Why Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) may kill you:

Disorders in the inflammatory and oxidative and nitrosative stress (IO&NS) pathways may explain cardiovascular disorders in ME/CFS.


Neuro Endocrinol Lett. 2009 Dec 29;30(6):300-311. [Epub ahead of print]

Maes M, Maes Clinics, Antwerp, Belgium. crc.mh@telenet.be 2

Frank N.M. Twisk Twisk FNM 1

1 ME-de-patiënten Foundation, Limmen, the Netherlands

2 Clinical Research Center for Mental Health (CRC-MH), Antwerp, Belgium.



There is evidence that disorders in inflammatory and oxidative and nitrosative (IO&NS) pathways and a lowered antioxidant status are important pathophysiological mechanisms

underpinning myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).


Important precipitating and perpetuating factors for ME/CFS are (amongst others)

bacterial and viral infections; bacterial translocation due to an increased gut permeability; and

psychological stress.


Recently, Jason et al (2006) reported that the mean age of patients with myalgic encephalomyelitis/chronic fatigue syndrome dying from heart failure, i.e. 58.7 years, is significantly lower than the age of those dying from heart failure in the general US population, i.e. 83.1 years.


These findings implicate that ME/CFS is a risk factor to cardio-vascular disorder.


This review demonstrates that disorders in various IO&NS pathways provide explanations for the earlier mortality due to cardiovascular disorders in ME/CFS.


These pathways are:



chronic low grade inflammation with extended production of nuclear factor kappa B and COX-2 and increased levels of tumour necrosis factor alpha;

2.   increased O&NS with increased peroxide levels, and phospholipid oxidation including oxidative damage to phosphatidylinositol;
3.     decreased levels of specific antioxidants, i.e. coenzyme Q10, zinc and dehydroepiandrosterone-sulphate;
4.  bacterial translocation as a result of leaky gut;
5. decreased omega-3 polyunsatutared fatty acids (PUFAs), and

increased omega-6 PUFA and saturated fatty acid levels;
6. the presence of viral and bacterial infections and psychological stressors. 


The mechanisms whereby each of these factors may contribute towards cardio-vascular disorder in ME/CFS are discussed.


ME/CFS is a multisystemic metabolic-inflammatory disorder.


The aberrations in IO&NS pathways may increase the risk for cardiovascular disorders.

PMID: 20038921 [PubMed - as supplied by publisher]




published by Neuro Endocrinol Lett. 2009 Dec 29;30(6).


Last Updated: 09/01/2010



Last Update 09/01/2010

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