On the 28th January, the MDPI published an article entitled ‘Dietary Supplementation for Fatigue Symptoms in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)—A Systematic Review‘ and this review covers research studies for a range of dietary supplements (as outlined below).
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.
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.
MEA Comment
This review of the use of dietary supplements in the management of fatigue in ME/CFS does not add anything important or new to what we already know.
The NICE guideline committee also reviewed all the relevant clinical trials, along with patient evidence, and concluded that there is no sound evidence to indicate that any of these supplements can reduce fatigue and improve energy levels in ME/CFS.
However, as the review indicates, there is some very low level evidence in support of some of these supplements.
My personal view is that some of them need to be properly assessed in high quality clinical trials before finally dismissing their use.
The ME Association has an information leaflet covering muscle energy supplements:
Dr Charles Shepherd,
Trustee and Hon. Medical Adviser to the ME Association,
Member of the 2018-2021 NICE guideline on ME/CFS committee,
Member of the 2002 Chief Medical Officer's Working Group on ME/CFS
