Maksoud, Rebekah, Balinas, Cassandra, Holden, Sean et al. · Journal of translational medicine · 2021 · DOI
This review looked at whether special supplements that target the energy-producing parts of cells (mitochondria) might help ME/CFS patients feel less fatigued. The researchers searched for published studies testing these supplements in ME/CFS patients and found 9 studies. About two-thirds of these studies showed some improvement in fatigue, but the overall evidence isn't strong enough yet to say these supplements definitely work.
This review is important because ME/CFS lacks approved treatments and a clear understanding of its underlying mechanisms. By systematically evaluating whether mitochondrial-targeting supplements help, this work helps both patients and clinicians understand what evidence currently exists and guides future research priorities in this understudied area.
This review does not prove that mitochondrial dysfunction causes ME/CFS or that these supplements are effective treatments. The mixed results across studies and acknowledged methodological weaknesses mean we cannot yet conclude whether any particular nutraceutical reliably reduces fatigue. Positive findings in some studies do not establish causation or demonstrate that mitochondrial targeting is the mechanism of any benefit.
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
Maksoud, Rebekah, Balinas, Cassandra, Holden, Sean, Cabanas, Hélène, Staines, Donald, & Marshall-Gradisnik, Sonya (2021). A systematic review of nutraceutical interventions for mitochondrial dysfunctions in myalgic encephalomyelitis/chronic fatigue syndrome.. Journal of translational medicine. https://doi.org/10.1186/s12967-021-02742-4
BibTeX
@article{mecfsatlas-maksoud-2021-systematic-review-2,
author = {Maksoud, Rebekah and Balinas, Cassandra and Holden, Sean and Cabanas, Hélène and Staines, Donald and Marshall-Gradisnik, Sonya},
title = {A systematic review of nutraceutical interventions for mitochondrial dysfunctions in myalgic encephalomyelitis/chronic fatigue syndrome.},
journal = {Journal of translational medicine},
year = {2021},
doi = {10.1186/s12967-021-02742-4},
note = {PubMed: 33596913},
url = {https://www.mecfsatlas.com/evidence/maksoud-2021-systematic-review-2},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/maksoud-2021-systematic-review-2
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