Rutherford, Gina, Manning, Philip, Newton, Julia L · Journal of aging research · 2016 · DOI
This review examined research showing that people with ME/CFS may have problems with how their muscles produce and use energy. Specifically, their muscles appear to rely too heavily on a less efficient energy pathway (lactate dehydrogenase) during and after exercise, and they have difficulty clearing the acidic byproducts that build up. These muscle-level energy problems could explain why ME/CFS patients experience severe fatigue and difficulty maintaining physical activity.
Understanding that ME/CFS involves measurable muscle-level energy metabolism problems provides biological validation for patients' experiences and shifts focus from psychological explanations to treatable biochemical dysfunction. This work supports the need for interventions targeting bioenergetic pathways and exercise protocols that account for abnormal lactate metabolism and acid clearance.
This review does not establish causation—abnormal lactate metabolism and acid clearance could be consequences rather than causes of ME/CFS. It does not identify which molecular mechanisms are primary drivers versus secondary effects, nor does it prove these findings apply uniformly across all ME/CFS patients. As a narrative review synthesis, it cannot validate the methodological quality of included studies or establish definitive prevalence of these findings.
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
Rutherford, Gina, Manning, Philip, & Newton, Julia L (2016). Understanding Muscle Dysfunction in Chronic Fatigue Syndrome.. Journal of aging research. https://doi.org/10.1155/2016/2497348
BibTeX
@article{mecfsatlas-rutherford-2016-understanding-muscle,
author = {Rutherford, Gina and Manning, Philip and Newton, Julia L},
title = {Understanding Muscle Dysfunction in Chronic Fatigue Syndrome.},
journal = {Journal of aging research},
year = {2016},
doi = {10.1155/2016/2497348},
note = {PubMed: 26998359},
url = {https://www.mecfsatlas.com/evidence/rutherford-2016-understanding-muscle},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/rutherford-2016-understanding-muscle
Contribute
Private, reviewed by a human. Not a public comment thread.