Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and fibromyalgia remain diagnostically and therapeutically challenging. Despite different formal classifications, CFS/ME is a neurological disorder, and fibromyalgia is a functional somatic syndrome; both conditions present with overlapping symptomatology. These include persistent fatigue unrelieved by rest, musculoskeletal pain, cognitive impairment, sleep disturbances, and reduced functional capacity. Standard pharmacologic therapies frequently fail to produce sustained benefit, prompting investigation into less conventionally recognized biomedical mechanisms.
A 2023 article published in ARS Medica Tomitana by Dr. Yuliya Semenova of Nazarbayev University School of Medicine provides an overview of the work of Dr. Geir Bjørklund (Council for Nutritional and Environmental Medicine, Norway), whose research has explored the intersections of environmental toxicology, nutritional medicine, and immune function in these syndromes (1). This work has introduced novel hypotheses and data concerning the biological underpinnings of symptom persistence and treatment resistance in CFS/ME and fibromyalgia.
A central research contribution of Bjørklund and collaborators is the identification of delayed-type hypersensitivity reactions to environmental metals, including nickel, mercury, cadmium, and gold, as potential triggers in fibromyalgia and related connective tissue disorders. Using the MELISA® lymphocyte transformation assay, Bjørklund and colleagues have demonstrated a significantly increased prevalence of metal sensitivity among patients with fibromyalgia and autoimmune conditions such as systemic lupus erythematosus and Sjögren’s syndrome. In follow-up studies, patients who underwent metal exposure reduction, notably through dental material replacement, showed marked symptomatic improvement. These findings support the hypothesis that persistent antigenic stimulation from bioaccumulated metals may promote chronic immune activation and neuroinflammation via T-cell-mediated mechanisms.
Parallel research by Bjørklund has addressed micronutrient deficiencies, which appear disproportionately prevalent in patients with CFS/ME and fibromyalgia. Deficits in magnesium, selenium, amino acids, and vitamins B and D have been associated with disrupted mitochondrial function, impaired neurotransmitter synthesis, altered redox balance, and dysfunctional pain modulation. His work has suggested that toxic metals may further aggravate these deficiencies by interfering with absorption and intracellular transport, amplifying biochemical vulnerability. These insights support the role of targeted nutritional interventions in mitigating symptom burden and restoring physiological resilience.
Bjørklund’s co-authored review in Molecular Neurobiology (2020) further expanded the pathophysiological framework of CFS/ME by integrating data on post-infectious immune dysregulation, nitro-oxidative stress, and mitochondrial dysfunction (2). Biomarkers frequently identified in patients include reduced levels of coenzyme Q10, NADH, and carnitine, alongside elevated nitric oxide metabolites and lipid peroxides. These findings suggest an underlying state of metabolic exhaustion and cellular stress that may contribute to exertional intolerance and neurocognitive symptoms, hallmarks of CFS/ME.
The role of infectious triggers, particularly herpesviruses and enteroviruses, has also been central to Bjørklund’s contributions. Epidemiological data indicate that up to 80% of CFS/ME patients report symptom onset following acute infection. Documented abnormalities include impaired natural killer cell cytotoxicity and skewed cytokine profiles, typically involving IL-1β, IL-6, and TNF-α elevations. These immune disturbances reinforce the diagnostic relevance of the Canadian Consensus Criteria and International Consensus Criteria, which emphasize immune-metabolic phenotyping, an approach consistently advocated by Bjørklund.
Regarding treatment, Bjørklund’s interest in pharmacognosy has led to exploring natural compounds with immunomodulatory and mitochondrial-supportive properties. Adaptogenic botanicals such as Rhodiola rosea and Panax ginseng, as well as coenzyme Q10, curcumin, and lipid replacement therapy, have been studied for their potential to reduce fatigue, modulate oxidative stress, and improve cellular function. While larger controlled trials are needed, preliminary findings support their integration into a multimodal treatment strategy, particularly for patients with identifiable biochemical imbalances.
The overarching message of Bjørklund’s work is the necessity of adopting a systems medicine approach to CFS/ME and fibromyalgia that integrates toxicological, immunological, and nutritional perspectives into the clinical evaluation. By identifying and addressing modifiable biomedical contributors to chronicity, this framework moves beyond symptomatic treatment and aligns with the broader goals of precision medicine.
While acknowledging these syndromes’ psychological and social dimensions, Bjørklund’s research underscores the insufficiency of psychogenic models in explaining the full spectrum of clinical and biochemical findings. His integrative, evidence-informed approach continues to shape the evolving discourse on chronic multisystem illness and calls for renewed research efforts focused on biomarker identification, mechanistic validation, and personalized intervention trials.
References
- Semenova Y. Complex Perspectives on CFS/ME and Fibromyalgia: An Interview with Dr. Geir Bjørklund. ARS Medica Tomitana. 2023;29(4):217–225. doi:10.2478/arsm-2023-0032
- Bjørklund G, Dadar M, Pivina L, Dosa MD, Semenova Y, Maes M. Environmental, neuro-immune, and neuro-oxidative stress interactions in chronic fatigue syndrome. Mol Neurobiol. 2020;57(11):4598-607.