List of abnormal findings in chronic fatigue syndrome and myalgic encephalomyelitis

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Myalgic encephalomyelitis/chronic fatigue syndrome is a complex multi-system disease and biological abnormalities in patients have been found affecting multiple bodily systems. No single biomarker-based diagnostic test has been validated but patients have a range abnormal physical findings affecting multiple bodily systems.[1] The CDC states that diagnosing ME/CFS relies on a physical and psychiatric assessment, observations, medical history, clinical interview, and results from a mix of blood and urine tests.[2]

Nervous system[edit | edit source]

Brain[edit | edit source]

Main article: Brain
  • Progressive brain changes[3]

Central nervous system[edit | edit source]

Main article: Central nervous system

Autonomic nervous system[edit | edit source]

Main article: Autonomic nervous system

Peripheral nervous system[edit | edit source]

Main article: Peripheral nervous system

Muscular system[edit | edit source]

Main article: Muscle

Immune system[edit | edit source]

Main article: Immune system

Immune dysregulation[edit | edit source]

Chronic infection[edit | edit source]

Lymphatic system[edit | edit source]

Cardiovascular system[edit | edit source]

Main article: Cardiovascular system
Main article: Cardiac problems in ME/CFS

Heart[edit | edit source]

Circulation[edit | edit source]

Blood vessels[edit | edit source]

Blood[edit | edit source]

Main article: Brain

Digestive system[edit | edit source]

Gastrointestinal tract[edit | edit source]

Main article: Gastrointestinal tract

Liver[edit | edit source]

Nutrition[edit | edit source]

Metabolism[edit | edit source]

  • Metabolic abnormalities in chronic fatigue syndrome/myalgic encephalomyelitis: a mini-review[75]
  • Analysis of peripheral blood mononuclear cell proteomes reveals mitochondrial dysfunction, supporting a model of deficient ATP production in ME/CFS.[76]

Cellular respiration[edit | edit source]

Exercise[edit | edit source]

  • reduced pain threshold[84]
  • translocation of bacteria[85]
  • loss of capacity to recover from acidosis on repeat exercise[86]
  • increased expression of sensory, adrenergic and immune genes following muscle exertion[87][88][89]
  • decreased oxygen utilization[90]
Abnormal findings in Chronic fatigue syndrome and myalgic encephalomyelitis. There is no single biomarker, but tests have found differences in blood flow to the brain, hand grip strength, metabolite and mitochondria abnormalities, reduced heart output, white and red blood cell differences, reduced blood volume, differences in gut bacteria, neuroinflammation, abnormal responses to exercise, and other abnormalities.

See also[edit | edit source]

Learn more[edit | edit source]

References[edit | edit source]

