Marcusson, J A, Lindh, G, Evengård, B · Contact dermatitis · 1999 · DOI
This study tested 50 patients with ME/CFS and 73 healthy people for allergic reactions to eight different metals. Researchers found that people with ME/CFS were more likely to be allergic to nickel—36% of ME/CFS patients had nickel allergies compared to only 19% of healthy people. This difference was especially pronounced in women with ME/CFS, where over half (52%) showed nickel allergy. The researchers suggest that nickel exposure might somehow trigger or contribute to ME/CFS in some people.
Understanding potential environmental triggers like metal allergies could help identify subgroups of ME/CFS patients and inform management strategies. The striking sex-based difference in nickel allergy prevalence raises important questions about immunological sex differences in ME/CFS pathogenesis.
This study does not prove that nickel allergy causes ME/CFS—it only shows an association. The study cannot establish whether nickel sensitivity triggers illness, results from illness-related immune changes, or is coincidental. Correlation between two conditions does not indicate causation, and replication studies with larger, well-characterized populations are needed.
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
Marcusson, J A, Lindh, G, & Evengård, B (1999). Chronic fatigue syndrome and nickel allergy.. Contact dermatitis. https://doi.org/10.1111/j.1600-0536.1999.tb06061.x
BibTeX
@article{mecfsatlas-marcusson-1999-chronic-fatigue,
author = {Marcusson, J A and Lindh, G and Evengård, B},
title = {Chronic fatigue syndrome and nickel allergy.},
journal = {Contact dermatitis},
year = {1999},
doi = {10.1111/j.1600-0536.1999.tb06061.x},
note = {PubMed: 10344482},
url = {https://www.mecfsatlas.com/evidence/marcusson-1999-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/marcusson-1999-chronic-fatigue
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