Goldenberg, Don L · Seminars in arthritis and rheumatism · 2024 · DOI
This study examines how long COVID, ME/CFS, fibromyalgia, and irritable bowel syndrome are similar conditions that all affect the nervous system and immune system together. Rather than being separate diseases, these conditions share common features and may work through the same underlying biological mechanisms. The researchers reviewed existing evidence and found striking similarities in how these conditions develop and affect patients.
This work is significant because it provides a unifying framework for understanding ME/CFS within a broader spectrum of related neuroimmune conditions, potentially accelerating research and validating patient experiences of symptom overlap. Recognition of these similarities may improve clinical recognition, reduce diagnostic delays, and guide researchers toward common therapeutic targets. For ME/CFS patients, this positioning strengthens the biological legitimacy of the condition and supports advocacy for appropriate research funding and clinical attention.
This systematic review does not establish causality or definitively prove that these conditions are manifestations of a single disease entity. It cannot determine whether observed similarities reflect shared mechanisms or are coincidental features, nor does it identify specific biomarkers or diagnostic tests to distinguish between conditions. The review does not establish treatment efficacy for any of these overlapping conditions.
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
Goldenberg, Don L (2024). How to understand the overlap of long COVID, chronic fatigue syndrome/myalgic encephalomyelitis, fibromyalgia and irritable bowel syndromes.. Seminars in arthritis and rheumatism. https://doi.org/10.1016/j.semarthrit.2024.152455
BibTeX
@article{mecfsatlas-goldenberg-2024-how-understand,
author = {Goldenberg, Don L},
title = {How to understand the overlap of long COVID, chronic fatigue syndrome/myalgic encephalomyelitis, fibromyalgia and irritable bowel syndromes.},
journal = {Seminars in arthritis and rheumatism},
year = {2024},
doi = {10.1016/j.semarthrit.2024.152455},
note = {PubMed: 38761526},
url = {https://www.mecfsatlas.com/evidence/goldenberg-2024-how-understand},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/goldenberg-2024-how-understand
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