Metabolic abnormalities in chronic fatigue syndrome/myalgic encephalomyelitis: a mini-review.
Tomas, Cara, Newton, Julia · Biochemical Society transactions · 2018 · DOI
Quick Summary
This review examines research showing that people with ME/CFS have problems with how their bodies use energy at a cellular level. Scientists have found several different metabolic abnormalities—issues with immune function, mitochondria (the cell's power plants), muscle acid buildup, and other energy-related problems—that could potentially be used as biomarkers (measurable signs) to diagnose the disease. However, no single test can yet reliably identify ME/CFS.
Why It Matters
ME/CFS currently lacks diagnostic biomarkers, making diagnosis difficult and delayed. This review consolidates evidence for metabolic abnormalities that could eventually lead to reliable blood tests or other measurable indicators for the disease, potentially improving diagnosis and understanding of disease mechanisms. Establishing valid biomarkers could also help validate ME/CFS as a biological disease and facilitate better treatment development.
Observed Findings
Multiple studies demonstrate immune dysregulation in ME/CFS including abnormal cytokine patterns
Mitochondrial dysfunction and impaired energy production have been observed in patient samples
Skeletal muscle acidosis and metabolic abnormalities affecting lactate metabolism are present in some patients
Metabolomic analysis has identified altered metabolic profiles in people with ME/CFS
Abnormalities in AMPK signaling pathways have been detected, suggesting disrupted energy sensing
Inferred Conclusions
Metabolic abnormalities in ME/CFS are multifactorial and likely involve dysfunction across several biological systems
These metabolic changes represent promising candidates for development as diagnostic biomarkers
Robust validation of biomarkers requires coordinated multi-site studies using standardized methodologies
Future research must clarify whether metabolic abnormalities are causative or consequential to disease pathogenesis
Remaining Questions
Which metabolic abnormalities are primary causes versus secondary consequences of ME/CFS?
What This Study Does Not Prove
This review does not prove that any single metabolic abnormality causes ME/CFS, nor does it establish whether identified metabolic changes are primary causes or secondary consequences of the disease. The review synthesizes existing literature rather than presenting new empirical data, so findings depend on the quality and methodologies of included studies. It does not provide diagnostic criteria or validate any biomarker for clinical use.