  1. ↑ Carruthers, BM; van de Sande, MI; De Meirleir, KL; Klimas, NG; Broderick, G; Mitchell, T; Staines, D; Powles, ACP; Speight, N; Vallings, R; Bateman, L; Bell, DS; Carlo-Stella, N; Chia, J; Darragh, A; Gerken, A; Jo, D; Lewis, DP; Light, AR; Light, KC; Marshall-Gradisnik, S; McLaren-Howard, J; Mena, I; Miwa, K; Murovska, M; Stevens, SR (2012), Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners (PDF), ISBN 978-0-9739335-3-6
  2. ↑ Centers of Disease Control (May 15, 2019). "Diagnosis of ME/CFS | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)". Centers for Disease Control and Prevention. Retrieved September 26, 2020.
  3. ↑ 3.0 3.1 Shan, Zack Y.; Kwiatek, Richard; Burnet, Richard; Del Fante, Peter; Staines, Donald R.; Marshall-Gradisnik, Sonya M.; Barnden, Leighton R. (April 28, 2016). "Progressive brain changes in patients with chronic fatigue syndrome: A longitudinal MRI study". Journal of Magnetic Resonance Imaging. 44 (5): 1301–1311. doi:10.1002/jmri.25283. ISSN 1053-1807. PMC 5111735. PMID 27123773.
  4. ↑ 4.0 4.1 Mathew, Sanjay J.; Mao, Xiangling; Keegan, Kathryn A.; Levine, Susan M.; Smith, Eric L.P.; Heier, Linda A.; Otcheretko, Viktor; Coplan, Jeremy D.; Shungu, Dikoma C. (April 2009). "Ventricular cerebrospinal fluid lactate is increased in chronic fatigue syndrome compared with generalized anxiety disorder: anin vivo3.0 T1H MRS imaging study". NMR in Biomedicine. 22 (3): 251–258. doi:10.1002/nbm.1315. ISSN 0952-3480.
  5. ↑ Murrough, James W.; Mao, Xiangling; Collins, Katherine A.; Kelly, Chris; Andrade, Gizely; Nestadt, Paul; Levine, Susan M.; Mathew, Sanjay J.; Shungu, Dikoma C. (July 2010). "Increased ventricular lactate in chronic fatigue syndrome measured by 1H MRS imaging at 3.0 T. II: comparison with major depressive disorder". NMR in Biomedicine. 23 (6): 643–650. doi:10.1002/nbm.1512. ISSN 1099-1492. PMID 20661876.
  6. ↑ Shungu, Dikoma C.; Weiduschat, Nora; Murrough, James W.; Mao, Xiangling; Pillemer, Sarah; Dyke, Jonathan P.; Medow, Marvin S.; Natelson, Benjamin H.; Stewart, Julian M. (September 2012). "Increased ventricular lactate in chronic fatigue syndrome. III. Relationships to cortical glutathione and clinical symptoms implicate oxidative stress in disorder pathophysiology". NMR in biomedicine. 25 (9): 1073–1087. doi:10.1002/nbm.2772. ISSN 1099-1492. PMC 3896084. PMID 22281935.
  7. ↑ Natelson, Benjamin H.; Vu, Diana; Coplan, Jeremy D.; Mao, Xiangling; Blate, Michelle; Kang, Guoxin; Soto, Eli; Kapusuz, Tolga; Shungu, Dikoma C. (January 2, 2017). "Elevations of ventricular lactate levels occur in both chronic fatigue syndrome and fibromyalgia". Fatigue: Biomedicine, Health & Behavior. 5 (1): 15–20. doi:10.1080/21641846.2017.1280114. ISSN 2164-1846. PMC 5754037. PMID 29308330.
  8. ↑ Nakatomi, Yasuhito; Mizuno, Kei; Ishii, Akira; Wada, Yasuhiro; Tanaka, Masaaki; Tazawa, Shusaku; Onoe, Kayo; Fukuda, Sanae; Kawabe, Joji (June 1, 2014). "Neuroinflammation in Patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: An 11C-(R)-PK11195 PET Study". Journal of Nuclear Medicine. 55 (6): 945–950. doi:10.2967/jnumed.113.131045. ISSN 0161-5505. PMID 24665088.
  9. ↑ Zeineh, Michael M; Kang, James; Atlas, Scott W; Raman, Mira M; Reiss, Allan L; Norris, Jane L; Valencia, Ian; Montoya, Jose G (October 29, 2014), "Right Arcuate Fasciculus Abnormality in Chronic Fatigue Syndrome", Radiology, 274 (2): 517–526, doi:10.1148/radiol.14141079
  10. ↑ 10.0 10.1 Mueller, Christina; Lin, Joanne C; Sheriff, Sulaiman; Maudsley, Andrew A; Younger, Jarred W (2019). "Evidence of widespread metabolite abnormalities in Myalgic encephalomyelitis/chronic fatigue syndrome: assessment with whole-brain magnetic resonance spectroscopy". Brain Imaging and Behavior. doi:10.1007/s11682-018-0029-4. Retrieved January 17, 2019.
  11. ↑ "Brain Imaging and Behavior publication from Dr. Jarred Younger's SMCI Ramsay pilot study supports involvement of neuroinflammation in ME/CFS". go.solvecfs.org. Retrieved January 17, 2019.
  12. ↑ 12.0 12.1 Puri, B K; Jakeman, P M; Agour, M; Gunatilake, K D R; Fernando, K A C; Gurusinghe, A I; Treasaden, I H; Waldman, A D; Gishen, P (July 2012). "Regional grey and white matter volumetric changes in myalgic encephalomyelitis (chronic fatigue syndrome): a voxel-based morphometry 3 T MRI study". The British Journal of Radiology. 85 (1015): e270–e273. doi:10.1259/bjr/93889091. ISSN 0007-1285. PMC 3474083. PMID 22128128.
  13. ↑ Gerwin Morris, Michael Maes, see citations 12 through 27 in "Myalgic encephalomyelitis/chronic fatigue syndrome and encephalomyelitis disseminata/multiple sclerosis show remarkable levels of similarity in phenomenology and neuroimmune characteristics" BMC Medicine, 17 September 2013
  14. ↑ Miwa, K (July 2015). "Cardiac dysfunction and orthostatic intolerance in patients with myalgic encephalomyelitis and a small left ventricle". Heart and Vessels. 30 (4): 484–489.
  15. ↑ Behan, W. M.H.; More, I.A.R.; Behan, P.O. (December 1991). "Mitochondrial abnormalities in the postviral fatigue syndrome". Acta Neuropathologica. 83 (1): 61–65. doi:10.1007/bf00294431. ISSN 0001-6322.
  16. ↑ 16.0 16.1 "Sensory characterization of somatic parietal tissues in humans with chronic fatigue syndrome". Neuroscience Letters. 208 (2): 117–120. April 19, 1996. doi:10.1016/0304-3940(96)12559-3. ISSN 0304-3940.
