Gut Inflammation in Chronic Fatigue Syndrome

Shaheen E Lakhan; Annette Kirchgessner

Disclosures

Nutr Metab. 2010;7(1) 

In This Article

Mitochondrial Failure and CFS

Dr. Sarah Myhill and colleagues have proposed that CFS is linked to "mitochondria failure".[82] Mitochondria use fuel molecules derived from food to produce energy by oxidative metabolism in the form of adenosine triphosphate or ATP, which when hydrolysed to the disphosphate, ADP, releases energy to produce muscle contractions, nerve impulses and all the energy-consuming processes needed to synthesize all of the complex molecules of the body. ATP recycles approximately every 10 seconds in a healthy individual. However, when mitochondria are impaired the energy they supply will be impaired and so the individually has poor stamina, as in CFS. Also, when a cell is filled with defective mitochondria, it not only becomes deprived of energy (ATP). It can accumulate a backlog of unused fuel molecules (glucose) and oxygen with disastrous effects. If the body is short of ATP, it can make a very small amount directly from glucose by converting it into lactic acid. This is exactly what many individuals with CFS do. They readily switch into anaerobic metabolism.[83] However, this results in serious problems.

The buildup of lactic acid in the blood, called lactic acidosis is associated with muscle pain, heaviness, aching and soreness ("lactic acid burn"), and might actually damage muscle and nerve tissue. People suffering from CFS have difficulty increasing their fitness.[84] Their response to incremental exercise is increased oxidative stress with marked alterations of muscle membrane excitability. Thus, mitochondrial dysfunction results in fatigue and could produce symptoms of CFS.

There is considerable evidence that mitochondrial dysfunction is present in some CFS patients. Muscle biopsies have shown abnormal mitochondrial degeneration in CFS patients.[82] Mitochondrial dysfunction occurs in neutrophils in CFS patients.[82] Neutrophils are the major effector cells of the immune system and the observed mitochondrial dysfunction is bound to have a deleterious effect on this system. Moreover, the degree of dysfunction was strongly correlated with the severity of their illness suggesting that the severity of a person's CFS relates to the severity of the mitochondrial dysfunction.[82]

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