Kurup, Ravi Kumar, Kurup, Parameswara Achutha · Acta neuropsychiatrica · 2003 · DOI
This study looked at a set of chemical processes in the body called the isoprenoid pathway in 15 people with ME/CFS. Researchers found that several key molecules and minerals were out of balance in ME/CFS patients compared to expected levels, including low magnesium, low energy-producing compounds in cells, and imbalanced brain chemicals. These patterns were associated with increased oxidative stress (cellular damage from unstable molecules) and problems with how the immune system presents viral antigens.
This mechanistic study proposes specific biochemical abnormalities in ME/CFS affecting energy metabolism, neurotransmitter balance, and immune function—pathways that could explain cardinal symptoms like fatigue and cognitive dysfunction. If validated, these biomarkers could aid in objective diagnosis and guide targeted therapeutic interventions.
This study does not establish causation or directionality; biochemical abnormalities could be consequences rather than drivers of ME/CFS. The very small sample size, lack of matched controls, and absence of statistical analysis means findings cannot be considered generalizable or statistically significant. The proposed hemispheric dominance correlation is speculative and requires independent replication.
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
Kurup, Ravi Kumar & Kurup, Parameswara Achutha (2003). Isoprenoid pathway dysfunction in chronic fatigue syndrome.. Acta neuropsychiatrica. https://doi.org/10.1034/j.1601-5215.2003.00045.x
BibTeX
@article{mecfsatlas-kurup-2003-isoprenoid-pathway,
author = {Kurup, Ravi Kumar and Kurup, Parameswara Achutha},
title = {Isoprenoid pathway dysfunction in chronic fatigue syndrome.},
journal = {Acta neuropsychiatrica},
year = {2003},
doi = {10.1034/j.1601-5215.2003.00045.x},
note = {PubMed: 26983655},
url = {https://www.mecfsatlas.com/evidence/kurup-2003-isoprenoid-pathway},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/kurup-2003-isoprenoid-pathway
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