A systematic review of mitochondrial abnormalities in myalgic encephalomyelitis/chronic fatigue syndrome/systemic exertion intolerance disease.
Holden, Sean, Maksoud, Rebekah, Eaton-Fitch, Natalie et al. · Journal of translational medicine · 2020 · DOI
Quick Summary
This review looked at 19 studies examining whether the power-generating structures in our cells (called mitochondria) work differently in people with ME/CFS compared to healthy people. While many studies found some differences in how these cellular power plants function, the results were inconsistent across different research groups, making it hard to draw clear conclusions about whether mitochondrial problems actually cause ME/CFS.
Why It Matters
Understanding whether mitochondrial dysfunction plays a role in ME/CFS is crucial because it could eventually lead to new diagnostic tests and targeted treatments. This review synthesizes what we currently know from multiple studies to identify where evidence is strong and where more research is needed to solve the ME/CFS puzzle.
Observed Findings
- Multiple studies reported changes in mitochondrial structure in ME/CFS patients
- Some studies found alterations in mitochondrial DNA and RNA levels
- Differences were reported in mitochondrial respiratory function compared to controls
- Changes in metabolite and coenzyme levels were documented in some studies
- High variability in findings across different research groups
Inferred Conclusions
- Mitochondrial abnormalities may be involved in ME/CFS pathophysiology, but current evidence is inconsistent
- Standardized diagnostic criteria and analysis methods are essential for future research
- Mitochondrial dysfunction cannot yet be established as a reliable biomarker for ME/CFS
- Higher-quality, well-designed studies using consistent methodologies are needed
Remaining Questions
- Do mitochondrial abnormalities cause ME/CFS symptoms, or are they a consequence of the illness?
- Which specific mitochondrial parameters, if any, are most relevant to ME/CFS pathophysiology?
- Why do different studies using similar methods produce inconsistent results?
- Can standardized mitochondrial testing protocols be developed and validated across research centers?
What This Study Does Not Prove
This review does not prove that mitochondrial abnormalities cause ME/CFS or that they are not involved—it merely shows that current studies have not yet provided consistent enough evidence to make firm conclusions. The inconsistencies across studies mean we cannot yet rely on mitochondrial measures as a diagnostic biomarker or therapeutic target.
Topics
Tags
Metadata
- DOI
- 10.1186/s12967-020-02452-3
- PMID
- 32727475
- Review status
- Editor reviewed
- Evidence level
- Established evidence from major reviews, guidelines, or evidence maps
- Last updated
- 7 April 2026