  17. ↑ Zhang, C.; Baumer, A.; Mackay, I.R.; Linnane, A.W.; Nagley, P. (April 1995). "Unusual pattern of mitochondrial DNA deletions in skeletal muscle of an adult human with chronic fatigue syndrome". Human Molecular Genetics. 4 (4): 751–754. ISSN 0964-6906. PMID 7633428.
  18. ↑ Albrecht, Robert (March 21, 1964). "Epidemic Neuromyasthenia Outbreak in a Convent in New York State". Journal of the American Medical Association. 187: 904–907.
  19. ↑ 19.0 19.1 Gow, J.W.; Behan, W. M.H.; Simpson, K.; McGarry, F.; Keir, S.; Behan, P.O. (January 1, 1994). "Studies on Enterovirus in Patients with Chronic Fatigue Syndrome". Clinical Infectious Diseases. 18 (Suppl 1): S126–S129. doi:10.1093/clinids/18.Supplement_1.S126. ISSN 1537-6591.
  20. ↑ 20.0 20.1 Cunningham, Louise; Bowles, N.E.; Lane, R. J.M.; Dubowitz, V.; Archard, L.C. (1990). "Persistence of enteroviral RNA in chronic fatigue syndrome is associated with the abnormal production of equal amounts of positive and negative strands of enteroviral RNA". Journal of General Virology. 71 (6): 1399–1402. doi:10.1099/0022-1317-71-6-1399.
  21. ↑ 21.0 21.1 Archard, LC; Bowles, NE; Behan, PO; Bell, EJ; Doyle, D (June 1, 1988). "Postviral Fatigue Syndrome: Persistence of Enterovirus RNA in Muscle and Elevated Creatine Kinase, Postviral Fatigue Syndrome: Persistence of Enterovirus RNA in Muscle and Elevated Creatine Kinase". Journal of the Royal Society of Medicine. 81 (6): 326–329. doi:10.1177/014107688808100608. ISSN 0141-0768. PMC 1291623. PMID 3404526.
  22. ↑ 22.0 22.1 Gow, J.W.; Behan, W.M.; Clements, G.B.; Woodall, C.; Riding, M.; Behan, P.O. (March 23, 1991). "Enteroviral RNA sequences detected by polymerase chain reaction in muscle of patients with postviral fatigue syndrome". BMJ. 302 (6778): 692–696. doi:10.1136/bmj.302.6778.692. ISSN 0959-8138. PMID 1850635.
  23. ↑ Brown, Audrey E; Jones, David E; Walker, Mark; Newton, Julia L (April 2, 2015), "Abnormalities of AMPK activation and glucose uptake in cultured skeletal muscle cells", PLoS One, 10 (4), doi:10.1371/journal.pone.0122982, PMID 25836975
  24. ↑ Dobberstein, Linda J. (April 20, 2015), "Master Enzyme Switch Deactivated In Chronic Fatigue Syndrome and Fibromyalgia", Wellness Resources
  25. ↑ Brenu, Ekua Weba; Huth, Teilah K.; Hardcastle, Sharni L.; Fuller, Kirsty; Kaur, Manprit; Johnston, Samantha; Ramos, Sandra B.; Staines, Don R.; Marshall-Gradisnik, Sonya M. (April 2014). "Role of adaptive and innate immune cells in chronic fatigue syndrome/myalgic encephalomyelitis". International Immunology. 26 (4): 233–242. doi:10.1093/intimm/dxt068. ISSN 1460-2377. PMID 24343819.
  26. ↑ Victoria Scott, David Strayer (2015). "Low NK Cell Activity in Chronic Fatigue Syndrome (CFS) and Relationship to Symptom Severity". Journal of Clinical & Cellular Immunology. 6 (4). doi:10.4172/2155-9899.1000348. ISSN 2155-9899.
  27. ↑ Montoya, Jose G.; Holmes, Tyson H.; Anderson, Jill N.; Maecker, Holden T.; Rosenberg-Hasson, Yael; Valencia, Ian J.; Chu, Lily; Younger, Jarred W.; Tato, Cristina M.; Davis, Mark M. (2017), "Cytokine signature associated with disease severity in chronic fatigue syndrome patients", Proceedings of the National Academy of Sciences of the United States of America, 114 (34): E7150–E7158, doi:10.1073/pnas.1710519114
  28. ↑ Study finds evidence of downregulated immune system in ME/CFS patients - MEAction - Landi, et al.
  29. ↑ New Research Discovers Evidence of Atypical & Classical ME/CFS - The Microbe Discovery Project - Apr 4, 2017
  30. ↑ Brenu, Ekua Weba; Huth, Teilah K.; Hardcastle, Sharni L.; Fuller, Kirsty; Kaur, Manprit; Johnston, Samantha; Ramos, Sandra B.; Staines, Don R.; Marshall-Gradisnik, Sonya M. (April 2014). "Role of adaptive and innate immune cells in chronic fatigue syndrome/myalgic encephalomyelitis". International Immunology. 26 (4): 233–242. doi:10.1093/intimm/dxt068. ISSN 1460-2377. PMID 24343819.
  31. ↑ Rönnberg, E; Calounova, G; Pejler, G (June 2017). "Novel characterisation of mast cell phenotypes from peripheral blood mononuclear cells in chronic fatigue syndrome/myalgic encephalomyelitis patients". Asian Pac J Allergy Immunol. 35 (2): 75–81.
  32. ↑ Loebel, Madlen; Grabowski, Patricia; Heidecke, Harald; Bauer, Sandra; Hanitsch, Leif G.; Wittke, Kirsten; Meisel, Christian; Reinke, Petra; Volk, Hans-Dieter (February 2016). "Antibodies to β adrenergic and muscarinic cholinergic receptors in patients with Chronic Fatigue Syndrome". Brain, Behavior, and Immunity. 52: 32–39. doi:10.1016/j.bbi.2015.09.013. ISSN 1090-2139. PMID 26399744.
  33. ↑ Maes, Michael; Mihaylova, Ivanka; Leunis, Jean-Claude (December 2007). "Increased serum IgM antibodies directed against phosphatidyl inositol (Pi) in chronic fatigue syndrome (CFS) and major depression: evidence that an IgM-mediated immune response against Pi is one factor underpinning the comorbidity between both CFS and depression". Neuro Endocrinology Letters. 28 (6): 861–867. ISSN 0172-780X. PMID 18063934.
  34. ↑ Maes, Michael; Ringel, Karl; Kubera, Marta; Anderson, George; Morris, Gerwyn; Galecki, Piotr; Geffard, Michel (September 5, 2013). "In myalgic encephalomyelitis/chronic fatigue syndrome, increased autoimmune activity against 5-HT is associated with immuno-inflammatory pathways and bacterial translocation". Journal of Affective Disorders. 150 (2): 223–230. doi:10.1016/j.jad.2013.03.029. ISSN 1573-2517. PMID 23664637.
