Valerian is a mild sleep aid that has the interesting effect of calming people when they are anxious while at the same time acting as a stimulant when people are fatigued. Although not strong enough by itself to normalize sleep in the early stages of treating CFIDS/FMS, it decreases the amount of sleep medication needed. When symptoms have been resolved for six months and sleep medications are weaned off, some patients like to continue using it to insure good sleep.
The main problems with Valerian's use for sleep are:
1. When one uses an inappropriate dose (i.e., taking less than 1 80mg is unlikely to be effective and taking over 450mg is unlikely to add much benefit).
2. As it can be a stimulant in fatigue, about 5-10% of CFIDS/FMS patients find they can't use it for sleep because it makes them "hyper" at night and keeps them up.
In another study using Valerian for anxiety, 100mg three times a day for three weeks was more effective than placebo. Because Valerian decreases fatigue, it's a helpful calming agent in CFIDS/FMS.
Valerian also eases bowel spasms and may decrease menstrual cramps, fluid retention and seizures. Although considered safe, even at high doses for short term use (and no significant toxicity has come to my attention with long term use), I would likely limit the dose to 450mg a day unless a higher dose shows clear benefit. Although used as a flavoring in food processing (e.g., drinks, baked goods, etc.), I would avoid using Valerian supplements during pregnancy. Valerian interacts well with other sleep medications and can also be taken with Melatonin 3/10mg at night.

In one study of 232 patients with "functional fatigue," those taking Ginseng 80mg a day (using the Ginsana Brand ®) experienced less fatigue with Ginseng vs. placebo after six weeks. Concentration also improved (LeGal M, et al.; Phyto Ther Res,1996; 10:4953).

Ginseng has been shown to reduce fatigue and improve exercise capacity. For most purposes the usual dose of standardized Panax Ginseng extract (5-7% Ginsengosides) is about 100-200mg a day. Asian and Siberian Ginseng also support adrenal function (also see Echinacea this page).Other studies also suggest that Asian (Panax) Ginseng may protect nerve cells and decrease cancer risk.
Remember, the potency of different forms of Ginseng is quite variable. To treat symptoms of an underactive adrenal (e.g., hypoglycemia, low blood pressure, etc.) use:
A. Asian (Panax) Ginseng-100mg twice a day, OR
B. Siberian Ginseng (Eleuthra) -Use (daily): 2-3gms of dry powdered root -OR 300-400mg of standardized concentrated extract OR 10cc (2 tsps) of the alcohol-based extract.
When using either form of Ginseng, take it for six weeks and then skip taking it for one to two weeks before resuming it. Continue this on-off cycle for 1-2 years or until you feel your ability to handle stress and infections has improved. Adding 1/2-2gms of vitamin C a day will also support the adrenal glands. Ginseng is quite safe and well-tolerated. Unlike Licorice, it does not pose the risk of raising adrenal hormones too high. (Donald Brown N.D.-NFM's Nutrition Science News 11/96; pp33-34; A good overview article for Ginseng.)

Echinacea also has other uses. Very importantly, it can stimulate the adrenal glands (Koen FE; 'The Influence of Echinacea Purpurea On The Hypophyseal-Adrenal System; Arzneim-Forsch; 3:133-137; 1953). Because the adrenals need a lot of vitamin C, consider taking 500-2000mg of vitamin C a day with the Echinacea (adrenal vitamin C levels will otherwise drop while taking the Echinacea as the adrenals "wake up").

Echinacea also strongly protects cancer patients against the drop in white blood cell counts that occur during radiation therapy. These studies suggest that it is a good idea for any cancer patient on radiation or chemotherapy to consider adding Echinacea to their regimen (Med Klin; 4:1546-7; 1969).

Uncontrolled trials have shown that topical Echinacea speeds wound healing, including abscesses, eczema, burns, herpes and varicose ulcers.

Although using different species and parts of the Echinacea plants each has its pros and cons, it is important to use a good brand. The importance of this is reflected in the estimate that over 50% of the Echinacea sold in the United States in this century was not Echinacea at all, but was (the unrelated) Missouri Snake Root! Check the label to document that the brand you use is actually Echinacea. One way to do this is to use a standardized "fresh pressed juice" that is noted on the bottle to have at least 2.4% beta-1,2-Fructofuranosides. Proper dosing is important as there tends to be an "all or nothing" effect (i.e., too low a dose has no effect).

Overall, Echinacea is best used to treat, rather than to prevent infections. If one has an impaired immune system, though, as in CFIDS/ FMS patients with recurrent or persistent yeast or other (e.g., respiratory) infections, long term use may be helpful. It is important to stop the Echinacea for 7-10 days every 6-8 weeks or it will stop being effective. A set of dosing recommendations made by Michael Murray, N.D., an excellent and very knowledgeable expert on herbal remedies, is as follows:
For acute infections use one of the following: -
1. Juice of the aerial (above ground) portion of Echinacea Purpurea stabilized in 22% Ethanol with a minimum of 2.4% beta 1,2-Fructofuranosides (it should say this on the bottle), 2-3 cc (1/2-3/4 tsp) three times a day (first choice) OR
2. Dried root (or as tea) 1000-2000mg (1-2gm) three times a day OR
3. Freeze-dried plant at 325-650mg three times a day (capsules) OR
4. Tincture (1:5) 3-4 cc (3/4-1 tsp) three times a day.
Echinacea is quite safe and nontoxic and some experts will even use it during pregnancy. For theoretical reasons, it is reasonable to not use it in autoimmune diseases (like Lupus or MS) or in AIDS or HIV positive patients.