ME and CFS Medical Abnormalities – Nutrient Issues


Following is a list of articles about abnormalities with nutrient issues in ME and CFS.

Links to the more than 1,000 peer-reviewed journal articles are listed on the ME and CFS Medical Abnormalities page of this website.


Bliksrud YT. Tenuous link between chronic fatigue syndrome and pyruvate dehydrogenase deficiency. Tidsskr Nor Laegeforen. 2017 Nov 28;137(23-24). PMID: 29231630

The authors comment on a study suggesting that pyruvate dehydrogenase deficiency is associated with CFS.


Earl KE, Sakellariou GK, Sinclair M, Fenech M, Croden F, Owens DJ, Tang J, Miller A, Lawton C, Dye L, Close GL, Fraser WD, McArdle A, Beadsworth MBJ. Vitamin D status in chronic fatigue syndrome/myalgic encephalomyelitis: a cohort study from the North-West of England. BMJ Open. 2017 Nov 8;7(11):e015296. PMID: 29118054

Low serum concentrations of total 25(OH)D do not appear to be a contributing factor to the level of fatigue of CFS/ME.


Joustra ML, Minovic I, Janssens KAM, Bakker SJL, Rosmalen JGM. Vitamin and mineral status in chronic fatigue syndrome and fibromyalgia syndrome: A systematic review and meta-analysis. PLoS One. 2017 Apr 28;12(4):e0176631. PMID: 28453534

The objectives of this meta-analysis were (1) to determine vitamin and mineral status in CFS and FMS patients as compared to healthy controls; (2) to investigate the association between vitamin and mineral status and clinical parameters, including symptom severity and quality of life; and (3) to determine the effect of supplementation on clinical parameters. Little evidence was found to support the hypothesis that vitamin and mineral deficiencies play a role in the pathophysiology of CFS and FMS, or that the use of supplements is effective in these patients.


Witham M, Kennedy G, Belch J, Hill A, Khan F. Association between vitamin D status and markers of vascular health in patients with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). Int J Cardiol. 2014 Jun 1;174(1):139-40. PMID: 24726169

An association between vitamin D status and vascular health was found in CFS/ME patients.


Mikirova N, Casciari J, Hunninghake R. The assessment of the energy metabolism in patients with chronic fatigue syndrome by serum fluorescence emission. Altern Ther Health Med. 2012 Jan-Feb;18(1):36-40. PMID: 22516851

The researchers determined that NADH levels could be used to gauge health status of CFS patients.


Blankfield A. A Brief Historic Overview of Clinical Disorders Associated with Tryptophan: The Relevance to Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM). Int J Tryptophan Res. 2012;5:27-32. PMID: 23032646

The current paper will focus on the emerging role of tryptophan deficiencies in CFS and fibromyalgia.


Antiel RM, Caudill JS, Burkhardt BE, Brands CK, Fischer PR. Iron insufficiency and hypovitaminosis D in adolescents with chronic fatigue and orthostatic intolerance. South Med J. 2011 Aug;104(8):609-11. PMID: 21886073

In patients presenting with chronic fatigue and/or orthostatic intolerance, low ferritin levels and hypovitaminosis D are common, especially in patients with excessive postural tachycardia.


Berkovitz S, Ambler G, Jenkins M, Thurgood S. Serum 25-hydroxy vitamin D levels in chronic fatigue syndrome: a retrospective survey. Int J Vitam Nutr Res. 2009 Jul;79(4):250-4. PMID: 20209476

25-OH vitamin D levels are moderately to severely suboptimal in CFS patients, with a mean of 44.4 nmol/L (optimal levels >75 nmol/L). These levels are lower and the difference is statistically significant (p<0.0004) than those of the general British population from a recent national survey, but similar to those in patients with other chronic conditions.


Maes M, Mihaylova I, Kubera M, Uytterhoeven M, Vrydags N, Bosmans E. Coenzyme Q10 deficiency in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is related to fatigue, autonomic and neurocognitive symptoms and is another risk factor explaining the early mortality in ME/CFS due to cardiovascular disorder. Neuro Endocrinol Lett. 2009;30(4):470-6. PMID: 20010505

CFS patients have very low levels of CoQ10, a mitochondrial nutrient that acts as a cofactor for ATP production and has antioxidant effects.  This may be related to increased mortality from chronic heart failure in the disease.


McCully KK, Malucelli E, Iotti S. Increase of free Mg2+ in the skeletal muscle of chronic fatigue syndrome patients. Dyn Med. 2006 Jan 11;5:1. PMID: 16405724

CFS patients had higher resting free Mg2+ levels compared to sedentary controls.


Heap LC, Peters TJ, Wessely S. Vitamin B status in patients with chronic fatigue syndrome. J R Soc Med. 1999 Apr;92(4):183-5. PMID: 10450194

There is a reduced functional B vitamin status, particularly of pyridoxine, in CFS patients.


Jacobson W, Saich T, Borysiewicz LK, Behan WM, Behan PO, Wreghitt TG. Serum folate and chronic fatigue syndrome. Neurology. 1993 Dec;43(12):2645-7. PMID: 8255470

Half of a group of CFS patients were deficient in folic acid.


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