Miwa, Kunihisa, Fujita, Masatoshi · Heart and vessels · 2010 · DOI
This study examined whether people with ME/CFS have lower levels of vitamin E, an important antioxidant that protects cells from damage. Researchers found that ME/CFS patients had significantly lower vitamin E levels than healthy controls, and these levels improved when patients went into remission, suggesting that oxidative stress (cellular damage from chemical imbalances) may play a role in ME/CFS.
This study provides biochemical evidence linking oxidative stress to ME/CFS pathology and suggests that measuring vitamin E levels might reflect disease activity or severity. Understanding oxidative stress mechanisms could lead to new diagnostic markers or therapeutic targets for ME/CFS, an illness where objective biomarkers remain limited.
This study does not prove that oxidative stress causes ME/CFS—only that it correlates with disease state. It does not establish whether low vitamin E is a cause of symptoms, a consequence of the disease process, or an independent finding. The small sample size and single time-point measurements limit generalizability and cannot establish causality.
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
Miwa, Kunihisa & Fujita, Masatoshi (2010). Fluctuation of serum vitamin E (alpha-tocopherol) concentrations during exacerbation and remission phases in patients with chronic fatigue syndrome.. Heart and vessels. https://doi.org/10.1007/s00380-009-1206-6
BibTeX
@article{mecfsatlas-miwa-2010-fluctuation-serum,
author = {Miwa, Kunihisa and Fujita, Masatoshi},
title = {Fluctuation of serum vitamin E (alpha-tocopherol) concentrations during exacerbation and remission phases in patients with chronic fatigue syndrome.},
journal = {Heart and vessels},
year = {2010},
doi = {10.1007/s00380-009-1206-6},
note = {PubMed: 20676841},
url = {https://www.mecfsatlas.com/evidence/miwa-2010-fluctuation-serum},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/miwa-2010-fluctuation-serum
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