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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 6,113 studies by evidence level, diagnostic criteria, PEM status, and research domain. Each entry links to the original source.

Studies sorted by review quality. 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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198 studies

E0 — Consensus629E1 — Replicated320E2 — Moderate2,745E3 — Preliminary2,419

ME/CFS4,003Long COVID206Post-infectious189Overlapping1,031

Required for diagnosis410Not specified / unclear2,176Not required3,527

Post-Exertional Malaise1,039Cognitive Dysfunction1,709Pain1,606Unrefreshing Sleep785Orthostatic Intolerance468

Cytokines812Gene Expression566Metabolomics468Neuroimaging463Autoantibodies454

Infection-Triggered1,155Long COVID Overlap562Pediatric491Severe226

Strong Phenotyping427Sex-Stratified325Severe ME Included114

Systematic Review258Meta-Analysis59RCT300

Higher42Moderate2,570Preliminary3,224Weak277

Peer-reviewed6,056Preprint3Unclear54

21–40 of 198 studies

E0 ConsensusPEM not requiredPreliminarySystematic-ReviewEditor reviewed

Role of dietary modification in alleviating chronic fatigue syndrome symptoms: a systematic review.

Jones, Kathryn, Probst, Yasmine·Australian and New Zealand journal of public health·2017

Researchers reviewed 22 studies looking at whether changing what you eat could help ME/CFS symptoms. They found some promise with certain supplements like omega-3 fatty acids and D-ribose, as well as foods high in polyphenols (like berries and green tea). However, the evidence overall was limited and inconsistent—meaning we don't yet have clear dietary recommendations that work reliably for most ME/CFS patients.

E0 ConsensusPEM unclearModerate confidenceReview-NarrativeEditor reviewed

Pediatric chronic fatigue syndrome: current perspectives.

Crawley, Esther·Pediatric health, medicine and therapeutics·2017

This review examines ME/CFS in children, showing it is a common condition that significantly affects children and their families. The good news is that most children improve when they receive specialized treatment from doctors who understand this illness. The review summarizes what we know about how many children get ME/CFS, what factors may be involved, and what treatments have evidence supporting them.

E0 ConsensusPEM not requiredPreliminarySystematic-ReviewEditor reviewed

Acupuncture and moxibustion for chronic fatigue syndrome in traditional Chinese medicine: a systematic review and meta-analysis.

Wang, Taiwu, Xu, Cong, Pan, Keli et al.·BMC complementary and alternative medicine·2017

This study reviewed 31 previous research trials examining whether acupuncture and moxibustion (traditional Chinese treatments involving needles and heat) help treat ME/CFS. The researchers found that combining multiple acupuncture and moxibustion techniques appeared more effective than using just one technique, and both were more effective than sham acupuncture (fake treatment). However, the overall quality of the research studies reviewed was weak, so stronger evidence is needed before drawing firm conclusions.

E0 ConsensusPEM requiredWeak / uncertainSystematic-ReviewEditor reviewed

A Systematic Review of Drug Therapies for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis.

Collatz, Ansel, Johnston, Samantha C, Staines, Donald R et al.·Clinical therapeutics·2016

Researchers searched for studies testing medications for ME/CFS and found 26 high-quality trials. While 10 medications showed some benefit in their respective studies, no single medication worked well for everyone with ME/CFS. This suggests that different patients may need different treatments, and more research is needed to find which medications help which patients.

E0 ConsensusPEM not requiredModerate confidenceSystematic-ReviewEditor reviewed

Chronic fatigue syndrome.

Cleare, Anthony J, Reid, Steven, Chalder, Trudie et al.·BMJ clinical evidence·2015

This research review looked at treatments for chronic fatigue syndrome (ME/CFS) and found that the condition affects between 0.006% and 3% of people depending on how it's diagnosed, with women more commonly affected than men. The researchers searched multiple medical databases for studies on four main treatments: antidepressants, cognitive behavioral therapy (a type of talk therapy), corticosteroids (anti-inflammatory drugs), and graded exercise therapy. They carefully reviewed 15 high-quality studies to evaluate how well these treatments work and whether they're safe.

E0 ConsensusPEM not requiredModerate confidenceSystematic-ReviewEditor reviewed

Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Systematic Review for a National Institutes of Health Pathways to Prevention Workshop.

Smith, M E Beth, Haney, Elizabeth, McDonagh, Marian et al.·Annals of internal medicine·2015

This study reviewed 35 clinical trials testing different treatments for ME/CFS to see what actually works. The researchers found that a few treatments showed promise—particularly a drug called rintatolimod for exercise performance, and talking therapies plus graded exercise programs for improving fatigue and daily functioning—but most other treatments tested didn't have enough evidence to prove they help. Overall, doctors still need better studies to know for sure which treatments work best for different patients.

