Tomas, Cara, Newton, Julia · Biochemical Society transactions · 2018 · DOI
This review examines research showing that people with ME/CFS have problems with how their bodies use energy at a cellular level. Scientists have found several different metabolic abnormalities—issues with immune function, mitochondria (the cell's power plants), muscle acid buildup, and other energy-related problems—that could potentially be used as biomarkers (measurable signs) to diagnose the disease. However, no single test can yet reliably identify ME/CFS.
ME/CFS currently lacks diagnostic biomarkers, making diagnosis difficult and delayed. This review consolidates evidence for metabolic abnormalities that could eventually lead to reliable blood tests or other measurable indicators for the disease, potentially improving diagnosis and understanding of disease mechanisms. Establishing valid biomarkers could also help validate ME/CFS as a biological disease and facilitate better treatment development.
This review does not prove that any single metabolic abnormality causes ME/CFS, nor does it establish whether identified metabolic changes are primary causes or secondary consequences of the disease. The review synthesizes existing literature rather than presenting new empirical data, so findings depend on the quality and methodologies of included studies. It does not provide diagnostic criteria or validate any biomarker for clinical use.
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
Tomas, Cara & Newton, Julia (2018). Metabolic abnormalities in chronic fatigue syndrome/myalgic encephalomyelitis: a mini-review.. Biochemical Society transactions. https://doi.org/10.1042/BST20170503
BibTeX
@article{mecfsatlas-tomas-2018-metabolic-abnormalities,
author = {Tomas, Cara and Newton, Julia},
title = {Metabolic abnormalities in chronic fatigue syndrome/myalgic encephalomyelitis: a mini-review.},
journal = {Biochemical Society transactions},
year = {2018},
doi = {10.1042/BST20170503},
note = {PubMed: 29666214},
url = {https://www.mecfsatlas.com/evidence/tomas-2018-metabolic-abnormalities},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/tomas-2018-metabolic-abnormalities
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