E0 ConsensusPreliminaryPEM unclearSystematic-ReviewPeer-reviewedReviewed
Nutraceutical Supplementation Effects on Subjective Fatigue Symptoms in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Systematic Review.
Brito, Emanuella M, Bonifanti, Leonardo, Patel, Rajvi et al. · Cureus · 2025 · DOI
Quick Summary
This review looked at studies testing whether vitamins, minerals, and dietary changes help ME/CFS patients feel less exhausted. Researchers found that a few supplements—like NADH, CoQ10, wasabi, and probiotics—showed promise in improving symptoms. However, many studies didn't use standardized ways to measure improvement, making it hard to compare results fairly across different research.
Why It Matters
ME/CFS currently lacks approved treatments, and many patients seek symptom relief through supplements. This review identifies which nutritional interventions have research support and highlights the need for better study standardization, helping patients and clinicians make more informed decisions while guiding future research priorities.
Observed Findings
- Several supplements showed improvement in ME/CFS symptom reporting: NADH, CoQ10, wasabi, and probiotics
- Many registered clinical trials lacked use of NIH NINDS-recommended Common Data Elements (CDEs)
- Systematic review methodology using clinical trial registries improved access to standardized trial design and result reporting
- The current literature on nutritional interventions in ME/CFS remains limited in quality and comparability
- Nutraceutical and dietary interventions are frequently used by ME/CFS patients despite limited evidence base
Inferred Conclusions
- Nutritional supplementation warrants further investigation as a potential supportive strategy for ME/CFS symptom management
- Adoption of standardized outcome measurement tools (NIH NINDS CDEs) is essential for enabling meaningful cross-study comparisons and clinical decision-making
- Future ME/CFS intervention trials should employ rigorous, consistent methodologies to strengthen evidence for supplement efficacy
Remaining Questions
- Which supplements show the most clinically meaningful benefit, and in which ME/CFS patient subgroups?
- What are the optimal dosages and durations of treatment for the identified promising supplements?
What This Study Does Not Prove
This systematic review does not prove that these supplements are definitively effective—it only identifies promising candidates requiring further rigorous testing. The lack of standardized measurement tools means the observed improvements may not be directly comparable across studies, and causation cannot be established from this review alone. Individual patient responses may vary significantly.
Tags
Symptom:Fatigue
Method Flag:PEM Not DefinedWeak Case DefinitionExploratory Only
Metadata
- DOI
- 10.7759/cureus.87178
- PMID
- 40755709
- Review status
- Editor reviewed
- Evidence level
- Established evidence from major reviews, guidelines, or evidence maps
- Last updated
- 12 April 2026
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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