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ME/CFS Atlas — A public knowledge atlas for ME/CFS

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ME/CFS Atlas is an evidence reference platform, not a medical provider. Content is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.

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ME/CFS Evidence Browser — Classified Studies on Myalgic Encephalomyelitis

Evidence browser

Search and filter 6,166 studies by evidence level, diagnostic criteria, PEM status, and research domain. Each entry links to the original source.

Studies sorted by evidence level, then year. Browse by topic instead →

Evidence level (E0–E3) reflects study type and replication, not methodological quality. A weak systematic review still sits at E0. How evidence levels work →

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214 studies

E0 — Consensus643E1 — Replicated320E2 — Moderate2,781E3 — Preliminary2,422

ME/CFS4,025Long COVID216Post-infectious189Overlapping1,050

Required for diagnosis414Not specified / unclear2,218Not required3,534

Post-Exertional Malaise1,063Cognitive Dysfunction1,735Pain1,620Unrefreshing Sleep799Orthostatic Intolerance478

Cytokines818Gene Expression567Metabolomics473Neuroimaging468Autoantibodies458

Infection-Triggered1,174Long COVID Overlap587Pediatric493Severe231

Strong Phenotyping438Sex-Stratified326Severe ME Included118

Systematic Review265Meta-Analysis60RCT300

Peer-reviewed6,109Preprint3Unclear54

181–200 of 214 studies

E3 PreliminaryReviewPEM not requiredReview-Narrative

Diet and its role in interstitial cystitis/bladder pain syndrome (IC/BPS) and comorbid conditions.

Friedlander, Justin I, Shorter, Barbara, Moldwin, Robert M·BJU international·2012

This review examined how food and beverages affect bladder pain syndrome (IC/BPS) and related conditions like fibromyalgia and chronic fatigue. Nearly 90% of patients report that certain foods make their symptoms worse—especially acidic foods like citrus and tomatoes, caffeine, alcohol, and spicy foods—while some substances like calcium and baking soda may help. The researchers recommend that patients work with their doctors to identify their personal food triggers through careful elimination diets rather than avoiding foods unnecessarily.

E3 PreliminaryReviewPEM unclearReview-Narrative

[Chronic fatigue syndrome and an approach to its treatment].

Akarachkova, E S·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·2010

This is a review article discussing chronic fatigue syndrome (ME/CFS) and treatment approaches. The authors examine what is known about the condition and offer clinical guidance on how to manage it. While not a new research study, it provides a medical perspective on understanding and treating this complex illness.

E3 PreliminaryBehavioralPEM not requiredObservational

Clinical observation on the effects of Bo's abdominal acupuncture in 40 cases of chronic fatigue syndrome.

Huang, Yong, Liao, Xiao-ming, Li, Xiao-xi et al.·Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan·2008

This study looked at whether a traditional Chinese acupuncture technique called Bo's abdominal acupuncture could help 40 people with chronic fatigue syndrome. Patients received acupuncture treatments once daily for 2 weeks, and researchers measured their symptoms and fatigue levels before and after treatment. The results showed that patients reported improvements in fatigue, loss of appetite, sleep problems, memory issues, diarrhea, and general pain.

E3 PreliminaryCohortPEM not requiredObservational

Self within a climate of contention: Experiences of chronic fatigue syndrome.

Travers, Michele Kerry, Lawler, Jocalyn·Social science & medicine (1982)·2008

This study explored how people with ME/CFS experience their illness and how they cope with it, based on interviews with 19 Australian adults (including 3 who recovered). Researchers found that people with ME/CFS often feel their sense of self is damaged by the illness, and they use two main strategies to manage this: protecting themselves (the Guardian Response) and rebuilding their lives with new meaning (the Reconstructing Response). The study shows that living with ME/CFS involves an ongoing struggle as people balance these coping strategies depending on how severe their symptoms are at any given time.

E3 PreliminaryCohortPEM not requiredCase-Control

Successful use of a primary care practice-specialty collaboration in the care of an adolescent with chronic fatigue syndrome.

