Taccori, Asher, Maksoud, Rebekah, Eaton-Fitch, Natalie et al. · Journal of translational medicine · 2023 · DOI
Researchers looked at 21 studies examining urine samples from ME/CFS patients to find markers that could help diagnose the condition. They focused especially on a substance called cortisol (a stress hormone) in urine. While they found some differences in urine samples between people with ME/CFS and healthy people, the results were too inconsistent to identify a reliable single marker for diagnosis.
ME/CFS currently lacks a definitive diagnostic test, making non-invasive urine-based biomarkers potentially valuable for diagnosis and understanding disease mechanisms. This systematic review synthesizes existing evidence to identify gaps in research and guide future studies toward more reliable diagnostic approaches. Understanding urinary markers could help clinicians identify ME/CFS earlier and advance understanding of the condition's multisystem effects.
This review does not establish that any single urinary biomarker can reliably diagnose ME/CFS. The substantial heterogeneity across studies means findings cannot yet be translated into clinical practice. The review also cannot determine whether urinary changes are causes or consequences of ME/CFS pathology.
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 →
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Primary citation
Taccori, Asher, Maksoud, Rebekah, Eaton-Fitch, Natalie, Patel, Maharshi, & Marshall-Gradisnik, Sonya (2023). A systematic review and meta-analysis of urinary biomarkers in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).. Journal of translational medicine. https://doi.org/10.1186/s12967-023-04295-0
BibTeX
@article{mecfsatlas-taccori-2023-systematic-review,
author = {Taccori, Asher and Maksoud, Rebekah and Eaton-Fitch, Natalie and Patel, Maharshi and Marshall-Gradisnik, Sonya},
title = {A systematic review and meta-analysis of urinary biomarkers in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).},
journal = {Journal of translational medicine},
year = {2023},
doi = {10.1186/s12967-023-04295-0},
note = {PubMed: 37408028},
url = {https://www.mecfsatlas.com/evidence/taccori-2023-systematic-review},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/taccori-2023-systematic-review
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