IJCEM Copyright © 2008-All rights reserved. Published by e-Century Publishing Corporation, Madison, WI 53711
Int J Clin Exp Med 2(1):1-16;2009

Original Article
Chronic fatigue syndrome and mitochondrial dysfunction

Sarah Myhill, Norman E. Booth, John McLaren Howard

Sarah Myhill Limited, Llangunllo, Knighton, Powys, Wales LD7 1SL, U.K.; Department of Physics and Mansfield College, University of
Oxford, Oxford OX1 3RH, U.K.; Acumen, PO Box 129, Tiverton, Devon EX16 0AJ, U.K.

Received December 3, 2008; accepted January 12, 2009; available online January 15, 2009

Abstract: This study aims to improve the health of patients suffering from chronic fatigue syndrome (CFS) by interventions based on
the biochemistry of the illness, specifically the function of mitochondria in producing ATP (adenosine triphosphate), the energy currency
for all body functions, and recycling ADP (adenosine diphosphate) to replenish the ATP supply as needed. Patients attending a private
medical practice specializing in CFS were diagnosed using the Centers for Disease Control criteria. In consultation with each patient,
an integer on the Bell Ability Scale was assigned, and a blood sample was taken for the “ATP profile” test, designed for CFS and other
fatigue conditions. Each test produced 5 numerical factors which describe the availability of ATP in neutrophils, the fraction complexed
with magnesium, the efficiency of oxidative phosphorylation, and the transfer efficiencies of ADP into the mitochondria and ATP into the
cytosol where the energy is used. With the consent of each of 71 patients and 53 normal, healthy controls the 5 factors have been
collated and compared with the Bell Ability Scale. The individual numerical factors show that patients have different combinations of
biochemical lesions. When the factors are combined, a remarkable correlation is observed between the degree of mitochondrial
dysfunction and the severity of illness (P<0.001). Only 1 of the 71 patients overlaps the normal region. The “ATP profile” test is a
powerful diagnostic tool and can differentiate patients who have fatigue and other symptoms as a result of energy wastage by stress
and psychological factors from those who have insufficient energy due to cellular respiration dysfunction. The individual factors indicate
which remedial actions, in the form of dietary supplements, drugs and detoxification, are most likely to be of benefit, and what further
tests should be carried out. (IJCEM812001).

Key Words: Chronic fatigue syndrome; myalgic encephalomyelitis; patient care; mitochondria; neutrophils, oxidative phosphorylation.

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Address all correspondence to: Norman E. Booth, PhD, Department of Physics and Mansfield College, University of Oxford, Oxford
OX1 3RH, U.K. Or: ‘Applegate’, Orchard Lane, East Hendred, Wantage OX12 8JW, U.K, Telephone: +44 (0)1235 833486, E-mail: