Vermeulen, Ruud C W, Vermeulen van Eck, Ineke W G · Journal of translational medicine · 2014 · DOI
This study looked at how well the body uses oxygen during exercise in people with ME/CFS compared to healthy people. Researchers found that people with ME/CFS extract less oxygen from their blood during exercise than healthy people do, suggesting their muscles aren't using oxygen efficiently. Interestingly, their hearts have to pump much harder to deliver oxygen, which argues against the idea that ME/CFS is simply caused by deconditioning (being out of shape).
This study provides physiological evidence that ME/CFS involves a fundamental metabolic problem—muscles cannot extract oxygen efficiently—rather than simple physical deconditioning. Understanding this mechanism could guide development of targeted treatments and validates the biological basis of exercise intolerance, helping counter misconceptions that ME/CFS is primarily psychological or behavioral.
This study does not establish what causes the reduced oxygen extraction or whether it is a primary defect or secondary consequence of another disease mechanism. The cross-sectional design means we cannot determine if this metabolic pattern develops before symptom onset or emerges as a result of illness. The small healthy control group (7-11 people) limits generalizability of normal reference values.
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
Vermeulen, Ruud C W & Vermeulen van Eck, Ineke W G (2014). Decreased oxygen extraction during cardiopulmonary exercise test in patients with chronic fatigue syndrome.. Journal of translational medicine. https://doi.org/10.1186/1479-5876-12-20
BibTeX
@article{mecfsatlas-vermeulen-2014-decreased-oxygen,
author = {Vermeulen, Ruud C W and Vermeulen van Eck, Ineke W G},
title = {Decreased oxygen extraction during cardiopulmonary exercise test in patients with chronic fatigue syndrome.},
journal = {Journal of translational medicine},
year = {2014},
doi = {10.1186/1479-5876-12-20},
note = {PubMed: 24456560},
url = {https://www.mecfsatlas.com/evidence/vermeulen-2014-decreased-oxygen},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/vermeulen-2014-decreased-oxygen
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