Huth, Teilah Kathryn, Eaton-Fitch, Natalie, Staines, Donald et al. · Journal of translational medicine · 2020 · DOI
Researchers reviewed 11 studies that measured tiny chemical molecules (metabolites) in the blood and urine of ME/CFS patients to see if problems with these chemicals might explain the illness. While they found some patterns—especially with chemicals related to amino acids (building blocks of proteins)—the results were inconsistent across different studies. The researchers concluded that we don't yet have enough evidence that metabolite problems cause ME/CFS.
Understanding whether metabolic dysfunction drives ME/CFS symptoms is crucial for developing targeted treatments and biomarkers for diagnosis. This review identifies critical gaps in how metabolomics research is currently conducted, providing researchers with a roadmap for designing more rigorous studies that could eventually establish metabolic abnormalities as disease mechanisms or diagnostic markers.
This review does not prove that metabolic problems cause ME/CFS or are the primary mechanism of illness—it only shows that current evidence is too inconsistent to draw such conclusions. The findings do not rule out metabolic involvement; rather, they indicate that better-designed studies with standardized methods are needed to determine whether metabolic dysfunction is truly linked to disease pathogenesis.
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
Huth, Teilah Kathryn, Eaton-Fitch, Natalie, Staines, Donald, & Marshall-Gradisnik, Sonya (2020). A systematic review of metabolomic dysregulation in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis/Systemic Exertion Intolerance Disease (CFS/ME/SEID).. Journal of translational medicine. https://doi.org/10.1186/s12967-020-02356-2
BibTeX
@article{mecfsatlas-huth-2020-systematic-review,
author = {Huth, Teilah Kathryn and Eaton-Fitch, Natalie and Staines, Donald and Marshall-Gradisnik, Sonya},
title = {A systematic review of metabolomic dysregulation in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis/Systemic Exertion Intolerance Disease (CFS/ME/SEID).},
journal = {Journal of translational medicine},
year = {2020},
doi = {10.1186/s12967-020-02356-2},
note = {PubMed: 32404171},
url = {https://www.mecfsatlas.com/evidence/huth-2020-systematic-review},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/huth-2020-systematic-review
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