Roerink, M E, Lenders, J W M, Schmits, I C et al. · Journal of internal medicine · 2017 · DOI
This study tested whether a condition called POTS (postural orthostatic tachycardia syndrome)—where heart rate increases too much when standing—is a reliable marker for ME/CFS. Researchers found that POTS was equally common in ME/CFS patients and in people with fatigue who don't have ME/CFS, suggesting POTS is not a useful diagnostic tool for ME/CFS. The study did find that adolescents with both conditions responded less well to cognitive behavioral therapy than those with ME/CFS alone.
This research challenges the assumption that POTS can be used to diagnose or characterize ME/CFS, potentially refocusing diagnostic efforts toward more specific biomarkers. For patients, it clarifies that POTS presence or absence does not define ME/CFS diagnosis. The finding that POTS may predict worse CBT response in adolescents could inform treatment selection and expectations.
This study does not establish whether POTS plays any pathophysiological role in ME/CFS—only that it is not a reliable diagnostic marker. The observational design cannot prove causation or whether POTS subtypes differ between groups. Results from a single Dutch tertiary center may not generalize to other populations or diagnostic settings.
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
Roerink, M E, Lenders, J W M, Schmits, I C, Pistorius, A M A, Smit, J W, Knoop, H, et al. (2017). Postural orthostatic tachycardia is not a useful diagnostic marker for chronic fatigue syndrome.. Journal of internal medicine. https://doi.org/10.1111/joim.12564
BibTeX
@article{mecfsatlas-roerink-2017-postural-orthostatic,
author = {Roerink, M E and Lenders, J W M and Schmits, I C and Pistorius, A M A and Smit, J W and Knoop, H and van der Meer, J W M},
title = {Postural orthostatic tachycardia is not a useful diagnostic marker for chronic fatigue syndrome.},
journal = {Journal of internal medicine},
year = {2017},
doi = {10.1111/joim.12564},
note = {PubMed: 27696568},
url = {https://www.mecfsatlas.com/evidence/roerink-2017-postural-orthostatic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/roerink-2017-postural-orthostatic
Contribute
Private, reviewed by a human. Not a public comment thread.