Table A12.

Chronic fatigue syndrome, fibromyalgia—Rev [207].

Chronic stress: (1) Increased formation of ROS (see Figure 4E) → peroxynitrite anion ↑ in the respiratory chain → irreversible inhibition of cytochrome C oxidase → cellular energy production ↓. (2) Leukocytes from patients with fibromyalgia: hypo-methylation and increased mRNA formation (see Figure 3) of genes with sensory, adrenergic and immunological functions. Cobalamin acts as an intracellular antioxidant in high concentrations.

Plasma vitamin B12 and HCys levels correlate positively/negatively, with exhaustion, comprehensive psychopathological rating scale, pain and memory ability. Therapy with high doses of vitamin B12 (1–2 mg/day) and folic acid (1–5 mg/day).