International ME/CFS Conference 2025 Features Oxaloacetate CFS Clinical Data

At the International ME/CFS Conference 2025 in Berlin, Oxaloacetate CFS Chief Science Officer Alan Cash, a global leader of oxaloacetate research—delivered a compelling keynote on the potential of oxaloacetate medical food to tackle the root metabolic dysfunctions implicated in ME/CFS and Long COVID.

Low Oxaloacetate Levels in ME/CFS Patients and the “Warburg Effect”

With an attendance of doctors, healthcare providers, ME/CFS patient advocates and a global streaming audience, Cash’s lecture first covers how ME/CFS patients’ low oxaloacetate levels indicate the need for foundational metabolic therapy and mitochondrial interventions. 

Mechanisms of Action from A Body of Research on Oxaloacetate

Two decades of scientific investigation of Oxaloacetate has led to several proposed mechanisms of action for the promising fatigue reduction in ME/CFS patients taking Oxaloacetate, such as

• Reduction in chronic inflammation via Nf-kB Reduction by up to 70%
  
  
• Reduction of the Warburg Effect by 48.8% and increased mitochondrial energy production
  
  
• Increase in the Redox NAD/NAD+ ratio by 50%
  
  
• Increase in PGC1a ratio by 58% to stimulate new mitochondrial biogenesis (more cellular powerplants)
  
  
• Increase in cellular glucose uptake (more cellular fuel for energy)

Promising Clinical Trials of Oxaloacetate CFS

Springer-Nature Journal of Translational Medicine:
Covering the latest clinical data, Cash summarizes the results of the Open-Label Proof of Concept trial published by Springer-Nature’s Journal of Translational Medicine. This trial consisted of six weeks of oxaloacetate treatment using a dose escalating methodology, ranging from 500 mg BID to 1,000 mg TID with both ME/CFS and Long COVID patients.

• Trial participants included ME/CFS patients with an average diagnosis of 8.9 years and Long COVID patients with symptoms for at least 6 months.
  
  
• ME/CFS patients were given oxaloacetate doses of either 500 milligrams twice per day, 1,000 milligrams twice per day or 1,000 milligrams three times per day.
  
  
• Reduction in fatigue was dose dependent, with the smallest dose yielding a 21.7% reduction in fatigue and the largest yielding a 33.3% reduction in six weeks.
   
• Long COVID patients were given either 500 milligrams twice per day or 1000 milligrams of oxaloacetate twice per day. Fatigue in Long COVID patients reduced by up to 46.8% in six weeks.

Frontiers in Neurology:
Cash then covered the first Randomized, Placebo-Controlled 3-month Clinical Trial of Oxaloacetate CFS peer-reviewed and published by Frontiers in Neurology. This study found:

• Oxaloacetate CFS reduced fatigue in ME/CFS patients by greater than 25% (on average). The improvement in fatigue lasted at least the length of the 3 month study.
  
  
• An “enhanced responder” sub-group of 40.5% of clinical trial patients experienced an average fatigue improvement of 63%-- indicating that for these patients, oxaloacetate is the right “key” to unlock fatigue for this sub-patient group.
  
  Metabolomic analysis of the blood samples taken during the study are underway at Stanford University and University of Melbourne to ascertain key features of why this subgroup performed so well.

The results of this study, along with doctor and patient reports and the existing body of research into Oxaloacetate supported the Food and Drug Administration’s allowance of the structure/function claim: “Oxaloacetate may help alleviate physical and mental fatigue symptoms associated with myalgic encephalomyelitis/chronic fatigue syndrome.”

Significance of Clinical Investigation of Oxaloacetate CFS

For the first time, ME/CFS patients have available a metabolic therapy with solid clinical backing: not just symptomatic relief, but normalization of core energy production processes. The data suggest that while not everyone benefits equally, those who do—especially “enhanced responders”—can experience dramatic improvements.

Cash emphasized the importance of further stratification and biomarker studies to predict which patients are likely to respond, some currently underway at Stanford University and University of Melbourne.