Kuo, Dennis Z, Cheng, Tina L, Rowe, Peter C·Pediatrics·2007

This case report describes how one teenager with ME/CFS improved significantly when their regular doctor and a specialized ME/CFS expert worked together as a team, even though they lived in different cities. By staying in regular contact through phone calls and emails and clearly dividing responsibilities, the two doctors were able to manage the teen's symptoms more effectively. The study suggests that this type of teamwork between primary care doctors and specialists can help young people with ME/CFS get better care.

E3 PreliminaryDiagnosticPEM not requiredMethods-Paper

The thoughts and methods for clinical research on acupuncture treatment of chronic fatigue syndrome.

Yao, Renmin·Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan·2007

This paper presents acupuncture treatment guidelines for chronic fatigue syndrome (ME/CFS), focusing on how acupuncture might restore balance to the body's energy systems according to traditional Chinese medicine. The authors discuss important considerations like which patients are most suitable for treatment, which acupuncture points to use, and how to measure whether the treatment is working.

E3 PreliminaryReviewPEM unclearReview-Narrative

The debate: myalgic encephalomyelitis and chronic fatigue syndrome.

Shepherd, Charles·British journal of nursing (Mark Allen Publishing)·2006

This article discusses the ongoing disagreement among doctors and researchers about ME/CFS, including what causes it and how to treat it. The author explains that while we still don't fully understand what causes the illness, we are learning more about the factors that may trigger or worsen it. Good news: doctors now have treatments available that can help reduce symptoms and improve quality of life for patients, rather than simply accepting the illness as untreatable.

E3 PreliminaryReviewPEM not requiredReview-Narrative

[On the important role of Siguan points in treatment of chronic fatigue syndrome].

Wang, Jing-jing, Meng, Hong, Cui, Cheng-bin et al.·Zhongguo zhen jiu = Chinese acupuncture & moxibustion·2006

This study examined whether a traditional Chinese medicine acupuncture technique called Siguan points might help treat chronic fatigue syndrome (ME/CFS). The researchers reviewed existing literature on this acupuncture method and concluded that using Siguan points as the main treatment approach showed promise for improving ME/CFS symptoms.

E3 PreliminaryCohortPEM not requiredCase-Control

Acupuncture in the treatment of post viral fatigue syndrome--a case report.

Mears, Tim·Acupuncture in medicine : journal of the British Medical Acupuncture Society·2005

This case report describes one patient with ME/CFS (chronic fatigue syndrome) who received electroacupuncture treatment. While the acupuncture did not cure the condition, the patient reported significant symptom improvement and was eventually able to return to work. This is one of the first published studies looking at how acupuncture might help ME/CFS patients.

E3 PreliminaryCommentaryPEM unclearEditorial

Supporting people with severe myalgic encephalomyelitis.

Crowhurst, Greg·Nursing standard (Royal College of Nursing (Great Britain) : 1987)·2005

This article helps nurses better understand ME/CFS, a serious condition that is often misunderstood by healthcare providers. The author describes the main symptoms people experience and discusses how healthcare services can support patients. The article emphasizes that ME/CFS is a real physical illness that needs more research to help doctors and nurses care for people with it properly.

E3 PreliminaryBehavioralPEM unclear

Ayurvedic treatment of chronic fatigue syndrome--a case report.

Vinjamury, Sivarama Prasad, Singh, Betsy B·Alternative therapies in health and medicine·2005

This case report describes one patient with chronic fatigue syndrome (ME/CFS) who received treatment using Ayurveda, a traditional medicine system from India. The authors documented whether Ayurvedic treatments helped reduce the patient's fatigue and other symptoms. While the patient showed some improvement, this is just one person's experience and cannot tell us whether this approach works for most people with ME/CFS.

E3 PreliminaryMechanismPEM not requiredObservational

The effect of granisetron, a 5-HT3 receptor antagonist, in the treatment of chronic fatigue syndrome patients--a pilot study.

The, G K H, Prins, J, Bleijenberg, G et al.·The Netherlands journal of medicine·2003

Researchers tested whether a medication called granisetron, which affects a brain chemical involved in nausea and other functions, might help ME/CFS patients feel less fatigued. Five women with ME/CFS took the medication for one month and reported significant improvements in how tired they felt and how much they could do. However, this was a very small study without a comparison group, so much more research is needed to confirm these results.

E3 PreliminaryReviewPEM unclearReview-Narrative

Atypical depression spectrum disorder - neurobiology and treatment.

