Mikirova, Nina, Casciari, Joseph, Hunninghake, Ronald · Alternative therapies in health and medicine · 2012
This study tested whether measuring a specific molecule in the blood called NAD(P)H could help diagnose and monitor ME/CFS. The researchers found that people with ME/CFS had lower levels of this energy-related molecule compared to healthy people, and this difference might be useful as a blood test marker for the disease.
ME/CFS currently lacks an objective diagnostic biomarker, making diagnosis challenging and delaying treatment. If validated in larger populations, a blood test measuring NAD(P)H could enable earlier diagnosis, track disease severity, and help evaluate whether treatments are working by objectively measuring metabolic function.
This study does not prove that low NAD(P)H causes ME/CFS fatigue or that treating it would improve symptoms. The cross-sectional design shows correlation but not causation, and the small sample size means results must be replicated in larger, multi-site cohorts before clinical adoption. The study also does not track whether NAD(P)H levels change with disease progression or treatment response.
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
Mikirova, Nina, Casciari, Joseph, & Hunninghake, Ronald (2012). The assessment of the energy metabolism in patients with chronic fatigue syndrome by serum fluorescence emission.. Alternative therapies in health and medicine. https://pubmed.ncbi.nlm.nih.gov/22516851/
BibTeX
@article{mecfsatlas-mikirova-2012-assessment-energy,
author = {Mikirova, Nina and Casciari, Joseph and Hunninghake, Ronald},
title = {The assessment of the energy metabolism in patients with chronic fatigue syndrome by serum fluorescence emission.},
journal = {Alternative therapies in health and medicine},
year = {2012},
note = {PubMed: 22516851},
url = {https://www.mecfsatlas.com/evidence/mikirova-2012-assessment-energy},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/mikirova-2012-assessment-energy
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