Casanova, Amaloha, Wevers, Anne, Navarro-Ledesma, Santiago et al. · Frontiers in physiology · 2023 · DOI
This review explains that mitochondria—the energy-producing structures in our cells—do much more than just make energy. They also help control sleep-wake cycles, interact with gut bacteria, and regulate the immune system. When mitochondria don't work properly, it may contribute to several diseases including ME/CFS, and the authors suggest that specific lifestyle and physiological strategies might help restore mitochondrial health.
This review is valuable for ME/CFS patients and researchers because it positions mitochondrial dysfunction as a potentially unifying mechanism linking energy metabolism, circadian disruption, gut dysbiosis, and immune dysregulation—core features of ME/CFS. By framing mitochondrial health as a root cause and proposing integrative recovery strategies, it offers a comprehensive biological framework for understanding and potentially treating this complex disease.
This review does not prove that mitochondrial dysfunction is the primary cause of ME/CFS, nor does it establish which proposed interventions are safe or effective for ME/CFS patients specifically. As a mechanistic narrative review without systematic methodology or original data, it cannot demonstrate causality or provide evidence-based clinical recommendations; it is exploratory rather than conclusive.
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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Primary citation
Casanova, Amaloha, Wevers, Anne, Navarro-Ledesma, Santiago, & Pruimboom, Leo (2023). Mitochondria: It is all about energy.. Frontiers in physiology. https://doi.org/10.3389/fphys.2023.1114231
BibTeX
@article{mecfsatlas-casanova-2023-mitochondria-all,
author = {Casanova, Amaloha and Wevers, Anne and Navarro-Ledesma, Santiago and Pruimboom, Leo},
title = {Mitochondria: It is all about energy.},
journal = {Frontiers in physiology},
year = {2023},
doi = {10.3389/fphys.2023.1114231},
note = {PubMed: 37179826},
url = {https://www.mecfsatlas.com/evidence/casanova-2023-mitochondria-all},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/casanova-2023-mitochondria-all
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