McGregor, N R, Dunstan, R H, Zerbes, M et al. · Biochemical and molecular medicine · 1996 · DOI
Researchers found that ME/CFS patients have a distinctive substance in their urine called CFSUM1 that is rarely found in healthy people. This study examined whether certain chemicals in urine could be linked to the different symptoms ME/CFS patients experience, such as fatigue, cognitive problems, muscle pain, and digestive issues. They discovered that two specific urine metabolites—CFSUM1 and beta-alanine—were strongly associated with symptom severity, suggesting these could eventually be used as biological markers for diagnosing ME/CFS.
This study provides preliminary evidence that ME/CFS may have measurable biological markers in urine that correlate with symptom patterns, which could lead to objective diagnostic tests rather than relying solely on symptom reporting. Identifying metabolite signatures associated with specific symptom clusters offers insights into the biological mechanisms underlying different ME/CFS presentations and may guide future targeted research.
This study does not prove that CFSUM1 or beta-alanine cause ME/CFS symptoms or that these metabolites are reliable diagnostic markers—association does not establish causation. The cross-sectional design cannot determine whether metabolite changes precede, follow, or are incidental to symptom development. The small sample size and single time-point measurements limit generalizability and do not establish whether these metabolites would reliably distinguish ME/CFS from other conditions.
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
McGregor, N R, Dunstan, R H, Zerbes, M, Butt, H L, Roberts, T K, & Klineberg, I J (1996). Preliminary determination of the association between symptom expression and urinary metabolites in subjects with chronic fatigue syndrome.. Biochemical and molecular medicine. https://doi.org/10.1006/bmme.1996.0036
BibTeX
@article{mecfsatlas-mcgregor-1996-preliminary-determination-2,
author = {McGregor, N R and Dunstan, R H and Zerbes, M and Butt, H L and Roberts, T K and Klineberg, I J},
title = {Preliminary determination of the association between symptom expression and urinary metabolites in subjects with chronic fatigue syndrome.},
journal = {Biochemical and molecular medicine},
year = {1996},
doi = {10.1006/bmme.1996.0036},
note = {PubMed: 8809350},
url = {https://www.mecfsatlas.com/evidence/mcgregor-1996-preliminary-determination-2},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/mcgregor-1996-preliminary-determination-2
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