Nagy-Szakal, Dorottya, Barupal, Dinesh K, Lee, Bohyun et al. · Scientific reports · 2018 · DOI
Researchers studied blood and gut bacteria samples from 50 people with ME/CFS and 50 healthy people to find biological markers of the disease. They found that people with ME/CFS have abnormal levels of certain substances in their blood called metabolites, particularly a fatty molecule called ceramide in those who also have irritable bowel syndrome. When scientists combined information about both blood metabolites and gut bacteria, they could identify ME/CFS patients more accurately than using either test alone.
This study provides objective biological markers that could eventually lead to better diagnostic tests for ME/CFS, potentially ending the long diagnostic odyssey many patients experience. The discovery of distinct metabolic signatures in ME/CFS subgroups (particularly those with IBS) suggests that personalized treatment approaches may be possible. These findings strengthen evidence that ME/CFS has measurable biological underpinnings rather than being primarily psychological.
This study does not prove that the identified metabolic changes cause ME/CFS symptoms—they may be consequences of the disease rather than causes. The findings cannot be generalized to all ME/CFS patients since the study involved only 50 patients and did not explore the full diversity of ME/CFS presentations. The study also does not establish whether these biomarkers can be used for routine clinical diagnosis without validation in larger, prospective populations.
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
Nagy-Szakal, Dorottya, Barupal, Dinesh K, Lee, Bohyun, Che, Xiaoyu, Williams, Brent L, Kahn, Ellie J R, et al. (2018). Insights into myalgic encephalomyelitis/chronic fatigue syndrome phenotypes through comprehensive metabolomics.. Scientific reports. https://doi.org/10.1038/s41598-018-28477-9
BibTeX
@article{mecfsatlas-nagy-szakal-2018-insights-into,
author = {Nagy-Szakal, Dorottya and Barupal, Dinesh K and Lee, Bohyun and Che, Xiaoyu and Williams, Brent L and Kahn, Ellie J R and Ukaigwe, Joy E and Bateman, Lucinda and Klimas, Nancy G and Komaroff, Anthony L and Levine, Susan and Montoya, Jose G and Peterson, Daniel L and Levin, Bruce and Hornig, Mady and Fiehn, Oliver and Lipkin, W Ian},
title = {Insights into myalgic encephalomyelitis/chronic fatigue syndrome phenotypes through comprehensive metabolomics.},
journal = {Scientific reports},
year = {2018},
doi = {10.1038/s41598-018-28477-9},
note = {PubMed: 29968805},
url = {https://www.mecfsatlas.com/evidence/nagy-szakal-2018-insights-into},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/nagy-szakal-2018-insights-into
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