Jones, David E J, Hollingsworth, Kieren G, Jakovljevic, Djordje G et al. · European journal of clinical investigation · 2012 · DOI
This study looked at how muscles produce and use energy during exercise in ME/CFS patients compared to healthy people. Researchers found that ME/CFS patients' muscles became more acidic (like buildup of lactic acid) during exercise and took much longer to recover back to normal levels, even after repeated exercise sessions. This abnormal response to exercise may explain why some ME/CFS patients feel worse after exertion rather than better.
This study provides mechanistic evidence for post-exertional malaise by demonstrating a specific muscle bioenergetic abnormality—impaired acid clearance—in ME/CFS patients. Understanding this physiological basis could guide development of targeted interventions and identify which patients might safely benefit from exercise therapy versus those at risk of harm.
This study does not prove that acidosis is the primary cause of ME/CFS or post-exertional malaise, only that it is associated with abnormal exercise response in a subset of patients. The small sample size and cross-sectional design prevent conclusions about causation or long-term disease progression. The study also cannot determine whether this bioenergetic abnormality predates ME/CFS onset or develops as a consequence of the disease.
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
Jones, David E J, Hollingsworth, Kieren G, Jakovljevic, Djordje G, Fattakhova, Gulnar, Pairman, Jessie, Blamire, Andrew M, et al. (2012). Loss of capacity to recover from acidosis on repeat exercise in chronic fatigue syndrome: a case-control study.. European journal of clinical investigation. https://doi.org/10.1111/j.1365-2362.2011.02567.x
BibTeX
@article{mecfsatlas-jones-2012-loss-capacity,
author = {Jones, David E J and Hollingsworth, Kieren G and Jakovljevic, Djordje G and Fattakhova, Gulnar and Pairman, Jessie and Blamire, Andrew M and Trenell, Michael I and Newton, Julia L},
title = {Loss of capacity to recover from acidosis on repeat exercise in chronic fatigue syndrome: a case-control study.},
journal = {European journal of clinical investigation},
year = {2012},
doi = {10.1111/j.1365-2362.2011.02567.x},
note = {PubMed: 21749371},
url = {https://www.mecfsatlas.com/evidence/jones-2012-loss-capacity},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/jones-2012-loss-capacity
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