Natelson, Benjamin H, Vu, Diana, Coplan, Jeremy D et al. · Fatigue : biomedicine, health & behavior · 2017 · DOI
Researchers used brain imaging to measure a substance called lactate in the fluid around the brain in people with ME/CFS, fibromyalgia, both conditions together, and healthy people. They found that lactate levels were higher in all three patient groups compared to healthy controls, but the levels were similar among the three patient groups. This means lactate alone cannot be used to distinguish ME/CFS from fibromyalgia.
This study provides neurobiological evidence that ME/CFS and fibromyalgia may share a common underlying metabolic abnormality—elevated brain lactate—even if they are distinct disorders. Understanding shared versus unique biological features helps researchers develop better diagnostic tools and targeted treatments for these debilitating conditions.
This study does not prove that elevated lactate causes ME/CFS or fibromyalgia, only that it is associated with both conditions. It does not establish whether lactate elevation is a primary disease mechanism or a secondary consequence of another underlying process. The study's cross-sectional design cannot determine whether lactate changes over time or respond to treatment.
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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