Micronutrition as a Therapeutic Strategy to Restore Mitochondrial Function in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Fibromyalgia

Résumé fourni par la source

Fibromyalgia and chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) are chronic, multisystem disorders characterized by persistent fatigue, musculoskeletal pain, cognitive dysfunction, sleep disturbances, and markedly reduced quality of life. Fatigue is one of the most disabling symptoms and remains insufficiently addressed by current therapeutic approaches. Increasing evidence implicates mitochondrial dysfunction, oxi-dative and nitrosative stress, immune dysregulation, and impaired nicotinamide adenine dinucleotide (NAD⁺) metabolism as central mechanisms underlying fatigue in these conditions. Micronutrients constitute essential cofactors of mitochondrial bioenergetics, redox homeostasis, and immune metabolism. This narrative review synthesizes current evidence on mitochondrial dysfunction in fibromyalgia and CFS/ME and examines the mechanistic and clinical rationale for targeted micronutritional interventions aimed at restoring redox balance, mitochondrial efficiency, and Adenosine triphosphate (ATP) production. Particular attention is given to strategies targeting glutathione repletion, NAD⁺ metabolism, and electron transport chain function. Finally, we present a proposal for a randomized placebo-controlled clinical trial in fibromyalgia patients with severe fatigue (PROMIS Fatigue T-score > 60), designed to evaluate a mitochondrial-oriented micronutritional formulation as an adjunctive therapeutic approach.

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