Heat vs. Fatigue: Hyperthermia as a Possible Treatment Option for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), 2025, Hochecker

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https://www.mdpi.com/1422-0067/26/11/5339#

Open Access
Article
Heat vs. Fatigue: Hyperthermia as a Possible Treatment Option for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)
by
Barbara Hochecker
1,*,
Katja Matt
1,
Melanie Scherer
1,
Alica Meßmer
1,
Alexander von Ardenne
2 and
Jörg Bergemann
1


1
Department of Life Sciences, Albstadt-Sigmaringen University of Applied Sciences, Anton-Günther-Strasse 51, 72488 Sigmaringen, Germany
2
Von Ardenne Institute of Applied Medical Research GmbH, 01324 Dresden, Germany
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2025, 26(11), 5339; https://doi.org/10.3390/ijms26115339
Submission received: 20 March 2025 / Revised: 26 May 2025 / Accepted: 29 May 2025 / Published: 1 June 2025
(This article belongs to the Special Issue Molecular Pathologies and Treatment for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome)
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Abstract

The aetiology and pathophysiology of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) have not yet been clarified.

Its exact diagnosis is also difficult because it has no biomarkers. This lack of knowledge leads to difficulties in treating the disease.

In our work, we are attempting to counteract this problem by analysing the central cellular mechanisms in ME/CFS patients and comparing them with those of healthy individuals.

This pilot study provides a small glimpse into the journey of nine people with ME/CFS—more specifically, how their peripheral blood mononuclear cells (PBMCs) responded immediately after a session of whole-body hyperthermia (WBH).

The clinical effect of WBH has already been investigated in other studies on the treatment of ME/CFS, and these studies have provided valuable insights into its potential benefits.

The present study is concerned with the investigation of cellular parameters, namely autophagy, mitochondrial function and mRNA expression, before and after WBH.

The results suggest that ME/CFS patients may have higher autophagy-related protein light chain 3 (LC3)-II levels and increased mitochondrial function compared with healthy individuals.

A whole-body hyperthermia session could lead to a reduction in LC3-II levels, resulting in a reversion to the levels observed in healthy donors.

In the case of mitochondrial parameters, hyperthermia could lead to an increase in the measured parameters.

This pilot study is a continuation of a previously published study in which only the isolated cells of ME/CFS patients and a healthy control group were treated with hyperthermia.

Keywords:
hyperthermia; myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS); human PBMCs (peripheral blood mononuclear cells); autophagy; mitochondrial function; mRNA expression

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https://twitter.com/user/status/1930993172735229983
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Whole-Body Hyperthermia Treatment
The heat therapy was carried out with the whole-body hyperthermia system ‘IRATHERM®1000M’ (Von Ardenne Institute of Applied Medical Research GmbH, Dresden, Germany). This system enables a rapid increase in core body temperature (to 39 °C in approx. 45 min) through uniform irradiance over the entire patient using 6 water-filtered infrared-A (wIRA) radiant heaters. Infrared-A radiation is short-wave IR radiation in the wavelength range from 780 to 1400 nm and is generated by a light bulb. One of the special features of this emitter is that it is encased in a layer of water. This layer of water serves as a filter, and the filtered radiation obtained is highly similar to Earth’s solar spectrum in the IR range [38]. The remaining IR-A has a high penetration depth into the human tissue, while at the same time, there is no thermal overload of the outer skin by IR-B and IR-C radiation. Therefore, water-filtered radiation is a proven method for performing hyperthermic applications [39]. The treatment session lasted one hour with a maximum core body temperature of 39 °C. During the session, the temperature was monitored via three temperature sensors (rectal, axillary and dermal) as well as by ear pulse and oxygen saturation.
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Years ago I did FIR saunas and all it did was exhaust me. It increased my metabolism but had no other benefits. I certainly wouldn't be able to attempt this today.
 
Dolphin said:
The results suggest that ME/CFS patients may have higher autophagy-related protein light chain 3 (LC3)-II levels and increased mitochondrial function compared with healthy individuals.

A whole-body hyperthermia session could lead to a reduction in LC3-II levels, resulting in a reversion to the levels observed in healthy donors.

