Regland, B, Andersson, M, Abrahamsson, L et al. · Scandinavian journal of rheumatology · 1997 · DOI
Researchers tested the spinal fluid of 12 women who had both fibromyalgia and ME/CFS and found unusually high levels of a molecule called homocysteine in their brains and spinal cords. They also noticed that patients with lower vitamin B12 levels in their spinal fluid reported more severe fatigue. This suggests that a vitamin B12 deficiency might prevent the body from properly breaking down homocysteine, which could contribute to symptoms like exhaustion.
This study provides early evidence of a specific biochemical abnormality in the central nervous system of ME/CFS patients, moving beyond symptoms to identify potential underlying mechanisms. If replicated, elevated CSF homocysteine could become a biomarker for disease and vitamin B12 supplementation could be explored as a therapeutic target.
This study does not prove that homocysteine elevation *causes* ME/CFS or fibromyalgia—it only shows a correlation. The small sample size, lack of control group, and female-only population limit generalizability. The study does not establish whether B12 supplementation would reduce homocysteine or improve fatigue.
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
Regland, B, Andersson, M, Abrahamsson, L, Bagby, J, Dyrehag, L E, & Gottfries, C G (1997). Increased concentrations of homocysteine in the cerebrospinal fluid in patients with fibromyalgia and chronic fatigue syndrome.. Scandinavian journal of rheumatology. https://doi.org/10.3109/03009749709105320
BibTeX
@article{mecfsatlas-regland-1997-increased-concentrations,
author = {Regland, B and Andersson, M and Abrahamsson, L and Bagby, J and Dyrehag, L E and Gottfries, C G},
title = {Increased concentrations of homocysteine in the cerebrospinal fluid in patients with fibromyalgia and chronic fatigue syndrome.},
journal = {Scandinavian journal of rheumatology},
year = {1997},
doi = {10.3109/03009749709105320},
note = {PubMed: 9310111},
url = {https://www.mecfsatlas.com/evidence/regland-1997-increased-concentrations},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/regland-1997-increased-concentrations
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