Grach et al. (2026)
- Authors: Stephanie L. Grach, Jaime Seltzer, Michael R. Mueller, Chris A. Aakre, Lasonya T. Natividad, Donna K. Lawson, Ravindra Ganesh, Ryan T. Hurt
- Institutes: Mayo Clinic, Rochester, MN, USA
- Publisher: Annals of Family Medicine
- Link: DOI
Summary
This research highlights a major gap in the medical care of ME/CFS patients, showing that many do not receive effective, symptom-specific medications until they reach a specialist. By identifying this “practice gap,” the study advocates for better physician training and provides treatment guides to help primary care providers manage the disease more effectively. Such improvements could lead to earlier symptom relief and a significantly better quality of life for millions of under-treated patients.
What was researched?
This study investigated the patterns of medication and supplement use among patients with ME/CFS before they received a specialist medical evaluation.
Why was it researched?
While ME/CFS specialists often use pharmacologic therapies to manage debilitating symptoms, there is a concern that these treatments are underutilized in general medical practice, leading to inadequate patient care.
How was it researched?
Researchers conducted a retrospective chart review of 571 adult patients referred to a specialty clinic in Minnesota between 2018 and 2022. They analyzed which medications and dietary supplements patients had already attempted to use for their symptoms prior to their first consultation with an ME/CFS specialist.
What has been found?
The study found that while 68.3% of patients had tried at least one medication, most were for pain or anxiety, such as serotonin-norepinephrine reuptake inhibitors (SNRIs) 💊, gabapentin 💊, or tricyclic antidepressants (TCAs) 💊. Medications for core symptoms like fatigue, brain fog, and orthostatic intolerance, such as low-dose naltrexone 💊, were rarely prescribed. Additionally, 72.2% of patients relied on supplements, most commonly vitamin D 💊, vitamin B12 💊, and fish oil 💊.
Discussion
The results demonstrate a clear disconnect between specialist-level care and general medical practice, where primary care clinicians often focus on secondary symptoms like mood while neglecting core physiological issues. This suggests that the high usage of supplements may be a result of patients seeking alternative solutions when standard medical options are not offered.
Conclusion & Future Work
Potentially beneficial medications for ME/CFS are significantly underprescribed in the general medical field. Better clinician education and the use of standardized treatment guides are essential to bridge this care gap and improve outcomes for this debilitating multisystem disease.