  35. ↑ 35.0 35.1 Mandarano, Alexandra H.; Maya, Jessica; Giloteaux, Ludovic; Peterson, Daniel L.; Maynard, Marco; Gottschalk, C. Gunnar; Hanson, Maureen R. (March 2, 2020). "Myalgic encephalomyelitis/chronic fatigue syndrome patients exhibit altered T cell metabolism and cytokine associations". The Journal of Clinical Investigation. 130 (3): 1491–1505. doi:10.1172/JCI132185. ISSN 1558-8238. PMC 7269566. PMID 31830003.
  36. ↑ 36.0 36.1 Racciatti, D.; Dalessandro, M.; Delle Donne, L.; Falasca, K.; Zingariello, P.; Paganelli, R.; Pizzigallo, E.; Vecchiet, J. (2004). "Study of immune alterations in patients with chronic fatigue syndrome with different etiologies". International Journal of Immunopathology and Pharmacology. 17 (2 Suppl): 57–62. doi:10.1177/03946320040170S210. ISSN 0394-6320. PMID 15345193.
  37. ↑ Maes, Michael; Bosmans, Eugene; Kubera, Marta (January 1, 2015). "Increased expression of activation antigens on CD8+ T lymphocytes in Myalgic Encephalomyelitis/chronic fatigue syndrome: inverse associations with lowered CD19+ expression and CD4+/CD8+ ratio, but no associations with (auto)immune, leaky gut, oxidative and nitrosative stress biomarkers". Neuro endocrinology letters. 36 (5): 439–446. ISSN 2354-4716. PMID 26707044.
  38. ↑ McGarry, Frances; Gow, John; Behan, Peter O (June 1, 1994), "Enterovirus in the Chronic Fatigue Syndrome", Annals of Internal Medicine, 120 (11): 972–973, doi:10.7326/0003-4819-120-11-199406010-00020
  39. ↑ Chia, JKS; Chia, AY (January 1, 2008). "Chronic fatigue syndrome is associated with chronic enterovirus infection of the stomach". Journal of Clinical Pathology. 61 (1): 43–48. doi:10.1136/jcp.2007.050054. PMID 17872383.
  40. ↑ 40.0 40.1 Miwa K., "Cardiac dysfunction and orthostatic intolerance in patients with myalgic encephalomyelitis and a small left ventricle" Heart Vessels, July 2015
  41. ↑ Hollingsworth K.G "Impaired cardiac function in chronic fatigue syndrome measured using magnetic resonance cardiac tagging" J Intern Med 2012; 271: 264–270.
  42. ↑ Olimulder, M.A.G.M.; Galjee, M.A.; Wagenaar, L.J.; van Es, J.; van der Palen, J.; Visser, F.C.; Vermeulen, R.C.W.; von Birgelen, C. (2016). "Chronic fatigue syndrome in women assessed with combined cardiac magnetic resonance imaging". Netherlands Heart Journal. 24: 709–716. doi:10.1007/s12471-016-0885-8.
  43. ↑ Reduced cardiac volumes in chronic fatigue syndrome associate with plasma volume but not length of disease: a cohort study
  44. ↑ Miwa K., Fujita M., "Cardiovascular dysfunction with low cardiac output due to a small heart in patients with chronic fatigue syndrome" Intern Med, 2009;48(21):1849-54
  45. ↑ Jason LA, Corradi K, Gress S, Williams S, Torres-Harding S, "Causes of death among patients with chronic fatigue syndrome" Health Care Women Int., 27(7): 615-626. 2006
  46. ↑ Natelson, Benjamin; Mao, Xiangling; Stegner, Aaron J; Lange, Gudrun; Vu, Diana; Blate, Michelle; Kang, Guoxin; Soto, Eli; Kapusuz, Tolga; Shungu, Dikoma C (2017). "Multimodal and simultaneous assessments of brain and spinal fluid abnormalities in chronic fatigue syndrome and the effects of psychiatric comorbidity". Journal of the Neurological Sciences. 375: 411-416. doi:10.1016/j.jns.2017.02.046.
  47. ↑ Costa, D.C.; Tannock, C.; Brostoff, J. (November 1995). "Brainstem perfusion is impaired in chronic fatigue syndrome". QJM: monthly journal of the Association of Physicians. 88 (11): 767–773. ISSN 1460-2725. PMID 8542261.
  48. ↑ Barnden, Leighton R.; Crouch, Benjamin; Kwiatek, Richard; Burnet, Richard; Mernone, Anacleto; Chryssidis, Steve; Scroop, Garry; Del Fante, Peter (2011). "A brain MRI study of chronic fatigue syndrome: evidence of brainstem dysfunction and altered homeostasis". NMR in Biomedicine. 24 (10): 1302–1312. doi:10.1002/nbm.1692. ISSN 1099-1492. PMC 4369126. PMID 21560176.
  49. ↑ Biswal, Bharat; Kunwar, Pratap; Natelson, Benjamin H. (February 15, 2011). "Cerebral blood flow is reduced in chronic fatigue syndrome as assessed by arterial spin labeling". Journal of the Neurological Sciences. 301 (1): 9–11. doi:10.1016/j.jns.2010.11.018. ISSN 0022-510X.
  50. ↑ Yoshiuchi, Kazuhiro; Farkas, Jeffrey; Natelson, Benjamin H. (2006). "Patients with chronic fatigue syndrome have reduced absolute cortical blood flow". Clinical Physiology and Functional Imaging. 26 (2): 83–86. doi:10.1111/j.1475-097X.2006.00649.x. ISSN 1475-097X.
  51. ↑ Freedman, M.; Kirsh, J.C.; Gray, B.; Chung, D.G.; Abbey, S.E.; Salit, I.E.; Ichise, M. (October 1992). "Assessment of regional cerebral perfusion by 99Tcm-HMPAO SPECT in chronic fatigue syndrome". Nuclear medicine communications. 13 (10): 767–772. ISSN 0143-3636. PMID 1491843.
  52. ↑ Chao, C.C.; Hu, S.; Pheley, A.M.; Schenck, C.H.; Grammith, F.C.; Sirr, S.A.; Peterson, P.K. (March 1, 1994). "Effects of mild exercise on cytokines and cerebral blood flow in chronic fatigue syndrome patients". Clinical and Diagnostic Laboratory Immunology. 1 (2): 222–226. ISSN 1071-412X. PMID 7496949.
  53. ↑ Lange, Gudrun; Wang, Samuel; DeLuca, John; Natelson, Benjamin H. (September 28, 1998). "Neuroimaging in chronic fatigue syndrome". The American Journal of Medicine. 105 (3, Supplement 1): 50S–53S. doi:10.1016/S0002-9343(98)00175-2. ISSN 0002-9343.
