Germain, Arnaud, Ruppert, David, Levine, Susan M et al. · Molecular bioSystems · 2017 · DOI
This study examined the chemicals in the blood of 17 ME/CFS patients and compared them to 15 healthy people. Researchers found 74 different chemicals at abnormal levels in ME/CFS patients, with 35 showing significant differences. Many of these chemicals are important for producing energy in the body, which could help explain why ME/CFS patients feel so exhausted.
This research provides potential metabolic biomarkers that could help diagnose ME/CFS objectively, addressing a major gap since no current biological tests confirm the disease. Understanding which metabolic pathways are disrupted offers insights into why patients experience profound fatigue and could guide development of targeted treatments.
This study does not prove that metabolic abnormalities cause ME/CFS—it only shows they are associated with the disease. The small sample size and lack of independent replication mean these findings must be confirmed in larger studies before use in clinical diagnosis. The cross-sectional design cannot establish whether metabolic changes occur before, during, or after disease onset.
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
Germain, Arnaud, Ruppert, David, Levine, Susan M, & Hanson, Maureen R (2017). Metabolic profiling of a myalgic encephalomyelitis/chronic fatigue syndrome discovery cohort reveals disturbances in fatty acid and lipid metabolism.. Molecular bioSystems. https://doi.org/10.1039/c6mb00600k
BibTeX
@article{mecfsatlas-germain-2017-metabolic-profiling,
author = {Germain, Arnaud and Ruppert, David and Levine, Susan M and Hanson, Maureen R},
title = {Metabolic profiling of a myalgic encephalomyelitis/chronic fatigue syndrome discovery cohort reveals disturbances in fatty acid and lipid metabolism.},
journal = {Molecular bioSystems},
year = {2017},
doi = {10.1039/c6mb00600k},
note = {PubMed: 28059425},
url = {https://www.mecfsatlas.com/evidence/germain-2017-metabolic-profiling},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/germain-2017-metabolic-profiling
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