Ghali, Alaa, Lacout, Carole, Ghali, Maria et al. · Scientific reports · 2019 · DOI
This study looked at lactate levels (a substance produced by muscles) in the blood of ME/CFS patients who were at rest. Researchers found that about 45% of patients had higher-than-normal lactate levels even when not exercising. Importantly, patients with elevated resting lactate tended to experience more severe post-exertional malaise (the symptom flare-ups that follow physical activity).
This study provides objective biological evidence that resting lactate elevation may be a measurable biomarker in a subset of ME/CFS patients, potentially helping identify those at risk for severe post-exertional malaise. Identifying such biomarkers is important for understanding disease mechanisms and could eventually inform personalized management strategies.
This study does not prove that elevated lactate causes post-exertional malaise or identify the underlying mechanism. The retrospective design and lack of control group limits causal inference. The study cannot determine whether lactate elevation is primary or secondary to other disease processes, nor does it establish whether resting lactate predicts PEM severity prospectively.
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
Ghali, Alaa, Lacout, Carole, Ghali, Maria, Gury, Aline, Beucher, Anne-Berengere, Lozac'h, Pierre, et al. (2019). Elevated blood lactate in resting conditions correlate with post-exertional malaise severity in patients with Myalgic encephalomyelitis/Chronic fatigue syndrome.. Scientific reports. https://doi.org/10.1038/s41598-019-55473-4
BibTeX
@article{mecfsatlas-ghali-2019-elevated-blood,
author = {Ghali, Alaa and Lacout, Carole and Ghali, Maria and Gury, Aline and Beucher, Anne-Berengere and Lozac'h, Pierre and Lavigne, Christian and Urbanski, Geoffrey},
title = {Elevated blood lactate in resting conditions correlate with post-exertional malaise severity in patients with Myalgic encephalomyelitis/Chronic fatigue syndrome.},
journal = {Scientific reports},
year = {2019},
doi = {10.1038/s41598-019-55473-4},
note = {PubMed: 31827223},
url = {https://www.mecfsatlas.com/evidence/ghali-2019-elevated-blood},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/ghali-2019-elevated-blood
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