Low omega-3 index and polyunsaturated fatty acid status in patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis, by Jesús Castro-Marrero, Joan Carles Domingo, Alba Martinez-Martinez, José Alegre, Clemens von Schacky in Prostaglandins, Leukotrienes and Essential Fatty Acids (PLEFA) [Published online: November 9, 2018]


  • Erythrocyte omega-3 index (5.75%) and n-3 PUFA levels are low in individuals with CFS/ME.
  • The erythrocyte omega-3 index may be a useful biomarker of overall health, but cut-off points need be validated in the Spanish CFS/ME population.
  • This study suggests that low EPA + DHA levels may be a risk factor for poor cardiovascular health and pro-inflammatory status in CFS/ME. Understanding the role of omega-3 PUFAs and immunometabolism should be the next step.
  • Further studies of omega-3 fatty acid supplementation in CFS/ME are warranted.

Research abstract:

Several studies have suggested that low levels of omega-3 fatty acids (n-3 PUFAs) including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are associated with cardiovascular risk, major depression, sleep problems, inflammation and other health-related issues. So far, however, erythrocyte PUFA status in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) has not been established. This study aimed to determine whether n-3 PUFA content and omega-3 index are associated with measures in CFS/ME patients.

Patients and Methods:
PUFA levels and omega-3 index were measured in 31 Spanish CFS/ME patients using the HS-Omega-3 Index® method. Demographic and clinical characteristics and self-reported outcome measures were also recorded.

A low mean omega-3 index (5.75%) was observed in 92.6% of the sample. Omega-3 index was inversely correlated with the AA/EPA ratio (p= 0.00002) and the BMI (p= 0.0106). In contrast, the AA/EPA ratio was positively associated with the BMI (p= 0.0038). No association for FIS-40 and PSQI measures was found (p> 0.05).

The low omega-3 index found in our CFS/ME patients may indicate increased risks for cardiovascular health, which should be further investigated. A low omega-3 index also suggests a pro-inflammatory state in these patients. Attempts should be made to increase the omega-3 index in CFS/ME patients, based on intervention trials assessing a potential therapeutic value.

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