Christoforou, Maritsa E, van Campen, Linda C, Visser, Frans C et al. · Cureus · 2026 · DOI
This study looked at five ME/CFS patients who also had mast cell activation syndrome (a condition where immune cells release too many chemicals). These patients took a medication called cromolyn sodium in higher doses than usual—up to 2400 mg per day instead of the standard 800 mg—by sipping it continuously throughout the day rather than taking four separate doses. All five patients reported improvements in their symptoms.
Many ME/CFS patients experience mast cell activation as a complicating condition, and this report suggests that higher-dose cromolyn with continuous dosing may benefit a subset of these patients. The novel delivery method could improve medication compliance compared to standard four-times-daily regimens. This finding warrants further investigation through larger prospective trials.
This case series cannot establish that high-dose cromolyn is effective for all ME/CFS patients or even for most patients with MCAS—it describes only five cases. It does not prove causation or determine whether symptom improvement was due to cromolyn, the continuous dosing method, placebo effect, or natural disease fluctuation. Larger controlled trials are needed before recommending this approach as standard practice.
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
Christoforou, Maritsa E, van Campen, Linda C, Visser, Frans C, Lee, Carlton K, Lemmon, Samantha L, Rowe, Peter C, et al. (2026). A Continuous Oral Regimen of High-Dose Cromolyn Sodium Is Effective for Some Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Patients With Mast Cell Activation Syndrome.. Cureus. https://doi.org/10.7759/cureus.102064
BibTeX
@article{mecfsatlas-christoforou-2026-continuous-oral,
author = {Christoforou, Maritsa E and van Campen, Linda C and Visser, Frans C and Lee, Carlton K and Lemmon, Samantha L and Rowe, Peter C and Azola, Alba M},
title = {A Continuous Oral Regimen of High-Dose Cromolyn Sodium Is Effective for Some Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Patients With Mast Cell Activation Syndrome.},
journal = {Cureus},
year = {2026},
doi = {10.7759/cureus.102064},
note = {PubMed: 41728426},
url = {https://www.mecfsatlas.com/evidence/christoforou-2026-continuous-oral},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/christoforou-2026-continuous-oral
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