Otero, Eduardo, Gálvez, Isabel, Ortega, Eduardo et al. · Biomedicines · 2023 · DOI
This study compared women with fibromyalgia (FM), some of whom also had been diagnosed with chronic fatigue syndrome (CFS), to healthy women. Researchers measured both what patients reported feeling (like stress and pain levels) and actual biological markers in their blood (like stress hormones and immune chemicals). They found that FM patients generally felt worse than healthy women, and their blood work matched this—showing higher stress hormones and lower mood-boosting chemicals. Interestingly, FM patients who also had a CFS diagnosis showed different blood markers than those with FM alone, suggesting these two conditions may overlap in ways that current diagnosis methods don't catch.
This research highlights a critical diagnostic challenge: ME/CFS and fibromyalgia may be misdiagnosed or confused because subjective symptoms overlap significantly. By demonstrating that objective biomarkers reveal biological differences between these conditions, the study supports the case for blood tests and other objective measures to distinguish them—potentially improving diagnosis and treatment for both patient groups.
This study does not prove that CFS is overdiagnosed in FM populations generally, only that biomarker patterns suggest potential overdiagnosis in this particular sample. It is a cross-sectional snapshot and cannot establish causation or whether these biomarker differences actually explain clinical outcomes. The study also does not determine which biomarkers would be most useful in clinical practice for differential diagnosis.
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
Otero, Eduardo, Gálvez, Isabel, Ortega, Eduardo, & Hinchado, María Dolores (2023). Influence of Chronic Fatigue Syndrome Codiagnosis on the Relationship between Perceived and Objective Psychoneuro-Immunoendocrine Disorders in Women with Fibromyalgia.. Biomedicines. https://doi.org/10.3390/biomedicines11051488
BibTeX
@article{mecfsatlas-otero-2023-influence-chronic,
author = {Otero, Eduardo and Gálvez, Isabel and Ortega, Eduardo and Hinchado, María Dolores},
title = {Influence of Chronic Fatigue Syndrome Codiagnosis on the Relationship between Perceived and Objective Psychoneuro-Immunoendocrine Disorders in Women with Fibromyalgia.},
journal = {Biomedicines},
year = {2023},
doi = {10.3390/biomedicines11051488},
note = {PubMed: 37239159},
url = {https://www.mecfsatlas.com/evidence/otero-2023-influence-chronic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/otero-2023-influence-chronic
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