  54. ↑ CMRC Conference 2017 day 1- Prof Dr Frans Visser, retrieved September 3, 2019
  55. ↑ Patrick Neary, J.; Roberts, Andy D.W.; Leavins, Nina; Harrison, Michael F.; Croll, James C.; Sexsmith, James R. (November 2008). "Prefrontal cortex oxygenation during incremental exercise in chronic fatigue syndrome". Clinical Physiology and Functional Imaging. 28 (6): 364–372. doi:10.1111/j.1475-097x.2008.00822.x. ISSN 1475-0961.
  56. ↑ Peterson, PK; Sirr, SA; Grammith, FC; Schenck, CH; Pheley, AM; Hu, S; Chao, C C (March 1994). "Effects of mild exercise on cytokines and cerebral blood flow in chronic fatigue syndrome patients". Clinical and Diagnostic Laboratory Immunology. 1 (2): 222–226. ISSN 1071-412X. PMID 7496949.
  57. ↑ Scherbakov, Nadja; Szklarski, Marvin; Hartwig, Jelka; Sotzny, Franziska; Lorenz, Sebastian; Meyer, Antje; Grabowski, Patricia; Doehner, Wolfram; Scheibenbogen, Carmen (2020). "Peripheral endothelial dysfunction in myalgic encephalomyelitis/chronic fatigue syndrome". ESC Heart Failure. 7 (3): 1064–1071. doi:10.1002/ehf2.12633. ISSN 2055-5822. PMC 7261521. PMID 32154656.
  58. ↑ Hurwitz, BE; Coryell, VT; Parker, M; Martin, P; LaPerriere ...., A; Bilsker, MS. "Chronic fatigue syndrome: illness severity, sedentary lifestyle, blood volume and evidence of diminished cardiac function". Clinical Science. 118 (2): 125–135.
  59. ↑ Streeten, DHP; Bell, D (1998). "Circulating Blood Volume in Chronic Fatigue Syndrome". Journal of Chronic Fatigue Syndrome. 4: 3–11.
  60. ↑ Simpson, LO (1989), "Nondiscocytic erythrocytes in myalgic encephalomyelitis", The New Zealand Medical Journal, 102 (864): 126–127, PMID 2927808
  61. ↑ Richards, RS; Wang, L; Jelinek, H (January 2007). "Erythrocyte oxidative damage in chronic fatigue syndrome". Archives of Medical Research. 38 (1): 94–98.
  62. ↑ Miller, Ruth R; Reid, W Darlene; Mattman, Andre; Yamabayashi, Cristiane; Steiner, Theodore; Parker, Shoshana; Gardy, Jennifer; Tang, Patrick; Patrick, David M (May 20, 2015). "Submaximal exercise testing with near-infrared spectroscopy in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome patients compared to healthy controls: a case–control study". Journal of Translational Medicine. 13 (1). doi:10.1186/s12967-015-0527-8. ISSN 1479-5876. PMC 4438583. PMID 25990639.
  63. ↑ Logan, Alan C; Venket Rao, A; Irani, Dinaz (June 2003). "Chronic fatigue syndrome: lactic acid bacteria may be of therapeutic value". Medical Hypotheses. 60 (6): 915–923. doi:10.1016/S0306-9877(03)00096-3. ISSN 0306-9877.
  64. ↑ Sheedy, John R.; Wettenhall, Richard E.H.; Scanlon, Denis; Gooley, Paul R.; Lewis, Donald P.; McGregor, Neil; Stapleton, David I.; Butt, Henry L.; DE Meirleir, Kenny L. (July 2009). "Increased d-lactic Acid intestinal bacteria in patients with chronic fatigue syndrome". In Vivo (Athens, Greece). 23 (4): 621–628. ISSN 0258-851X. PMID 19567398.
  65. ↑ https://getinfo.de/en/search/id/BLCP%3ACN055885616/%60Bacterial-Colonosis-in-Patients-with-Persistent/
  66. ↑ "High-throughput 16S rRNA gene sequencing reveals alterations of intestinal microbiota in myalgic encephalomyelitis/chronic fatigue syndrome patients". Anaerobe. 22: 50–56. August 1, 2013. doi:10.1016/j.anaerobe.2013.06.002. ISSN 1075-9964.
  67. ↑ 67.0 67.1 Giloteaux, Ludovic; Goodrich, Julia K.; Walters, William A.; Levine, Susan M.; Ley, Ruth E.; Hanson, Maureen R. (June 23, 2016). "Reduced diversity and altered composition of the gut microbiome in individuals with myalgic encephalomyelitis/chronic fatigue syndrome". Microbiome. 4. doi:10.1186/s40168-016-0171-4. ISSN 2049-2618. PMC 4918027. PMID 27338587.
  68. ↑ Pimentel, M; Hallegua, D; Chow, EJ; Wallace, D; Bonorris, G; Lin, HC (April 1, 2000), "Eradication of small intestinal bacterial overgrowth decreases symptoms in chronic fatigue syndrome: A double blind, randomized study", Gastroenterology, 118 (4): 414, doi:10.1016/S0016-5085(00)83765-8
  69. ↑ Maes, Michael; Mihaylova, Ivana; Leunis, Jean-Claude (April 1, 2007). "Increased serum IgA and IgM against LPS of enterobacteria in chronic fatigue syndrome (CFS): Indication for the involvement of gram-negative enterobacteria in the etiology of CFS and for the presence of an increased gut–intestinal permeability". Journal of Affective Disorders. 99 (1): 237–240. doi:10.1016/j.jad.2006.08.021. ISSN 0165-0327.
  70. ↑ Zalewski, Pawel; Finkelmeyer, Andreas; Frith, James; Maclachlan, Laura; Blamire, Andrew; Newton, Julia L. (June 18, 2018). "Liver volume is lower and associates with resting and dynamic blood pressure variability in chronic fatigue syndrome". Fatigue: Biomedicine, Health & Behavior. 6 (3): 141–152. doi:10.1080/21641846.2018.1488525. ISSN 2164-1846.
  71. ↑ I.M., Cox; M.J., Campbell; D., Dowson (1991), "Red blood cell magnesium and chronic fatigue syndrome", The Lancet, doi:10.1016/0140-6736(91)91371-Z, PMID 1672392
  72. ↑ Plioplys, A.V.; Plioplys, S. (1995). "Serum levels of carnitine in chronic fatigue syndrome: clinical correlates". Neuropsychobiology. 32 (3): 132–138. doi:10.1159/000119226. ISSN 0302-282X. PMID 8544970.
  73. ↑ Kuratsune, H.; Yamaguti, K.; Takahashi, M.; Misaki, H.; Tagawa, S.; Kitani, T. (January 1994), "Acylcarnitine deficiency in chronic fatigue syndrome", Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 18 (Suppl 1): 62–67, ISSN 1058-4838, PMID 8148455
