Suárez, Andrea, Guillamó, Elisabet, Roig, Teresa et al. · Journal of women's health (2002) · 2010 · DOI
This study looked at a chemical called nitric oxide in the blood of people with ME/CFS and healthy controls before and after exercise. Researchers found that people with ME/CFS had much higher levels of this chemical in their blood after exercise compared to healthy people. The findings suggest that measuring nitric oxide response to exercise might help doctors diagnose ME/CFS in the future.
ME/CFS lacks objective diagnostic biomarkers, making diagnosis primarily symptom-based and subject to delay or misdiagnosis. This study identifies a measurable biological difference in nitric oxide metabolism during exercise that may help develop an objective test. If validated, such a test could improve diagnostic accuracy and support the biological basis of ME/CFS.
This study does not prove that elevated nitrate production causes ME/CFS or explain the mechanism behind the abnormality. Correlation between nitrate levels and disease does not establish causation. The findings are also limited to women and would need replication in men and larger diverse populations before clinical adoption.
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
Suárez, Andrea, Guillamó, Elisabet, Roig, Teresa, Blázquez, Alicia, Alegre, José, Bermúdez, Jordi, et al. (2010). Nitric oxide metabolite production during exercise in chronic fatigue syndrome: a case-control study.. Journal of women's health (2002). https://doi.org/10.1089/jwh.2008.1255
BibTeX
@article{mecfsatlas-surez-2010-nitric-oxide,
author = {Suárez, Andrea and Guillamó, Elisabet and Roig, Teresa and Blázquez, Alicia and Alegre, José and Bermúdez, Jordi and Ventura, José Luis and García-Quintana, Ana María and Comella, Agustí and Segura, Ramon and Javierre, Casimiro},
title = {Nitric oxide metabolite production during exercise in chronic fatigue syndrome: a case-control study.},
journal = {Journal of women's health (2002)},
year = {2010},
doi = {10.1089/jwh.2008.1255},
note = {PubMed: 20469961},
url = {https://www.mecfsatlas.com/evidence/surez-2010-nitric-oxide},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/surez-2010-nitric-oxide
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