E0 ConsensusPEM not requiredPreliminarySystematic-ReviewEditor reviewed

Traditional Chinese medicine for chronic fatigue syndrome: a systematic review of randomized clinical trials.

Wang, Yu-Yi, Li, Xin-Xue, Liu, Jian-Ping et al.·Complementary therapies in medicine·2014

This review examined 23 studies testing traditional Chinese medicine (TCM) treatments for chronic fatigue syndrome, involving 1,776 patients. The treatments included herbal medicines, acupuncture, qigong, and other TCM approaches. Most studies found that TCM helped reduce fatigue symptoms, though the quality of these studies was often poor, and it's unclear if TCM improves overall quality of life for patients.

E0 ConsensusPEM not requiredModerate confidenceReview-NarrativeEditor reviewed

[Psychopharmacological treatment in patients with somatoform disorders and functional body syndromes].

Kapfhammer, H P·Der Nervenarzt·2012

This review looked at how psychiatric medications (mainly antidepressants) might help people with physical symptoms that doctors cannot fully explain medically. The researchers found that antidepressants can reduce pain and other symptoms in conditions like fibromyalgia and irritable bowel syndrome, but they found no clear proven medication strategy for chronic fatigue syndrome (ME/CFS) yet.

E0 ConsensusPEM unclearWeak / uncertainObservationalEditor reviewed

Treating chronic fatigue syndrome - a study into the scientific evidence for pharmacological treatments.

Kreijkamp-Kaspers, Sanne, Brenu, Ekua Weba, Marshall, Sonya et al.·Australian family physician·2011

This study looked at what medicines and supplements 94 people with ME/CFS were taking and checked what scientific evidence supported their use. The patients were using hundreds of different treatments, with antidepressants, pain relievers, sleep aids, and B vitamins being the most common. However, when researchers searched for rigorous studies proving these treatments work for ME/CFS, they found very limited evidence—only 20 good-quality trials existed for the medicines patients were using.

E0 ConsensusPEM not requiredModerate confidenceSystematic-ReviewEditor reviewed

Mindfulness-based stress reduction for people with chronic diseases.

Merkes, Monika·Australian journal of primary health·2010

This review looked at 15 studies testing whether mindfulness meditation programs (called MBSR) help people with chronic illnesses feel better. The studies included people with ME/CFS, fibromyalgia, chronic pain, and other long-term conditions. All 15 studies found that people who participated in these programs experienced improvements in their symptoms, mood, and quality of life, with no negative effects reported.

E0 ConsensusPEM unclearPreliminarySystematic-ReviewEditor reviewed

Alternative medical interventions used in the treatment and management of myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia.

Porter, Nicole S, Jason, Leonard A, Boulton, Aaron et al.·Journal of alternative and complementary medicine (New York, N.Y.)·2010

This review looked at 70 research studies testing complementary and alternative treatments for ME/CFS and fibromyalgia. The researchers found that most studies (86%) reported at least some positive effect from the treatments tested, with acupuncture, meditation practices, and supplements like magnesium and L-carnitine showing the most promise. However, the quality of these studies varied widely, making it difficult to draw firm conclusions about which treatments actually work.

E0 ConsensusPEM not requiredModerate confidenceMeta-AnalysisEditor reviewed

[A meta analysis on randomized controlled trials of acupuncture treatment of chronic fatigue syndrome].

Wang, Jing-jing, Song, Yu-jing, Wu, Zhong-chao et al.·Zhen ci yan jiu = Acupuncture research·2009

This review analyzed 28 studies testing whether acupuncture helps people with ME/CFS. Researchers combined results from randomized controlled trials (the gold standard for testing treatments) and found that patients receiving acupuncture reported better outcomes than those in control groups. However, the authors note that more high-quality studies are needed to confirm these findings.

E0 ConsensusPEM not requiredWeak / uncertainSystematic-ReviewEditor reviewed

Traditional Chinese medicinal herbs for the treatment of idiopathic chronic fatigue and chronic fatigue syndrome.

Adams, Denise, Wu, Taixiang, Yang, Xunzhe et al.·The Cochrane database of systematic reviews·2009

This study looked at whether herbal medicines used in traditional Chinese medicine (TCM) could help treat chronic fatigue and ME/CFS. Researchers searched through thousands of medical studies to find high-quality tests comparing TCM herbs to placebo or standard treatments, but they found that none of the available studies were rigorous enough to draw reliable conclusions about whether these treatments actually work.

