Tomas, Cara, Elson, Joanna L, Strassheim, Victoria et al. · PloS one · 2020 · DOI
This study looked at how well the energy-producing parts of cells (mitochondria) work in people with ME/CFS compared to healthy people. Researchers found that both people with moderate and severe ME/CFS had problems with how their cells produce energy, but severely affected patients had additional problems with how their cells break down glucose for energy. This suggests that severe ME/CFS involves more widespread energy problems than moderate ME/CFS.
This research provides cellular-level evidence that ME/CFS involves real, measurable abnormalities in how cells produce energy—findings that help validate patients' experiences of profound fatigue and suggest different disease mechanisms operate in moderate versus severe cases. Understanding these bioenergetic differences could eventually inform treatment strategies tailored to disease severity.
This study does not prove that mitochondrial dysfunction causes ME/CFS symptoms or that correcting these abnormalities will improve patient outcomes. It also does not establish whether the observed bioenergetic changes are primary disease drivers or secondary consequences, nor does it clarify how PBMC dysfunction relates to symptoms in other tissues.
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
Tomas, Cara, Elson, Joanna L, Strassheim, Victoria, Newton, Julia L, & Walker, Mark (2020). The effect of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) severity on cellular bioenergetic function.. PloS one. https://doi.org/10.1371/journal.pone.0231136
BibTeX
@article{mecfsatlas-tomas-2020-effect-myalgic,
author = {Tomas, Cara and Elson, Joanna L and Strassheim, Victoria and Newton, Julia L and Walker, Mark},
title = {The effect of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) severity on cellular bioenergetic function.},
journal = {PloS one},
year = {2020},
doi = {10.1371/journal.pone.0231136},
note = {PubMed: 32275686},
url = {https://www.mecfsatlas.com/evidence/tomas-2020-effect-myalgic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/tomas-2020-effect-myalgic
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