer-related fatigue: a meta-analysis. Support Care Cancer. 2018 Feb;26(2):415-425.

REFB Exercise Therapy

REFB1 Buffart LM, van Uffelen JG, et al. Physical and psychosocial benefits of yoga in cancer patients and survivors, a systematic review and meta-analysis of randomized controlled trials. BMC Cancer. 2012 Nov 27;12:559.

REFB2 Mishra SI, Scherer RW, et al. Exercise interventions on health-related quality of life for people with cancer during active treatment. Cochrane Database Syst Rev. 2012 Aug 15;(8):CD008465.

REFB3 Langhorst J, Klose P, et al. Efficacy and safety of meditative movement therapies in fibromyalgia syndrome: a systematic review and meta-analysis of randomized controlled trials. Rheumatol Int. 2013 Jan;33(1):193-207.

REFB4 Tomlinson D, Diorio C, et al. Effect of exercise on cancer-related fatigue: a meta-analysis. Am J Phys Med Rehabil. 2014 Aug;93(8):675-686.

REFB5 Heine M, van de Port I, et al. Exercise therapy for fatigue in multiple sclerosis. Cochrane Database Syst Rev. 2015 Sep 11;(9):CD009956.

REFB6 Cramer H, Lauche R, et al. Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer. Cochrane Database Syst Rev. 2017 Jan 3;1:CD010802.

REFB7 Duong N, Davis H, et al. Mind and body practices for fatigue reduction in patients with cancer and hematopoietic stem cell transplant recipients: A systematic review and meta-analysis. Crit Rev Oncol Hematol. 2017 Dec;120:210-216.

REFB8 Larun L, Bruberg KG, et al. Exercise therapy for chronic fatigue syndrome. Cochrane Database Syst Rev. 2017;4:CD003200.

REFB9 Xiang Y, Lu L, et al. Does Tai Chi relieve fatigue? A systematic review and meta-analysis of randomized controlled trials. PLoS One. 2017 Apr 5;12(4):e0174872.

REFB10 Song S, Yu J, et al. Ameliorative effects of Tai Chi on cancer-related fatigue: a meta-analysis of randomized controlled trials. Support Care Cancer. 2018 Jul;26(7):2091-2102.

REFB11 Wayne PM, Lee MS, et al. Tai Chi and Qigong for cancer-related symptoms and quality of life: a systematic review and meta-analysis. J Cancer Surviv. 2018 Apr;12(2):256-267.

REFC Herbs and Supplements

REFC1 Alegre J, Rosés JM, et al. [Nicotinamide adenine dinucleotide (NADH) in patients with chronic fatigue syndrome]. Rev Clin Esp. 2010;210(6):284-288.

REFC2 de Oliveira Campos MP, Riechelmann R, et al. Guarana (Paullinia cupana) improves fatigue in breast cancer patients undergoing systematic chemotherapy. J Altern Complement Med. 2011;17(6):505-512.

REFC3 Etemadifar M, Sayahi F, et al. Ginseng in the treatment of fatigue in multiple sclerosis: a randomized, placebo-controlled, double-blind pilot study. Int J Neurosci. 2013;123(7):480-486.

REFC4 Su CX, Wang LQ, et al. Chinese herbal medicine for cancer-related fatigue: a systematic review of randomized clinical trials. Complement Ther Med. 2014 Jun;22(3):567-579.

REFC5 Castro-Marrero J, Cordero MD, et al. Does oral coenzyme Q10 plus NADH supplementation improve fatigue and biochemical parameters in chronic fatigue syndrome? Antioxid Redox Signal. 2015;22(8):679-685.

REFC6 An JH, Kim YJ, et al. L-carnitine supplementation for the management of fatigue in patients with hyperthyroidism on levothyroxine treatment: a randomized, double-blind placebo-controlled trial. Enocr J. 2016;63(10):885-895.

REFC7 Bach HV, Kim J, et al. Efficacy of Ginseng Supplements on Fatigue and Physical Performance: a Meta-analysis. J Korean Med Sci. 2016 Dec;31(12):1879-1886.

REFC8 Castro-Marrero J, Sáez-FrancásN, et al. Effect of coenzyme Q10 plus nicotinamide adenine dinucleotide supplementation on maximum heart rate after exercise testing in chronic fatigue syndrome – A randomized, controlled, double-blind trial. Clin Nutr. 2016;35(4):826-834.

REFC9 Chung VC, Wu X, et al. Chinese Herbal Medicine for Symptom Management in Cancer Palliative Care: Systematic Review And Meta-analysis. Medicine (Baltimore). 2016 Feb;95(7):e2793.

REFC10 Liu CH, Tsai CH, et al. Effects of the traditional Chinese herb Astragalus membranaceus in patients with poststroke fatigue: A double-blind, randomized, controlled preliminary study. J Ethnopharmacol. 2016;194:954-962.

REFC11 Low MS, Speedy J, et al. Daily iron supplementation for improving anaemia, iron status and health in menstruating women. Cochrane Database Syst Rev. 2016 Apr 18;4:CD009747.

REFC12 Marx W, Teleni L, et al. Efficacy and Effectiveness of Carnitine Supplementation for Cancer-Related Fatigue: A Systematic Literature Review and Meta-Analysis. Nutrients. 2017 Nov 7;9(11).

REFC13 Houston BL, Hurrie D, et al. Efficacy of iron supplementation on fatigue and physical capacity in non-anemic iron-deficient adults: a systematic review of randomised controlled trials. BMJ Open. 2018;8(4):e019240.

REFD Massage

REFD1 Pan YQ, Yang KH, et al. Massage interventions and treatment-related side effects of breast cancer: a systematic review and meta-analysis. Int J Clin Oncol. 2014 Oct;19(5):829-841.

REFD2 Shin ES, Seo KH, et al. Massage with or without aromatherapy for symptom relief in people with cancer. Cochrane Database Syst Rev. 2016 Jun 3;(6):CD009873.

REFE Other Therapies

REFE1 Lee J, Han M, et al. Effects of foot reflexology on fatigue, sleep and pain: a systematic review and meta-analysis. J Korean Acad Nurs. 2011 Dec;41(6):821-33.

Revision Information

  • Reviewer: EBSCO NAT Review Board Eric Hurwitz, DC
  • Review Date: 02/2020
  • Update Date: 05/26/2020