Mihrshahi, Robin, Beirman, Robyn · The New Zealand medical journal · 2005
This review article examines what scientists currently understand about what causes ME/CFS and how the illness develops. The authors looked at research across four main areas: infections, immune system problems, hormonal and nervous system imbalances, and mental health factors. They suggest that ME/CFS likely results from a combination of these factors rather than a single cause.
This work is important because it attempts to integrate multiple competing theories of ME/CFS into a coherent multifactorial framework, helping patients and clinicians understand that the illness likely involves several biological systems rather than a single cause. This perspective can guide more comprehensive research and treatment approaches.
As a literature review, this article does not present original experimental data or clinical trials, so it cannot prove causation or establish which factors are primary versus secondary in ME/CFS development. The conclusions are limited by the quality and completeness of studies available at the time of publication (2005), and some proposed mechanisms may have been superseded by more recent research.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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