Review Comparative Metabolomics of Four Fatigue Disorders: [CFS/ME], [LC], Fibromyalgia (FM), and Major Depressive Disorder (MDD), 2024, Kuruvilla et al

Comparative Metabolomics of Four Fatigue Disorders: Chronic Fatigue Syndrome (CFS/ME), Long COVID, Fibromyalgia (FM), and Major Depressive Disorder (MDD)

Heather G Kuruvilla, Colleen Weaver, Joshua Jones, Hunter Tenpas

[Poster presentation at Scholars Symposium 2024]

Fatigue is a common symptom associated with illness. However, in some chronic health conditions, fatigue becomes so severe that it limits the patient’s ability to perform tasks associated with daily living. Chronic fatigue syndrome, fibromyalgia, long COVID, and major depressive disorder are examples of poorly understood medical conditions which cause debilitating fatigue. The cost of these disorders is huge, both in terms of human suffering and economic impact, as many patients are rendered unable to work and struggle to care for themselves. Understanding the pathophysiology of these disorders would benefit patients and their families as well as society at large.

Metabolomics, the scientific study of metabolites in an organ or tissue (Oxford Dictionary), may offer hope to scientists trying to unravel the pathophysiology of these disorders. Since metabolomic testing can be conducted on blood samples, it is non-invasive. Many different compounds can be assessed from a single sample.

Our hypothesis is that by comparing results of metabolomic testing from patients with fatigue-related disorders, we can find common threads which may help explain pathophysiology.

In our review of the literature, we found that increased pyruvate levels were found in all four of the fatigue-related disorders studied, while three of the four disorders were also marked by increased lactate levels. GDF15, a marker for mitochondrial stress, was also elevated in three of the four disorders, and was uncharacterized in fibromyalgia. All of the disorders were characterized by dysregulated sphingolipids and phosphatidylcholine and were correlated with metabolites that suggested below-normal ATP levels.

Further research may allow for better understanding and treatment of these debilitating disorders.

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Note that this is a research proposal based on a fairly simplistic narrative review.