Morris, Gerwyn, Puri, Basant K, Walker, Adam J et al. · Pharmacological research · 2019 · DOI
This review examines what goes wrong in the bodies of ME/CFS patients and looks at treatments that might help. Researchers found that ME/CFS involves several biological problems, including inflammation, increased cellular stress, gut problems, and energy production issues. The review highlights five promising supplements—coenzyme Q10, melatonin, curcumin, molecular hydrogen, and N-acetylcysteine—that target these problems, though much more testing is needed.
ME/CFS lacks established, effective, evidence-based treatments, representing a significant unmet clinical need affecting millions. This review identifies specific biological pathways amenable to targeted intervention and highlights candidate therapeutics based on mechanistic understanding rather than empiricism, potentially redirecting research toward more effective treatments.
This systematic review does not prove that any of the proposed supplements are clinically effective in ME/CFS patients—the evidence reviewed remains preliminary and mostly preclinical. The review cannot establish causation between the identified pathophysiological abnormalities and ME/CFS symptoms, nor can it determine which abnormalities are primary versus secondary. Clinical efficacy requires rigorous randomized controlled trials, which are largely absent for these interventions.
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
Morris, Gerwyn, Puri, Basant K, Walker, Adam J, Maes, Michael, Carvalho, Andre F, Walder, Ken, et al. (2019). Myalgic encephalomyelitis/chronic fatigue syndrome: From pathophysiological insights to novel therapeutic opportunities.. Pharmacological research. https://doi.org/10.1016/j.phrs.2019.104450
BibTeX
@article{mecfsatlas-morris-2019-myalgic-encephalomyelitis,
author = {Morris, Gerwyn and Puri, Basant K and Walker, Adam J and Maes, Michael and Carvalho, Andre F and Walder, Ken and Mazza, Catherine and Berk, Michael},
title = {Myalgic encephalomyelitis/chronic fatigue syndrome: From pathophysiological insights to novel therapeutic opportunities.},
journal = {Pharmacological research},
year = {2019},
doi = {10.1016/j.phrs.2019.104450},
note = {PubMed: 31509764},
url = {https://www.mecfsatlas.com/evidence/morris-2019-myalgic-encephalomyelitis},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/morris-2019-myalgic-encephalomyelitis
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