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In ME/CFS and fibromyalgia, mitochondrial dysfunction can result from: Gut dysbiosis Chronic viral infections Metabolic dysfunction (e.g., poor insulin regulation or nutrient deficiencies) Toxin exposure (e.g., heavy metals, mold, or other environmental factors) However, the potential for medication-induced mitochondrial damage is often overlooked

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(4) Heffernan MA, Thorburn AW, Fam B, Summers R, Conway-Campbell B, Waters MJ, Ng FM