  74. ↑ Majeed, T.; de Simone, C.; Famularo, G.; Marcellini, S.; Behan, P.O. (November 1995), "Abnormalities of carnitine metabolism in chronic fatigue syndrome", European Journal of Neurology, 2 (5): 425–428, doi:10.1111/j.1468-1331.1995.tb00151.x, ISSN 1351-5101, PMID 24283722
  75. ↑ Tomas, Cara; Newton, Julia (June 19, 2018). "Metabolic abnormalities in chronic fatigue syndrome/myalgic encephalomyelitis: a mini-review". Biochemical Society Transactions. 46 (3): 547–553. doi:10.1042/BST20170503. ISSN 0300-5127.
  76. ↑ 76.0 76.1 Sweetman, Eiren; Kleffmann, Torsten; Edgar, Christina; de Lange, Michel; Vallings, Rosamund; Tate, Warren (September 24, 2020). "A SWATH-MS analysis of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome peripheral blood mononuclear cell proteomes reveals mitochondrial dysfunction". Journal of Translational Medicine. 18 (1): 365. doi:10.1186/s12967-020-02533-3. ISSN 1479-5876. PMC 7512220.
  77. ↑ Armstrong, Christopher W.; McGregor, Neil R.; Lewis, Donald P.; Butt, Henry L.; Gooley, Paul R. (May 30, 2015). "Metabolic profiling reveals anomalous energy metabolism and oxidative stress pathways in chronic fatigue syndrome patients". Metabolomics. 11 (6): 1626–1639. doi:10.1007/s11306-015-0816-5. ISSN 1573-3882.
  78. ↑ Fluge, Øystein; Mella, Olav; Bruland, Ove; Risa, Kristin; Dyrstad, Sissel E.; Alme, Kine; Rekeland, Ingrid G.; Sapkota, Dipak; Røsland, Gro V. (December 22, 2016). "Metabolic profiling indicates impaired pyruvate dehydrogenase function in myalgic encephalopathy/chronic fatigue syndrome". JCI insight. 1 (21): e89376. doi:10.1172/jci.insight.89376. ISSN 2379-3708. PMC 5161229. PMID 28018972.
  79. ↑ Plioplys, AV; Plioplys, S (1995). "Serum levels of carnitine in chronic fatigue syndrome: clinical correlates". Neuropsychobiology. 32 (3): 132–8. PMID 8544970.
  80. ↑ Lane, RJ; Barrett, MC; Taylor, DJ; Kemp, GJ; Lodi, R (May 1998). "Heterogeneity in chronic fatigue syndrome: evidence from magnetic resonance spectroscopy of muscle". Neuromuscul Disord. 8 (3–4): 204–9. PMID 9631403.
  81. ↑ Jones, David EJ; Hollingsworth, Kieren G; Taylor, Renee R; Blamire, Andrew M; Newton, Julia L (April 2010). "Abnormalities in pH handling by peripheral muscle and potential regulation by the autonomic nervous system in chronic fatigue syndrome". J Intern Med. 267 (4): 394–401. doi:10.1111/j.1365-2796.2009.02160.x. PMID 20433583.
  82. ↑ Lengert, Nicor; Drossel, Barbara (July 2015). "In silico analysis of exercise intolerance in myalgic encephalomyelitis/chronic fatigue syndrome". Biophysical Chemistry. 202: 21–31. doi:10.1016/j.bpc.2015.03.009. PMID 25899994.
  83. ↑ Naviaux, Robert K.; Naviaux, Jane C.; Li, Kefeng; Bright, A. Taylor; Alaynick, William A.; Wang, Lin; Baxter, Asha; Nathan, Neil; Anderson, Wayne (September 13, 2016). "Metabolic features of chronic fatigue syndrome". Proceedings of the National Academy of Sciences. 113 (37): E5472–E5480. doi:10.1073/pnas.1607571113. ISSN 0027-8424. PMID 27573827.
  84. ↑ Whiteside, Alan; Hansen, Stig; Chaudhuri, Abhijit (2004). "Exercise lowers pain threshold in chronic fatigue syndrome". Pain. 109 (3): 497–499. doi:10.1016/j.pain.2004.02.029. PMID 15157711.
  85. ↑ Shukla, Sanjay K; Cook, Dane; Meyer, Jacob; Vernon, Suzanne D; Le, Thao; Clevidence, Derek; Robertson, Charles E; Schrodi, Steven J; Yale, Steven; Frank, Daniel N (December 18, 2015). "Changes in Gut and Plasma Microbiome following Exercise Challenge in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)". PLoS ONE. doi:10.1371/journal.pone.0145453. PMID 26683192.
  86. ↑ Jones, David EJ; Hollingsworth, Kieren G; Jakovljevic, Djordje G; Fattakhova, Gulnar; Pairman, Jessie; Blamire, Andrew M; Trenell, Michael I; Newton, Julia L (July 12, 2011). "Loss of capacity to recover from acidosis on repeat exercise in chronic fatigue syndrome". Eur J Clin Invest. 42 (2): 186–94. doi:10.1111/j.1365-2362.2011.02567.x. PMID 21749371.
  87. ↑ Light, Alan R; White, Andrea T; Hughen, Ronald W; Light, Kathleen C (July 31, 2009). "Moderate exercise increases expression for sensory, adrenergic, and immune genes in chronic fatigue syndrome patients but not in normal subjects". J Pain. 10 (10): 1099–112. doi:10.1016/j.jpain.2009.06.003. PMID 19647494.
  88. ↑ Light, Alan R; Bateman, Lucinda; Jo, D; Hughen, Ronald W; Vanhaitsma, TA; White, Andrea T; Light, Kathleen C (July 13, 2011), "Gene expression alterations at baseline and following moderate exercise in patients with Chronic Fatigue Syndrome and Fibromyalgia Syndrome", J Intern Med, 271 (1): 64–81, doi:10.1111/j.1365-2796.2011.02405.x, PMID 21615807
  89. ↑ White, Andrea T; Light, Alan R; Hughen, Ronald W; VanHaitsma, Timothy A; Light, Kathleen C (December 30, 2011), "Differences in metabolite-detecting, adrenergic, and immune gene expression after moderate exercise in patients with chronic fatigue syndrome, patients with multiple sclerosis, and healthy controls", Psychosom Med, 74 (1): 46–54, doi:10.1097/PSY.0b013e31824152ed, PMID 22210239
  90. ↑ Vermeulen, Ruud CW; Vermeulen van Eck, Ineke WG (2014). "Decreased oxygen extraction during cardiopulmonary exercise test in patients with chronic fatigue syndrome". Journal of Translational Medicine. 12 (1): 20. doi:10.1186/1479-5876-12-20. ISSN 1479-5876. PMC 3903040. PMID 24456560.