Murck, Harald·Acta neuropsychiatrica·2003

This article explores a type of depression with unusual symptoms—like eating more and sleeping more instead of less—that is often overlooked in standard depression assessments. The author suggests this pattern of depression shares biological similarities with chronic fatigue syndrome, fibromyalgia, and other related conditions, and that all of these may involve a common problem with how the body regulates stress hormones. Different medications may work better for this type of depression than those typically used for other forms.

E3 PreliminaryReviewPEM unclearReview-Narrative

An overview of chronic fatigue syndrome.

Jackson, Elizabeth·Nursing standard (Royal College of Nursing (Great Britain) : 1987)·2003

This article reviews what we know about ME/CFS, including the symptoms people commonly experience and how they can be treated. The author describes a new model of patient care that was tested in the community, which combines several different therapeutic approaches to help manage the condition.

E3 PreliminaryReviewPEM unclearReview-Narrative

Chronic fatigue syndrome. Symptom relief is primary goal.

Hoffman, Diane B·Advance for nurse practitioners·2002

This article discusses chronic fatigue syndrome (ME/CFS) and emphasizes that helping patients feel better is the main goal of treatment. The author, writing for nurse practitioners, focuses on practical approaches to managing symptoms and improving patients' quality of life.

E3 PreliminaryReviewPEM unclearReview-Narrative

The symptoms and management of myalgic encephalomyelitis.

Richardson, Amanda·Nursing times·2002

ME/CFS is a long-lasting illness that affects people differently, and doctors still don't fully understand what causes it or how to cure it. However, there are helpful ways to manage the symptoms, and the best treatment plans are created together with each individual patient. While no medicine has been specifically designed for ME/CFS, doctors can adapt treatments used for similar symptoms in other conditions to help reduce suffering.

E3 PreliminaryReviewPEM unclearReview-Narrative

[Physical activity for mental health].

Martinsen, E W·Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke·2000

This review examined whether exercise can help treat mental health conditions like depression and anxiety. The research found that exercise works best for mild to moderate depression and chronic fatigue syndrome, and may also help with panic disorder, anxiety, and other conditions. Exercise appears to be a useful, affordable alternative or addition to standard treatments like medication and therapy.

E3 PreliminaryCohortPEM not requiredObservational

Treatment of chronic fatigue syndrome with 5-HT3 receptor antagonists--preliminary results.

Späth, M, Welzel, D, Färber, L·Scandinavian journal of rheumatology. Supplement·2000

Researchers tested whether two medications that block serotonin receptors (tropisetron and ondansetron) might help ME/CFS patients feel less fatigued. About one third of the patients who took these medications reported meaningful improvement in fatigue and energy levels over 15 days, with no serious side effects reported.

E3 PreliminaryReviewPEM unclearReview-Narrative

Chronic fatigue syndrome: current concepts of pathogenesis and treatment.

Lloyd, A R, Hickie, I, Peterson, P K·Current clinical topics in infectious diseases·1999

This review article examines what scientists understood in 1999 about how ME/CFS develops and what treatments might help. The authors synthesize existing knowledge about the condition's causes, which involve the immune system, infections, and other body system changes. They discuss various approaches to managing symptoms and improving function for people living with ME/CFS.

E3 PreliminaryPEM not required

Fatigue that doesn't go away.

Propsner, N M·New Jersey medicine : the journal of the Medical Society of New Jersey·1999

This article describes chronic fatigue syndrome (ME/CFS), a condition where people experience extreme tiredness that doesn't improve with rest. The fatigue often begins after a viral infection and is more commonly seen in middle-aged women. While current treatments can help manage symptoms, researchers are working to better understand the condition and develop more effective approaches.

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Or browse by topic

PEM Immune Neuro Metabolic Biomarkers Severe ME Long COVID Cognitive

Curated Collections

Thematic groupings by clinical question or research area.

Neuroinflammation Evidence

PET imaging and other studies providing evidence for brain inflammation in ME/CFS.

Metabolism & Mitochondria

Metabolomics and mitochondrial function studies revealing energy metabolism disruption.

Biomarkers

Studies identifying potential biological markers for ME/CFS diagnosis and stratification.

PEM-Specific Research

Studies specifically examining post-exertional malaise, the hallmark symptom of ME/CFS.