Lacourt, Tamara E, Vichaya, Elisabeth G, Chiu, Gabriel S et al. · Frontiers in behavioral neuroscience · 2018 · DOI
This study explores why people with ME/CFS experience persistent fatigue by examining how inflammation in the body may damage cells' ability to produce energy. The researchers propose that chronic inflammation forces cells to switch to a less efficient energy-production method, while at the same time the body may be spending energy at rates it cannot sustain, creating an energy crisis. Sleep problems and disrupted body rhythms may also play a role in this imbalance.
This work provides a testable mechanistic framework for understanding ME/CFS fatigue rooted in cellular energy metabolism and inflammation, moving beyond descriptive symptom accounts. If accurate, it suggests that interventions targeting metabolic switching, mitochondrial function, sleep, and circadian alignment could address fatigue at its physiological source rather than symptomatically.
This is a narrative review, not a primary experimental study, so it does not provide new empirical data proving the proposed mechanism in ME/CFS patients. The model describes correlation and proposed causality but does not establish that inflammation directly causes the metabolic switch or that preventing the switch would resolve fatigue. The review acknowledges limited mechanistic evidence specifically in cancer-related fatigue, leaving that connection uncertain.
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
Lacourt, Tamara E, Vichaya, Elisabeth G, Chiu, Gabriel S, Dantzer, Robert, & Heijnen, Cobi J (2018). The High Costs of Low-Grade Inflammation: Persistent Fatigue as a Consequence of Reduced Cellular-Energy Availability and Non-adaptive Energy Expenditure.. Frontiers in behavioral neuroscience. https://doi.org/10.3389/fnbeh.2018.00078
BibTeX
@article{mecfsatlas-lacourt-2018-high-costs,
author = {Lacourt, Tamara E and Vichaya, Elisabeth G and Chiu, Gabriel S and Dantzer, Robert and Heijnen, Cobi J},
title = {The High Costs of Low-Grade Inflammation: Persistent Fatigue as a Consequence of Reduced Cellular-Energy Availability and Non-adaptive Energy Expenditure.},
journal = {Frontiers in behavioral neuroscience},
year = {2018},
doi = {10.3389/fnbeh.2018.00078},
note = {PubMed: 29755330},
url = {https://www.mecfsatlas.com/evidence/lacourt-2018-high-costs},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/lacourt-2018-high-costs
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