In the case of mitochondrial parameters, hyperthermia could lead to an increase in the measured parameters.
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I assume they meant decreased mitochondrial function at base line.

Edit. No, looking at the chart, the ME/CFS cells already had higher mitochondrial function than the healthy cells at baseline. So, why would you want to increase function further away from normal?
 
Mij said:
It increased my metabolism but had no other benefits.
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In the chart above, they don't seem to treat the healthy cells with heat. Presumably if they had, mitochondrial function in those cells would also have increased with heat, just as the ME/CFS cells did. Typically, stuff moves faster, chemical reactions happen faster with heat. The fact that the healthy cells weren't also treated makes me wonder about this study.

It's a bit interesting that the ME/CFS cells seemed to have higher mitochondrial function at baseline, but it's a small study.
 
For what it's worth:
I and my two children became ill after being inside a brick house during an extended heat wave - it was very hot for days and we had no A/C. We had just received our household items from overseas where they had been treated with methyl bromide. The reaction of the bromide with the proteins in wool and leather had produced a tremendous stink of hydrogen sulphide that lingered for weeks. We couldn't open the windows for several days after receiving all the furniture and boxes - because it was so hot. We all became ill, but I'm not sure if it was an infection as well - I think it was. I have wondered if this is a recipe for producing ME/CFS - heat and exposure to sulphides for days, with an immune challenge thrown in.

I usually feel worse in heat.

That said, many countries have a tradition of sauna use, so maybe it's useful for something.
 
I haven't red the paper but the mere thought of heat as a treatment fills me with horror.
I spent a few days camping in the tropics a month ago and it has taken until now to recover. Not that cold is the answer either.
 
If ME/ CFS cells had higher function at baseline why would increasing this be a good thing?

It may tip from a relatively stable ( but pretty awful ) state into a worse one .

Heat here is a big negative . ( But perhaps that's the Scottish genetics where 18 °C feels tropical :))
 
Hutan said:
I usually feel worse in heat.

That said, many countries have a tradition of sauna use, so maybe it's useful for something.
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I forgot to mention that the FIR saunas did help with the pain I was experiencing in my neck for 6 months, I tried everything, but after one session of FIR the pain was completely gone. So perhaps it helps with pain.
 
Utsikt said:
I used to be able to deal with heat up to 35C. Now I start to struggle at 15-20C.
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Pretty similar although my new limit is a bit higher, above 22C room temperature (some variation for the dew point) my body goes weird. Ideally I like below 20. Summers are bad bad bad

Compared that to my former life enjoying heat, be it a beach, steam room or sauna, running in a jungle… I’ve spent years living in countries that never got below 25 and with sensible management was fine in 35.

I’d add that rapid changes cause me issues too, so the idea of that discussed in this proposal is… interesting.
 
Kiristar said:
I'm totally heat intolerant now such a treatment would cause a relapse in me.

I very much doubt most severe patients could tolerate this at all.
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I’m also quite heat intolerant despite being mild. Just standing in the hot sun for a few minutes can make me close to fainting. This seems quite dangerous, especially given the number of pwME who report temperature regulation issues. Playing with fire if you will
 
jnmaciuch said:
I’m also quite heat intolerant despite being mild. Just standing in the hot sun for a few minutes can make me close to fainting. This seems quite dangerous, especially given the number of pwME who report temperature regulation issues. Playing with fire if you will
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Good point my apologies the two statements weren't meant to be linked and I didn't intend to suggest that it was only a severe grade symptom, sorry.

With me, when I was mild I couldn't tolerate a sauna just didn't know why but a sunny summer's day was ok. That said for me it is a symptom that has got worse over time, just normal weather impacts me much more these days.
 
Kiristar said:
Good point my apologies the two statements weren't meant to be linked and I didn't intend to suggest that it was only a severe grade symptom, sorry.

With me, when I was mild I couldn't tolerate a sauna just didn't know why but a sunny summer's day was ok. That said for me it is a symptom that has got worse over time, just normal weather impacts me much more these days.
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No worries, didn’t think you were implying that! [Edit: I was just agreeing that I have the same heat intolerance at mild :) ]
 
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I'm enjoying a frosty (-1C) morning here in central Alberta. I don't think hot days makes my ME worse, but it certainly adds to "I don't feel like doing anything active".
 
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