Natelson, Benjamin H, Vu, Diana, Coplan, Jeremy D et al. · Fatigue : biomedicine, health & behavior · 2017 · DOI
Researchers used brain imaging to measure a substance called lactate in the fluid around the brain in people with ME/CFS, fibromyalgia, both conditions together, and healthy people. They found that lactate levels were higher in all three patient groups compared to healthy controls, but the levels were similar among the three patient groups. This means lactate alone cannot be used to distinguish ME/CFS from fibromyalgia.
This study provides neurobiological evidence that ME/CFS and fibromyalgia may share a common underlying metabolic abnormality—elevated brain lactate—even if they are distinct disorders. Understanding shared versus unique biological features helps researchers develop better diagnostic tools and targeted treatments for these debilitating conditions.
This study does not prove that elevated lactate causes ME/CFS or fibromyalgia, only that it is associated with both conditions. It does not establish whether lactate elevation is a primary disease mechanism or a secondary consequence of another underlying process. The study's cross-sectional design cannot determine whether lactate changes over time or respond to treatment.
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
Natelson, Benjamin H, Vu, Diana, Coplan, Jeremy D, Mao, Xiangling, Blate, Michelle, Kang, Guoxin, et al. (2017). Elevations of Ventricular Lactate Levels Occur in Both Chronic Fatigue Syndrome and Fibromyalgia.. Fatigue : biomedicine, health & behavior. https://doi.org/10.1080/21641846.2017.1280114
BibTeX
@article{mecfsatlas-natelson-2017-elevations-ventricular,
author = {Natelson, Benjamin H and Vu, Diana and Coplan, Jeremy D and Mao, Xiangling and Blate, Michelle and Kang, Guoxin and Soto, Eli and Kapusuz, Tolga and Shungu, Dikoma C},
title = {Elevations of Ventricular Lactate Levels Occur in Both Chronic Fatigue Syndrome and Fibromyalgia.},
journal = {Fatigue : biomedicine, health & behavior},
year = {2017},
doi = {10.1080/21641846.2017.1280114},
note = {PubMed: 29308330},
url = {https://www.mecfsatlas.com/evidence/natelson-2017-elevations-ventricular},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/natelson-2017-elevations-ventricular
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