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Ferroportin is regulated at the systemic level by the peptide hormone hepcidin, which binds directly to ferroportin and its ubiquitination, internalization, and subsequent lysosomal degradation effectively block cellular iron export [74]

These effects are especially relevant to CIRS, where chronic vascular hypoperfusion and low VEGF contribute to fatigue and neurocognitive dysfunction

Shah J, Mark O, Weltman H, Barcelo N, Lo W, Wronska D, Kakkilaya S, Rao A, Bhat ST, Sinha R, Omar S

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The authors also claim that low serum acylcarnitine levels confirm an accurate diagnosis, however, there are no established biomarkers in ME/CFS