Armstrong, Christopher W, McGregor, Neil R, Sheedy, John R et al. · Clinica chimica acta; international journal of clinical chemistry · 2012 · DOI
Researchers used a specialized blood test called NMR to compare the levels of different chemicals in the blood of 11 people with ME/CFS and 10 healthy people. They found that people with ME/CFS had significantly lower levels of two amino acids (building blocks of protein): glutamine and ornithine. These findings suggest that people with ME/CFS may have problems with how their bodies process certain proteins and manage nitrogen, which are important for energy and cell function.
This study provides objective biochemical evidence that ME/CFS involves measurable metabolic abnormalities, particularly in amino acid and nitrogen metabolism. If validated in larger cohorts, identifying specific metabolic biomarkers could improve diagnostic accuracy and help distinguish ME/CFS from other conditions, potentially advancing both patient diagnosis and research into disease mechanisms.
This study does not prove that low glutamine and ornithine cause ME/CFS or explain how these metabolic changes relate to specific symptoms like post-exertional malaise or cognitive dysfunction. It is a small preliminary study, so findings must be replicated in larger populations before they can be used clinically. Correlation between these amino acids and other metabolites does not establish the biochemical pathways responsible for the disturbances.
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
Armstrong, Christopher W, McGregor, Neil R, Sheedy, John R, Buttfield, Ian, Butt, Henry L, & Gooley, Paul R (2012). NMR metabolic profiling of serum identifies amino acid disturbances in chronic fatigue syndrome.. Clinica chimica acta; international journal of clinical chemistry. https://doi.org/10.1016/j.cca.2012.06.022
BibTeX
@article{mecfsatlas-armstrong-2012-nmr-metabolic,
author = {Armstrong, Christopher W and McGregor, Neil R and Sheedy, John R and Buttfield, Ian and Butt, Henry L and Gooley, Paul R},
title = {NMR metabolic profiling of serum identifies amino acid disturbances in chronic fatigue syndrome.},
journal = {Clinica chimica acta; international journal of clinical chemistry},
year = {2012},
doi = {10.1016/j.cca.2012.06.022},
note = {PubMed: 22728138},
url = {https://www.mecfsatlas.com/evidence/armstrong-2012-nmr-metabolic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/armstrong-2012-nmr-metabolic
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