Tirelli, Umberto, Franzini, Marianno, Valdenassi, Luigi et al. · Journal of clinical medicine · 2021 · DOI
This study tested whether a treatment called oxygen-ozone autohemotherapy (a procedure where blood is drawn, treated with ozone gas, and returned to the body) could help ME/CFS patients with fatigue. Among 200 patients treated, most experienced significant improvements in their fatigue levels within 30 days, with nearly half reporting the best possible improvement on a fatigue scale. No serious side effects were reported.
Fatigue is the defining symptom of ME/CFS and profoundly impacts quality of life; most current treatments offer limited benefit. If validated, oxygen-ozone therapy could represent a novel therapeutic option for this debilitating condition with no approved pharmaceutical treatments.
This observational study without a control group or blinded design cannot establish that oxygen-ozone autohemotherapy causes fatigue improvement—natural fluctuation, placebo effect, or concurrent interventions may explain the results. The findings do not prove efficacy compared to standard care or other treatments, nor do they establish the mechanism by which the treatment might work.
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
Tirelli, Umberto, Franzini, Marianno, Valdenassi, Luigi, Pandolfi, Sergio, Berretta, Massimiliano, Ricevuti, Giovanni, et al. (2021). Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Greatly Improved Fatigue Symptoms When Treated with Oxygen-Ozone Autohemotherapy.. Journal of clinical medicine. https://doi.org/10.3390/jcm11010029
BibTeX
@article{mecfsatlas-tirelli-2021-patients-myalgic,
author = {Tirelli, Umberto and Franzini, Marianno and Valdenassi, Luigi and Pandolfi, Sergio and Berretta, Massimiliano and Ricevuti, Giovanni and Chirumbolo, Salvatore},
title = {Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Greatly Improved Fatigue Symptoms When Treated with Oxygen-Ozone Autohemotherapy.},
journal = {Journal of clinical medicine},
year = {2021},
doi = {10.3390/jcm11010029},
note = {PubMed: 35011770},
url = {https://www.mecfsatlas.com/evidence/tirelli-2021-patients-myalgic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/tirelli-2021-patients-myalgic
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