Review Dietary Supplementation for Fatigue Symptoms in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)—A Systematic Review, 2025, Dorczok

https://www.mdpi.com/2072-6643/17/3/475

Open Access
Systematic Review
Dietary Supplementation for Fatigue Symptoms in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)—A Systematic Review
by
Marie Celine Dorczok
1,2,*,
Gloria Mittmann
1,
Nilufar Mossaheb
2,3,
Beate Schrank
4,
Lucie Bartova
3,5,
Matthias Neumann
1,6 and
Verena Steiner-Hofbauer
1


1
Research Centre Transitional Psychiatry, Karl Landsteiner University of Health Sciences, 3500 Krems, Austria
2
Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria
3
Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, 1090 Vienna, Austria
4
Department of General Psychiatry, Vienna Health Association Clinic Ottakring, 1160 Vienna, Austria
5
Clinical Division of General Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria
6
Research Unit for Curriculum Development, Medical University of Vienna, 1090 Vienna, Austria
*
Author to whom correspondence should be addressed.
Nutrients 2025, 17(3), 475; https://doi.org/10.3390/nu17030475
Submission received: 20 December 2024 / Revised: 25 January 2025 / Accepted: 26 January 2025 / Published: 28 January 2025
(This article belongs to the Section Clinical Nutrition)
Versions Notes

Abstract

Background/Objectives:

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex neuroimmunological disorder with limited treatment options. Despite the widespread use of Dietary Supplements (DSs) among ME/CFS patients to alleviate fatigue and associated symptoms, evidence remains inconclusive. This systematic review aims to provide an updated synthesis of the efficacy of DS interventions and explore possible mechanisms underlying their therapeutic effects.

Methods:

This systematic review was conducted according to PRISMA guidelines. Several databases (Ebsco Host, PubMed, Scopus, Google Scholar) were used for the systematic search, which was based on the broad search terms ME/CFS and DS with a focus on publications between 1994 and 2024. The primary outcome was fatigue, with additional considerations including psychological well-being, physical activity, and biochemical markers. Two independent researchers screened the studies for eligibility in a multi-stage process and assessed quality and bias using Cochrane’s risk of bias tools (RoB-2, ROBINS-I).

Results:

Fourteen studies (N = 809) of heterogeneous designs were included, showing a high risk of bias, mostly due to missing data and selection bias. While some interventions (L-carnitine and guanidinoacetic acid, oxaloacetate, CoQ10–selenium combination, NADH and NADH-CoQ10 combination) showed significant reductions in fatigue, methodological limitations, like small sample sizes and missing data, prevent firm conclusions. Mixed results were reported for secondary outcomes like cognitive function and inflammatory markers. Six studies noted adverse effects, including nausea and insomnia.

Conclusions:

Though some DSs showed potential in reducing fatigue in ME/CFS, methodological limitations and inconsistent results hinder definitive conclusions. Future research should improve diagnostic criteria and include more diverse populations.

Keywords: myalgic encephalomyelitis/chronic fatigue syndrome; dietary supplements; PRISMA; long-COVID; chronic fatigue syndrome; clinical trials

 

I think these studies are often done just so someone can get a publication. They add nothing, usually. Always the same story: the studies weren't good enough to say anything of value.

 

All the authors/participants are psychiatrists.