New Research on Energy Metabolomics & Mitochondrial Function in ME/CFS by Fluge & Mella

Drs. Oystein Fluge and Olav Mella from Norway are the authors of research over the past few years showing that some individuals with ME/CFS recover (at least temporarily) with rituximab, a drug that depletes the body of B lymphocytes. B cells are the cells that make antibodies and are hence the prime suspects in autoimmune diseases. If someone gets better when their B cells are depleted it suggests that the immune/autoimmune response is key to the illness.

ME/CFS Studies- Learn More About the Research 

Now this team has published a study suggesting that the energy problem in ME/CFS may not be due to dysfunction of the mitochondria as has been suggested by many teams, but due to inadequate fuel (acetyl Co-A) being available for the mitochondria to use to create ATP (the body’s source of energy).

Through a series of elegant experiments, Fluge & Mella have shown that the enzyme (pyruvate dehydrogenase) which breaks down pyruvate into Acetyl Co-A may not be working optimally – possibly being blocked by regulatory molecules created by the body. To compensate for this loss of fuel into the citric acid cycle, amino acids that can enter the cycle directly and not pass through pyruvate dehydrogenase are being depleted. This suggests that some patients may not utilize carbohydrates optimally for energy and rely instead on protein for energy. In Chapter 5 of my manual, I explain that for reasons as yet unknown (in 2012) people with ME/CFS and FM tend to do better on a high protein low carb diet. Maybe this research could explain this clinical observation.

Metabolic Switch May Bring on Chronic Fatigue

Fluge & Mella also found an increase in lactate when muscle cells were grown in serum spiked with blood from patients with ME/CFS AND when those cells were put under both aerobic and anaerobic strain. Normally increased lactate indicates an absence of oxygen for the mitochondria to function. In the absence of oxygen, the mitochondria shut down and pyruvate is converted to lactate producing far fewer ATPs than when oxygen is present. However, with a block of PDH, lactate builds up even when there is adequate oxygen. For more on this study and many, many other great blogs.

 Author: Eleanor (Ellie) Stein MD FRCP(C)

I am a psychiatrist with a small private practice in Calgary and am an assistant clinical professor in the faculty of medicine at the University of Calgary. Since 2000, I have worked with over 1000 patients, all with ME/CFS, FM and ES. My passion for this field comes from my own struggle with these diseases, my desire to improve my health and then pass on what I learn. My goal is for every patient in Canada to have access to respectful, effective health care within the publicly funded system. If you are looking for help and resources to help combat ME/CFS, FM and ES, see my guides and webinars.

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