Ramírez-Morales, Ricardo, Bermúdez-Benítez, Elyzabeth, Martínez-Martínez, Laura-Aline et al. · Autoimmunity reviews · 2022 · DOI
This study looked at how often fibromyalgia and ME/CFS occur together in the same patients by reviewing 21 published research papers. The researchers found that nearly half of people diagnosed with one condition also had the other condition. This overlap suggests these two illnesses share common features, particularly fatigue, unrefreshing sleep, and brain fog.
Understanding the overlap between fibromyalgia and ME/CFS is crucial because patients with both conditions may benefit from integrated diagnostic approaches and tailored treatment strategies. This finding validates the lived experience of many patients who struggle with overlapping symptoms and helps guide clinicians in recognizing and diagnosing these interconnected conditions more effectively.
This meta-analysis demonstrates correlation and overlap but does not establish whether fibromyalgia and ME/CFS are the same disease, distinct disorders with shared features, or whether one causes the other. The high heterogeneity across studies and reliance on older diagnostic criteria means the true overlap may differ from the reported 47.3% estimate. The study cannot determine causative mechanisms or explain why these conditions co-occur.
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
Ramírez-Morales, Ricardo, Bermúdez-Benítez, Elyzabeth, Martínez-Martínez, Laura-Aline, & Martínez-Lavín, Manuel (2022). Clinical overlap between fibromyalgia and myalgic encephalomyelitis. A systematic review and meta-analysis.. Autoimmunity reviews. https://doi.org/10.1016/j.autrev.2022.103129
BibTeX
@article{mecfsatlas-ramrez-morales-2022-clinical-overlap,
author = {Ramírez-Morales, Ricardo and Bermúdez-Benítez, Elyzabeth and Martínez-Martínez, Laura-Aline and Martínez-Lavín, Manuel},
title = {Clinical overlap between fibromyalgia and myalgic encephalomyelitis. A systematic review and meta-analysis.},
journal = {Autoimmunity reviews},
year = {2022},
doi = {10.1016/j.autrev.2022.103129},
note = {PubMed: 35690247},
url = {https://www.mecfsatlas.com/evidence/ramrez-morales-2022-clinical-overlap},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/ramrez-morales-2022-clinical-overlap
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