Centers for Disease Control and Prevention (CDC) - The Centers for Disease Control and Prevention is a U.S. government agency dedicated to epidemiology and public health. It operates under the auspices of the Department of Health and Human Services.

See Centers for Disease Control and Prevention.

central nervous system (CNS) - One of the two parts of the human nervous system, the other part being the peripheral nervous system. The central nervous system consists of the brain and spinal cord, while the peripheral nervous system consists of nerves that travel from the central nervous system into the various organs and tissues of the body.

orthostatic intolerance (OI) - The development of symptoms when standing upright, where symptoms are relieved upon reclining. Patients with orthostatic intolerance have trouble remaining upright for more than a few seconds or a few minutes, depending upon severity. In severe orthostatic intolerance, patients may not be able to sit upright in bed. Orthostatic intolerance is often a sign of dysautonomia. There are different types of orthostatic intolerance, including postural orthostatic tachycardia syndrome (POTS).

mitochondria Important parts of the biological cell, with each mitochondrion encased within a mitochondrial membrane. Mitochondria are best known for their role in energy production, earning them the nickname "the powerhouse of the cell". Mitochondria also participate in the detection of threats and the response to these threats. One of the responses to threats orchestrated by mitochondria is apoptosis, a cell suicide program used by cells when the threat can not be eliminated.

