Almulla, Abbas F, Moustafa, Shatha R, Al-Dujaili, Arafat H et al. · Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999) · 2021 · DOI
This study looked at a mineral called cesium in the blood of people with schizophrenia and compared it to healthy people. They found that people with schizophrenia had lower cesium levels, and this was connected to cognitive problems (like memory and thinking difficulties), fatigue symptoms, and signs of immune system activity. The researchers suggest that low cesium might contribute to some of the symptoms seen in schizophrenia.
ME/CFS and schizophrenia both involve cognitive dysfunction, fatigue, and immune-inflammatory dysregulation. If trace elements like cesium are implicated in these pathways, it may suggest novel avenues for understanding overlapping mechanisms between psychiatric and post-viral conditions, and potential nutritional or micronutrient-based interventions.
This study cannot prove that low cesium causes schizophrenia symptoms or cognitive impairment—only that they are associated. The cross-sectional design means we cannot determine causality or direction of effect. Furthermore, the biological mechanism by which cesium influences immune activation or cognition remains unexplained and would require mechanistic studies to establish.
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 →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Almulla, Abbas F, Moustafa, Shatha R, Al-Dujaili, Arafat H, Al-Hakeim, Hussein K, & Maes, Michael (2021). Lowered serum cesium levels in schizophrenia: association with immune-inflammatory biomarkers and cognitive impairments.. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999). https://doi.org/10.1590/1516-4446-2020-0908
BibTeX
@article{mecfsatlas-almulla-2021-lowered-serum,
author = {Almulla, Abbas F and Moustafa, Shatha R and Al-Dujaili, Arafat H and Al-Hakeim, Hussein K and Maes, Michael},
title = {Lowered serum cesium levels in schizophrenia: association with immune-inflammatory biomarkers and cognitive impairments.},
journal = {Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)},
year = {2021},
doi = {10.1590/1516-4446-2020-0908},
note = {PubMed: 32556004},
url = {https://www.mecfsatlas.com/evidence/almulla-2021-lowered-serum},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/almulla-2021-lowered-serum
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