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Month 3+: Long-term remodeling

[DOI] [PMC free article] [PubMed] [Google Scholar] 23.Horning BD, Suciu RM, Ghadiri DA, Ulanovskaya OA, Matthews ML, Lum KM, et al

When investigating elevated B12, additional tests such as active B12 (holotranscobalamin), methylmalonic acid, and homocysteine may help clarify true B12 status

The next paragraphs will discuss genetic predisposition and susceptibility as an underlying risk factor for ME/CFS - the superimposition of external stressors and exposures (59) results in a state of aberrant homeostasis, where a temporary homeostatic state of functioning occurs, but functions at a less optimum level (64)

Some clinical studies have found elevated lactate levels (395, 396) in ME/CFS patient blood, cerebrospinal fluid, and muscles, suggesting there is reduced oxidative phosphorylation and a switch to anaerobic glycolysis (392, 397399)