Wirth, Klaus J, Löhn, Matthias · Medicina (Kaunas, Lithuania) · 2023 · DOI
This study examines why ME/CFS patients often experience other conditions like POTS, mast cell activation, endometriosis, and small fiber neuropathy at the same time. The researchers analyzed how these conditions might share common problems with blood vessel function and chemical messengers in the body. They found strong evidence that excessive inflammatory chemicals and problems with a specific receptor in the body (β2AdR) may be the connecting link between all these conditions.
Understanding that ME/CFS shares common vascular and inflammatory mechanisms with its associated conditions could lead to more unified treatment approaches and better clinical management of patients who have multiple comorbidities. This framework may help explain why patients experience such a constellation of symptoms and could guide development of therapies targeting the root causes rather than individual conditions separately.
This analysis does not provide experimental proof of causation—it is a theoretical synthesis of existing research. It does not prove that all ME/CFS patients with comorbidities share identical mechanisms, nor does it establish which condition triggers the others or whether they share a single common cause versus having overlapping independent pathways.
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
Wirth, Klaus J & Löhn, Matthias (2023). Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Comorbidities: Linked by Vascular Pathomechanisms and Vasoactive Mediators?. Medicina (Kaunas, Lithuania). https://doi.org/10.3390/medicina59050978
BibTeX
@article{mecfsatlas-wirth-2023-myalgic-encephalomyelitis,
author = {Wirth, Klaus J and Löhn, Matthias},
title = {Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Comorbidities: Linked by Vascular Pathomechanisms and Vasoactive Mediators?},
journal = {Medicina (Kaunas, Lithuania)},
year = {2023},
doi = {10.3390/medicina59050978},
note = {PubMed: 37241210},
url = {https://www.mecfsatlas.com/evidence/wirth-2023-myalgic-encephalomyelitis},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/wirth-2023-myalgic-encephalomyelitis
Contribute
Private, reviewed by a human. Not a public comment thread.