anticholinergic (ACh) - Involving blocking the neurotransmitter acetylcholine. Anticholinergic side effects may include dilated pupils in the eyes, photophobia, dry mouth, decreased mucus in the lungs, respiratory depression, decreased gastrointestinal motility, constipation, decreased then increased blood pressure, rapid heartbeat or heart palpitations, urinary retention, vasodilation, drowsiness, confusion, and agitation, and decreased sweating.

autoantibody An antibody that works against the body's own antigens, a hallmark of autoimmune diseases. Autoantibodies are the opposite of an antibodies.

cognition Thought processes, including attention, reasoning, and memory.

The clear yellowish fluid that remains from blood plasma after clotting factors have been removed by clot formation. (Blood plasma is simply blood that has had its blood cells removed.)[1]

serum The clear yellowish fluid that remains from blood plasma after clotting factors have been removed by clot formation. (Blood plasma is simply blood that has had its blood cells removed.)

The word "membrane" can have different meanings in different fields of biology. In cell biology, a membrane is a layer of molecules that surround its contents. Examples of cell-biology membranes include the "cell membrane" that surrounds a cell, the "mitochondrial membranes" that form the outer layers of mitochondria, and the "viral envelope" that surrounds enveloped viruses. In anatomy or tissue biology, a membrane is a barrier formed by a layer of cells. Examples of anatomical membranes include the pleural membranes that surrounds the lungs, the pericardium which surrounds the heart, and some of the layers within the blood-brain barrier.

membrane The word "membrane" can have different meanings in different fields of biology. In cell biology, a membrane is a layer of molecules that surround its contents. Examples of cell-biology membranes include the "cell membrane" that surrounds a cell, the "mitochondrial membranes" that form the outer layers of mitochondria, and the "viral envelope" that surrounds enveloped viruses. In anatomy or tissue biology, a membrane is a barrier formed by a layer of cells. Examples of anatomical membranes include the pleural membranes that surrounds the lungs, the pericardium which surrounds the heart, and some of the layers within the blood-brain barrier.

serum The clear yellowish fluid that remains from blood plasma after clotting factors have been removed by clot formation. (Blood plasma is simply blood that has had its blood cells removed.)

metabolite A chemical compound produced by, or involved in, metabolism. The term is often used to refer to the degradation products of drugs in the body.

The BMJ (previously the British Medical Journal) is a weekly peer-reviewed medical journal.

BMJ The BMJ (previously the British Medical Journal) is a weekly peer-reviewed medical journal.

cytokine any class of immunoregulatory proteins secreted by cells, especially immune cells. Cytokines are small proteins important in cell signaling that modulate the immune system. (Learn more: me-pedia.org)

microbiome The full collection of microscopic organisms (especially bacteria and fungi) which are present in a particular environment, particularly inside the human body.

metabolomics The analysis of the chemical metabolism within cells, tissues or organisms. The term is often used to refer to the full set of metabolites found in a cell in a given environment.

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