E0 ConsensusPEM not requiredModerate confidenceMeta-AnalysisEditor reviewed

Efficacy of cognitive behavioral therapy for chronic fatigue syndrome: a meta-analysis.

Malouff, John M, Thorsteinsson, Einar B, Rooke, Sally E et al.·Clinical psychology review·2008

This study reviewed 15 previous research studies on whether cognitive behavioral therapy (CBT)—a type of talk therapy focused on thoughts and behaviors—helps people with chronic fatigue syndrome. Overall, people who received CBT showed moderate improvement in fatigue compared to those who didn't receive it. About half of the people who completed CBT no longer met the clinical criteria for severe fatigue, though some people dropped out of treatment.

E0 ConsensusPEM not requiredModerate confidenceSystematic-ReviewEditor reviewed

Cognitive behaviour therapy for chronic fatigue syndrome in adults.

Price, Jonathan R, Mitchell, Edward, Tidy, Elizabeth et al.·The Cochrane database of systematic reviews·2008

This review looked at 15 studies involving over 1,000 people with ME/CFS to see if cognitive behaviour therapy (CBT)—a type of talk therapy focused on thoughts and behaviors—could help reduce fatigue. Compared to usual care, CBT showed modest improvements in fatigue at the end of treatment, with 40% of people in CBT improving versus 26% in usual care. However, the benefits were less clear when researchers checked on people months later.

E0 ConsensusPEM unclearModerate confidenceReview-NarrativeEditor reviewed

Treatment of chronic fatigue syndrome: findings, principles and strategies.

Luyten, Patrick, Van Houdenhove, Boudewijn, Pae, Chi-Un et al.·Psychiatry investigation·2008

This review examines current treatments for ME/CFS and discusses what we know about what causes the condition. The authors suggest that effective treatment should be personalized to each patient's needs and focus on helping people make lasting changes to their lifestyle that restore both mental and physical balance. The review emphasizes that while treatments exist, many patients still have a poor prognosis even when receiving care.

E0 ConsensusPEM not requiredModerate confidenceSystematic-ReviewEditor reviewed

The placebo response in the treatment of chronic fatigue syndrome: a systematic review and meta-analysis.

Cho, Hyong Jin, Hotopf, Matthew, Wessely, Simon·Psychosomatic medicine·2005

This study looked at how often ME/CFS patients improve simply from believing they will improve (the placebo effect) in clinical trials. Researchers found that the placebo response in ME/CFS is actually lower than many people assume—only about 20% of patients improved with placebo. Interestingly, patients were less likely to show placebo improvement when the treatment was psychological or psychiatric in nature, possibly because many ME/CFS patients believe their illness is physical rather than mental.

E0 ConsensusPEM not requiredModerate confidenceSystematic-ReviewEditor reviewed

Interventions for the treatment and management of chronic fatigue syndrome: a systematic review.

Whiting, P, Bagnall, A M, Sowden, A J et al.·JAMA·2001

This review looked at 44 studies testing different treatments for ME/CFS to see which ones actually work. The researchers found that cognitive behavioral therapy (talk-based therapy) and graded exercise therapy (gradually increasing activity) showed the most promise, while other treatments like supplements and immunological therapies had unclear or limited benefits. However, the studies used different measurements and methods, making it hard to draw firm conclusions.

E0 ConsensusPEM not requiredModerate confidenceSystematic-ReviewEditor reviewed

Cognitive behaviour therapy for adults with chronic fatigue syndrome.

Price, J R, Couper, J·The Cochrane database of systematic reviews·2000

This review examined whether cognitive behaviour therapy (CBT)—a type of talk therapy that helps people change unhelpful thinking patterns and gradually return to activities—helps adults with ME/CFS. Researchers looked at three high-quality studies and found that CBT did improve physical functioning compared to standard medical care or relaxation therapy. However, the evidence was limited to people who could attend clinic appointments; more research is needed in people with milder or more severe forms of the illness.

E0 ConsensusPEM not requiredModerate confidenceReview-NarrativeEditor reviewed

Cognitive behavior therapy for chronic fatigue syndrome: efficacy and implications.

Sharpe, M·The American journal of medicine·1998

This review examines cognitive behavior therapy (CBT), a talk-based treatment that helps people change thought patterns and behaviors that may be making their fatigue worse. Research from two rigorous clinical trials shows that CBT can significantly help people with ME/CFS feel better and become more active. While most people improve, complete recovery is rare.

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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.