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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

41–60 of 214 studies

E0 ConsensusReviewPEM unclearObservational

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 ConsensusReviewPEM unclearSystematic-Review

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 ConsensusReviewPEM not requiredSystematic-Review

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 ConsensusReviewPEM not requiredMeta-Analysis

[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 ConsensusReviewPEM not requiredSystematic-Review

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 ConsensusReviewPEM not requiredSystematic-Review

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 ConsensusReviewPEM unclearReview-Narrative

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 ConsensusReviewPEM not requiredMeta-Analysis

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 ConsensusReviewPEM not requiredSystematic-Review

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 ConsensusReviewPEM unclearReview-Narrative

Chronic fatigue syndrome.

Reid, Steven, Chalder, Trudie, Cleare, Anthony et al.·Clinical evidence·2003

This systematic review summarizes what is known about chronic fatigue syndrome (ME/CFS) by examining existing research. The authors looked at the best available evidence about how the condition develops, how it affects people, and what treatments might help. This type of review helps doctors and patients understand the current state of knowledge about ME/CFS.

E0 ConsensusReviewPEM not requiredSystematic-Review

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 ConsensusReviewPEM unclearReview-Narrative

Chronic fatigue syndrome.

Reid, S, Chalder, T, Cleare, A et al.·BMJ (Clinical research ed.)·2000

This was a systematic review that brought together existing research about chronic fatigue syndrome (ME/CFS) to understand what was known at the time. The researchers looked at multiple studies to summarize the current evidence about the condition. This type of overview helps doctors and patients understand the state of knowledge about ME/CFS.

E0 ConsensusReviewPEM not requiredSystematic-Review

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 ConsensusReviewPEM not requiredReview-Narrative

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.

E0 ConsensusReviewPEM not requiredEditorial

The treatment of chronic fatigue syndrome: science and speculation.

Wilson, A, Hickie, I, Lloyd, A et al.·The American journal of medicine·1994

This review examined different treatments for ME/CFS and found that the condition is complex, affecting people in various ways. No single treatment has been proven to work well for most patients over the long term. The authors suggest that the best approach combines medical care, psychological support, and symptom management tailored to each person's needs.

E1 ReplicatedTrialPEM not requiredRCT

Dose-effect of long-snake-like moxibustion for chronic fatigue syndrome: a randomized controlled trial.

Luo, Hong, Gong, Rui, Zheng, Rui et al.·Journal of translational medicine·2023

This study tested whether longer sessions of moxibustion (a traditional Chinese medicine heat treatment) might work better than shorter sessions for chronic fatigue syndrome. Sixty women with CFS were treated either 60 minutes or 30 minutes per session, three times per week for four weeks. The 60-minute sessions produced greater improvements in fatigue and other symptoms, and thermal imaging showed better changes in body heat patterns with the longer treatment.

E1 ReplicatedTrialPEM not requiredRCT

eLearning improves allied health professionals' knowledge and confidence to manage medically unexplained chronic fatigue states: A randomized controlled trial.

Jones, Matthew D, Casson, Sally M, Barry, Benjamin K et al.·Journal of psychosomatic research·2023

This study tested whether an online training program could help doctors and therapists better understand and treat chronic fatigue conditions. Allied health professionals who completed the 4-week online course significantly improved their knowledge and confidence in managing these patients, compared to those who didn't receive training. Most participants found the course helpful and would recommend it to others.

E1 ReplicatedTrialPEM unclearRCT

Amygdala and Insula Retraining (AIR) Significantly Reduces Fatigue and Increases Energy in People with Long COVID.

Toussaint, Loren L, Bratty, Alexandra J·Evidence-based complementary and alternative medicine : eCAM·2023

This study tested whether a brain retraining program called Amygdala and Insula Retraining (AIR) could help people with Long COVID feel less exhausted and have more energy. Over 3 months, people who did the AIR program reported significantly less fatigue and more energy compared to a control group that received a different wellness program. The AIR group showed roughly twice the improvement in energy levels and four times the improvement in fatigue compared to the control group.

E1 ReplicatedTrialPEM not requiredRCT

The Efficacy and Safety of Myelophil, an Ethanol Extract Mixture of Astragali Radix and Salviae Radix, for Chronic Fatigue Syndrome: A Randomized Clinical Trial.

Joung, Jin-Yong, Lee, Jin-Seok, Cho, Jung-Hyo et al.·Frontiers in pharmacology·2019

Researchers tested a herbal supplement called Myelophil (made from two plant extracts) in 97 people with ME/CFS over 12 weeks. Overall, the supplement didn't significantly reduce fatigue compared to placebo. However, in people with severe fatigue symptoms at the start, Myelophil did show meaningful improvement in fatigue levels and quality of life. The treatment was safe with no serious side effects reported.

E1 ReplicatedCommentaryPEM not requiredEditorial

Rethinking the treatment of chronic fatigue syndrome-a reanalysis and evaluation of findings from a recent major trial of graded exercise and CBT.

Wilshire, Carolyn E, Kindlon, Tom, Courtney, Robert et al.·BMC psychology·2018

This study re-examined a large, well-known trial called PACE that tested whether exercise therapy and talking therapy could help people with ME/CFS. When researchers checked the original study data using the methods that were promised before the trial started, they found much weaker benefits than originally reported. The treatments did not clearly work better than standard care, recovery rates were very low, and improvements seemed to fade after two years.

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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.