Maksoud, Rebekah, Magawa, Chandi, Eaton-Fitch, Natalie et al. · BMC medicine · 2023 · DOI
Researchers reviewed 101 studies looking for biological markers (biomarkers) that could help diagnose ME/CFS. A biomarker is something measurable in your blood or body that shows a disease is present. While scientists found many potential biomarkers affecting the immune system, energy production, circulation, and other body functions, none have been proven reliable enough to use as a diagnostic test yet.
ME/CFS currently lacks an objective diagnostic test, requiring symptom-based diagnosis after excluding other conditions. This review synthesizes evidence on potential biomarkers that could eventually enable faster, more accurate diagnosis and advance understanding of disease mechanisms. Identifying reliable biomarkers is essential for developing targeted treatments and validating ME/CFS as a biological disease.
This review does not establish that any single biomarker can diagnose ME/CFS in clinical practice—it reveals that none have been adequately validated yet. The heterogeneity and poor reproducibility across studies means findings from one research group often cannot be confirmed by others. This review identifies promising research directions but does not prove causation between identified markers and ME/CFS pathology.
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
Maksoud, Rebekah, Magawa, Chandi, Eaton-Fitch, Natalie, Thapaliya, Kiran, & Marshall-Gradisnik, Sonya (2023). Biomarkers for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): a systematic review.. BMC medicine. https://doi.org/10.1186/s12916-023-02893-9
BibTeX
@article{mecfsatlas-maksoud-2023-biomarkers-myalgic,
author = {Maksoud, Rebekah and Magawa, Chandi and Eaton-Fitch, Natalie and Thapaliya, Kiran and Marshall-Gradisnik, Sonya},
title = {Biomarkers for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): a systematic review.},
journal = {BMC medicine},
year = {2023},
doi = {10.1186/s12916-023-02893-9},
note = {PubMed: 37226227},
url = {https://www.mecfsatlas.com/evidence/maksoud-2023-biomarkers-myalgic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/maksoud-2023-biomarkers-myalgic
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